Impairment vs. Disability
 The debate
Many people who have Body Integrity Identity Disorder say they want to be disabled. Many other say they don't want to be disabled, they "just" want to be amputees. We argue that the two are not necessarily contradictory.
Anecdotal evidence shows that a majority of transabled individuals do want an impairment, but do not wish to have a "disability". That is, they want to be amputees, paraplegic, etc, but they do not want the perceived loss of indepedence, nor the disabling experience.
 What is the difference?
An impairment is the condition itself: An amputation, paraplegia, deafness, blindness. These, in and of themselves are somewhat neutral. The disability only comes from interacting with a non-accessible society. Being unable to hear is an impairment. Being unable to communicate because people refuse to use sign language or exchange written notes is a disability. Being unable to walk is an impairment. Being unable to get in a building because the doors are too narrow for your wheelchair is a disability.
 Models of disability
 Differences between models at a glance
|Social Model||Medical Model|
|Disability is a difference.||Disability is a deficiency or abnormality.|
|Being disabled, in itself, is neutral.||Being disabled is negative.|
|Disability derives from interaction between the individual and society.||Disability resides in the individual.|
|The remedy for disability-related problems are a change in the interaction between the individual and society.||The remedy for disability-related problems is cure or normalization of the individual.|
|The agent of remedy can be the individual, an advocate, or anyone who affects the arrangements between the individual and society.||The agent of remedy is the professional.|
The difference in thinking about Disability and Impairments between the Social and Medical models are profound and quite significant. They impact on aspects of life as important as how one perceives oneself.
 Why does it matter?
In any discussion, it is important for everyone to be on the same page and to understand the same concepts.
Beyond that, however, this change in perception can be important in how people with Body Integrity Identity Disorder relate to the medical community. While the idea that BIID is a mental illness is reviled by some elements within the BIID "community", it is an interesting concept to examine.
Let's accept (even if only momentarily) that Body Integrity Identity Disorder is indeed a mental illness. This makes it an impairment/disability. Let's then consider: If the solution is within the individual with an impairment/disability, rather than with the medical professional, then, transabled individuals know the solution to their problem. For many of us, surgery is what we know will heal us.
It would take a medical professional that understands and accepts the Social Model rather than the Medical Model, and we could be that much closer to acceptable treatment protocols.