> Why is it that if someone wants to cut off their own healthy limbs, we are calling this a fetish rather than saying what it is, a mental illness.

I do call it a mental illness. If I came across someone that wants to amputate a healthy limb, I'd tell them they're mentally ill and need professional help. Most amputees I know feel the same way. As an amputee (RBKA, due to necrotizing fasciitis and sepsis), -I know a number of amputees and none have "wanted' to be an amputee.

I ask the hard question then... what separates this person's fetish/mental illness from a trans person who wants to cut off their genitals than? It's weird that one is viewed as a fetish/mental illness while the other is viewed as an identity issue. Also in this article the person is a medical professional and an adult while most trans are children who are allowed (and encouraged) to make this decision.