Apotemnophilia is a rare paraphilia where a person experiences sexual arousal from the idea of having an amputation themselves (not simply being attr
Apotemnophilia is a rare paraphilia where a person experiences sexual arousal from the idea of having an amputation themselves (not simply being attracted to amputees—that’s sometimes called acrotomophilia).
Form it can take: People may fantasize about losing a limb, imagine themselves as amputees, seek medical simulations (braces, crutches, wheelchairs), or—rarely—attempt to self-induce amputations.
Origins debated: Some researchers see it as related to body integrity identity disorder (BIID)—a condition where people feel an overwhelming mismatch between their physical body and how they “should” be. Others classify it primarily as a sexual fetish. In many cases, it appears to overlap.
Why It’s Considered High-Risk
Unlike many fetishes, apotemnophilia can drive people to physically harm themselves in order to achieve the desired state (such as freezing or crushing a limb to force doctors to amputate).
Because of this, it is taken seriously not just as a sexual interest but as a mental health concern with real medical dangers.
The condition is very rare but has been documented in medical and psychological literature since the 1970s.
Related Concepts
Acrotomophilia: Sexual attraction to partners who are amputees.
Body Integrity Identity Disorder (BIID): A psychiatric condition where people feel that one or more of their healthy limbs “do not belong to them” and strongly desire amputation. Not always sexual, but can overlap with apotemnophilia.
Extreme pornography communities: Some online groups encourage or eroticize surgical modification or amputation, which can increase risk for people struggling with these urges.
This story is undeniably disturbing, yet it offers a critical reminder: mental health complex enough to drive such extreme actions deserves compassion, not exploitation. Meanwhile, the justice system has responded with a firm, measured response.
Here’s what’s been reported about the case involving the NHS vascular surgeon, Neil Hopper:
Key Details of the Case
The Crime & Motivation
What he did: In April 2019, Neil Hopper deliberately froze his legs using dry ice until they were no longer viable, resulting in the need for below-knee amputations The GuardianNew York PostPeople.comThe Independent.
Why?: He harbored a long-standing sexual obsession or fetish tied to amputation, and had dreams of being an amputee The GuardianNew York PostThe TimesThe Independent.
Fraudulent Insurance Claims
Hopper falsely told insurance companies that his amputations were due to sepsis—a natural medical condition—not self-inflicted damage The GuardianPeople.comThe IndependentSky News.
He received approximately £466,000 (roughly $600,000–$625,000), which he spent on a campervan, home renovations, a hot tub, high-end prosthetics, and other luxuries The GuardianNew York PostThe TimesSky NewsThe Independent.
Legal Consequences
Sentence: He pleaded guilty to two counts of fraud by false representation and three counts related to possession of extreme pornographic material. He was sentenced to 32 months in prison—22 months for fraud and 10 months for the pornography charges, to be served consecutively The GuardianNew York PostPeople.comSky NewsThe Independent.
The court also issued a 10-year Sexual Harm Prevention Order, and authorities will pursue the recovery of the fraudulently obtained funds The GuardianThe TimesPeople.comThe Independent.
He has been suspended from the medical register since December 2023 and will serve part of his sentence before potential release on licence The Guardian+1The Times+1People.com.
Aftermath & Repercussions
Despite his criminal actions, independent reviews concluded that his past surgical practice did not endanger his patients The Guardian+1The Independent. Nonetheless, some former patients are now seeking legal advice, worried about surgeries they received under his care The GuardianAftonbladetThe Independent.
He had previously gained media attention—featured in television interviews and even shortlisted as a candidate for ESA’s “parastronaut” program—after presenting his amputations as a medical tragedy, not self-inflicted harm The Guardian+1The TimesAftonbladet.
Mental health is complex, layered, and deeply human. It cannot be treated with a drive-through approach, nor entrusted to quick fixes. Our children deserve better. They deserve experts who bring both expertise and integrity to the table—professionals who listen with care, lead with compassion, and hold themselves accountable to the highest standards of protection and truth. Because when it comes to the minds and hearts of children, only the very best will do