I'm in favour of most cosmetic surgeries but I think you're missing the point, these leftists aren't against bodily autonomy, they don't think it applies when the person isn't thinking clearly. If someone wanted to amputate their arm because having it reminds them of past trauma and someone objected, you'd have to be pretty dense to conclude they are against bodily autonomy.
I think this is a really poorly thought out counterargument, for multiple reasons.
One--"this person isn't thinking clearly" is not, in itself, a good reason to deny bodily autonomy. This excuse has been used to deny people bodily autonomy countless times in the past, whether forcing on them medical interventions they don't want (like lobotomies) or preventing them from access care they do want (as many young women seeking procedures like tubal ligation or hysterectomies can attest). Ultimately because you can choose a standard of "thinking clearly" arbitrarily, you are saying simply, with heartfelt condescension, "if someone has preferences I disagree with strongly enough, I can deny their preferences and substitute my own."
Two--it's a bad example. People don't want to cut their arm off because of trauma. There are people who want to have otherwise healthy limbs amputated, and people with body dysmorphia (NB people sometimes mix these up--"dysmorphia" and "dysphoria" are different words with different usages) who are perennially unhappy with their appearance no matter how many cosmetic procedures they get. But, crucially, these people are still adults who can make their own decisions. If (big if!) their conditions are treatable by talk therapy, you can't force them into talk therapy against their will. And since in this application this argument is exactly isomorphic to the arguments deployed against trans people (down to assuming there exists some magical super-effective form of talk therapy that can arbitrarily alter people's preferences), I take a very jaundiced view of it!
There are conditions that, as a society, we tend to view as sufficiently mentally disabling that we don't treat the preferences expressed within those conditions as authentic, like actual psychosis, mania, being very drunk, or being very depressed. We can dispute which conditions can be classified in this way, but I think a key attribute of most of them is that the preferences expressed are not consistent and are in conflict with preferences expressed when these conditions are less severe or absent. People often regret things they do when suffering from psychosis or mania; drunkenness directly affects our self-control; people may express preferences when very depressed (like a preference to die) that they later regret if their depression goes into remission or is successfully treated.
Body integrity identity disorder (the medical term for people who want a healthy limb amputated) is rare, and seems to me to not typically be accompanied by (say) psychosis. It also seems resistant to treatment, and is more akin to body dysmorphia, and there is, IIRC, some indication that people with BIID who do successfully get the offending part amputated are often quite happy with the outcome. It is much better that this should happen in a hospital, rather than in some home amputation scenario where they might bleed out and die. There are also people into castration as a sexual fetish, for instance--these are not people who have had a break with reality, they are under no illusions as to the medical consequences of such a thing, and if that's their turn-on, they should probably be allowed to pursue it! That's a bullet I can easily bite. I don't get it. I certainly don't share that preference. But "you like things that spook the normies" is not a reason to deny someone a free choice. That argument has been used against LGBT people for decades, and it's horseshit.
Lastly--very many more common body modifications (tattoos, boob jobs, rhinoplasties, piercings) have consequences that are just as permanent, it's just that, as a culture, we happen to classify them as normal, because they are common. It's quite a circular logic, isn't it? If we define as acceptable only preferences that are widely shared, we are not building a liberal society, but one of reactionary conformism where any notable deviation is punished, and people are afraid to express their preferences out of fear theirs will be seen as too strange and they will be punished for it.
We also do not ban people from joining the military, or skydiving in those super-dangerous wingsuits, or doing daredevil motorcycle stunts, or drinking because they might regret it, even though those all are, to some extent, notably risky activities that might seriously harm your body. So even the criterion of "your preferences might eventually change" is a pretty bad one!
turnnoffyourmind
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