Article

The Concept of Autogynephilia and the Typology of Male Gender Dysphoria

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Abstract

This study tested the hypothesis that all gender-dysphoric males who are not sexually aroused by men (homosexual) are instead sexually aroused by the thought or image of themselves as women (autogynephilic). Subjects were 212 adult male-to-female transsexuals. These were divided into four groups; one homosexual and three nonhomosexual. The three nonhomosexual groups were heterosexual, bisexual, and analloerotic (unattracted to male or female partners, but not necessarily devoid of all erotic behavior). A Core Autogynephilia Scale was developed to assess a subject's propensity to be sexually aroused by the fantasy of being a woman. The four transsexual groups were compared on this measure (and on several others), using Newman-Keuls multiple-range tests at p less than .05. As predicted, all three nonhomosexual groups were more likely than the homosexual group to report sexual stimulation by cross-gender fantasy. This finding supports the hypothesis that the major types of nonhomosexual gender dysphoria constitute variant forms of one underlying disorder, which may be characterized as autogynephilic gender dysphoria.

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... Male pedophiles have been shown to be up to 3 times more likely to be non-right-handed (Cantor, Klassen, et aI., 2005). Nonhomosexual male-to-female trans, sexuals (who have been shown empirically to experience autogynephilia; Blanchard, 1985Blanchard, , 1988Blanchard, , 1989b) similarly show elevated rates of tlon-righthandedness (Green & Young, 2001). Very little is known regarding handedness in any of the other paraphilias. ...
... These disorders vary in kind as well as degree. There are two common syndromes or types, which differ in their age of onset, course, associated features, and sex ratio, and probably in their etiology (Blanchard, 1989a(Blanchard, , 1989b. One type is associated with homosexuality (in the ordinary sense of erotic attraction to members of one's own biological sex), and the other type is associated with autogynephilia. ...
... The asexual individuals represent those cases in which the autogynephilic disorder nullifies or overshadows the person's erotic attraction to women, and the bisexual individuals represent those cases in which the autogynephilic disorder instead gives rise to some secondary erotic interest in men that coexists with the person's basic attraction to women (Blanchard, 1985). Blanchard (1989b) suggested that the latter phenomenon need not reflect an equal attraction to the male and female phenotypes and would perhaps be better characterized as "pseudobisexuality." Because males who are autogynephilic transsexuals, like homosexual transsexuals, believe that "inside" they are really members of the opposite sex (i.e., women), those attracted to women mayparadoxically-label their erotic feelings for women as "homosexual" and view themselves as "lesbians trapped in a man's body." ...
... Le « projet hétérosexuel » de la femme trans a ainsi longtemps constitué un critère diagnostique d'accès au protocole de traitement de réassignation. Blanchard [37] expliquait en 1989 que les « transsexuels » (nommés ainsi dans ses écrits) se divisent en deux catégories : les homosexuels (en se basant sur le sexe assigné à la naissance) et les autres, autogynéphiles. Or, s'il y a un transsexualisme homosexuel et un transsexualisme autogynéphile, « c'est suggérer implicitement que tous les types de transsexualisme ont affaire avec la sexualité, c'est-à-dire sont explicables à l'aide de cette dimension » [10] là où les « pathologies sexuées » et « pathologies sexuelles » sont liées. ...
... Que racontent ces personnes de leur construction trans depuis leur petite enfance jusqu'à ce jour dans le rapport à leur corps, leur sexualité, leur corporéité, construction du lien à l'autre, leur fantasmes, etc. Certaines personnes trans expliquent qu'il n'y a pas de transition en tant que telle. Il s'agirait plutôt de la même personne rééquilibrée, « en harmonie avec ce qu'elle est et qui elle est » [37]. ...
... Comment montrer une « conviction inébranlable » d'appartenir à l'autre genre, ne pas aimer son corps et vouloir accéder à un certain nombre d'opérations et plus particulièrement celle des organes génitaux pour se tenir à un projet de transition ? Nous saisissons la complexité d'un désir et d'un projet de transition quel qu'il soit, qui peine à entrer dans un tel cadre contraignant [37]. Medico [16] explique que les personnes trans sont révélatrices des failles de notre système de genre. ...
Article
Résumé Objectifs Comprendre la place et les évolutions des prises en charge médicales et psychologiques de la vie sexuelle des femmes trans, dans le cadre des parcours de transition/affirmation de genre. Méthode Une revue narrative de la littérature médicale, psychiatrique et psychologique. Après sélection, 19 articles ont été retenus et analysés de façon inductive à l’aide de la théorie ancrée et des méthodes classiques d’analyse de contenu thématique. Résultats La majorité des articles recensés et analysés font le constat d’une relative absence de recherches sur le thème de la vie sexuelle. Les traitements chirurgicaux de réassignation sexuelle augmentent significativement la qualité de la vie sexuelle des femmes trans sauf dans le cadre de la pose d’un « néovagin ». Les changements d’orientation sexuelle ne sont pas toujours liés aux éléments du traitement entrepris par les personnes mais apparaissent liés à d’autres facteurs psychosociaux. Discussion Les catégories d’orientation sexuelle sont fluides autant que les pratiques sexuelles et le genre. Elles évoluent selon le moment de vie des personnes interrogées dans une parole singulière. Conclusions Après avoir longtemps été considérée comme un élément central du diagnostic de « transsexualisme », la question de la sexualité et notamment de l’orientation sexuelle des personnes apparaît actuellement peu prise en compte dans les parcours de soin. Cette absence est critiquée fortement par les auteurs des principales revues de la littérature déjà publiées. On suggère une meilleure prise en compte de la vie sexuelle comme élément clinique de l’histoire singulière des femmes trans. On observe par ailleurs que la pratique des opérations chirurgicales sur les organes génitaux n’occupe pas la place centrale qu’elle occupait encore récemment et que la question de la sexualité se pose indépendamment des modifications anatomiques génitales.
... In his seminal work on autogynephilia, Blanchard (1989b) developed the "Core Autogynephilia Scale." This measure includes eight items asking respondents whether they have experienced sexual arousal in response to different thoughts or fantasies about being a woman or having a woman's body. ...
... In a study focusing mainly on male-to-female transsexuals, Veale et al. (2008) also assessed natal females using items adapted from Blanchard's (1989b) Core Autogynephilia Scale. Importantly, however, they changed the wording of six (out of eight) items from the original measure. ...
... Lawrence argued that some of Moser's items were inappropriate, because they tended to conflate sexual arousal to the idea of having a female body (or engaging in stereotypically feminine behavior) with arousal to interpersonal sexual fantasies. For example, one of Moser's items, "I have been erotically aroused by preparing (shaving my legs, applying make-up, etc.) for a romantic evening or when hoping to meet a sex partner" was an adaptation of Blanchard's item "Have you ever felt sexually aroused when putting on women's perfume or makeup, or when shaving your legs?" (Note that this item was not on the Core Autogynephilia Scale [Blanchard, 1989b] but from the Cross-Gender Fetishism Scale [Blanchard, 1985].) Only Moser's item has an interpersonal component. ...
Article
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Blanchard proposed that autogynephilia is a natal male’s paraphilic sexual arousal in response to the thought or fantasy of being a woman. Furthermore, based on evidence collected from natal males with gender dysphoria, Blanchard argued that autogynephilia is the fundamental motivation among nonhomosexual males (i.e., those not exclusively attracted to men) who pursue sex reassignment surgery or live as transgender women. These ideas have been challenged by several writers who have asserted, or offered evidence, that autogynephilia is common among women. However, their evidence was weakened by problematic measures and limited comparison groups. We compared four samples of autogynephilic natal males (N = 1549), four samples of non-autogynephilic natal males (N = 1339), and two samples of natal females (N = 500), using Blanchard’s original measure: the Core Autogynephilia Scale. The autogynephilic samples had much higher mean scores compared with non-autogynephilic natal males and natal females, who were similar. Our findings refute the contention that autogynephilia is common among natal females.
... Other research contradicts the findings of this study before and since (e.g. Benjamin, 1969;Blanchard, 1989;de Vries et al., 2014;Dewhurst et al., 1969); however, the damage had already been done. Over the next 20 years, many University-based Gender Identity Clinics across the United States would also shut down (Erickson-Schroth, 2014). ...
... 'Normal' sex and gender. In the opening lines of "The Concept of Autogynephilia," Blanchard (1989) defines transsexuality in relation to dysphoria: "[t]he term gender dysphoria refers to the discontent with one's biological sex and the desire to be regarded by others as a member of the opposite sex" (emphasis added, p. 616). In the opening paragraph of "Typology of male-to-female transsexualism," Blanchard (1985) describes the differences between transsexualism "within the male population" (p. ...
... 'Normal' sexuality. In the two articles examined here, Blanchard (1989Blanchard ( , 1985 offers clear definitions of what constitutes normal sexual behaviour. However, it is important to establish that Blanchard understands sexuality to be irrevocably linked to transsexualism, particularly among those assigned male at birth, using sexuality to divide them into two types: those who experience or have experienced sexual arousal in association with cross-dressing (whom he calls "autogynephilic") and those who are, and have always been, completely sexually attracted to men (whom he calls "homosexual"; Blanchard, 1989). ...
Thesis
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Medical, community, and academic discourses offer competing interpretations of sex, gender, and the complexities of trans experiences, with variable attention to trans contributions to social and political thought and practice. Existing research shows that academic, medical, and psychological discourses continue to use pathologizing approaches and often misgender trans people (Ansara & Hegarty, 2011), with predictably negative impacts on trans people and communities (McNeil, Bailey, Ellis, Morton, & Regan, 2012). Using Critical Discourse Analysis and working from a stance that is critical of institutional complicities with dominating forms of power, this thesis explores the implications of medical, community, and academic discourses about trans people. In the interests of richly contextualized analysis, I have chosen to ground my discussions of selected discourses within a historical context, attending to the lived impacts on trans people and communities, and to the importance of evaluating ethical practices used in treating and researching them, through the inclusion of auto-ethnographic reflections on my own experiences. The majority of medical discourse sampled pathologizes trans experiences, defining trans people as abnormal and describing sex, gender, and sexuality as interconnected binaries. Transsexual separatist communities mirror this discourse in numerous ways, modifying medicalized categories to define their own transsexual identities as normal and all other trans identities as abnormal. Trans activists challenge both discourses, incorporating aspects of social justice thought and affirming diversities of perspective and experience. The thesis concludes with a review of participatory research projects representing a tentative step forward for researchers, trans people and communities by incorporating trans discourses within scientific approaches. These projects break with some of the ethical problems informing past psycho/medical inquiry and offer a glimpse at what trans-positive science might look like. Recommendations to realise this potential and recast academics as allies to minoritized communities are offered.
... 3e5 An ETII can become so intense that the individual only experiences arousal by thought of being the erotic target. 6,7 This suggests that the level of sexual arousal toward erotic targets may exist on a continuum (ie, some people having greater, lesser, or equal arousal to external and internal targets). In addition to sexual arousal, ETIIs may include wanting behavioral or physical changes to become the object of desire. ...
... 8,9 Autogynephilia occurs when natal males are aroused by the thought of themselves being a woman and may change their bodies and behavior to reflect those of a woman. 6,7,10 Heterosexual men who are aroused by the thought of themselves as a woman may wish for a more female-like body through permanent physical transformations. This desire may manifest through feelings of discomfort with sex assigned at birth in some people. ...
... 5,26 Greater nonheterosexuality in autogynephilia may reflect sexual interest in the idea of having sex with a man as a woman. 6,27 Whether elevated rates of nonheterosexuality are found in paraphilias in general is unclear. 28 However, any positive associations may point to common correlates (eg, genetic or psychosocial) or indicate greater sexual openness. ...
Article
Introduction: Erotic target identity inversions (ETIIs) are poorly studied paraphilias that involve sexual arousal by the idea or fantasy of being the object of one's sexual desires. Aim: To conduct a large non-clinical online survey to investigate self-reported sexual arousal, behavioral expression, and psychological correlates of 4 proposed ETIIs. Methods: A total of 736 natal males and 549 natal females responded to items about self-reported sexual arousal to the idea of acting as an animal (autoanthropomorphozoophilia) or the idea of acting as a child or infant (autonepiophilia), natal males reporting arousal to the idea of acting as a woman (autogynephilia), and natal females reporting arousal to the idea of acting as a man (autoandrophilia). Data pertaining to sexual orientation, childhood gender nonconformity, gender identity discomfort, autism, masochism, and humiliation were also collected. Main outcome measures: The main outcome was a measure of self-reported arousal and expression of the ETIIs being explored using 4 items: arousal level (-3 to 3) when imagining being the erotic target exemplar; frequency of engagement in dressing or behaving like their preferred target (0-4); strength of feeling that they would be better off as the target (0-4); and the frequency of consideration of making physical changes to look or function more like the target (0-4). Results: Mild levels of reported sexual arousal to the idea of being the preferred erotic target were common among the 4 groups, characterizing about half of them. Gender identity discomfort was associated with autogynephilia, autoandrophilia, and autoanthropomorphozoophilia. Greater gender nonconformity was associated with autogynephilia, autoandrophilia, and autonepiophilia. Autism scores were associated with autoandrophilia and autonepiophilia. Masochism was not associated with ETII scores, but humiliation was. Clinical implications: Findings suggest that it may be important to distinguish between subgroups of those with different levels and types of ETII arousal/expression. Strengths & limitations: Strengths of this study include the large, non-clinical sample of men and women for the investigation of ETIIs and the inclusion of measures of psychological correlates. The use of an Internet sample with self-report measures may be unrepresentative, although the Internet has the advantage of allowing recruitment from stigmatized or unusual groups. The cross-sectional nature limits our conclusions, as no causal inferences can be made. Conclusion: The results support the concept of ETIIs as a paraphilic dimension in non-clinical samples and the possible role of gender-related psychological factors. Brown A, Barker ED, Rahman Q. Erotic Target Identity Inversions Among Men and Women in an Internet Sample. J Sex Med 2019;XX:XXX-XXX.
... 2,4,6e13 Although the clinical value of a classification based on sexual orientation is subject to debate, 5,14,15 several authors have proposed that sexual orientation and sexual behavior are indicative of different etiologies of gender incongruence, 2,16 and further relevant predictors for the successful outcome of gender affirmation (GA) treatment. 17,18 In the 1980s, Blanchard 19 proposed a new typology of gender incongruence in trans women based on sexual orientation and introduced the concept of autogynephilia. Blanchard 19 suggested the existence of "2 fundamentally different types" of gender incongruence in trans women (p.616). ...
... 17,18 In the 1980s, Blanchard 19 proposed a new typology of gender incongruence in trans women based on sexual orientation and introduced the concept of autogynephilia. Blanchard 19 suggested the existence of "2 fundamentally different types" of gender incongruence in trans women (p.616). He classified these 2 types as "homosexual" (exclusively androphilic), on the one hand, and "non-homosexual" (exclusively gynephilic, bisexual, and analoerotic), on the other hand. ...
... He classified these 2 types as "homosexual" (exclusively androphilic), on the one hand, and "non-homosexual" (exclusively gynephilic, bisexual, and analoerotic), on the other hand. 2,19,20 In accordance with this theory, trans women of the latter group "are more similar to each other-and to transvestites-than any of them is to the homosexual (ie, androphilic) type" (p.439). 21 Their common feature, and that of transvestites, would be "a history of erotic arousal in association with the thought or image of themselves as women" (p.439). ...
Article
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Background One of the most prominent etiological theories of gender incongruence in trans women proposes a paraphilic erotic target location error (ie, autogynephilia) as a causal factor in gynephilic (ie, exclusively gynephilic and bisexual) trans women. We hypothesized that a paraphilic erotic target location should manifest itself in various aspects of sexual behavior, solitary and dyadic sexual desire, and psychosexual experience. Aim To compare sexual behavior, sexual desire, and psychosexual experience of exclusively gynephilic and bisexual trans women with that of androphilic trans women to explore whether their sexuality differs substantially. Methods Trans women diagnosed with gender dysphoria (Diagnostic and Statistical Manual of Mental Disorders–5) were recruited at 4 transgender healthcare centers in Germany. The present study analyzed items on sexual behavior, desire, and experience of a self-report questionnaire, collected as part of a cross-sectional multicenter study. Main Outcomes Multiple aspects of sexuality were examined using self-constructed items. Sexual desire was measured using the Sexual Desire Inventory and psychosexual experience using the Multidimensional Sexuality Questionnaire. Results Significantly more exclusively gynephilic than androphilic trans women reported a history of sexual arousal in relation to cross-dressing. However, little evidence was found that gynephilic and androphilic sexual desire, behavior, and psychosexual experience differ profoundly. Interestingly, a statistically non-significant trend indicated that gynephilic trans women who had not yet undergone gender affirming surgery showed the highest levels of sexual desire (solitary and dyadic), whereas the opposite was the case for androphilic trans women. Clinical Translation Data of this study indicate that sexual orientation does not appear to be a good predicator for sexual behavior, desire, and psychosexual experience in trans women. Strengths and Limitations We investigated sexual desire and experience using standardized and evaluated measures such as the Sexual Desire Inventory and Multidimensional Sexuality Questionnaire. Future studies with a larger sample size should investigate how different gender affirming medical intervention might have diverging influences on sexual behavior, desire, and experience. Conclusion Ultimately, this study found little evidence for the hypothesis that sexual behavior, sexual desire, and psychosexual experience differ substantially in gynephilic (exclusively gynephilic and bisexual) and androphilic trans women.
... Early understandings of gender identity relied upon binary conceptualizations of gender/sex 1 where individuals were classified as transsexual based on identifying with the "opposite" of their "genetic" sex (Benjamin, 1966). Early research 1 3 focused on developing typologies of transsexuality (Benjamin, 1966;Blanchard, 1989aBlanchard, , 1989b) that centered exclusively on the experiences of trans women. 2 Based on his experience working with clients in a gender dysphoria program, Fisk (1973Fisk ( , 1974 felt that a focus on typologies was not central to the treatment of gender dysphoria. Instead, he described individuals with dysphoria as being heterogeneous and ranging in severity. ...
... Clinical typologies of transsexual/transgender individuals (Benjamin, 1966;Blanchard, 1989aBlanchard, , 1989b have been developed for trans women, and clinical conceptualizations of gender dysphoria have emphasized binary understandings of gender. It was, therefore, hypothesized that ratings for both scales would be higher for individuals with transfeminine versus transmasculine identities and higher for binary (transfeminine and transmasculine) versus non-binary/agender identities. ...
Article
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The present research explored transgender individuals’ subjective ratings of two clinical measures of gender dysphoria: the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA) and the Utrecht Gender Dysphoria Scale (UGDS). Participants read each scale and provided a global rating regarding how well they captured their experiences of gender dysphoria. Participants included 622 transgender individuals who identified as transfeminine (n = 221), transmasculine (n = 206), and non-binary/agender (n = 195). Findings indicated clear patterns of responses across gender identity and assigned sex, but not clinical diagnosis. For the GIDYQ-AA, transfeminine and transmasculine individuals rated the scales more positively than did non-binary/agender individuals. In addition, participants who were assigned male rated the scale to be a more accurate measure of their dysphoria than did participants who were assigned female. For the UGDS, transfeminine individuals rated the scale most positively, followed by transmasculine individuals, and then non-binary/agender individuals. All pairwise comparisons were significant. Likewise, participants who were assigned male rated the scale to be a more accurate measure than did those who were assigned female. It is important to note that subjective ratings were relatively low (M = 3.40, SD = 1.09 for GIDYQ-AA; M = 3.43, SD = 1.22 for UGDS on a 5-point scale) where little more than half of the participants (52.5% GIDYQ-AA; 54% UGDS) agreed or strongly agreed that the scales captured their experience. Discussion focused on the implications for using these measures of gender dysphoria in both clinical and research settings.
... Estos términos surgen en 1989 cuando Ray Blanchard propone dos taxonomías dentro de la expresión sexual en las personas MtF, señalando que esta población era más heterogénea que la población FtM (Blanchard, 1989;Cuypere et al., 1995;Lawrence, 2010b;Smith, Goozen, Kuiper, & Cohen-Kettenis, 2005a). Según Blanchard, los transexuales MtF se pueden sentir atraídos sexualmente por mujeres (ginefílicos), por varones (androfílicos), por ambos sexos (bisexuales) o ningún sexo (analoerótico). ...
... En el caso de los individuos MtF androfílicos se sienten atraídos exclusivamente por los hombres, suelen tener comportamientos femeninos desde la infancia, presentan muchas dificultades para adaptarse al rol masculino y tienden a presentarse a edades muy tempranas para el tratamiento de su disforia (Blanchard, 1988(Blanchard, , 1989. Sin embargo, esta clasificación no ha estado exenta de polémica y existe desacuerdo entre algunos profesionales, ya que en esta tipología, la identidad de género se reduce a una mera cuestión de atracción (Lawrence, 2010a(Lawrence, , 2011Nuttbrock, Bockting, Rosenblum, Mason, & Hwahng, 2010;Veale, 2014). ...
Thesis
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La transexualidad se caracteriza por una marcada incongruencia entre género y sexo biológico. La población transexual busca la transición “hombre-mujer” (MtF) o “mujerhombre”(FtM). La literatura muestra una mayor concordancia entre gemelos monocigóticos que dicigóticos, lo que sugiere la contribución genética. Objetivos: Esta investigación consistió en el análisis citogenético y molecular del cariotipo de una población transexual. Posteriormente se realizó el análisis molecular de siete polimorfismos genéticos, cuatro de repetición: ERα-rs3138774, ERβ-rs113770630, AR rs193922933 y CYP19-rs60271534, y tres polimorfismos de única base (SNPs): ERα-rs2234693, ERα-rs9340799 y CYP17-rs743572, en una población de 974 transexuales y 1.327 controles. El diagnóstico y selección de la muestra se realizó en las Unidades de Identidad de Género de los Hospitales Clínic (Barcelona) y Carlos Haya (Málaga). Material y Métodos: El análisis del cariotipo se realizó mediante bandas G y el microarray Affymetrix CytoScan™ high-density. El estudio de los polimorfismos consistió en la amplificación de las regiones polimórficas y posterior establecimiento de los genotipos mediante electroforesis capilar (3130 XL Genetic Analyzer), o mediante digestión enzimática en el caso de los polimorfismos de única base. El análisis de las frecuencias se realizó con los tests Mann-Whitney o Chi-cuadrado y el software SPSS® 23.0. El análisis de interacción se realizó mediante regresión logística binaria con el software SNPStats. Los falsos positivos se excluyeron con la corrección de Bonferroni. Resultados: Los receptores de estrógenos alfa y beta están implicados en la base genética de la transexualidad. La población FtM mostró mayor número de repeticiones CA (ERβ-rs113770630) que la población control. Las frecuencias alélicas y genotípicas del ERα- rs9340799 (genotipo A/A) fueron también significativas en la población FtM. Se encontraron combinaciones alélicas significativas entre ERα-rs9340799, ERβ-rs113770630 y AR-rs193922933 en la población MtF. Conclusión: Los receptores de estrógenos alfa y beta juegan un papel clave en la diferenciación sexual del cerebro en nuestra especie.
... Indeed, whether variation in gender expression among same-sex sexually oriented individuals is meaningful with respect to biodevelopment has long interested researchers in this field (e.g., Blanchard, 1989;Gooren, 2006). Figure 1 depicts three theoretical possibilities regarding the ways that gender expression might relate to sexual orientation biodevelopment. ...
... Second, variability in gender expression among same-sex attracted individuals of the same sex might reflect differences in the "dose" or amount of exposure to a particular biological process that shifts brain development along the female-male continuum (Fig. 1B). It is thought that a higher dose of exposure would be associated with wider impact on the brain and behavior and, therefore, lead to a phenotype consisting of both same-sex sexual orientation and gender nonconformity (Blanchard, 1989). Thus, a possible dosage effect would be reflected in cases where a biomarker is evident among same-sex sexually oriented individuals who are gender-conforming, but especially among those who are more markedly gender-nonconforming or transgender. ...
Article
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Sexual orientation is a core aspect of human experience and understanding its development is fundamental to psychology as a scientific discipline. Biological perspectives have played an important role in uncovering the processes that contribute to sexual orientation development. Research in this field has relied on a variety of populations, including community, clinical, and cross-cultural samples, and has commonly focused on female gynephilia (i.e., female sexual attraction to adult females) and male androphilia (i.e., male sexual attraction to adult males). Genetic, hormonal, and immunological processes all appear to influence sexual orientation. Consistent with biological perspectives, there are sexual orientation differences in brain development and evidence indicates that similar biological influences apply across cultures. An outstanding question in the field is whether the hypothesized biological influences are all part of the same process or represent different developmental pathways leading to same-sex sexual orientation. Some studies indicate that same-sex sexually oriented people can be divided into subgroups who likely experienced different biological influences. Consideration of gender expression in addition to sexual orientation might help delineate such subgroups. Thus, future research on the possible existence of such subgroups could prove to be valuable for uncovering the biological development of sexual orientation. Recommendations for such future research are discussed.
... Men with ETIIs vary in the extent to which they retain attraction to other individuals (Blanchard, 1989b(Blanchard, , 1992. Indeed, some men with ETIIs are analloerotic, or exclusively sexually aroused by fantasizing about themselves as another individual. ...
... Studies that have examined the co-occurrence of autogynephilia and sexual attraction to women among gender dysphoric natal males or male-to-female transgender women provide indirect evidence supporting the idea that autogynephilia is an ETII. These studies have converged on the general finding that gender dysphoric natal males (Blanchard, 1985(Blanchard, , 1989b(Blanchard, , 1992Blanchard, Clemmensen, & Steiner, 1987;Freund, Steiner, & Chan, 1982;Zucker et al., 2012) and transgender women (Lawrence, 2005;Nuttbrock et al., 2011;Smith, van Goozen, Kuiper, & Cohen-Kettenis, 2005;Veale, Clarke, & Lomax, 2008) who are sexually attracted to women report higher levels of autogynephilia or erotic cross-dressing, compared with those who are exclusively sexually attracted to men. Conversely, men with transvestic fetishism overwhelmingly report at least some attraction to women, with the majority identifying as heterosexual (Docter & Fleming, 2001;Docter & Prince, 1997;Långström & Zucker, 2005;Zucker et al., 2012). ...
Chapter
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Sexual orientation is conventionally understood as relative attraction to men versus women. It has recently been argued that male sexual orientation in particular can be extended to include other dimensions of sexual attraction besides gender. One such dimension is sexual maturity, or relative attraction to children versus adults. A less familiar dimension is location, or relative attraction to other individuals versus sexual arousal by the fantasy of being one of those individuals. Erotic target identity inversions (ETIIs) refer to some men’s sexual arousal by the fantasy of being the same kinds of individuals to whom they are sexually attracted. Thus, ETIIs reflect the movement from external attraction to internal attraction on the dimension of location. ETIIs can motivate men to change their appearance and behavior to become more like the individuals to whom they are sexually attracted. ETIIs also provide a compelling theoretical explanation for otherwise puzzling phenomena, such as cross-dressing among heterosexual men, desire for limb amputation, and the furry phenomenon. Despite its scientific and clinical value, the concept of ETIIs has been underappreciated and understudied. This chapter reviews the ETIIs that have been previously identified in the literature, addresses important issues related to ETIIs, discusses the causes and development of ETIIs, and proposes future directions for research.
... Moreover, she insists on keeping her penis, even if it is only for her personal pleasure. Thus, her issue of gender identity seems more narcissistic, involving autogynephilic desire (Blanchard 1989) linked to an idealization of the image of women, combined with a rejection of the masculine register perceived not as threatening but as synonymous with a degradation of her self-image. The masculine register arouses very oppressive feelings in her of self-disgust harking back to a confusion of identities in the relationship with the primary object. ...
Article
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Although transgenderism is accorded an increasingly important place at the heart of studies concerning problems of gender nonconformity, it remains a phenomenon that is poorly known, and difficult to define, in particular in its relationship with transsexualism. In fact, in spite of an undeniable kinship between them, these two phenomena can be distinguished one from the other, and each represents a way of relating to the subject of the difference between the sexes. To clarify this subject, this article initially presents their emergence, their commonalities and their differences from a historical point of view. Next, both ways of relating to the difference between the sexes are analysed through two clinical case studies, one of transsexualism and one of transgenderism (from extracts of non-directive clinical interviews, as well as data from the Rorschach test and the Thematic Apperception Test [TAT], analysed by the French psychoanalytic method). At the end of this investigation, it is concluded that the distinction between these two phenomena refers to two abstractions of the difference between the sexes, leading to a transformation that can be pictured as a fulfilment driven by this perception.
... Furthermore, academia has historically ignored the real needs of trans women, and instead forwarded theories that pathologize our existence [2]. Although these theories have been critiqued and rebuked [10], there is still a dearth of research that engages trans people as active participants in the generation of knowledge and technologies that work to better our lives. ...
Research Proposal
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... However, we can affirm with some certainty its heterogeneous and multifactorial nature with specific constitutional and environmental factors (Zucker & Bradley, 1995;Zucker & Green, 1992;Zucker, Wood, & VanderLaan, 2014). Many researchers (Blanchard, 1985(Blanchard, , 1989Doorn, Portinga, & Verschoor, 1994;Lawrence, 2010a;Ovesey & Person, 1999) have proposed a subdivision in types of transsexualism based on biologic sex and sexual orientation. Other researchers differentiate ''early-onset'' transsexuals from ''late-onset'' transsexuals (Cohen-Kettenis & Gooren, 1999;Lawrence, 2005Lawrence, , 2013aNieder et al., 2011;Zucker et al., 2012). ...
Article
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The main aim of this study was to investigate the associations between personality features and attachment patterns in transsexual adults. We explored mental representations of attachment, assessed personality traits, and possible personality disorders. Forty-four individuals diagnosed with gender identity disorder (now gender dysphoria), 28 male-to-female and 16 female-to-male, were evaluated using the Shedler–Westen assessment procedure-200 (SWAP-200) to assess personality traits and disorders; the adult attachment interview was used to evaluate their attachment state-of-mind. With respect to attachment, our sample differed both from normative samples because of the high percentage of disorganized states of mind (50% of the sample), and from clinical samples for the conspicuous percentage of secure states of mind (37%). Furthermore, we found that only 16% of our sample presented a personality disorder, while 50% showed a high level of functioning according to the SWAP-200 scales. In order to find latent subgroups that shared personality characteristics, we performed a Q-factor analysis. Three personality clusters then emerged: Healthy Functioning (54% of the sample); Depressive/Introverted (32%) and Histrionic/Extroverted (14%). These data indicate that in terms of personality and attachment, GD individuals are a heterogeneous sample and show articulate and diverse types with regard to these constructs.
... Some researchers suggest that this is the case (e.g. Bailey, 2003;Blanchard, 1989;Lawrence, 2013) and assert that transition is almost inevitably eroticized, whereas others disagree, stating that the idea that trans people eroticize transition is clearly false as it obviates trans people's sense of gender as being to do with their felt sense of self (Moser, 2009;Serano, 2008Serano, , 2010Veale, 2014) which is the asserted position of the vast majority of trans people. Consequently, while the concept of autogynephilia might provide some clinical insight for understanding the transition-related life experiences of a minority of trans people, there is no need to assert it as a universal, or to hierarchize between different experiences. ...
... One example of this would be autogynephilia (Bailey 2003;Blanchard, 1989), a term that refers to natal males who derive sexual arousal from the prospect of being or physically becoming a woman. In the case of autogynephilia, there is thus a sexual component that contributes to the desire to transition to the other sex. ...
... В концепции Р. Блэнчарда [Blanchard, 1989] трансгендерные женщины делятся на четыре группы по типу сексуальной ориентации: гомосексуальные, бисексуальные, гетеросексуальные и асексуальные. Бленчард показал, что трансгендерные женщины последних трех групп статистически не сильно отличаются между собой, что позволило объединить их в группу «негомосексуальных» трансгендеров. ...
Article
The article analyzes the situation of transgender people in modern Russian society. The research included a survey of Moscow's cysgender population, semi-structured interviews with transgender people, and expert interviews. The study revealed that the prob lem of transgender people is connected with the negative attitude of society towards them and also with the difficulties of their socialization. This is due to the low awareness of the population about transgenderity in general and the low level of qualification of medical personnel working with transgender people. The author gives practical recommendations to improve the situation of transgender people, based on the results of the analysis. © 2017 «Russian Public Opinion Research Center» (OAO «VCIOM»).
... However, although he has not considered sexual orientation as a critical aspect of his assessment of someone as being transsexual, the role of sexual orientation in the context of transgender, and its link to the outcome of transition-related medical interventions (TRMI; e.g., sex hormones, breast-and genital reconstructive surgery), has been questioned (Hirschfeld, 1910). Since then, many medical and mental health professionals have regarded the anticipated post-transitional heterosexual behaviour of transgender individuals as predictive of a good outcome of TRMI (Blanchard, 1985(Blanchard, , 1988(Blanchard, , 1989Smith, Van Goozen, Kuiper, & Cohen-Kettenis, 2005a, 2005b. For a long time, professionals who endorsed surgery set up a gatekeeping system based on sexual orientation in order to regulate the number of requests for TRMI. ...
... Sexual orientation was often used as a parameter to subtype people with gender dysphoria. Blanchard [62] divided natal males with GD in homosexual (natal males attracted to males) and non-homosexual (natal males attracted to females, attracted to both or neither sexes). Subsequently, Lawrence [63] described different developmental trajectories between these subtypes: the homosexual subtype displays more childhood femininity, and a better psychological functioning after SRS in comparison to the nonhomosexual subtype. ...
Article
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Background: Personality assessment can be useful to better understand the complexity of transgender and transsexual people. In particular, the Shedler Westen Assessment Procedure-200 (SWAP-200) is a measure that provides an accurate dimensional evaluation of personality. When assessing gender non-conforming people, however, clinicians can encounter some difficulties in giving appropriate ratings to all the items. Purpose of the review: A brief guide to the use of SWAP-200 with transgender patients is provided, taking into account three areas of psychological functioning: identity, relationships and sexuality. The authors review, one by one, the SWAP-200 items related to these areas, and, relying on their clinical experience and on scientific literature on Gender Dysphoria, they propose recommendations for making personality diagnoses meaningful. Conclusion: This paper facilitates a better clinical understanding of transgender people, and help clinicians to be more knowledgeable in the assessment of this heterogeneous population.
... From another perspective, Anne Lawrence, MD, PhD, presents "Autogynephilia: A Paraphilic Model of Gender Identity Disorder." Drawing upon the work of Ray Blanchard (1989), Dr. Lawrence explains the little-known (to clinicians) concept of autogynephilia-defined as a male's propensity to be sexually aroused by the thought or image of himself as female. She argues that the idea of autogynephilia-which is conceptualized as both a paraphilia and a sexual orientation-provides an alternative to the traditional model of transsexualism that emphasizes gender identity. ...
... Differences and similarities in brain structure between transgender women and cisgender, and transgender men and cisgender men have been examined in correlation to identity derived from sexuality. Environmental factors were also examined for the possibility of inciting gender dysphoria resulting in controversial theories such as the two distinct etiologies for androphilic and gynephilic transgender women put forward by Blanchard [15]. Despite the far-ranging intellectual interest in the matter, no conclusive cause has been found to explain the onset of gender dysphoria. ...
... 3e5 Blanchard was one of the first scientists to suggest the existence of subgroups in the cohort of MtF trans persons based on demographic and sexual characteristics. 6,7 He reported that some were sexually interested in men (classified as homosexual or androphilic), whereas others were more attracted to women (gynephilic) or both men and women. Blanchard subsequently suggested that individuals who first sought medical attention for MtF gender dysphoria at an older age more frequently had children and were commonly married to females. ...
Article
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Introduction It has been theorized that there are 2 subgroups within the male-to-female (MtF) transgender population: individuals who are predominantly androphilic and those who are predominantly gynephylic or interested in both male and female partners. Aim To explore the role of a dichotomous distribution of age at dysphoria onset in individuals diagnosed with MtF gender dysphoria. Methods 40 patients who presented to a surgical clinic in Germany for gender-affirming surgery (GAS) were included in this study. Their age distribution was plotted as a histogram and the population was then divided at the median self-reported age of onset of gender dysphoria—that is, those 17 years and younger and those 18 years and older. The 2 groups were then compared with regard to demographic data, partnership history, various quality of life parameters, as well as sexual orientation and sexual history. Main Outcome Measure Self-designed questionnaires for demographics and sexuality, Questions on Life Satisfaction and Body Image (FLZM), Freiburg Personality Inventory, Rosenberg Self-Esteem Scale, and Patient Health Questionnaire were used. Results Early-onset, gender-dysphoric MtF patients underwent GAS at a much younger age (mean 32.7 vs 43.8 years, P = .004), but had similar characteristics regarding weight, height, body mass index, marital status, and living situation to individuals who reported later onset of gender dysphoria. Preoperatively, they showed greater depressive symptoms (4.6 vs 3.3 points, P = .045), which disappeared after GAS. Following surgery, the younger MtFs were predominantly attracted to men (52.6%), whereas individuals who were diagnosed with late-onset of gender dysphoria preferred women or both men and women (85.7%) as sexual partners (P = .010). Younger trans individuals were more frequently sexually active (73.7% vs 42.9%, P = .049). Conclusion Our findings suggest that there are 2 MtF populations that differ in age of dysphoria onset, sexual history, and multiple personal details including sexual orientation. These data may be used to improve care to transgender individuals by providing treatment reflecting their sexual interests. Zavlin D, Wassersug RJ, Chegireddy V, et al. Age-Related Differences for Male-to-Female Transgender Patients Undergoing Gender-Affirming Surgery. Sex Med 2019;7:86–93.
... In autogynephilia, men who are otherwise sexually attracted to women internalize their attraction to some degree, such that they are sexually aroused by the fantasy of being a woman. Men with ETIIs such as autogynephilia vary in the degree to which they retain sexual attraction to their external erotic target (Blanchard, 1989b(Blanchard, , 1992. Among men with ETIIs who are capable of sexual attraction to other individuals, the external and internal erotic targets are similar. ...
Article
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Furries are individuals who are especially interested in anthropomorphic or cartoon animals (e.g., Bugs Bunny). They often strongly identify with anthropomorphic animals and create fursonas, identities of themselves as those anthropomorphic animals. Some practice fursuiting, or wearing costumes that resemble anthropomorphic animals. Furries have been portrayed as sexually motivated in the media and popular culture, although little empirical research has addressed this issue. If some furries are sexually motivated, they may be motivated by an erotic target identity inversion (ETII): sexual arousal by the fantasy of being the same kinds of individuals to whom they are sexually attracted. Furries with ETIIs would experience both sexual attraction to anthropomorphic animals and sexual arousal by fantasizing about being anthropomorphic animals, because they often change their appearance and behavior to become more like anthropomorphic animals. We surveyed 334 male furries recruited from the Internet about their sexual orientation, sexual motivation, and sexual interests. A large majority of our sample reported non-heterosexual identities (84%) and some degree of sexual motivation for being furries (99%). Male furries also tended to report a pattern of sexual interests consistent with an ETII involving anthropomorphic animals. Both sexual attraction to anthropomorphic animals and sexual arousal by fantasizing about being anthropomorphic animals were nearly universal. Furthermore, male furries tended to be sexually aroused by fantasizing about being the same kinds of anthropomorphic animals to whom they were sexually attracted, with respect to gender and species. This sexual motivation and these unusual sexual interests do not justify discrimination or stigmatization.
... What I'm really struggling with is this idea that changes in legislation that look to improve the lives of a vulnerable minority group can be framed as being in direct opposition to women's rights. That trans women are being vilified to such an overwhelmingly hysterical degree that educated people who enjoy accusing the rest of us of 'rejecting science' for accepting trans women as women simultaneously cling on to outdated theories like Blanchard's "concept of autogynephilia" (Blanchard, 1989) to justify hyper-sexualising/fetishising the 'motives' of trans women (and totally ignore trans men). ...
Book
Drawing on the incredible wealth of diversity of languages, cultures and movements in which lesbian feminisms have been articulated, this book confronts the historic devaluation of lesbian-feminist politics within Anglo-American discourse and ignites a transnational and transgenerational discussion regarding the relevance of lesbian feminisms in today’s world, a discussion that challenges the view of lesbian feminism as static and essentialist. Through careful consideration of contemporary debates, these writers, theorists, academics and activists consider the wider place of lesbian feminisms within queer theory, post-colonial feminism, and the movement for LGBT rights. It considers how lesbian feminisms can contribute to discussions on intersectionality, engage with trans activism and the need for trans-inclusion, to ultimately show how lesbian feminisms can offer a transformative approach to today’s sexual and gender politics. https://www.zedbooks.net/shop/book/lesbian-feminism/
... 10. Bailey and Blanchard became infamous in the late 1990s and early 2000s for their controversial theories of the two pathways to "transsexualism" in male-to-female individuals, which include either "extreme homosexuality" or "autogynephilia" (i.e., the self-obsessed and narcissistic fantasy of themselves as women, which constitutes a paraphilia). See Bailey (2003) and Blanchard (1989) for more on this notion that "some transsexuals [transgender women] are the most feminine of males" (Chivers et al., 2004, p. 742). concordance). ...
... Je rappelle la fameuse controverse autour du livre du même auteur paru en 2003. Elle portait sur une autre hypothèse associant genre, orientation sexuelle et sexualité, se basant sur le concept d'auto gynéphilie proposé par Ray Blanchard (1989) et qui réfère à un amour ou une excitation face à l'image de soi en femme. L'autogynéphilie serait une forme de paraphilie que l'on retrouve encore dans la 5 e édition du DSM dans le trouble paraphilique fétichiste sous forme de sous-catégorie. ...
... Bisexual men are likely to be a heterogeneous group, who could differ in relative interest in women and men, in strength of libido (Lippa, 2020), in sensation-seeking, in paraphilic interests (e.g., Blanchard, 1989), and in relative interest in stimulating their partner's penis versus having their partner stimulate their own penis. It would be interesting to see whether a well-powered study would detect the FBOE in any of these subtypes, and if so, in which ones. ...
Article
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This study investigated the relations between numbers of older brothers, numbers of older sisters, and the odds of homosexuality in later-born males, including males who are most attracted sexually to prepubescent or early pubescent children (pedohebephiles) and males who are most attracted sexually to adults (teleiophiles). The authors meta-analyzed data from 24 samples of homosexual and heterosexual men, originally reported in 18 studies, and totaling 18,213 subjects. The results confirmed that older brothers increase the odds of same-sex preference in pedohebephiles as they do in teleiophiles. They also replicated the recent finding that older sisters have a similar but weaker statistical association with the odds of homosexuality. These findings have two theoretical implications. First, the findings for older brothers and older sisters indicate some commonality in the factors that influence sexual preference in teleiophiles and those that influence sexual preference in pedohebephiles. Second, the finding for older sisters confirms a prediction stemming from the hypothesis that male fetuses stimulate maternal antibodies that increase the odds of homosexuality in later-born males. Such immunization could result from miscarried as well as full-term fetuses, and number of older sisters should correlate with number of male fetuses miscarried before gestation of the subject. Read only link: https://rdcu.be/b6T7k
... The communalities in behavioral and neuronal responses (i.e., both being strongest for lesbian stimuli) might be related to the controversial concept of autogynephilia in TW (Blanchard, 1989). While the self-reported orientation of our TW sample is gynephilic on average before and after GHT (Auer et al., 2014), the perceived sexual arousal by watching the intercourse of other women might have experienced a potentially hormone-induced actualization. ...
Preprint
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While the concept of sexual orientation is more clearly defined in cisgender, this is less so in transgender individuals. Both experienced gender and sex hormones have a relation to sexual preferences, arousal in response to erotic stimuli, and thus sexual orientation. In transgender individuals sexual orientation occasionally changes before or during transition, which may involve gender-affirming hormone therapy. Using functional magnetic resonance imaging, we investigated whether the neuronal and behavioral patterns of sexual arousal in transgender individuals moved from the given (before) to their chosen gender after 4.5 months of hormone therapy. To this aim, trans women and men as well as age-matched cisgender controls rated visual stimuli showing heterosexual, lesbian or gay intercourse for subjective sexual arousal. Utilizing a Bayesian framework allowed us to incorporate behavioral findings in cisgender individuals of different sexual orientations. The hypothesized changes in response patterns could indeed be observed in the behavioral responses to the single but not the differentiation between stimulus categories with the strongest results for trans men and lesbian scenes. Activation of the ventral striatum supported our hypothesis only for lesbian scenes in trans women. This prominent role of lesbian stimuli might be explained by their differential responses in cis women and men. We show that correlates of sexual arousal in transgender individuals might change in direction of the chosen gender. Future investigations longer into transition might resolve the discrepancy on behavioral and neuronal levels.
... But in 1989, as practitioners were still trying to make sense of these exceptions to the 'classical transsexual' and 'transvestite' categories, Blanchard forwarded a new theory of transgender taxonomy and aetiology: autogynephilia (Blanchard, 1989a(Blanchard, , 1989b. The theory proposed that there were two fundamentally different types of trans women, each characterised by different 'erotic anomalies' (Blanchard, 1989a, p. 322). ...
Article
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It is generally accepted within psychology and among trans health providers that transgender people who transition do so because they have a gender identity that is incongruent with their birth-assigned sex, and distinct from their sexual orientation. In contradiction to this standard model, the theory of autogynephilia posits that transgender women’s female gender identities and transitions are merely a by-product of their sexual orientations. While subsequent research has yielded numerous lines of evidence that, taken together, disprove the theory, autogynephilia is still often touted by anti-transgender groups, including trans-exclusionary feminists. Here, I provide an updated overview of the scientific case against autogynephilia. Following that, I will forward an alternative ‘embodiment fantasies’ model that explains all the available findings better than autogynephilia theory, and which is more consistent with contemporary thinking regarding gender and sexual diversity. I will also demonstrate how autogynephilia theory relies on essentialist, heteronormative, and male-centric presumptions about women and LGBTQ+ people, and as such, it is inconsistent with basic tenets of feminism.
... 28 Focused on trans women, models of dysphoria have reinforced the "woman trapped in a man's body" narrative [29][30] and are reminiscent of outdated typologies based on trans women that conflate gender identity with sexual orientation and attraction. [31][32][33] Models of gender dysphoria also reify binary understandings of gender/sex 11 where traditional clinical scales [34][35] use binary language and anchor those understandings based on assigned sex. Recent research has documented that many transgender and nonbinary individuals do not feel that these scales capture their experience of gender dysphoria. ...
Article
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Purpose: Clinical definitions of gender dysphoria have primarily centered on a binary conceptualization of gender. The present study aimed to understand nonbinary trans individuals' experiences of gender dysphoria. Methods: Data were collected online from a non-clinical sample comprised of 205 nonbinary and agender participants. Analysis focused on answers to a single open-ended question prompting participants to describe their gender dysphoria as it relates to their body and/or appearance. Results: First, content analysis was used to document 11 contextual elements in which participants described their
... L'autogynéphilie ou comment re-sexualiser le TIG Dans les années 1980, le sexologue Ray Blanchard va questionner cette conceptualisation consensuelle du TIG comme trouble non sexuel par le biais d'une catégorie, l'autogynéphilie, qu'il invente pour décrire l'excitation sexuelle que certains hommes éprouvent à se penser ou s'imager en femmes (Blanchard 1989). Sa version, qui va rester marginale, est intéressante cependant pour saisir la façon dont les liens entre désir sexuel et genre sont envisagés. ...
Article
This study explores the development of self and gender identity within the lived experience of transgender individuals who were assigned female at birth and now identify as male or male spectrum. A psychoanalytically informed interview technique was employed here, involving six participants, aged 20–37 for 3–4 one-hour interviews. Alongside close attention to the content and the manner of representation of self and other across interviews, the analysis was also informed by counter-transference processes. Three core themes emerged from the data: ‘What’s in a Name?’; ‘Rejected, Bullied, Ignored and Forgotten’; and ‘I’m a Boy (not a Girl)’. Recollections of traumatic experiences and the use of laughter were other notable details that appeared across participants. Links are made between the emerging themes and concepts of incongruent mirroring and the development of a false self. Directions for further research and clinical implications for working with transgender clients in a psychotherapeutic context are also outlined.
Chapter
The word “transvestism” generally means cross-dressing, regardless of its purpose. In popular language, it is also associated with acting in a manner or style associated with the other sex. In sexuology, the term transvestism, from the Latin “trans” (across, over) and “vestitus” (dress, and dressed, clothed) was introduced by Magnus Hirschfeld in 1910 in his book The Transvestites: The erotic drive to cross dressing. Though the term transvestism is just about a hundred years old, there have been references to transvestic behavior/cross-dressing in the Bible (J Forensic Leg Med 16:109–114, 2009) and in the writings of Herodotus and Hippocrates. They described some Scythian males wearing female clothes, and ascribed their cross-dressing to depression (so-called Melancholia Scythorum). Some Roman Emperors, e.g., Caligula, Heliogabalus (aka Elagabalus, possibly transgendered) and Nero, cross-dressed (Transvestism: a handbook with case studies for psychologists, psychiatrists and counselors, New York, 1979).
Chapter
Since the origins of humanity the possibility of an area existing beyond the binary subdivision of sexual genders has been incorporated into myth and symbolic representations as expressed through rite, from Plato's Androgyne to Hermaphrodite, from the myth of Attis and Cybele to the figure of Venus Castina. At the same time different cultures have envisaged, and in some cases continue to envisage, outside any "pathologized" category, the possibility of there being a non-correspondence between an individual's biological sex and their subjective experience of belonging to a given sexual gender: for example, the Neapolitan Femminiello, the "two-spirits" among American natives, and the Hijras, who still exist on the Indian sub-continent. Nevertheless, in the West today this existential condition is to some extent shaped, and somehow even produced, by a series of discourses, which are first and foremost medical/psychiatric and define and mold its very nature. Gender Dysphoria, the clinical taxonomic category which the American Psychiatric Association has recently adopted to replace the existing Gender Identity Disorder, refers to an individual's affective/cognitive discontent with the assigned gender and the distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender, which in many, but not all, cases also involves a somatic transition by cross-sex hormone treatment and genital surgery (Sex Reassignment Surgery) (APA 2013). As Michel Foucault would have it, psychiatric knowledge molds bodies. In any case, the work of preparation and drafting of the recent edition of the DSM, the Diagnostic and Statistical Manual of Mental Disorders (APA 2013), has been accompanied by a lively debate on whether or not it is legal to include the condition within the ranks of Mental Disorders. The result of this debate was to keep the condition in the manual, therefore interpreting it as a manifestation of a Mental Disorder. In the present paper, we will analyze the main historical stages of the process of inclusion of this condition within psychiatric knowledge. We will, therefore, discuss the main problems that this inclusion produces, questioning the very foundations of psychiatric knowledge. Moreover, we will consider the exact nature of this condition within the framework of a phenomenological/existential approach, beyond the simplistic diagnostic criteria proposed by the American manual.
Chapter
This chapter addresses phenomena seen in children that represent departure from a gender essentialist viewpoint. This is the idea that normal people can be categorized as male or female, and that social behavior should ordinarily follow from biological sex. Gender essentialism is integral to most traditional religious and philosophical systems, but is now almost excluded from many academic and professional forums. This chapter discusses gender incongruity, and disorders of sexual differentiation, as examples of challenges to the gender essentialist viewpoint.
Article
Introduction Paraphilias are a frequently uncomfortable topic for clinicians to encounter during a clinical interview. Autogynephilia, a paraphilic condition characterized by a male’s sexual arousal at the idea of himself as a female, represents a relatively unfamiliar topic in the realm of psychosomatic medicine. Case Details We describe a case of a male patient who obtained medications without prescription, specifically estrogen supplementation, to alleviate the effects of a paraphilic preoccupation that he self-diagnosed as autogynephilia. This is believed to have led to spontaneous bilateral pulmonary emboli formed during hospitalization. Discussion This report calls attention to the abilities of patients to obtain medications from unregulated online sources without physician oversight. In the context of thoughts or behaviors that prove difficult to discuss with clinicians, this may predispose some individuals to putting themselves at significant risk. Conclusions In self-medicating distressing paraphilic ideations for a prolonged period, this individual was predisposed to the hypercoagulable state that resulted in a pulmonary embolism during psychiatric hospitalization.
Article
Sexual scientists have recognized for over a century that biologic males who seek sex reassignment - male-to-female (MtF) transsexuals - are not a homogeneous clinical population but comprise two or more distinct subtypes with different symptoms and developmental trajectories. The most widely used typologies of MtF transsexualism have been based on sexual orientation and have distinguished between persons who are androphilic (exclusively sexually attracted to males) and those who are nonandrophilic (sexually attracted to females, both males and females, or neither gender). In 1989, psychologist Ray Blanchard proposed that most nonandrophilic MtF transsexuals display a paraphilic sexual orientation called autogynephilia, defined as the propensity to be sexually aroused by the thought or image of oneself as a woman. Studies conducted by Blanchard and colleagues provided empirical support for this proposal, leading to the hypothesis that almost all nonandrophilic MtF transsexuals are autogynephilic, whereas almost all androphilic MtF transsexuals are not. Blanchard?s ideas received increased attention in 2003 after they were discussed in a book by psychologist J. Michael Bailey. The concept of autogynephilia subsequently became intensely controversial among researchers, clinicians, and MtF transsexuals themselves, causing widespread repercussions. This article reviews the theory of autogynephilia, the evidence supporting it, the objections raised by its critics, and the implications of the resulting controversy for research and clinical care.
Article
Aim To establish what impact, if any, the gender-affirmation process, has on sexuality and sexual experiences. Introduction Sexuality is a multi-faceted construct that influences our attraction to others. Gender transition is the process of aligning our physical sex characteristics with our psychological gender. Our sexuality and our gender identity are often mistakenly assumed to be inextricably linked. It is important to consider and understand the influence of the gender-affirmation process on sexuality and sexual experiences. Method A thematic synthesis of the available qualitative literature regarding sexuality, and sexual experiences in both transgender people and their partners were appraised, and synthesised. Thomas and Harden's (2008) stepwise process for conducting a thematic synthesis was followed. Results A total of seven articles were of relevance and included in the review. Two analytical and six sub-themes were found. The two analytical themes are: ‘Re-negotiating previous ‘norms” and ‘Establishing identity’. Conclusion During the gender-affirmation process, sexuality, and sexual experiences alter. This has clinical implications for transgender people and their partners, in particular, valuable therapeutic discussion points that need to be considered during the gender-affirmation process.
Thesis
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This study is broadly an exploration of how people who suffer from sexual orientation OCD (SO-OCD) and gender identity OCD (GI-OCD) use language to construct their identity, and how that process is framed by (hetero)normative idealogies. Instead of writing the abstract of the study (which you can find on page 4), I will highlight the different chapters that might be the most interesting for different readers: PSYCHOLOGISTS WORKING ON OCD should especially read: - CHAPTER 1 where I review the literature on OCD, and especially section 1.4 where I identify the gap my project fills. - CHAPTER 3 where I operationalize the concept of the feared self not as a fixed cognitive construct, but one that is discursively negotiated through language. - CHAPTERS 6-9 a detailed analysis of OCD sufferers' language use and how they construct their identity by distancing themselves from their feared self. - CHAPTER 10 is really where my argument comes together. I interpret the linguistic findings from chapters 6-7 through queer theory and Foucauldian self-governmentality. I especially argue that by distancing from a feared self, OCD sufferers run towards what I call an "idealized pure self" that is always and only the identity they wish to embody. This idealized self is constituted by a strong adherence to heteronormative understandings of gender and sexuality. The idea of a "pure self" is inscribed withing a sociocultural frame that has constructed sexuality as the locus of the "true self". In addition, I challenge the assumption that homophobia is the sociocultural factors causing SO-OCD. I demonstrate that this assumption doesn't account for LGBTQA+ OCD sufferers who obsess about being not LGBTQA+. As such, I suggest to conceptualize OCD not as a fear of "becoming" something that is socially taboo, but rather as a fear of "losing" something that is socially cherished. This fear of becoming or losing are two sides of the same coin that are shaped by (hetero)normative Discourses. Thus, the sociocultural factor shaping SO-/GI-OCD fears is argued to be tied to the notion of normativity. - CHAPTER 11: summarizes the whole study and section 11.3 explicitly states the contributions to the research on OCD SOCIOLINGUISTS INTERESTED IN LANGUAGE, GENDER, SEXUALITY & CORPUS LINGUISTICS should read: - Chapter 2 reviews Foucault's work on self-governmentality, queer theory and how all of this can be operationalized through linguistics - One of the major contributions of my thesis to sociolinguistics is a methodological one. In fact, I triangulated corpus-assisted discourse analysis with ethnographic approaches. Chapter 4 describes how I constructed a forum and conducted a 18 month long ethnography (or netnography), and CHAPTER 5 describes the methodic steps in my analysis. - CHAPTERS 6-9 are a detailed accounts of my participants' language use. - CHAPTER 10 interprets the findings through queer theory (see above), and section 10.5 suggests an additional way to conceptualize normativity in the field of language, gender and sexuality. - CHAPTER 11 gives a summary of everything, and sections 11.4 and 11.5 explicitly highlight the contributions to sociolinguistics and avenues for future research.
Article
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The present study aimed to expand current understandings of gender dysphoria by explicating the social context in which it is experienced and by centering the analysis on the lived experience of trans individuals. Data were collected online from a non-clinical sample comprised of 610 transgender participants. Participants answered two open-ended prompts to describe their gender dysphoria as experienced in a social context. Thematic analysis was used to code the data and determine main themes. Four socially-salient themes emerged regarding gender dysphoria: 1) External Triggers; 2) Internal Processing; 3) Interruption of Social Functioning; and 4) Moderated by Transition. When describing their experiences, participants identified external triggers for dysphoria that were social in nature as well as internal processes that occurred in response to those triggers. Often this led to an interruption of social functioning. For some of our participants, gender dysphoria was moderated by transition. Results of the present study suggest that trans individuals’ experience of gender dysphoria is greatly impacted by social context. Discussion focuses on the way the present findings may be best understood in relation to the literature on minority stress. Consideration of gender dysphoria as a proximal stressor may help to conceptually disaggregate gender dysphoria from psychological stress in the way we frame mental health considerations for trans individuals.
Article
Although frequently discussed in terms of sex dimorphism, the neurobiology of sexual orientation and identity is unknown. We report multimodal magnetic resonance imaging data, including cortical thickness (Cth), subcortical volumes, and resting state functional magnetic resonance imaging, from 27 transgender women (TrW), 40 transgender men (TrM), and 80 heterosexual (40 men) and 60 homosexual cisgender controls (30 men). These data show that whereas homosexuality is linked to cerebral sex dimorphism, gender dysphoria primarily involves cerebral networks mediating self-body perception. Among the homosexual cisgender controls, weaker sex dimorphism was found in white matter connections and a partly reversed sex dimorphism in Cth. Similar patterns were detected in transgender persons compared with heterosexual cisgender controls, but the significant clusters disappeared when adding homosexual controls, and correcting for sexual orientation. Instead, both TrW and TrM displayed singular features, showing greater Cth as well as weaker structural and functional connections in the anterior cingulate-precuneus and right occipito-parietal cortex, regions known to process own body perception in the context of self.
Article
Dominant/submissive role-play (D/s) is associated with specialized roles including Mistress, Master, Slave, Switch, Sadist, and Masochist. The current study uses cluster analysis to provide empirical evidence that no binary opposition or single spectrum constitutes a workable typology of individuals based on their affinities for these roles. The optimality of a particular choice of clustering scheme, including the number of clusters, is established using a replication technique which is presented in detail. A large number (n = 236,353) of individualized results (profiles) generated by the BDSM Test, a popular anonymous web survey, were analyzed. We hypothesize a two-dimensional typology of D/s profiles as the inferential result of our cluster analyses.
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IntroductionThis paper introduces the German S3-guideline Gender Incongruence, Gender Dysphoria and Trans Health: Diagnostics, Counselling and Treatment that was finalized in October 2018.Objectives The objective of the guideline group was to adapt the 1997 Standards for Treatment and Expert Opinion on Transsexuals to current scientific developments and research results and to make them applicable for appropriate health care in Germany.Methods The treatment recommendations of the guideline are based on empirical evidence which was systematically researched and evaluated. In a structured consensus process, the guideline group, who is representative for the target group, and a stakeholder group of trans people in Germany agreed on 100 recommendations.ResultsThe guideline aims to individualize and deregulate the field of trans health care. Reasonable options for the treatment of gender incongruence and/or gender dysphoria are identified. Based on empirical and clinical evidence, a procedure is recommended which is tailored to the individual conditions of the treatment.Conclusion The guideline reflects the current international state of trans health care on the basis of empirical evidence and relates it to the German health care system. Its application should be backed up by clinical and therapeutic expertise.
Article
Este trabalho tem o objetivo de abordar criticamente a teoria da autoginefilia de Ray Blanchard. Segundo o autor, existem dois tipos de mulheres transexuais em função de suas sexualidades: aquelas atraídas por homens e todas as demais, que seriam autoginefílicas. A autoginefilia, compreendida como uma parafilia, designa um conjunto de fantasias sexuais a respeito da imagem de si mesmo/a enquanto mulher. Blanchard postula que a etiologia da identidade feminina em mulheres transexuais não-androfílicas seja a autoginefilia. Nos debruçamos, desta forma, sobre a literatura crítica a respeito do tema, dando especial enfoque às perspectivas das próprias mulheres transexuais. Sustentamos que a teoria proposta por Blanchard é não apenas inconsistente com as narrativas das próprias mulheres transexuais, como também responsável por reiterar visões estigmatizantes a respeito da sexualidade das mulheres transexuais, particularmente daquelas que não se atraem exclusivamente por homens.
Chapter
Language and terminology are vital aspects of LGBTQ health care. Building a basic LGBTQ health vocabulary is fundamental to establishing relationships with LGBTQ patients. This chapter focuses on improving communication with the LGBTQ patients. It sets forth a brief overview of LGBTQ-related history, providing a foundation on which to base discussion in later chapters of the health disparities and barriers to quality health care encountered by these populations. Myriad terms exist with which to describe the complexity of gender identity, sexual orientation, and sexuality. A solid understanding of this language can improve patient-provider relationships in many practice settings and streamline provider-provider communication.
Book
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Contemporary Issues and Perspectives on Gender Research This thematic collection of papers aims to bring together two fields of inquiry: research on gender politics and policy changes, with particular attention to gender aspects of democratic institutions and research on dynamics of LGBTIQA+ population and understanding of different gender identities. This volume on contemporary challenges in gender research is conceptualized interdisciplinary and covers issues that are currently relevant to gender studies within the social sciences and humanities. The objective was to make a productive and stimulating publication with research across various fields-philosophy, sociology, economy, political science, legal studies, anthropology, cultural studies-in order to facilitate a better understanding of current challenges to gender theory and practice. The volume also aims to move forward in research and theorizing the consequences of increased opposition and attacks to gender equality. Its focus is on analysis and understanding the relation between gender equality and processes of de-democratization, the implications of backlash for equality rights and policies and the dynamics of response of the actors that promote gender and sexuality rights. The fact that gender studies are endangered and suffocated at many universities across Europe indicates the high relevance of this field in theory and research and reveals the revitalization of patriarchal, authoritarian and conservative influence on norms and principles of women's rights and feminist intellectual, activist and artistic practices. The actuality and content of the papers, their scientific foundations and the high quality of research results of fundamental and applicative character, are the key reasons why the collection as a whole meets all the necessary standards for publication. This volume provides a valuable contribution to the development of gender studies, an input into understanding and critically reconsidering basic concepts in creating gender identities and in gendering institutions. Prof. dr Nevena Petrusic This thematic collection of papers is dedicated to current topics of gender studies, abounds with results from recent research projects and provides the review of contemporary relevant literature in these fields. Authors from different disciplines of social sciences and humanities perceive various gender issues in the context of current social situation. The volume is characterized by a remarkable innovation in the selection of topics and unavoidable interdisciplinary approach in the study of gender issues. Prof. dr Sladjana Jovanovic Considering the interdisciplinarity in the study of gender issues, actuality of themes, different approaches and interpretation of particular problems, as well as the informative and epistemological value of the publication, I consider it particularly important to be published in Series Edited Volumes by the Institute of Social Sciences. Dr Zoran Lutovac
Article
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Cet article étudie deux controverses ayant eu lieu lors du travail de révision du Manuel diagnostique et statistique des troubles mentaux (DSM) entre 2008 et 2013. À cette occasion, le groupe de travail sur les « paraphilies » – des attirances et comportements sexuels considérés comme anormaux ou pathologiques – a proposé d’inclure deux nouveaux troubles mentaux controversés : l’un désignant l’attirance sexuelle pour le viol (trouble paraphilique coercitif) et le deuxième pour les adolescent-e-s au début de la puberté (hébéphilie). En mobilisant la critique féministe des sciences et la sociologie des sciences et des techniques, cette recherche analyse la manière dont les savoirs psychiatriques sur la sexualité masculine sont produits, façonnés et négociés au sein du travail de révision du DSM. Ce faisant, il interroge les frontières entre normal et pathologique ainsi que les tensions historiques et les paradoxes au cœur de la catégorie des paraphilies.
Book
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The aim of the QACP resource book is to aid reflexivity among mental health practitioners, primarily around gender-sexuality, but also with regard to other axes of power and privilege in social life. The book can broadly be divided into three major focal points – further divided into seven chapters. The first part (Chapter 2) focuses on understanding the social construction of normative gender and sexuality. The aim of this chapter is to get participants, particularly those who are heterosexual and cisgender, to appreciate how ideas of normative sexuality (heterosexual) and gender (cisgender), continually confused with “normal” and “natural”, are constructed through complex social processes. The second part of the book (Chapters 3, 4, 5) is focused on creating locally relevant knowledge for therapeutic issues such as stressors unique to living as a queer/trans person in India, working with the families of queer and trans persons, working with queer and trans couple issues, gaining perspective on understanding interpersonal violence within queer relationships. This part of the book also elaborates on the historical understanding of ways in which non-normative genders and sexualities have been pathologised within the psy disciplines, and provides insights into ways of shifting from harmful to neutral to affirmative practice. Some basic principles/tenets that a queer affirmative practitioner must follow are also laid out. The third focal point of the book (Chapters 6 and 7) is to critically examine concepts within existing models of counselling practice that are informed by heteronormative and cisgender binary assumptions, and altering these to make them more responsive and affirmative to the psychic and interpersonal struggles of queer/trans clients.
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This report suggests systematic strategies for the descriptive classification of nonhomosexual gender identity disorders, based on clinical observations and research findings. The classification of biological males is considered first. A review of cross-gender taxonomies shows that previous observers have identified and labeled a homosexual type far more consistently than any other category of male gender dysphoric. It is suggested that the apparent difficulty in differentiating reliably among the nonhomosexual types results from the sharing of many overlapping characteristics by the various groups. This is supported by a review of informal, mostly clinical, observations and by the findings of three studies designed to test the hypothesis that the nonhomosexual gender dysphorias, together with transvestism, constitute a family of related disorders in men. It is concluded that the main varieties of nonhomosexual gender dysphoria are more similar to each other than any of them is to the homosexual type. Two recommendations, based on the foregoing review, are offered for the classification of male gender dysphorics in research studies. When the number of subjects is small, they may be classified simply as homosexual or nonhomosexual. When the number is larger, the nonhomosexual cases may be classified as heterosexual, bisexual, or analloerotic (unattracted to male or female partners, but not necessarily devoid of sexual drive or activities).
Chapter
Adult male gender patients present with such diverse signs and symptoms that one cannot assume that they are all suffering from the same disorder or that they will all respond optimally to the same method of clinical management. Therefore, whether the ultimate goal is to investigate the causes of gender disorders or to establish the optimal treatment strategies for different types of patients, the researcher must first partition his or her sample of gender-disturbed males into a manageable number of descriptively homogeneous groups. Several authors have advanced typological schemes for doing this (e.g., Benjamin, 1966, 1967; Bentler, 1976; Buhrich & McConaghy, 1978, 1979; Meyer, 1974; Person & Ovesey, 1974a, 1974b; Stoller, 1971), and a taxonomy that is bound to be influential may be found in the DSM-III (American Psychiatric Association, 1980). These typologies are grossly similar (probably because there is widespread agreement on the descriptive dimensions of greatest importance), although authors differ somewhat in the labels they attach to the various discriminable syndromes and even more in their etiological hypotheses for the different types. (See Table 1, Chapter 1 and related discussion for a comparison of representative typologies.)
Article
Previous studies suggest, but do not demonstrate, the existence of 2 particular stages in the development of constancy of gender identity: understanding of gender permanence, followed by understanding of the genital basis of gender. This study, based on a sample of Swedish children, provides evidence that gender permanence and the genital basis of gender are distinct aspects of gender understanding, and confirms the suggested developmental progression.
Article
We examined whether an erotic response to cross‐dressing fantasies could be detected in heterosexual male cross‐dressers (HCDs) who verbally denied any erotic arousal in association with cross‐dressing for at least the past year. Subjects were 37 HCD patients and 10 paid heterosexual controls. HCDs were divided into groups according to their response to a questionnaire item asking the proportion of occasions that cross‐dressing was erotically arousing during the past year and offering response options from always to never. Penile blood volume was monitored while subjects listened to descriptions of cross‐dressing and sexually neutral activities. All HCD groups responded significantly more to cross‐dressing than to neutral narratives (p < .01); controls did not. Results suggest that only those causal hypotheses of heterosexual cross‐dressing need be considered that can account, also, for the presence of fetishism.
Article
Developmental data were obtained on the ability to discriminate between the sexes on the basis of dress, hair and genitalia. The focus of interest was on developmental changes in ability to discriminate on the basis of genitalia and in knowledge that the genital cue constitutes the critical characteristic. It was found that about half of a group of 7-yr-old children were able to discriminate on the basis of the genital cue while significantly more than half of the 9-yr-olds manifested such discrimination. However, it was only in the 11-yr-old group that more than half of the Ss appeared to be aware that the genital cue is the dominant characteristic differentiating boys from girls.
Transvestism is not simply a sexual disorder, but is best understood as primarily a disorder of the sense of self. A descriptive background of transvestism is provided through a review of developmental history, clinical course, presonality structure, and family history. The predominant transvestic fantasies and their modes of enactment are described. The disorder of the sence of self that gives rise to transvestic behavior is identified as a split in the ego into incompatible male and female gender identities. The split is attributed to an early identification with the mother as a defense against unresolved separation anxiety engendered during the separation-individuation phase of infantile development. The effect of this split upon the sense of reality, object relations, and adaptation to stress in transvestism are examined for a psychodynamic point of view.
Article
This study tested a prediction derived from the hypothesis that asexual and bisexual transsexualism are actually subtypes of heterosexual transsexualism. Two questionnaire scales measuring erotic attraction to males and females were administered to 163 male-to-female transsexuals. A cluster analysis of their scores divided the subjects into four groups: heterosexual, homosexual, bisexual, and asexual. Fisher Exact tests were used to compare the frequency with which subjects in the four clusters reported a history of erotic arousal in association with cross-dressing. As predicted, there were no differences among the asexual, bisexual, and heterosexual transsexuals, and all three groups included a much higher proportion of fetishistic cases than the homosexual group (p less than or equal to .0001, two-tailed). These findings support the view that male transsexuals may be divided into two basic types: heterosexual and homosexual.
Article
This study showed that the "socially desirable" presentation for a heterosexual male gender dysphoric is one that emphasizes traits and behaviors characteristic of "classic" transsexualism. Fifty-one homosexual and 64 heterosexual adult male gender patients were administered the Crowne-Marlowe (1964) Social Desirability Scale as well as eight questionnaire measures that tapped various features of the clinical history commonly given great weight in differential diagnosis. The tendency for a heterosexual subject to describe himself in terms of moral excellence or admirable personal qualities was significantly correlated with scores in the "transsexual" direction on all eight sexological measures; for the homosexual subjects, only one correlation was significant. It is argued that the patients most motivated to create a favorable impression on the examiner are likely to be those most anxious to obtain approval for sex reassignment surgery. Because, in this population, the socially desirable presentation is "feminine," it is possible that the differences in the histories produced by transvestites and heterosexual transsexuals are exaggerated to an unknown degree by the motivation of the latter to obtain approval for this operation. The findings do not diminish the important distinction between these groups, but they do suggest caution in interpreting the self-report data that have been used in comparing them.
Article
Men other than those with true psychosexual inversion e.g., transvestites, homosexuals, and schizophrenics) may seek sex reassignment surgery for a variety of reasons related to individual psychopathology. Unlike transsexuals, however, these patients have a deep underlying attachment to their masculinity, and their desire for sex change is transitory. Thus it is important that the psychiatrist allows sufficient time to evaluate the stability of the patient's desire for surgery.
Article
The heterosexual transvestite provides an interesting example of a socially induceq “pathology” because he seems to have internalized part of a social relationship, and acts toward himself in a way that a normal person acts toward a socio-sexually significant other.
Article
A revision of the typology of male cross-gender identity was carried out by means of formalized, easily replicable methods. The results suggest (1) that there are two discrete types of cross-gender identity, one heterosexual, the other homosexual; (2) that transvestism, and closely related conditions of cross-gender identity, occur exclusively or almost exclusively in heterosexuals; (3) that of the two types of transsexualism distinguished in this study, type A is, in heterosexuals, very rare or completely nonexistent; (4) that (in the course of time) transvestites or borderline transsexuals (defined below) may develop sustained cross-gender identity, as observed by Stoller (1971); (5) that although, according to Hoenig and Kenna (1974), transsexualism by itself is not an anomalous erotic preference, it is (virtually) always either preceded by transvestism or accompanied by homosexuality or cross-gender fetishism.
Article
Professional, patient and media forces tend to oversimplify the complexity of the gender dysphoria syndrome. Because sex reassignment surgery may be helpful to some patients with the syndrome and harmful to others, mental health professionals need to competently perform differential diagnoses of both the gender disorder and the associated psychopathologies. This frequently involves distinctions between subtle forms of psychosis, character pathologies of varying severity, and major developmental problems. Surgery should not be considered the only, or the best, treatment for the syndrome. Contrary to popular belief, psychotherapy can help many patients, especially those with secondary gender dysphoria.
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