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... While these studies do sometimes provide relevant insights into trans people's experiences of sexuality, they often do so only superficially and without much detail. For example, theory (e.g., Blanchard, 1985Blanchard, , 1988Blanchard, , 1989Lawrence, 2004) and research (e.g., Nuttbrock et al., 2011;Smith, Goozen, Kuiper, & Cohen-Kettenis, 2005;Veale, Clarke, & Lomax, 2008) on the subject of autogynephilia aim not so much at describing male-to-female (MtF) persons' experience of sexuality but rather at describing or testing the theory of autogynephilia as an explanation for their wish for transition. Similarly, gay and bisexual female-to-male (FtM) persons' identity development has been studied to determine if these persons' cross-gender identity was "bona fide" (Dickey & Stephens, 1995, p. 444), as homosexuality after transition was, at that time, a contraindication for sex reassignment therapy (SRT; see also Bockting, Benner, & Coleman, 2009;Coleman, Bockting, & Gooren, 1993). ...
... These fantasies could be sexual in nature or could provoke (intended or unintended) sexual arousal, which means that a significant aspect of sexual fantasies for some participants involved seeing oneself in sexual fantasy as fully embodied in one's identified gender. These latter fantasies (particularly as they occur among trans women) have been controversially theorized as pathological "autogynephilia" (Blanchard, 1985(Blanchard, , 1988(Blanchard, , 1989Lawrence, 2004). In this theory, heterosexual men. ...
... In this study, we did not aim to test Blanchard's (1985Blanchard's ( , 1988Blanchard's ( , 1989) theory of autogynephilia; rather, we sought to describe and inductively theorize the role and meaning of (sexual) fantasy practice among a small sample of trans people. We thereby chose to focus on participants' descriptions of these fantasizing practices, the subjective meanings ascribed to these practices, the explanations participants offered, and participants' reflections on Blanchard's (and other scholars') theories about trans sexual experience. ...
Abstract This pilot study explores the specificity of twelve Dutch trans people's experience of sexuality in order to provide new hypotheses and perspectives for future research. Emerging themes include the interconnection of sexual development with coming out and transition processes, the way incongruence between gender identity, gendered embodiment, and social perception of gender affected participants' experience of sexuality, and changes in physical sexual functioning after hormone therapy and/or various types of surgery. Our research design allowed for subjective accounts of trans people's experience of sexuality and detailed descriptions of changes in sexuality that occurred over time and throughout the coming out and transitioning processes.
... Blanchard formally defined autogynephilia as "a male's propensity to be sexually aroused by the thought or image of himself as a female" (Blanchard, 1991, p. 235). In a remarkable series of papers (Blanchard, 1985(Blanchard, , 1988(Blanchard, , 1989a(Blanchard, , 1989b(Blanchard, , 1991(Blanchard, , 1992(Blanchard, , 1993a(Blanchard, , 1993b(Blanchard, , 1993cBlanchard & Clemmensen, 1988;Blanchard, Clemmensen, & Steiner, 1985, 1987, he explored the role of autogynephilia in the erotic lives of hundreds of male gender dysphoric patients. ...
... His research revealed that gender dysphoric males who were primarily attracted to men (androphilic) usually reported having been quite feminine as children (Blanchard, 1988). They first presented clinically at an average age of 26 years (Blanchard et al., 1987). ...
... Blanchard's other category of gender dysphoric males included those attracted primarily to women (gynephilic); those attracted to both women and men (bisexual); and those with little attraction to other persons of either sex (analloerotic, "not attracted to other people"). Blanchard (1988) found that the males in this combined group reported less childhood femininity than those in the androphilic group; some might not have been especially masculine as children, but few if any had been extremely feminine. Those in the combined group presented for initial evaluation later in life, at an average age of 34 years (Blanchard et al., 1987). ...
Autogynephilia is defined as a male's propensity to be sexually aroused by the thought or image of himself as female. Autogynephilia explains the desire for sex reassignment of some male-to-female (MTF) transsexuals. It can be conceptualized as both a paraphilia and a sexual orientation. The concept of autogynephilia provides an alternative to the traditional model of transsexualism that emphasizes gender identity. Autogynephilia helps explain mid-life MTF gender transition, progression from transvestism to transsexualism, the prevalence of other paraphilias among MTF transsexuals, and late development of sexual interest in male partners. Hormone therapy and sex reassignment surgery can be effective treatments in autogynephilic transsexualism. The concept of autogynephilia can help clinicians better understand MTF transsexual clients who recognize a strong sexual component to their gender dysphoria.
... He found that a majority of the gynephilic (87.5%, n = 16), asexual (75%, n = 12) and bisexual (65.7%, n = 35) groups reported having experienced cross-gender arousal in response to wearing women's clothing on at least one occasion in their lives, while only 15% (n = 100) of the androphilic group responded similarly (Blanchard, 1985). He also found that the gynephilic, bisexual, and asexual groups, on average, reported less recalled childhood feminine gender expression and presented for sex reassignment later in life than the androphilic group (Blanchard, 1988). Based on these results, Blanchard argued that there are two fundamentally different types of MtF transsexuals-androphilic and nonandrophilic (where nonandrophilic includes the gynephilic, bisexual, and asexual groups). ...
... While Blanchard published numerous articles on autogynephilia, the bulk of the empir-ical data supporting the model can be found in three papers. Two of these papers provide evidence that there are two classes of transsexuals-androphilic and nonandrophilic (Blanchard, 1985;Blanchard, 1988). In the third, he developed the Core Autogynephilia and Autogynephilic Interpersonal Fantasy scales (which measure various aspects of cross-gender arousal) and showed that the nonandrophilic group scored significantly higher on these tests than the androphilic group (Blanchard, 1989b). ...
... This study is also one of several that indirectly bring into question the necessity for evoking paraphilia as a separate cause of gender dysphoria in nonandrophilic transsexual women. One of Blanchard's main arguments for proposing that nonandrophilic MtF transsexualism must have a unique (and likely paraphilic) etiology was his belief that a reciprocal FtM group (i.e., nongynephilic transsexual men) did not exist or were merely anomalous (Blanchard, 1988(Blanchard, , 1989a. It turns out, however, that nongynephilic FtM transsexuals are not nearly as rare as previously claimed ). ...
Autogynephilia is a paraphilic model that states that all male-to-female (MtF) transsexuals who are not exclusively attracted toward men are instead sexually oriented toward the thought or image of themselves as a woman. The assertion that transsexual women are sexually motivated in their transitions challenges the standard model of transsexualism—that is, that transsexuals have a gender identity that is distinct from their sexual orientation and incongruent with their physical sex. This article provides a review of the evidence against autogynephilia and makes the case that the taxonomy and terminology associated with this theory are both misleading and unnecessarily stigmatizing.
... Contemporary taxonomies still reference sexuality when describing trans classification (e.g., Lawrence, 2017). For example, Blanchard (1988) has argued that there are two types of transsexual women: 1) homosexual transsexuals who are attracted to men; and 2) all others who are not strictly attracted to men whom he refers to as autogynephilic transsexuals. 2 Within these models, "true" transsexuals are understood to be solely attracted to cisgender men, abstinent from sexual activities prior to medical affirmation, and to reaffirm (hetero)cisgenderist sexual practices after gender affirmation procedures (Davy, 2020;Prunas, 2019;Riggs et al., 2019). ...
... Within both Benjamin's and Blanchard's typologies, the only individuals authorized to be trans are those who endorse a desire to transition to the "other" gender/sex (Benjamin, 1966;Blanchard, 1988). Individuals who may have endorsed gender identities outside the gender binary (e.g., gender fluid, nonbinary, agender) were not included within this medicalized classification. ...
Past research has constructed a medicalized model of trans women’s sexuality, where trans women are believed to be hyposexual and distressed by their bodies pre-transition, and are cured of their sexual dysfunction as a result of gender affirmative medical procedures. The current study engaged a community sample (N = 169) of trans feminine and nonbinary individuals assigned male at birth (TFNB) to investigate predictors of sexual experiences after addressing methodological biases of prior studies, including body satisfaction (using a modified Body Image Scale) and social contextual factors. Hierarchical regressions were conducted to test the hypothesis that after accounting for demographic variables and social contextual aspects (i.e., body satisfaction, social dysphoria, and fetishization), medical transition (i.e., hormone therapy) would not significantly predict five outcomes of sexual experience (i.e., receptive penetration, insertive penetration, importance of sex, sexual pleasure, and sexual intimacy). Across all models, medical transition was not a significant predictor of sexual experiences; however, sexual orientation, age, body satisfaction, and experiences of fetishization were frequent predictors. Results suggest that the sexual experiences of TFNB individuals do not align with the medicalized model and that demographic and contextual factors play an important role in the sexual outcomes for this population.
... Among the variables included in these classifications, the individual's sexuality (i.e., sexual drive, sexual fantasies, and sexual orientation) was soon included, and the sexual life of transgender people began to be considered, in the assessment process, as a tool to validate transgender identity. For example, Blanchard argued that adult maleto-female individuals who are not sexually attracted to men were aroused by "the thought or image of themselves as women" (Blanchard, 1988), resulting in the wish to become women themselves. Autogynephilia was the term used to describe this phenomenon (Blanchard, 1988) and was classified a paraphilia underlying "transvestism and some forms of male-to-female (MtF) transsexualism" (Lawrence, 2011, p. 135). ...
... For example, Blanchard argued that adult maleto-female individuals who are not sexually attracted to men were aroused by "the thought or image of themselves as women" (Blanchard, 1988), resulting in the wish to become women themselves. Autogynephilia was the term used to describe this phenomenon (Blanchard, 1988) and was classified a paraphilia underlying "transvestism and some forms of male-to-female (MtF) transsexualism" (Lawrence, 2011, p. 135). For decades, "true transsexuals" were assumed to be asexual, with an extremely low sexual drive, or strictly attracted to people of the same gender they were assigned at birth (Prunas, 2019). ...
Objectives: The study investigates how trans masculine and nonbinary individuals describe the use of their bodies during sexual activities. Methods: Three hundred and sixty-one trans masculine and nonbinary individuals were asked to describe their use of body during sex through an online survey. Data were analyzed through thematic analysis. Results: Eleven subthemes emerged that were organized in 4 overarching themes: Relational Factors; Behavioral Factors; Sexual Roles; and Transgender Related Factors. Some differences emerged between trans masculine and nonbinary participants. Conclusions: Although some of our participants described a lack of sexual activity, our participants overall described a wide range of activities.
... The early onset TS group has been found to show several characteristics and a developmental pattern which is clearly different from that of the late onset group. The early onset group, for instance, has been shown to present earlier for assessment, to report more childhood feminine identification, to show better social gender reorientation, to have less erotic arousal when cross-dressing and to show less postoperative regrets than the late onset group (Blanchard, 1988;Blanchard et al., 1989;Doorn et al. 1994;Johnson and Hunt, 1990). It is therefore possible that biological etiological factors play a more important role in the early than in the late onset group. ...
... To our knowledge, this study is the first on laterality and cognition in a homogeneous group of early onset transsexuals who are sexually attracted to same (biological) sex-partners. In the terminology of Blanchard (1988) they are the so-called homosexual TS, despite the fact that these TS are attracted to heterosexual, instead of homosexual partners. The term implicates that our findings may be interpreted as findings on same-sex attracted persons, with or without gender identity problem. ...
It is still unclear to what extent cross-gender identity is due to pre- and perinatal organising effects of sex hormones on the brain. Empirical evidence for a relationship between prenatal hormonal influences and certain aspects of gender typical (cognitive) functioning comes from pre- and postpubertal clinical samples, such as women suffering from congenital adrenal hyperplasia and studies in normal children. In order to further investigate the hypothesis that cross-gender identity is influenced by prenatal exposure to (atypical) sex steroid levels we conducted a study with early onset, adult, male-to-female and female-to-male transsexuals, who were not yet hormonally treated, and nontranssexual adult female and male controls. The aim of the study was to find out whether early onset transsexuals performed in congruence with their biological sex or their gender identity. The results on different tests show that gender differences were pronounced, and that the two transsexual groups occupied a position in between these two groups, thus showing a pattern of performance away from their biological sex. The findings provide evidence that organisational hormonal influences may have an effect on the development of cross-gender identity.
... Although these authors may have differed in the number of subtypes or in the percentages each of their subtypes consisted of, they identified and labeled a homosexual type more consistently than any other category of cross-gendered male. Blanchard (1985Blanchard ( , 1988Blanchard ( , 1989) made a distinction between various subtypes of nonhomosexual transsexuals and homosexual transsexuals and actually investigated similarities and differences between the groups. He concluded that the nonhomosexual subtypes are more similar to each other than any of them are to the homosexual type. ...
... Only a minority of the homosexuals reported a history of such erotic arousal, whereas a majority of the nonhomosexual groups acknowledged such a history. Furthermore, the homosexual groups were younger at initial presentation, reported more feminine identification, and were less likely to report sexual stimulation by cross-gender fantasy (the thought or image of themselves as women) than the nonhomosexual group (Blanchard, 1985(Blanchard, , 1988(Blanchard, , 1989. Leavitt and Berger (1990) found another difference between their probably comparable subtypes of male transsexuals. ...
Transgenderism and Intersexuality in Childhood and Adolescence: Making Choices presents an overview of the research, clinical insights, and ethical dilemmas relevant to clinicians who treat intersex youth and their families. Exploring gender development from a cross-cultural perspective, esteemed scholar Peggy T. Cohen-Kettenis and experienced practitioner Friedemann Pfäfflin focus on assessment, diagnosis, and treatment issues. To bridge research and practical application, they include numerous case studies, definitions of relevant terminology, and salient chapter summaries.
... Although these authors may have differed in the number of subtypes or in the percentages each of their subtypes consisted of, they identified and labeled a homosexual type more consistently than any other category of cross-gendered male. Blanchard (1985Blanchard ( , 1988Blanchard ( , 1989) made a distinction between various subtypes of nonhomosexual transsexuals and homosexual transsexuals and actually investigated similarities and differences between the groups. He concluded that the nonhomosexual subtypes are more similar to each other than any of them are to the homosexual type. ...
... Only a minority of the homosexuals reported a history of such erotic arousal, whereas a majority of the nonhomosexual groups acknowledged such a history. Furthermore, the homosexual groups were younger at initial presentation, reported more feminine identification, and were less likely to report sexual stimulation by cross-gender fantasy (the thought or image of themselves as women) than the nonhomosexual group (Blanchard, 1985(Blanchard, , 1988(Blanchard, , 1989. Leavitt and Berger (1990) found another difference between their probably comparable subtypes of male transsexuals. ...
... Although these authors may have differed in the number of subtypes or in the percentages each of their subtypes consisted of, they identified and labeled a homosexual type more consistently than any other category of cross-gendered male. Blanchard (1985Blanchard ( , 1988Blanchard ( , 1989) made a distinction between various subtypes of nonhomosexual transsexuals and homosexual transsexuals and actually investigated similarities and differences between the groups. He concluded that the nonhomosexual subtypes are more similar to each other than any of them are to the homosexual type. ...
... Only a minority of the homosexuals reported a history of such erotic arousal, whereas a majority of the nonhomosexual groups acknowledged such a history. Furthermore, the homosexual groups were younger at initial presentation, reported more feminine identification, and were less likely to report sexual stimulation by cross-gender fantasy (the thought or image of themselves as women) than the nonhomosexual group (Blanchard, 1985(Blanchard, , 1988(Blanchard, , 1989. Leavitt and Berger (1990) found another difference between their probably comparable subtypes of male transsexuals. ...
... While male cross-dressers and transfeminine individuals can be motivated by factors other than autogynephilia, such as a natural tendency to be feminine associated with male homosexuality (Bailey, 2003;Blanchard, 1988Blanchard, , 1989bIlly, 2023;Lawrence, 2017;Smith et al., 2005), the majority of those in Western countries have been identified as likely to be autogynephilic based on clinical and community data (Lawrence, 2010a(Lawrence, , 2013b. In recent decades, transfeminine individuals recruited from online communities appear overwhelmingly to be autogynephilic (Lawrence & Bailey, 2009), as evidenced by one study in which almost all transfeminine participants displayed high levels of autogynephilia regardless of how they reported their sexual attraction to men and women (Veale et al., 2008). ...
Autogynephilia is a natal male’s propensity to be sexually aroused by the thought or fantasy of being a woman. Both male cross-dressers and transfeminine individuals (a broad range of individuals born male with a feminine gender identity; e.g., trans women) have been shown to be motivated or characterized by autogynephilia. Although there is a lack of research on whether other potentially related aspects of sexuality are comparable between them, the conceptual framework of autogynephilia offers several predictions that can be tested empirically. Following these predictions, the present study examined whether 10 diverse aspects of sexuality differed between 519 male cross-dressers and 288 transfeminine individuals recruited from online communities, as well as between both groups and 293 cisgender men and 301 cisgender women recruited as control groups. The overwhelming majority of male cross-dresser and transfeminine participants identified as heterosexual, bisexual, asexual, or pansexual. Compared with transfeminine participants, male cross-dressers reported more core and general autogynephilia, paraphilic interests, sociosexual orientation, sexual compulsivity, and problematic pornography use, but less bisexual attraction. Compared with cisgender men and women, male cross-dressers and transfeminine participants as a combined sample reported more bisexual attraction, sexual orientation ambiguity, core and general autogynephilia, paraphilic interests, analloeroticism, sexual compulsivity, and problematic pornography use, but less perceived desirability as a partner. Differences were larger comparing male cross-dressers and transfeminine participants with either control group than with each other. Results suggest that while autogynephilia is especially important to the sexuality of male cross-dressers, it also figures importantly in the sexuality of transfeminine individuals, even if it is expressed and organized differently.
... Elevated recalled CSAB among European/North American transgender androphilic males and transgender gynephilic females have been consistently documented (see Tables 1-4 in Lawrence, 2010). Retrospective research comparing androphilic and non-androphilic transgender males demonstrates that the androphilic group recalls greater CSAB compared to the non-androphilic group (Blanchard, 1988;Smith et al., 2005). Similarly, retrospective research comparing gynephilic and non-gynephilic transgender females confirms that the gynephilic group recalls greater CSAB compared to the non-gynephilic group (Chivers & Bailey, 2000;Smith et al., 2005). ...
Same-sex sexual attraction in both males and females has been associated with childhood sex-atypical behavior. Gynephilic females recall behaving in a manner that is less female-typical and more male-typical compared to cisgender androphilic females, whereas androphilic males recall behaving in a manner that is less male-typical and more female-typical compared to cisgender gynephilic males. In addition, male and female ambiphilic individuals exhibit intermediate levels of childhood sex-atypicality. In this study, we examined recalled childhood sex-typed behavior among Iranian cisgender gynephilic males (n = 236), cisgender ambiphilic males (n = 51), cisgender androphilic males (n = 191), transgender androphilic males (n = 60), cisgender androphilic females (n = 243), cisgender ambiphilic females (n = 96), cisgender gynephilic females (n = 32), and transgender gynephilic females (n = 122). Both cisgender androphilic males and cisgender gynephilic females recalled elevated childhood sex-atypicality, scoring intermediate between cisgender gynephilic males and cisgender androphilic females. Male and female ambiphilic participants scored intermediate between their other- and same-sex attracted cisgender counterparts. Transgender androphilic males exhibited hyper-feminized childhood behavior, scoring even more female-typical than cisgender androphilic females. Transgender gynephilic females recalled behaving as male-typical as cisgender gynephilic males. Consistent with previous research, our findings from Iran - a non-Western, Middle Eastern culture - provide cross-cultural support for the universality of childhood sex-atypicality as a normative developmental precursor of monosexual or ambisexual same-sex attraction in both males and females who are cisgender and transgender.
... 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). ...
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.
... Other ways in which patients might distort data and how they would affect the results were not discussed. Later analyses focused instead on the age participants were when submitting for approval for SRS (e.g., Blanchard, 1988) although this age was known to increase with marriage and parenthood, both more common in gynephilic MTFs than androphilic MTFs ( Blanchard et al., 1987). As gender dysphoria might be observed as early as 2 years of age ( Coleman et al., 2012), precedence arguments based later in life are unpersuasive. ...
... Blanchard a établi une distinction entre les « transsexuels homosexuels » et les « transsexuels non homosexuels », mais les termes « transsexuels d'apparition précoce et tardive » ou « transsexuels primaires et secondaires » ont également été utilisés pour décrire des groupes similaires (Doorn et al., 1994). Selon Blanchard, le type « homosexuel » se caractérise par une identification plus féminine dans l'enfance, moins d'excitation érotique lors du travestissement, une demande précoce d'évaluation clinique et moins de regrets postopératoires que le groupe hétérosexuel (Blanchard, 1988 ;Blanchard et al., 1989). Les transsexuels non homosexuels avaient tendance à être plus âgés au moment de la présentation clinique, moins féminins quand ils étaient enfants, plus susceptibles d'avoir des antécédents d'excitation sexuelle au moment du travestissement et souvent excités sexuellement par le fantasme d'être une femme. ...
Depuis que des interventions médicales de réassignation de sexe ont été mises à la disposition de personnes transgenres (1951), il est apparu nécessaire d’identifier les candidats qui pourraient bénéficier de ces interventions. Cela a ouvert la voie à l’élaboration de lignes directrices cliniques très strictes pour l’identification des typologies de personnes transsexuelles, mettant l’accent sur le « diagnostic différentiel » entre les « vrais transsexuels » et le reste de la population transgenre qui demande une prise en charge clinique. Ces lignes directrices ont ouvert la voie à une « pathologisation » de la vie sexuelle des personnes transsexuelles de la part des professionnels de la santé mentale. La présente étude vise à donner un aperçu des racines historiques qui sont à l’origine de ces préjugés et de mettre en évidence les transformations progressives qui ont abouti à la notion de « confirmation de genre ».
... Sexualpräferenzstörungen ist im Zusammenhang mit dem Thema Trans höchst umstritten. Das auf Blanchard (1985Blanchard ( , 1988Blanchard ( , 2005 zurückgehende Konstrukt der Autogynäphilie als sexuelle Erregung durch einen oder mehrere eigene feminisierte Körperteile im Sinne einer Sonderform der Autosexualität stellt keinen schlüssigen Ausschluss von GIK oder GD dar (Moser, 2010;Serano, 2010;Veale, 2014). Es dürfte bei einem relevanten Prozentsatz von trans Frauen anzutreffen sein, ohne dass es relevante differentialdiagnostischen Überlegungen zuließe (Lawrence, 2011;Veale, 2014 Najmabadi, 2008;Norman et al., 2016). ...
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.
... 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. ...
... Smith et al. did observe, however, that androphilic MtFs had a more feminine appearance than nonandrophilic MtFs. Androphilic MtFs also report more childhood crossgender behavior than their nonandrophilic counterparts (Blanchard, 1988;Money & Gaskin, 1970-1971Whitam, 1987). ...
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.
... An assumption that was originally introduced by Blanchard (1985Blanchard ( , 1988Blanchard ( , 2005 and revisited by various scientists later on (e.g. Smith et al., 2005aSmith et al., , 2005b. ...
... 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. ...
While most abnormal psychology texts seem to aim solely for breadth, the acclaimed Oxford Textbook of Psychopathology aims for depth, with a focus on adult disorders and special attention given to the personality disorders. Almost a decade has passed since the first edition was published, establishing itself as an unparalleled guide for professionals and graduate students alike, and in this second edition, esteemed editors Paul H. Blaney and Theodore Millon have once again selected the most eminent researchers in abnormal psychology to cover all the major mental disorders, allowing them to discuss notable issues in the various pathologies which are their expertise. This collection exposes readers to exceptional scholarship, a history of psychopathology, the logic of the best approaches to current disorders, and an expert outlook on what future researchers and mental health professionals will be facing in the years to come. With extensive coverage of personality disorders and issues related to classification and differential diagnosis, this volume will be exceptionally useful for all mental health workers, clinical psychologists, psychiatrists, and social workers, and as a textbook focused on understanding psychopathology in depth, as well as a valuable guide for graduate psychology students and psychiatric residents.
... There is little question that autogynephilia existsinsomenatalmalesandfiguresimportantlyintheirlives.For example, autogynephilia is the motivation why some males crossdress fetishistically (Bailey, 2003;Blanchard, 1989aBlanchard, , 1991Lawrence, 2013). It is also part of the motivation why, rarely, natal males who are nonhomosexual (i.e., not exclusively attracted to men) physically transform their bodies into those of women (Blanchard, 1985(Blanchard, , 1988(Blanchard, , 1989bLawrence, 2004Lawrence, , 2007Lawrence, , 2013. ...
Men’s sexual arousal patterns have been an important window into the nature of their erotic interests. Autogynephilia is a natal male’s paraphilic tendency to be sexually aroused by the thought or image of being a woman. Autogynephilic arousal per se is difficult to assess objectively, because it is inwardly focused. However, assessing sexual arousal patterns of autogynephilic males in response to external stimuli is also potentially useful. For example, there is substantial association between autogynephilia and gynandromorphophilia (GAMP), or sexual attraction to gynandromorphs (GAMs), colloquially “she-males.” GAMP men’s sexual arousal patterns in response to GAM, female, and male stimuli have recently been characterized. In the present study, we extended this understanding by comparing the sexual arousal patterns of autogynephilic male cross-dressers, GAMP men, heterosexual men, and homosexual men. Erotic stimuli included sexually explicit videos of men, women, and GAMs. Autogynephilic men were much more similar in their arousal patterns to heterosexual and GAMP men than to homosexual men. However, similar to GAMP men, autogynephilic men showed increased arousal by GAM stimuli relative to female stimuli compared with heterosexual men.
... An assumption that was originally introduced by Blanchard (1985Blanchard ( , 1988Blanchard ( , 2005 and revisited by various scientists later on (e.g. . However, this position has recently been challenged (Cohen-Kettenis & Pfäfflin, 2010) attraction [sexual orientation] per se plays only a minor role in contemporary treatment protocols or decisions' (Zucker et al., 2013, p. 906). ...
The current literature shows growing evidence of a link between gender dysphoria (GD) and autism spectrum disorder (ASD). This study reviews the available clinical and empirical data. A systematic search of the literature was conducted using the following databases: PubMed, Web of Science, PsycINFO and Scopus; utilizing different combinations of the following search terms: autism, autism spectrum disorder (ASD), Asperger's disorder (AD), co-morbidity, gender dysphoria (GD), gender identity disorder (GID), transgenderism and transsexualism. In total, 25 articles and reports were selected and discussed. Information was grouped by found co-occurrence rates, underlying hypotheses and implications for diagnosis and treatment. GD and ASD were found to co-occur frequently - sometimes characterized by atypical presentation of GD, which makes a correct diagnosis and determination of treatment options for GD difficult. Despite these challenges there are several case reports describing gender affirming treatment of co-occurring GD in adolescents and adults with ASD. Various underlying hypotheses for the link between GD and ASD were suggested, but almost all of them lack evidence.
... An assumption that was originally introduced by Blanchard (1985Blanchard ( , 1988Blanchard ( , 2005 and revisited by various scientists later on (e.g. Smith et al., 2005aSmith et al., , 2005b. ...
Since the beginning of contemporary transition-related care at the outset of the 20th century, sexual orientation has ben considered to be closely connected with gender identity and the developmental trajectories of trans people. Specifically, health professionals have regarded the anticipated post-transitional heterosexual behaviour of trans adults as predictive of a good outcome of cross-sex hormones and gender-confirming surgeries. This article reviews the current literature according to the question of whether the sexual orientation of trans people is linked to outcome measures following transition-related interventions. A comprehensive review was undertaken using the Medline database, searching for empirical studies published between 2010 and 2015. Out of a total of 474 studies, only 10 studies reported a follow-up of trans adults and assessed sexual orientation in the study protocol at all. Sexual orientation was predominantly assessed as homosexual versus non-homosexual related to sex assigned at birth. Only one 1 of 10 follow-up studies found a significant association according to the outcome between groups differentiated by sexual orientation. Empirically there is no link between sexual orientation and outcome of transition-related health care for trans adults. In order to provide comprehensive health care, we recommend asking for sexual behaviours, attractions and identities, as well as for gender experiences and expressions; however, this knowledge should not drive, but simply inform, such comprehensive care.
... Differences between FtM and MtF were statistically significant (p for trend \0.005 at ANOVA). These Italian results about GD onset are in line with worldwide data [13][14][15][16][17][18]. In addition, they indicate that, despite the majority of individuals reporting an onset of GD before 11 years (85.9 % of FtM and 66.2 % of MtF), their first access to the clinic was greatly delayed (20 years), i.e. in their third decade [12]. ...
Purpose:
Despite international guidelines being available, not all gender clinics are able to face gender dysphoric (GD) youth population needs specifically. This is particularly true in Italy. Centers offering specialized support are relatively few and a commonly accepted Italian approach to GD youth has still not been defined. The aim of the present Position Statement is to develop and adhere to Italian guidelines for treatment of GD adolescents, in line with the "Dutch Approach", the Endocrine Society (ES), and the World Professional Association for Transgender Health (WPATH) guidelines.
Methods:
An in-depth brainstorming on the application of International guidelines in the Italian context was performed by several dedicated professionals.
Results:
A staged approach, combining psychological support as well as medical intervention is suggested. In the first phase, individuals requesting medical help will undergo a psycho-diagnostic procedure to assess GD; for eligible adolescents, pubertal suppression should be made available (extended diagnostic phase). Finally, from the age of 16 years, cross-sex hormonal therapy can be added, and from the age of 18 years, surgical sex reassignment can eventually be performed.
Conclusions:
The current inadequacy of Italian services offering specialized support for GD youth may lead to negative consequences. Omitting or delaying treatment is not a neutral option. In fact, some GD adolescents may develop psychiatric problems, suicidality, and social marginalization. With access to specialized GD services, emotional problems, as well as self-harming behavior, may decrease and general functioning may significantly improve. In particular, puberty suppression seems to be beneficial for GD adolescents by relieving their acute suffering and distress and thus improving their quality of life.
... Blanchard [88] investigated "homosexual transsexuals" (i.e., sexually oriented toward individuals of the same biological sex) and "nonhomosexual transsexuals," but the terms "early-onset and late-onset transsexuals" or "primary and secondary transsexuals" have also been used to describe roughly the same groups [124]. Blanchard's "homosexual" group appeared to present earlier for assessment, to report more feminine identification in childhood, to show better social gender reorientation, to have less erotic arousal when crossdressing, and to show fewer postoperative regrets than the heterosexual group [124][125][126][127]. The postoperative regrets of the heterosexual group are easily understood, as this group probably has a much longer history of untreated gender dysphoria, has for a longer period unsuccessfully tried to live in the original gender role, and consequently developed stronger ties to their original role (partner, father, colleague). ...
Transsexualism is considered to be the extreme end of the spectrum of gender identity disorders characterized by, among other things, a pursuit of sex reassignment surgery (SRS). The origins of transsexualism are still largely unclear. A first indication of anatomic brain differences between transsex-uals and nontranssexuals has been found. Also, certain parental (rearing) factors seem to be associated with transsexualism. Some contradictory findings regarding etiology, psychopathology and success of SRS seem to be related to the fact that certain subtypes of transsexuals follow different developmental routes. The observations that psychotherapy is not helpful in altering a crystallized cross-gender identity and that certain transsexuals do not show severe psychopathology has led clinicians to adopt sex reas-signment as a treatment option. In many countries, transsexuals are now treated according to the Standards of Care of the Harry Benjamin International Gender Dysphoria Association, a professional organization in the field of transsexualism. Research on postoperative functioning of transsexuals does not allow for unequivocal conclusions, but there is little doubt that sex reassignment substantially alleviates the suffering of transsexuals. However, SRS is no panacea. Psychotherapy may be needed to help transsexuals in adapting to the new situation or in dealing with issues that could not be addressed before treatment.
... Ele representa aproximadamente 45% dos seus pacientes, os quais têm um histórico recorrente relacionado à excitação sexual em usar roupas de mulher, além de apresentaram os primeiros sintomas relativamente mais tarde. Esses indivíduos são menos femininos na infância, diferentemente do grupo dos homossexuais, mas já manifestavam fantasias sexuais de ter um corpo feminino desde essa fase (Blanchard, 1985b(Blanchard, , 1988(Blanchard, , 1989. ...
This article discusses some common categories used in the field of Sexology, that are somewhat unclear in terms of definitions. Sexology, while a very recent science, has been built up through the contribution of researchers from many different areas of knowledge who usually work with different epistemological assumptions and categories. Such a multi-disciplinary approach brings, on the one hand, a rich contribution to the field, but, on the other hand, also creates much confusion and lack of communication between scientists. I tried to identify and compare these categories using empirical evidence and explanatory studies in the actual literature. Interpretative research was left out of the review because it does not contribute to this attempt at interdisciplinary theorizing. This critical review, written in English, provides a contribution to one such category "transsexualism," illustrating some of the recent ways of approaching this issue in academic and clinical terms.
... Homosexual MF transsexuals are exclusively sexually attracted to males (androphilic), do not experience autogynephilia, are highly feminine in their childhood, do not generally have success with attempts to live in the male role, and tend to present for treatment of their gender dysphoria at a younger age. By splitting MF transsexuals into these two groups based on their sexual orientation, Blanchard (1985bBlanchard ( , 1988Blanchard ( , 1989 and others (Freund, Steiner, & Chan, 1982;Johnson & Hunt, 1990;Smith, van Goozen, Kuiper, & Cohen-Kettenis, 2005) have found evidence for the average differences between these groups that Blanchard proposed. However, these differences do not necessarily imply a typology exists. ...
Previous theories and research have suggested there are two distinct types of male-to-female (MF) transsexuals and these types can be distinguished by their sexuality. Using the scales Attraction to Femininity in Males, Core Autogynephilia, Autogynephilic Interpersonal Fanasy, and Attraction to Transgender Fiction as indicator variables, taxometric analysis was applied to an online-recruited sample of 308 MF transsexuals to investigate whether such a distinction is justified. In accordance with previous research findings, MF transsexuals categorized as "nonandrophilic" scored significantly higher on Core Autogynephilia than did those categorized as "androphilic"; they also scored significantly higher on Attraction to Femininity in Males and Attraction to Transgender Fiction. Results of one of the taxometric procedures, L-Mode, gave slightly more support for a dimensional, rather than taxonic (two-type), latent structure. Results of the two other taxometric procedures, MAMBAC and MAXCOV, showed greater support for a dimensional latent structure. Although these results require replication with a more representative sample, they show little support for a taxonomy, which contradicts previous theory that has suggested MF transsexuals' sexuality is typological.
... Blanchard's formulation has had influence within the psychiatric community, as evidenced by autogynephilia appearing in the text revision of the DSM-IV (American Psychiatric Association, 2000). By dividing MTF transsexuals into these two groups based on their sexual orientation, Blanchard (1985 Blanchard ( , 1988 Blanchard ( , 1989) and others (Freund, Steiner, & Chan, 1982; Johnson & Hunt, 1990; Nuttbrock et al., 2009; Smith, van Goozen, Kuiper, & Cohen-Kettenis, 2005;) have found evidence for average differences between these groups that were proposed by Blanchard. However, some of these findings have been inconsistent with Blanchard's theory. ...
Ray Blanchard presented a theory of male-to-female (MtF) transsexualism based on a typology, classifying MtF transsexuals as autogynephilic or homosexual. This theory has produced much debate, and many transsexuals have disagreed with it. In this research, comments about Blanchard's theory were collected through an anonymous questionnaire from a convenience sample of 170 mostly White/European Internet-using MtF transsexuals. Positive responses to the theory were given by 15.9% of participants, 31.9% gave neutral responses, and 52.2% gave negative responses. The most common theme of the responses was that the theory was too narrow and restrictive. Other common themes were that the theory was simply wrong, did not apply to the participant's experience, was not acceptable, was not important, only applied to cross-dressers, and suggested underlying motives of the researcher. Some participants reported that they had experienced autogynephilia, and some reported changes of their sexual orientation. Given the anonymity of the participants, transsexual participants were unlikely to consciously distort their responses. Although there were sampling limitations, this study lends insight into the proportion of MtF transsexuals who are supportive of/opposed to Blanchard's typology and the reasons why some are opposed to it. The findings are of interest as transsexuals' reactions to the theory can be and have been used to theorize about the nature of autogynephilia.
... Five MtF and 10 FtM reported that they had not started on cross-sex hormones, though all were living in some capacity as the other sex. Participants were also categorized as homosexual or nonhomosexual, due to previous reports suggesting that there are two subtypes (Blanchard, 1985(Blanchard, , 1988 with potentially meaningful differences. Those who reported sexual preference for the same natal sex were classed as homosexual and the rest, who either reported a preference opposite to their natal sex, bisexuality, or asexuality, were classed as nonhomosexual. ...
The literature examining the co-occurrence of gender dysphoria (GD) and autistic traits has so far been limited to a series of small case studies and two systematic studies, one looking at autistic traits in gender dysphoric children and the other set within the context of the extreme male brain hypothesis and looking at adults. The current study examined this co-occurrence of GD and autistic traits in an adult population, to see whether this heightened prevalence persisted from childhood as well as to provide further comparison of MtF versus FtM transsexuals and homosexual versus nonhomosexual individuals. Using the Autistic Spectrum Quotient (AQ), 91 GD adults (63 male-to-female [MtF] and 28 female-to-male [FtM]) undertaking treatment at a gender clinic completed the AQ. The prevalence of autistic traits consistent with a clinical diagnosis for an autism spectrum disorder (ASD) was 5.5 % (n = 3 MtF and n = 2 FtM) compared to reports of clinical diagnoses of 0.5-2.0 % in the general population. In contrast to the single previous report in adults, there was no significant difference between MtF and FtM on AQ scores; however, all of those who scored above the clinical cut-off were classified as nonhomosexual with respect to natal sex. Results were considered in the context of emerging theories for the observed co-occurrence of GD and autistic traits.
... The standard autogynephilic motivation for transsexuality is that the individual experiences sexual arousal and satisfaction from imagining themselves or appearing as cross-gendered; their desire to change sex is a completion of that sexual script. Perhaps the autogynephilic narrative is missing from these stories because they are less common among gender-variant teens requesting sex change (Blanchard, 1988). Also missing from the collection were letters representing what psychiatrists of the day might have called transvestic fetishism. ...
Due to his high public profile, Harry Benjamin was often the first contact for those who identified as transsexual in the 1960s and 1970s, until his retirement in 1976. Among the over 800 letters from transsexuals written to Benjamin, 21 were from youth seeking his medical assistance. These letters, written from 1963–1976, provide a rare window into the lives and subjectivities of transsexual youth before the modern transgender movement took shape. Often taking the form of short autobiographies, these pioneers wrote about the meaning of their genders and sexualities, sometimes in great detail. Narrative analyses of these letters focused on narrative explanations for their transsexual desire; how Benjamin, his colleagues, and transsexual correspondents co-constructed transsexual narratives; and the rejection of these youth by their families and peers.
... Much of the social scientific focus on transgendered individuals has derived from an interest in understanding "deviation" from the "normal" and "natural" two-sex system (see Herdt 1994). While extremely diversified, this literature is organized around psychiatric and psychological concerns (Blanchard 1988; Brown 1990; Docter 1988; Persinger and Stettner 199 1 ; Person and Ovesey 1984), anthropological examinations of transgenderism (Blackwood 1984; Bullough and Bullough 1993; Kochems 1983,1985; Whitehead 1981 ), and defining and describing various categories of transgenderists and their cultural manifestations (Chauncey 1994; Newton 1979; Talamini 1982). With the exception of Weinberg, Williams, and Pryor's (1994) research on transsexual bisexuals and treatises written by transgendered individuals (Bornstein 1994; Morris 1974; Rothblatt 1995), the literature on transgenderism has focused primarily on issues of sex and gender. ...
Drawing on data from interviews with 65 masculine-to-feminine transgenderists, the authors examine the coming-out experiences of transgendered individuals. Drawing on the literature that shows gender to be an inherent component of the social infrastructure that at an individual level is accomplished in interaction with others, they demonstrate that interactional challenges to gender are insufficient to challenge the system of gender. Whereas many transgenderists believe that their actions and identities are radical challenges to the binary system of gender, in fact, the majority of such individuals reinforce and reify the system they hope to change.
... , particularly those who are sexually attracted to members of their own biological sex, invariably show an early childhood onset of cross-gender behavior, including the wish to be of the opposite sex (Blanchard, 1988;Freund, Langevin, Satterberg, & Steiner, 1977;Green, 1974). In contrast, however, prospective studies of children referred clinically for concerns regarding their gender identity development show that only a small minority persist with the desire to change their sex upon reaching adolescence or young adulthood ...
This study compared 358 children (mean age, 7.2 years) and 72 adolescents (mean age, 15.8 years) referred clinically for problems in their gender identity development with regard to demographic characteristics, behavioral problems, as measured by the Child Behavior Checklist (CBCL), and peer relations. Compared with the adolescent sample, the child sample had a greater proportion of males, had a higher mean IQ, was more likely to come from a higher social class background, was more likely to be living with both of their parents, was more likely to be Caucasian, was more likely to be born in Canada, and was more likely to speak English as a first language. The adolescent sample showed significantly more general behavioral disturbance on the CBCL than did the child sample although both age groups had, on average, mean scores that fell within the clinical range. The adolescent sample also had significantly poorer peer relations than the child sample, as judged by a three-item Peer Relations Scale derived from the CBCL. The differences in CBCL psychopathology generally remained significant even when controlling for the differences in demographics. The strongest predictor of CBCL psychopathology was that of the Peer Relations Scale. The role of both poor peer relations and the demographic variables in accounting for the CBCL psycho- pathology and with regard to gender identity differentiation is discussed.
... The converse would be the result for birth-assigned females. A weak to moderate relationship (correlations around .30) between sexual orientation and recalled childhood feminine gender identity has been found previously in studies using transwomen (Blanchard, 1988Blanchard, , 1989 Johnson & Hunt, 1990; Y. L. S. Smith et al., 2005b; Veale, Clarke, & Lomax, 2008b) and transmen (Chivers & Bailey, 2000). Cross-gender eroticism is also correlated with the gender-variant outcomes in the Identity-Defence Model. ...
This article presents a comprehensive model to explain the development of the various manifestations of gender variance amongst birth-assigned males and females. As background, two previous theories of gender-variance development proposed by Richard Docter and Ray Blanchard are introduced. The model presented in this article is called the identity-defense model of gender-variance development because it has two parts. Firstly, biological factors and early childhood influences determine whether and to what degree a gender-variant identity develops. Secondly, personality and environment factors determine whether defense mechanisms are used to repress the gender variance. If defense mechanisms are used, then the resultant outcome is either a nonclassical transsexual or cross-dresser, depending on the degree of gender variance. If defense mechanisms are not used, then classical transsexuals or drag artists are the likely outcomes, again depending on the level of the gender variance. Sexual orientation and cross-gender eroticism are strongly correlated with the gender-variant outcomes in the model, and this is explained in the model using Bem's (1996)4.
Bem , D. J. 1996. Exotic becomes erotic: A developmental theory of sexual orientation. Psychological Review., 103: 320–335. [CrossRef], [Web of Science ®]View all references exotic becomes erotic developmental theory of sexual orientation.
... У кли нич кој прак си нај че шћа је хо мо сексу ал на ори јен та ци ја, док се код ма њег броја тран ссек су а ла ца ис по ља ва ју оста ле три вр сте пол не ори јен та ци је [6]. Нај ве ћи број тран ссек су ал них осо ба, и то му шка ра ца ко ји же ле да про ме не пол, ис тра жи вао је аме ричко-ка над ски кли нич ки пси хо лог и сек со лог Реј Блан шар (Ray Blan chard) [7]. Он на во ди да по сто је два ти па му шка ра ца ко ји же ле да пре ђу у су про тан пол: они ко ји ис по ља вају хо мо сек су а ли зам и они ко ји ис по ља ва ју ауто ги не фи ли ју. ...
Gender identity disorder is a sexual disorder characterized by strong identification with the opposite gender, followed by unpleasant feeling dueto the birth given gender. Longstanding clinical experience with transgender population has brought new knowledge and better understanding of gender identity and gender identity disorders. Initial knowledge referred to sexual orientation of gender dysphoric persons such as homosexual, heterosexual, bisexual and asexual.The contemporary literature dealing with transgenderism and transsexualism brings out the concept of autogynephilia (from Greek "love oneself as a woman") which is the subject of numerous controversies among the experts in this field as well as in the transgender community. The concept of autogynephilia gained importance in Blanchard's work and his attempts to improve diagnostic categories of gender identity disorders and implement efficient strategies in the management of adult male patients. The main topic of this paper refers to the evolution of the autogynephilia concept, which most prominent authors within the field elaborate as a type of male paraphillic tendency of a person to be sexually by the idea of a phantasy or an image of oneself as a woman, naming these persons "nonhomosexual transsexuals" or "autogynephilic transsexuals".
... In our study we find some support for the idea of a difference between younger and older applicants for SRS from the sexual orientation of our subjects. Blanchard and colleagues (Blanchard, 1988; Blanchard et al., 1989) found that homosexual transsexuals were more likely to attend gender clinics at earlier ages and had more consistent cross gender histories. Our sample of early-age SRS applicants consisted almost entirely of homosexual transsexuals (28 versus 1 bisexual) and is thus different from adult samples where heterosexual and bisexual transsexualism are more prevalent. ...
Adolescent transsexuals were compared with adolescent psychiatric out-patients and first-year university students to determine the extent to which other psychopathology is a necessary condition for the development of transsexualism. Three areas of psychological functioning associated with fundamental psychological disturbances—perceptual inaccuracy, disorders of thought and negative self-image—were assessed by means of the Rorschach Comprehensive System. The group of adolescent transsexuals was found to be intermediate between adolescent psychiatric patients and nonpatients for extent of perceptual inaccuracy. They did not differ significantly from nonpatients with regard to thinking disturbances and negative self-image. The psychiatric patients included significantly more individuals characterized by negative self image than the other groups. The results support the idea that mayor psychopathology is not required for the development of transsexualism. © 1997 John Wiley & Sons, Inc.
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.
Resumen
Desde la década de 1950, se han llevado a cabo con frecuencia reasignaciones quirúrgicas de sexo. Como este procedimiento terapéutico quirúrgico es polémico, parece importante explorar las consecuencias reales de esta intervención y evaluar objetivamente su pertinencia. En este contexto, hemos llevado a cabo una revisión de las publicaciones. Después de examinar las limitaciones metodológicas de los estudios de seguimiento, se presenta el futuro psicológico, sexual, social y profesional de los individuos sometidos a una intervención quirúrgica transexual. Por último, se consideran aspectos pronósticos. En las publicaciones, los estudios de seguimiento tienden a mostrar que las transformaciones quirúrgicas tienen consecuencias positivas para los sujetos. En la mayoría de los casos, los transexuales están muy satisfechos con su intervención y cualquier dificultad experimentada es a menudo pasajera y desaparece en un plazo de un año después de la transformación quirúrgica. Los estudios muestran que hay menos de un 1% de arrepentimientos, y un poco más de un 1% de suicidios entre los sujetos operados. La investigación empírica no confirma la opinión de que el suicidio está fuertemente asociado con la transformación quirúrgica.
Since gender-confirming medical interventions for transgender individuals were made available, the need has emerged to identify candidates who could benefit the most from such interventions. This opened the way to the elaboration of very strict clinical guidelines for the identification of the typologies of trans individuals and for the emphasis on “differential diagnosis” between “true transsexuals” and the rest of the trans population coming to clinical attention. These guidelines set the stage for a “pathologization” of the sexual life of transgender individuals in the eyes of mental health professionals. This review is intended to offer an overview of these historical roots from which such prejudices and biases have stemmed.
Norms are considered to influence expectations toward gender-related behavior. Deviations from these norms are often perceived negatively by the social environment. The objective of this study was to investigate adults diagnosed with a Gender Identity Disorder (GID), their recalled play behavior, and peer preferences in childhood and adolescence. Differences between individuals who applied for transition from female to male (FtMs) and those who applied for transition from male to female (MtFs) and between age-of-onset subgroups were explored. Data collection took place as part of the European Network for the Investigation of Gender Incongruence. The sample consisted of N = 634 participants (mean age = 30.6) diagnosed with GID according to DSM-IV-TR who were recruited between 2007 and 2012. Participants answered two questions regarding recalled play behavior and three questions on peer preferences. Nonconforming gender expression was more frequently recalled in FtMs than MtFs. Within gender groups, individuals who were categorized as early-onset recalled nonconforming gender expression more frequently than individuals who were categorized as late-onset. The results of the study are in line with previous findings indicating different phenomenological pathways in individuals applying for gender-affirming treatment that warrant attention. Factors that are considered to impact on gender-related differences in nonconforming gender expression are discussed.
Male-to-female (MtF) transsexuals are often described as “women trapped in men’s bodies,” but there are two different types of MtF transsexuals, and this description is more applicable to one type than the other. One MtF transsexual type consists of extremely feminine men who are exclusively sexually attracted to men; they are usually referred to as homosexual MtF transsexuals. The second MtF transsexual type consists of men who are not conspicuously feminine, who are primarily sexually attracted to women, and who have a history of sexual arousal in association with cross-dressing. Transsexuals of the latter type, who are usually referred to as nonhomosexual MtF transsexuals, nevertheless feel an intense desire to have female bodies and live as women. They are perhaps better described as “men trapped in men’s bodies.” In 1989, psychologist Ray Blanchard proposed that MtF transsexuals of this second type exhibit a paraphilic sexual interest called autogynephilia: the propensity to be sexually aroused by the thought or image of oneself as a female. This book contains first-person narratives by 249 MtF transsexuals who acknowledged having experienced autogynephilia. This introductory chapter describes the research that led to the development of the concept of autogynephilia and to an understanding of its clinical manifestations.
Autogynephilia is defined as a male's propensity to be sexually aroused by the thought of himself as a female. It is the paraphilia that is theorized to underlie transvestism and some forms of male-to-female (MtF) transsexualism. Autogynephilia encompasses sexual arousal with cross-dressing and cross-gender expression that does not involve women's clothing per se. The concept of autogynephilia defines a typology of MtF transsexualism and offers a theory of motivation for one type of MtF transsexualism. Autogynephilia resembles a sexual orientation in that it involves elements of idealization and attachment as well as erotic desire. Nearly 3% of men in Western countries may experience autogynephilia; its most severe manifestation, MtF transsexualism, is rare but increasing in prevalence. Some theorists and clinicians reject the transsexual typology and theory of motivation derived from autogynephilia; their objections suggest a need for additional research. The concept of autogynephilia can assist clinicians in understanding some otherwise puzzling manifestations of nonhomosexual MtF transsexualism. Autogynephilia exemplifies an unusual paraphilic category called 'erotic target identity inversions', in which men desire to impersonate or turn their bodies into facsimiles of the persons or things to which they are sexually attracted. Copyright (C) 2011 S. Karger AG, Basel
HistoryTerminologyDiagnostic CriteriaTranssexual TypologyEpidemiologyClinical Presentation and CourseAssociated FeaturesDiagnosis and Assessment of Gender Identity DisordersTreatmentResults of Sex ReassignmentTreatment of Families of Persons with Gender Identity DisordersSummary and Conclusions
The psychological characteristics of individuals with Gender Dysphoria have recently been under scrutiny again in the discussions regarding the latest Standards of Care (SOC7) of the World Professional Association for Transgender Health, the new version of the classification system Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association, and by the preparations for the International Classification of Diseases (ICD-11) of the World Health Organization. In the central discussion whether Gender Dysphoria is a mental disorder or not, reference is often made to the level of psychopathology in individuals presenting for treatment. The current chapter provides an overview of the current literature on the psychological functioning and problems in natal male individuals with Gender Dysphoria. In the context of an increasing acceptance of Gender Dysphoria, information on the sexuality of these individuals is also slowly becoming more available. Since this information can help to further increase our knowledge on the phenomenon of Gender Dysphoria, the current chapter also includes an overview on the evolving ideas concerning sexual orientation, and a brief overview of the literature concerning the sexual functioning of natal male individuals with Gender Dysphoria before treatment.
Sex hormones, androgens in particular, direct the sexual differentiation of the brain. However, prenatal exposure to androgens appears to influence the development of masculine gender role behavior more than the development of a male gender identity. A male gender development results from a dialogue between biological, environmental and psychological factors. When these factors work, for some reason, against a male pathway, the consequence may be some or extreme (e.g. transsexualism) gender variance in behavior and/or identity.
In Japan, greater numbers of people with gender identity disorders (GID) are seeking professional help. The aim of our study is to show the clinical significance of classifying them into two subgroups when we address biological males with GID. From January 2001 to August 2009, 27 biological male patients with GID were consecutively examined at a university hospital in a major city in Japan. We formulated patients' own past history concerning their gender identity on the basis of their narratives presented in several interviews. The present study suggested that Japanese biological male patients with GID who have, since childhood, manifested a special longing for feminine clothes and behaviors, could be positioned as a "core group;" and, patients with an uncomfortable feeling about their own sex that did not appear until adolescence could be positioned as a "periphery group." As a result of psychotherapy in our samples, while the "core group" patients did not waver in their conviction that "I am a woman," the cross-gender identification eventually disappeared in the "periphery group." Identifying these two subgroups proved to be of great importance in deciding the management strategy for biological males with GID.
چکيده مقاله:
هدف : پژوهش حاضر بهعنوان بخشی از يک مطالعه وسيعتر روی نقشهای جنسيتی افراد مبتلا به اختلال هويت جنسی ش جنسی در مبتلايان و مقايسه آنان با افراد سالم بود. روش : در بررسی مقطعی حاضر، 12 مرد و 27 زن مبتلا به اختلال هويت جنسی با 81 مرد و 89 زن شاهد مقايسه شدند. گرايش جنسی افراد و انگاره فرد از هويت جنسی با دو پرسش بررسی شد. دادهها با استفاده از آزمون T ، تحليل واريانس، آزمون مجذور خی و آماره کاپا تحليل شدند. يافتهها : در گروه مردان مبتلا به GID ، يک نفر به زنان گرايش جنسی داشت و بقيه (7/91 درصد) به مردان گرايش داشتند. در گروه زنان مبتلا به GID ، فراوانی گرايش جنسی به زنان و مردان، بهترتيب، 3/96 و 7/3 درصد بود. فراوانی دگرجنسگرايی در مردان و زنان شاهد، بهترتيب 8/93 و 7/69 درصد برآورد شد. فراوانی افراد مبتلا به GID متمايل به جنسيت زيستی خود ميان مردان و زنان تفاوتی نشان نداد (05/0< p ) و همخوانی بالايی ميان جنسيت زيستی و گرايش جنسی اين افراد ديده شد (653/0= κ ، 164/0= SE ، 001/0> p ). نتيجهگيری : در بيماران ايرانی دچار اختلال هويت جنسی ( GID ) همخوانی بالايی ميان جنسيت ترجيحی و گرايش جنسی افراد ديده شد.
واژههای کلیدی: اختلال هويت جنسي؛ ملال جنسيتي؛ گرايش جنسي؛ همجنسگرايی،
This book by Anne A. Lawrence describes the feelings and behavior of autogynephilic male-to-female transsexuals in their own words.
German clinicians began describing individuals with some form of gender discomfort over 160 vears ago. This culminated with the publication of Die Transvestiten by Magnus Hirschfeld in 1910. Currently, the most commonly used terms for these conditions are transsexualism, gender dysphoia, and gender identity disorders (GID). With the publication of the 3rd edition of The Diagnostic and Statistical Manual (DSM-III) of the American Psychiatric Association in 1980, one finds mention of these GID for the first lime in a formal diagnostic classification system. These GID were further legitimized in 1987, with the publication of DSM-III-Revised. Currently, DSM-IV is under preparation by a subcommittee on GID. There is considerable controversy about revisions in terminology and classification of these GID currently under discussion. This paper also deals with the relationship between gender identity and sexual orientation. There is some evidence to suggest a correlation between age of onset of gender dysphoria and sexual orientation subsequently established. Finally, the author discusses the pros and cons of a recommendation to remove GID from DSM-IV altogether. Those in favor of such a recommendation argue that their iclusion stigmatizes gender dysphoric individuals by placing a psychiatric label on them.
Transvestic fetishism and the nonhomosexual type of male-to-female (MTF) transsexualism are closely-related entities, but the former is usually considered a paraphilic phenomenon, whereas the latter is not. I argue that it is useful for therapists to think about both entities, and the clinical spectrum to which they belong, as paraphilic phenomena. Both of these forms of nonhomosexual male transgenderism can be understood as outgrowths of autogynephilia, or paraphilic sexual arousal to the thought or image of oneself as a female. Autogynephilia resembles a sexual orientation, in that it consists of both erotic elements and elements that are not explicitly erotic. Autogynephilia plausibly explains the development of cross-gender identities in nonhomosexual transgender males. Understanding the meaning, significance and implications of autogynephilia can assist therapists in case conceptualization and can facilitate respectful, empathetic therapeutic work with nonhomosexual male transgender clients.
This study investigated why more males than females complain of dissatisfaction with their anatomical sex (gender dysphoria). New referrals to a university gender identity clinic were dichotomously classified as heterosexual or homosexual. There were 73 heterosexual and 52 homosexual males; 1 heterosexual and 71 homosexual females. The average heterosexual male was 8 years older at inception than the homosexual groups. The heterosexual males reported that their first cross-gender wishes occurred around the time they first cross-dressed, whereas the homosexual groups reported that cross-gender wishes preceded cross-dressing by 3-4 years. Some history of fetishistic arousal was acknowledged by over 80% of the heterosexual males, compared to fewer than 10% of homosexual males and no homosexual females. The results suggest that males are not differentially susceptible to gender dysphoria per se, but rather that they are differentially susceptible to one of the predisposing conditions, namely, fetishistic transvestism.
This chapter is a review of clinical and experimental studies that may suggest questions useful in research on the etiology of cross-gender identity (which is here conceived as an extreme form of masculine gender identity in females or feminine gender identity in males). The first section addresses itself to the typology of cross-gender identity and demonstrates that there are two main types, one occurring in homosexual, the other in heterosexual (or just nonhomosexual) persons. Next, the relationships among androphilia (an erotic preference for physically mature males), homosexual-type cross-gender identity, and feminine gender identity (in males) in general are explored. The second section investigates the feasibility of physiological hypotheses of homosexual cross-gender identity and discusses, in this context, relevant work on the development of gender identity in intersexes. The third section explores the relevance of animal studies to the problem of gender identity.
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.)
Our earlier Femine Gender Identity Scale for males appear to measure a strong single factor which was reliable and displayed substantial discriminant validity. However, the number of items was small and there was substantial overlap between items with respect to their meaning. In an attempt to overcome these limitations, in the present study the scale was extended and validated. Each item of the new scale differentiated among the groups in an experimental sample and, subsequently, in a cross-validation sample. A secondary finding was the significantly higher femine gender identity scores of homosexual patients over homosexual nonpatients.
An analysis of postoperative data obtained from 42 male-to-female transsexuals showed them to fall into three distinct categories: homosexual transsexuals, asexual transsexuals, and heterosexual transsexuals. Additonal data covering the areas of gender vs. sexual dysphoria, surgical details, background characteristics, sexuality-related behaviors, and postoperative adaptation further differentiated these groups and suggest that the categorization is theoretically meaningful and relevant to understanding the causes and course of the transsexual phenomenon. An extensive developmental theory is suggested to account for both differences and commonalities among the different subgroups of transsexuals, as well as among these and related groups, such as effeminate homosexuality and transvestism. The theory is sufficiently specific for making empirical predictions.
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.
Primary transsexuals are schizoid obsessive, socially withdrawn, asexual, unassertive, and out of touch with anger. Underlying this personality, they have a typical borderline syndrome characterized by separation anxiety, empty depression, sense of void, oral dependency, defective selfidentity, and impaired object relations with absence of trust and fear of intimacy. The authors' opinion, they most resemble a subgroup of the borderline syndrome which Grinker calls 'the adaptive, affectless, defended, 'as if' persons'. Unlike other borderline patients, however, primary transsexuals are distinguished by severe impairment of both core gender identity and of gender role identity from earliest childhood.
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.
Gender dysphoria syndrome (The how, what, and why o f a disease)
- N Fisk
FISK, N. (1973). Gender dysphoria syndrome (The how, what, and why o f a disease).
Proceedings of the second interdisciplinary sym-posium on gender dysphoria syndrome Palo Alto: Stanford University Press Cross-gender identity in a broader context Extension of the Gender Identity Scale for males
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- Plenum
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In D. Laub & P. Gandy (Eds.), Proceedings of the second interdisciplinary sym-posium on gender dysphoria syndrome (pp. 7-14). Palo Alto: Stanford University Press. FREUND, K. (1985). Cross-gender identity in a broader context. In B. W. Steiner (Ed.), Gender dysphoria: Development, research, management (pp. 259-324). New York: Plenum. FREUND, K., LANGEVIN, R., SATTERBERG, J., & STEINER, B. W. (1977). Extension of the Gender Identity Scale for males. Archives of Sexual Behavior, 6, 507-519.