The Case Against Autogynephilia

Abstract

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.

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The Case Against Autogynephilia
Julia M. Seranoa
a Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, California
Online publication date: 09 October 2010
To cite this Article Serano, Julia M.(2010) 'The Case Against Autogynephilia', International Journal of Transgenderism, 12:
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International Journal of Transgenderism, 12:176–187, 2010
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Taylor & Francis Group, LLC
ISSN: 1553-2739 print / 1434-4599 online
DOI: 10.1080/15532739.2010.514223
The Case Against Autogynephilia
Julia M. Serano
ABSTRACT. 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.
KEYWORDS. Autogynephilia, paraphilia, erotic target location error, transsexualism, transvestic
fetishism, transgender, gender identity, sexual orientation, cross-gender arousal, sexualization
There are few concepts within the fields of
transgender studies and human sexuality that
are more controversial than autogynephilia. The
word was coined by psychologist Ray Blanchard
in the late 1980s based on his research on trans-
gender individuals on the male-to-female (MtF)
spectrum, that is, those who are assigned a male
sex at birth but who gravitate toward female
gender identities and/or feminine gender expres-
sions. Some MtF spectrum individuals live pri-
marily as men but engage in cross-dressing on
occasion (MtF cross-dressers); others identify
and live as women, often taking steps to physi-
cally and legally transition to female (transsex-
ual women); still others may adopt alternative
transgender identities and/or find other outlets
for their cross-gender feelings. Blanchard has
(and subsequently others have) used the term
autogynephilia to describe two significantly dif-
ferent phenomena. First, it is used descriptively
to denote a type of erotic fantasy common to
Julia M. Serano, PhD, is affiliated with the Department of Molecular and Cell Biology at the University
of California, Berkeley in Berkeley, California.
Address correspondence to Julia M. Serano, 515 LSA Building (MCB #3200), Department of Molecular
and Cell Biology, University of California, Berkeley, Berkeley, CA 94720, USA. E-mail: hi@juliaserano.com
many (but not all) MtF spectrum individuals in
which they become aroused by the idea of being
or becoming women. Second, the term has been
used theoretically to describe a paraphilic model
in which the aforementioned fantasies arise as a
result of a misdirected heterosexual sex drive
(i.e., instead of or in addition to being attracted
to women, the individual becomes attracted to
the idea of becoming a woman) and once estab-
lished, such fantasies become the primary cause
of any gender dysphoria and desire to physically
transition to female that the individual might
experience (Blanchard, 1989a; this model will
be discussed in greater detail in a subsequent
section).
As others have noted, conflation between the
descriptive and theoretical definitions of auto-
gynephilia has lead to a great deal of confu-
sion in the literature on the subject (Wyndzen,
2005). For example, when an author describes
an individual as an autogynephilic transsexual,
176
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Julia M. Serano 177
are they simply stating the fact that the individ-
ual has experienced “autogynephilic” fantasies
in the past? Or are they suggesting that the in-
dividual suffers from a paraphilia and became
gender dysphoric as a result of such fantasies?
To avoid this problem, throughout this article,
I will use the term cross-gender arousal to de-
scribe sexual arousal that occurs in response to
cross-dressing or imagining oneself being or be-
coming a member of the sex other than the one
they were assigned at birth, and I will use the
term autogynephilia exclusively to denote the
paraphilic model that Blanchard and others have
forwarded.
While nobody seriously doubts the existence
of cross-gender arousal, there has been con-
siderable debate about autogynephilia. The as-
pects of the theory that have garnered the most
contention are its claims that (a) transsexual
women come in two (and only two) subtypes—
androphilic and autogynephilic and (b) the as-
sumption of causation—that a “misdirected het-
erosexual impulse” causes cross-gender arousal,
which then subsequently causes gender dyspho-
ria and a desire to transition. While numerous
critiques of the theory exist, proponents of au-
togynephilia have attempted to play down the
significance of these critiques on the basis that
they were not published in the peer-reviewed lit-
erature (Bailey & Triea, 2007; Lawrence, 2007).
Here, drawing on these previous critiques, I ar-
gue that autogynephilia theory is clearly incor-
rect. I also discuss how the typology and ter-
minology associated with the theory needlessly
sexualizes MtF spectrum people and exacerbates
the societal discrimination this group already
faces.
NOMENCLATURE
Most of the terms used in this article are
consistent with those commonly found in the
sexological literature with the following excep-
tions. Proponents of autogynephilia typically la-
bel transsexuals based upon their birth-assigned
sex (e.g., calling MtF transsexuals “male trans-
sexuals” and using male pronouns in refer-
ence to them). Because this language is mis-
leading and considered “maligning” by many
transgender people (Winters, 2008), I will in-
stead use language that affirms transsexuals’
self-identified/post-transition sex (e.g., referring
to MtF transsexuals as transsexual women and
female-to-male (FtM) transsexuals as transsex-
ual men). Since the labels homosexual and het-
erosexual become confusing when the person
in question changes his or her sex, I will use
the term androphilic to describe people who are
exclusively attracted to men, and gynephilic to
describe people exclusively attracted to women.
Also, I will be making a distinction between
gender identity (i.e., whether one identifies as or
feels that they are or should be a girl/woman or
boy/man) and gender expression (i.e., whether
one’s gender presentation, mannerisms, and in-
terests are considered feminine or masculine).
AUTOGYNEPHILIA THEORY
The theory of autogynephilia was developed
by Blanchard over a series of papers published
between 1985 and 1993. The salient points of
this work will be described here; for a more
detailed account of the concept and its history,
see Lawrence (2004) and Blanchard (2005). For
years prior to Blanchard’s work, MtF transsex-
ual candidates typically had to fit the “clas-
sic” transsexual archetype—which included be-
ing overtly feminine throughout their lives, not
exhibiting any signs of fetishism or excessive
sexual activity pre-transition, and being hetero-
sexual (i.e., androphilic) post-transition—in or-
der to qualify for sex reassignment (Meyerowitz,
2002). However, the psychologists and sexolo-
gists who serve as gatekeepers of sex reassign-
ment increasingly recognized that many of those
presenting as MtF transsexuals did not fit this
archetype, either because they experienced at-
traction toward women, were not especially fem-
inine as children or adults, and/or tended to seek
out sex reassignment much later in life after hav-
ing lived for many years as heterosexual men.
There were also indications that many in this
latter group had previously identified as cross-
dressers and/or had a history of cross-gender
arousal (reviewed in Blanchard, 1989a).
Blanchard set out to make sense of these pre-
vious findings by analyzing questionnaire data
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178 INTERNATIONAL JOURNAL OF TRANSGENDERISM
from patients that had presented at the Clarke
Institute of Psychiatry (where he worked as
a gatekeeper) over the course of many years.
Based on their self-reports, Blanchard subdi-
vided MtF transsexuals by sexual orientation
into four groups—androphilic, gynephilic, bi-
sexual, and asexual. He found that a majority of
the gynephilic (87.5%, n=16), asexual (75%,
n=12) and bisexual (65.7%, n=35) groups re-
ported 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 re-
sponded similarly (Blanchard, 1985). He also
found that the gynephilic, bisexual, and asex-
ual groups, on average, reported less recalled
childhood feminine gender expression and pre-
sented 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). Proponents of the
theory have described androphilic MtF trans-
sexuals as “extremely feminine gay men” and
suggested that they transition to female primar-
ily to attract heterosexual men (Bailey, 2003,
p. 146). In contrast, based on its association
with cross-gender arousal, Blanchard proposed
that nonandrophilic MtF transsexualism had a
distinct, paraphilic etiology. The fact that para-
philias are presumed to be male-specific (and
that Blanchard conceptualizes MtF transsexuals
as “male transsexuals”) seemed consistent with
the fact that, according to the medical litera-
ture of the time, there appeared to be no FtM
equivalent to nonandrophilic transsexualism
(Blanchard, 1989a).
While other researchers had previously
described MtF cross-gender arousal (calling it
“transvesticism” or “cross-gender fetishism”),
Blanchard reenvisioned these phenomena as
all being manifestations of “autogynephilia”
(literally, “love of oneself as a woman”). In
order to explain its prevalence in nonandrophilic
MtF transsexuals, Blanchard hypothesized
that autogynephilia arose from a “misdirected
type of heterosexual impulse, which arises
in association with normal heterosexuality
but also competes with it.” (Blanchard, 1991,
p. 241). He proposed that gynephilic MtF
transsexuals experience both autogynephilia
and “normal” attraction to women, whereas,
asexual MtF transsexuals “represent those
cases in which the autogynephilic disorder
nullifies or overshadows any erotic attraction
to women” (Blanchard, 1989a, p. 324). He also
argued that bisexuality in MtF transsexuals is
better described as “pseudobisexuality”: “The
effective erotic stimulus in these interactions
...isnotthemalephysiqueofthepartner,as it
is in true homosexual attraction, but rather the
thought of being a female, which is symbolized
in the fantasy of being penetrated by a man. For
these persons, the male sexual partner serves the
same function as women’s apparel or makeup,
namely, to aid and intensify the fantasy of being
a woman” (Blanchard, 1989a, pp. 323–324).
It should be noted that Blanchard conceptual-
izes autogynephilia as but one of several possible
“erotic target location errors,” which hypothet-
ically occur when men who have a particular
sexual object choice develop a paraphilic desire
to become that sexual object themselves (Freund
& Blanchard, 1993). The evidence forwarded to
support this theory is entirely anecdotal, consist-
ing of case histories of certain individuals who
both are pedophilic and engage in age regression
play or of individuals who are both attracted to
amputees and wish to become amputees them-
selves (Freund & Blanchard, 1993; Lawrence,
2006; for challenges to the theory as it has been
applied to people who seek out amputations,
see Brang, McGeoch, & Ramachandran, 2008;
Sullivan, 2008). Autogynephilia is the one
proposed “erotic target location error” for which
the most empirical data has been generated and,
as such, it will be the sole focus of this review.
While Blanchard authored numerous papers
on autogynephilia between 1985 and 1993, the
theory did not garner much attention until the
early 2000s when Anne Lawrence and J. Michael
Bailey began to publicly advocate his theo-
ries. Their writings—particularly Bailey’s book,
The Man Who Would Be Queen: The Science
of Gender Bending and Transsexualism—have
generated controversy both in the transgen-
der community and within the field of sexol-
ogy (for a variety of perspectives on this, see
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Julia M. Serano 179
Transgender Tapestry, 2000–2001, issues 92–
94, and Archives of Sexual Behavior, 2008, vol.
37, no. 3).
In recent papers, proponents of autogy-
nephilia have argued that the theory should be
accepted because it has more explanatory po-
tential than what they call the “feminine essence
narrative”—that is, the idea forwarded by some
transsexuals that they are rather uncomplicat-
edly “women trapped in men’s bodies” (Bailey
& Triea, 2007; Blanchard, 2008). According to
this argument, while the feminine essence nar-
rative may hold true for androphilic transsexual
women (whose feminine gender expression and
attraction to men allows them to come off as
sufficiently “womanly”), nonandrophilic and/or
nonfeminine transsexual women fail to achieve
conventional ideals of womanhood and, there-
fore, must comprise a different category and
arise from a distinct etiology. However, pitting
autogynephilia against an overly simplistic
“feminine essence narrative” ignores a more
nuanced view that I will refer to here as the
gender variance model, which holds that gender
identity, gender expression, sexual orientation,
and physical sex are largely separable traits that
may tend to correlate in the general population
but do not all necessarily align in the same
direction within any given individual (Brill
& Pepper, 2008; Lev, 2004; Serano, 2007).
According to this model, transsexuals share the
experience of discordance between their gender
identity and physical sex (which leads to gender
dysphoria and a desire to physically transition)
but are expected to differ with respect to their
gender expression and sexual orientation (just
as nontranssexuals vary in these aspects).
This variation in gender expression and sexual
orientation may lead individuals to follow
different transgender trajectories and develop
different sexual histories. If autogynephilia is to
be taken seriously as a theory, it should explain
the observed differences in MtF transsexuals at
least as well as (if not better than) the gender
variance model.
IS AUTOGYNEPHILIA’S
TWO-SUBTYPE TAXONOMY VALID?
While Blanchard published numerous arti-
cles on autogynephilia, the bulk of the empir-
ical data supporting the model can be found
in three papers. Two of these papers pro-
vide 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).
The experiments found in these three papers
were conducted in the 1980s on the same, or
largely overlapping, populations (i.e., clients
at the Clarke Institute). Wyndzen (2003) has
pointed out numerous shortcomings of this
work; these, in part, include (a) that Blanchard’s
subtypes were not empirically derived but rather
stemmed from his initial grouping of individuals
based on their sexual orientation, thus, “begging
the question” that transsexuals fall into subtypes
based on their sexual orientation; (b) that he
did not include nontranssexual female control
groups; (c) that Blanchard relied exclusively on
clinical samples that may not accurately reflect
the greater nonclinical transgender population
(c.f., Hooker, 1957); and (d) that his results had
not been replicated. Indeed, Blanchard himself
described his results as “provisional” and stated
that “the present findings, therefore, need repli-
cation” (Blanchard, 1989b, p. 620).
Since Wyndzen’s critique, three papers have
been published that have partially replicated
some of Blanchard’s findings while calling oth-
ers into question. Smith, van Goozen, Kupier,
and Cohen-Kettenis (2005) tested a number of
psychological, sexual, and gender-related vari-
ables in both transsexual women and transsexual
men. They found statistically significant differ-
ences between “homosexual” (i.e., attracted to
one’s birth-assigned sex) and “nonhomosexual”
transsexuals on both the MtF and FtM spec-
trums. For example, androphilic MtF and gy-
nephilic FtM individuals were generally found
to exhibit more cross-gender behavior as chil-
dren and applied for sex reassignment ear-
lier than their nonandrophilic MtF and nongy-
nephilic FtM counterparts, respectively. Smith
et al. (2005) also found that 53.8% of their
nonandrophilic and 29.5% of their androphilic
MtF subjects reported having experienced
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180 INTERNATIONAL JOURNAL OF TRANSGENDERISM
cross-gender arousal (both these percentages are
significantly higher than those reported by ei-
ther FtM group). While this suggests that cross-
gender arousal may be more common in the
nonandrophilic MtF population, the difference
between these groups is not nearly as pro-
nounced as Blanchard claimed and does not sup-
port his contention that cross-gender arousal is
strictly associated with nonandrophilic (but not
androphilic) MtF transsexualism.
This study is also one of several that indirectly
bring into question the necessity for evoking
paraphilia as a separate cause of gender dyspho-
ria 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., nongy-
nephilic transsexual men) did not exist or were
merely anomalous (Blanchard, 1988, 1989a).
It turns out, however, that nongynephilic FtM
transsexuals are not nearly as rare as previously
claimed (Bockting et al., 2009). The simplest ex-
planation for this is that neither nongynephilic
FtM nor nonandrophilic MtF transsexualism are
paraphilic but, rather, both occur because gen-
der identity and sexual orientation are separable
traits. Additionally, while Smith et al. (2005)
found that their “homosexual” and “nonhomo-
sexual” groups differed on several traits, these
groups did not vary with regards to the intensity
of their gender dysphoria and body dissatisfac-
tion (a similar result was recently obtained by
Deogracias et al., 2007). Together, these find-
ings are far more consistent with a gender vari-
ance model of transsexualism than with autogy-
nephilia theory.
A more recent attempt to test some of Blan-
chard’s findings can be found in Veale, Clarke,
and Lomax (2008), which examined several
aspects of MtF sexuality. This study is no-
table in that it avoids several of the previ-
ously mentioned methodological shortcomings
of Blanchard’s work. First, a nonclinical MtF
population (recruited primarily via the Inter-
net) was studied—such a group would be ex-
pected to give a more accurate account than
Blanchard’s research subjects, as their answers
were anonymous and could not be used to
deny them the means to transition. Second,
they used a control group of nontranssexual
women. Third, instead of dividing MtF trans-
sexuals into groups based on their sexual ori-
entation (as previous studies have done), they
categorized individuals as either autogynephilic
or nonautogynephilic based on their responses
to four surveys, including Blanchard’s Core Au-
togynephilia and Autogynephilic Interpersonal
Fantasy scales. The authors explain that this
categorization scheme was empirically derived
based on their own taxometric analysis (Veale
et al., 2008).
The results of Veale et al. (2008) supports
some of Blanchard’s claims. For example,
transsexuals in the autogynephilic group first
experienced a desire to change their sex signifi-
cantly later than those in the nonautogynephilic
group. The authors also found that recalled
childhood femininity correlated with attraction
to males. However, what is most striking about
their results is that their autogynephilic and non-
autogynephilic groups did not segregate along
lines of sexual orientation. For example, both
autogynephilic and nonautogynephilic groups
scored roughly equal on attraction to the male
physique, and 68% of the nonautogynephilic
group scored the highest possible gynephilic
score. Asexual individuals in their study fell
mostly in the nonautogynephilic group. They
also found that attraction to the male physique
highly correlated with sexual attraction to males
in MtF bisexuals—this contradicts Blanchard’s
claim that individuals in this group are “pseu-
dobisexuals” who do not experience genuine at-
traction to men. Together, these results strongly
challenge autogynephilia theory’s claim that
nonandrophilic MtF transsexualism arises from
a misdirected heterosexual impulse and is nec-
essarily associated with cross-gender arousal.
Another recent study conducted by Nuttbrock
et al. (2009) examined the frequency of cross-
gender arousal in a nonclinical sample of 571
MtF transgender individuals living in the New
York City metropolitan area (nontranssexual fe-
male controls were not used). The sample in
the study by Nuttbrock et al. (2009) was sig-
nificantly more diverse with regard to age and
ethnicity than the population Blanchard stud-
ied back in the 1980s. Their results, like those
of Smith et al. (2005), revealed a correlation
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Julia M. Serano 181
between cross-gender arousal and sexual orien-
tation but one that was not deterministic, as 23%
of the androphilic subjects experienced cross-
gender arousal, while 27% of the nonandrophilic
group did not. Furthermore, within a given sex-
ual orientation, the incidence of cross-gender
arousal was significantly higher in Whites com-
pared with non-Whites, and in older subjects
compared with younger subjects. The reduced
levels of cross-gender arousal in younger sub-
jects led the authors to suggest that cross-
gender arousal “may be a historically fading
phenomenon.” Finally, the authors also found
that cross-gender arousal correlated with gy-
nephilia in a linear (rather than nonmonotonic)
fashion. This finding challenges Blanchard’s as-
sertion that, in nonandrophilic MtF individuals,
cross-gender arousal competes with “normal” at-
traction to women (Blanchard, 1991, 1992).
The three studies I have just described
provide evidence that there are some significant
differences in gender expression (and perhaps
other traits) between MtF transsexuals of
differing sexual orientations; similar differences
have been reported between heterosexual and
homosexual subjects who are not transsexual (re-
viewed in Lippa, 2005). Thus, these differences
are most likely related to the subjects’ differing
sexual orientations rather than reflecting under-
lying transsexual subtypes. Furthermore, none of
these studies supports Blanchard’s contention of
a strict association between cross-gender arousal
and nonandrophilic MtF transsexualism. These
results are corroborated by the opinions of nu-
merous psychologists and sexologists who work
with trans-clients who have gone on record to
say that they do not believe that MtF transsexuals
neatly fall into two discrete classes (Bockting,
2005; Gooren, 2006; Lane, 2008; Moser, 2008),
and by other research studies (including Blan-
chard’s own work) that consistently demonstrate
that a significant number of androphilic MtF
transsexuals experience cross-gender arousal,
while many nonandrophilic MtF transsexuals
do not (reviewed in Lawrence, 2005).
One of the most troubling aspects regarding
autogynephilia is that proponents of the theory
have consistently tried to dismiss the afore-
mentioned exceptions as being the result of
misreporting on the part of research subjects.
Notably, it is always those transsexuals who
are constructed as “autogynephiles” that are
accused of either lying about their sexual
orientation, or of supposedly denying their
experiences with cross-gender arousal; in
contrast, the reports of those who neatly fit the
“androphile” archetype are never questioned
(Bailey, 2003; Bailey & Triea, 2007; Blanchard,
1985; Blanchard, Clemmensen, & Steiner, 1987;
Lawrence, 2004; Lawrence, 2008). This double
standard is not only illogical (as someone who
wished to appear like the “classic” transsexual
stereotype would likely deny both attraction
to women and cross-gender arousal), but it is
tantamount to hand-picking which evidence
counts and which does not based upon how
well it conforms to the model. Furthermore, the
evidence cited to support these accusations of
misreporting is far from definitive and open to
alternative interpretations (Wyndzen, 2005). If
proponents of autogynephilia insist that every
exception to the model is due to misreporting,
then autogynephilia theory must be rejected on
the grounds that it is unfalsifiable and therefore
unscientific. If, on the other hand, we accept
that these exceptions are legitimate, then it is
clear that autogynephilia theory’s two-subtype
taxonomy does not hold true.
CORRELATION DOES NOT IMPLY
CAUSATION
Blanchard’s model makes two etiological
claims. The first is that cross-gender arousal
arises from a “misdirected heterosexual im-
pulse”; this claim was shown to be highly
suspect in the previous section. The second
claim—that cross-gender arousal causes gender
dysphoria and a desire to transition to female
in nonandrophilic MtF transsexuals—is based
solely on Blanchard’s correlations and his anec-
dotal theory of “erotic target location errors.” No
hard evidence has been forwarded to establish
or support this proposed causal relationship. In
fact, in the original papers in which Blanchard
first developed and tested his theory of auto-
gynephilia (Blanchard, 1989a, 1989b, 1991,
1992), there is no exploration or even discussion
of the possibility that cross-gender arousal may
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182 INTERNATIONAL JOURNAL OF TRANSGENDERISM
be an effect of gender dysphoria (rather than its
cause) or that both traits might simply correlate
in nonandrophilic MtF individuals for some
other reason. This oversight is surprising, given
that Blanchard’s own research provides several
lines of evidence to indicate that the causal
relationship he proposes does not hold true.
First, there are the previously discussed ex-
ceptions to the two-subtype taxonomy. Any-
where from 10% to 36% of androphilic MtF
transsexuals experience cross-gender arousal
(reviewed in Lawrence, 2005). If one discounts
accusations that all of these individuals are mis-
reporting their experiences, then there appear to
be only two other potential explanations. The
first is that cross-gender arousal does cause
transsexualism in this group—this would un-
dermine Blanchard’s contention that androphilic
and nonandrophilic MtF transsexualism neces-
sarily have distinct etiologies. The second, and
more parsimonious, explanation is that cross-
gender arousal does not cause transsexualism
in these individuals—this would suggest that
cross-gender arousal might not cause transsex-
ualism in the nonandrophilic MtF group either.
The causal relationship forwarded by Blanchard
is also brought into question by the fact that
many nonandrophilic MtF transsexuals never
experience cross-gender arousal. This demon-
strates that the assumption of causation is false
in, at a bare minimum, these individuals. This
fact appears incompatible with autogynephilia
theory, as it seemingly creates a third subtype
of MtF transsexual that now requires expla-
nation: nonautogynephilic, nonandrophilic MtF
transsexuals.
Second, the presumption of causality is
challenged by the fact that many MtF spectrum
people who experience cross-gender arousal find
that it is merely a passing phase rather than cen-
tral to their transgender experience. For instance,
transsexual women typically experience a sharp
decrease in cross-gender arousal after transition
(Lawrence, 2005). While one could argue that
this reduction might simply be a by-product of
having lower androgen levels, some transsexuals
experience this reduction in cross-gender arousal
prior to hormone therapy and orchiectomy
(Serano, 2007). Further, many MtF cross-
dressers who have not taken steps toward
physical transition also experience a decrease
in cross-gender arousal over time (Buhrich
& Beaumont, 1981; Buhrich & McConaghy,
1977a, 1977b; Doorn, Poortinga, & Verschoor,
1994; Ovesey & Person, 1976). While early
explorations of feminine clothing and thoughts
of female embodiment may be highly arousing
(perhaps related to the sexual symbolism
associated with femaleness and femininity
in our culture), this sexual charge wanes for
many MtF cross-dressers and pretransition
transsexuals as they begin to interact socially
in the feminine role, to develop a conscious
female identity, and/or to view their transgender
inclinations as authentic and nothing to be
ashamed of (Doorn et al., 1994; Serano, 2007).
There is agreement in the medical literature that
paraphilias tend to be “chronic and lifelong,”
and persist until one’s sex drive diminishes with
advancing age (American Psychiatric Associa-
tion, 2000, p. 568). The fact that many pre- and
nontransition MtF spectrum people who are not
especially old, and who continue to be sexually
active, nevertheless, experience a large decrease
in cross-gender arousal over time, strongly
suggests that cross-gender arousal is not the
driving force behind their transgenderism.
It should be noted that Blanchard and oth-
ers have tried to explain away this flaw in the
theory by arguing that autogynephilia is both a
paraphilia and a sexual orientation (Blanchard,
1991; Lawrence. 2007). According to this idea,
“autogynephiles” who come to identify as fe-
male have developed a “pair-bond” with their
female selves, and the reduction in cross-gender
arousal they experience is akin to how long-term
couples tend to become less sexually active with
one another over time. This explanation is quite a
stretch, as there is no biological evidence to sug-
gest that humans or other animals are capable of
pair-bonding with themselves and/or their own
physically-sexed bodies. Furthermore, the term
pair-bonding has traditionally been used to de-
scribe monogamous pairings. The fact that many
MtF cross-dressers and nonandrophilic transsex-
ual women continue to engage in relationships
with other people after experiencing this sharp
decrease in cross-gender arousal strongly sug-
gests that they are not pair-bonded to their female
selves. It is far more parsimonious to suggest that
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Julia M. Serano 183
cross-gender arousal is an effect of, or merely
correlates with, MtF transgenderism (especially
in its earliest stages) rather than being its cause.
The third and perhaps most damaging find-
ing for the presumption of causality is that many
nonandrophilic MtF individuals report that they
experienced an awareness of wanting to be fe-
male long before they ever experienced cross-
gender arousal. For example, in Bailey’s book,
the three individuals whom he offers as typical
examples of autogynephiles all recalled experi-
encing cross-gender feelings as young children
prior to ever experiencing cross-gender arousal
(Bailey, 2003, pp. 151–152, 160, 167). Simi-
larly, Blanchard has repeatedly forwarded his
case study of Philip as a quintessential exam-
ple of autogynephilia (Blanchard, 1991). Yet
according to his own reports, Philip describes
having experienced cross-gender feelings at the
age of 6, well before he first experienced cross-
gender arousal during puberty at the age of 12
or 13. There is a general consensus that cross-
gender arousal typically first occurs during or
after the onset of puberty; this is consistent with
the fact that people, in general, typically experi-
ence their first sexual fantasies between the ages
of 11 to 13 (reviewed in Leitenberg & Henning,
1995). Since Blanchard et al. (1987) reported
that the average age that their nonandrophilic
MtF research subjects first recognized their de-
sire to be female was 9.82 years, this suggests
that the majority of these individuals exhibited
signs of cross-gender identity prior to experi-
encing cross-gender arousal. Similarly, Buhrich
and Beaumont (1981) reported that nearly 50%
of the 212 MtF cross-dressers they studied began
cross-dressing prior to ever having experienced
cross-gender arousal. Together, these findings
indicate that cross-gender arousal does not cause
transsexualism or cross-gender expression in the
majority of nonandrophilic MtF individuals.
Aside from accusations of misreporting, three
responses have been offered by proponents of
autogynephilia to counter the evidence that
cross-gender arousal is not a cause of MtF
transsexualism. First, Lawrence (2007) cites two
rare cases of male children who precociously
experienced erections in response to cross-
dressing as young children in order to suggest
that cross-gender arousal may be the cause
of nonandrophilic MtF transsexualism even
when the individual in question experienced an
early awareness of wanting to be female. To
evoke these highly atypical cases to account for
the rather high percentage of nonandrophilic
transsexual women who experience a desire to
be female prior to puberty seems unreasonable.
Second, Lawrence has broadened Blanchard’s
“erotic target location error” theory to include
romantic love (Lawrence, 2007). Having done
this, she then argues that those nonandrophilic
MtF transsexuals who have not experienced
cross-gender arousal, or who experienced
such arousal only after becoming aware of
their desire to be female, may nevertheless be
motivated by a romantic-love version of auto-
gynephilia. The notion that individuals who do
not experience erotic arousal to some stimulus
might nevertheless be described as having a
paraphilic relationship with that same stimulus
has extraordinary ramifications. By the same
reasoning, men who love their own children, but
who are not sexually aroused by them, could
nevertheless be said to experience pedophilia.
Given the lack of empirical evidence to support
this autogynephilia-as-romantic-love hypothe-
sis, Lawrence’s argument is not very persuasive.
Third, Lawrence has suggested that the afore-
mentioned exceptions do not seriously challenge
autogynephilia because it is just a model: “Blan-
chard proposed that transsexuals with a history
of autogynephilic eroticism behave as though
they were motivated by the desire to actual-
ize their paraphilic fantasy of feminizing their
bodies” (Lawrence, 2004, p. 73). This is not
quite true, however, as Blanchard clearly and
repeatedly claimed that “autogynephilia” was
both a paraphilia and the cause of nonandrophilic
MtF transsexualism (Blanchard, 1989a, 1989b,
1991). As Wyndzen (2003) points out, “His
causal claims are what allows him to form cat-
egories of transsexuals based on sexual orienta-
tion.” Even Bailey, a proponent of Blanchard’s
model, has argued that “distinguishing ‘homo-
sexual,’ ‘heterosexual,’ ‘bisexual,’ and ‘asexual’
transsexuals diagnostically makes sense only
if the different types have fundamentally dif-
ferent causes. Otherwise, why not distinguish
‘tall,’ ‘medium-sized,’ and ‘short’ transsexuals,
or ‘blonde’ and ‘brunette’ subtypes?” (Bailey,
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184 INTERNATIONAL JOURNAL OF TRANSGENDERISM
2003, p. 162). As the results summarized in this
section show, cross-gender arousal cannot be
the cause of transsexualism in the majority of
nonandrophilic transsexual women. Further-
more, the existing evidence is far more consis-
tent with the notion that cross-gender arousal
is an effect of, or merely correlates with, MtF
transsexualism, rather than being its cause.
WHAT EXACTLY ARE
“AUTOGYNEPHILIC” FANTASIES?
While autogynephilia clearly does not have
sufficient explanatory power as a theory of trans-
sexual etiology and taxonomy, one might ask
whether the alternate meaning of the term (i.e.,
to denote fantasies or arousal centered on the
idea of being or becoming female) has any merit.
It should be noted that Blanchard conceptual-
ized autogynephilia very broadly to describe a
wide range of sexual fantasies and behaviors
(e.g., arousal in response to cross-dressing, fan-
tasies of having a female body, fantasies of be-
ing sexually appreciated as a woman by a man,
and imagining oneself as a woman while en-
gaging in sex with a partner; Blanchard, 1989a,
1991). While relatively few transsexual men re-
port arousal in response to wearing male-typical
clothing (Smith et al., 2005), many have pre-
transition fantasies where they imagine them-
selves as physically male while engaging in
sex with a partner or become aroused by the
prospect of being sexually appreciated as a man
by others (Green, 2001). It makes sense that
pretransition transsexuals (whose gender iden-
tity is discordant with their physical sex) might
imagine themselves inhabiting the “right” body
in their sexual fantasies and during their sex-
ual experiences with other people. Indeed, crit-
ics of autogynephilia theory have argued that
such sex embodiment fantasies appear to be
an obvious coping mechanism for pretransition
transsexuals (e.g., Barnes, 2001; Gooren, 2006;
Serano, 2007). This coping mechanism expla-
nation would also help to account for the sharp
decrease in such fantasies that occurs in trans-
sexual women after transition (Lawrence, 2005).
We also live in a heterosexual-male-centric
culture, where female bodies and feminine
gender expression and presentation are rou-
tinely objectified and sexualized to a far greater
extent than their male/masculine counterparts
(American Psychological Association Task
Force, 2007). This might account for why
both androphilic and nonandrophilic MtF
transsexuals experience far higher levels of
arousal in response to cross-dressing than their
FtM counterparts (Smith et al., 2005). This
would also explain why a significant percentage
of nontranssexual women who have been
administered questionnaires similar, or virtually
identical, to Blanchard’s Core Autogynephilia
and Autogynephilic Interpersonal Fantasy
surveys display autogynephilia (Moser, 2009a;
Veale et al., 2008). The fact that nontranssexual
women exhibit patterns of arousal similar to
those seen in transsexual women indicate that
autogynephilic fantasies are neither transsexual-
specific nor paraphilic (as paraphilias are
purportedly extremely rare or nonexistent in na-
tal women; American Psychiatric Association,
2000, p. 568). Given this, there is no valid reason
why Blanchard’s term autogynephilia should be
used to single out MtF transsexual’s fantasies
and desires. In fact, because autogynephilia has
repeatedly been described as a paraphilia and
a cause of transsexualism in the sexological
literature, its usage from this point forward
would be both misleading and maligning to
the majority of transsexual women who find
the term to be unnecessarily stigmatizing.
The use of more neutral language to describe
these phenomena (e.g., cross-gender arousal,
female/feminine embodiment fantasies) would
be more respectful and accurate.
AUTOGYNEPHILIA THEORY AND
TERMINOLOGY ARE NEEDLESSLY
STIGMATIZING
Many transgender activists and advocates feel
that autogynephilia theory (and the terminology
associated with it) is not merely incorrect, but
unnecessarily stigmatizing. To understand why
this is, it must first be acknowledged that trans-
sexuals’ gender identities and gendered experi-
ences are deemed to be less socially and legally
valid than those of nontranssexuals, and that
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Julia M. Serano 185
much of the societal discrimination that trans-
sexuals face is predicated on this double stan-
dard (Currah, Juang, & Minter, 2006; Serano,
2007). Furthermore, those who wish to invali-
date transsexual perspectives typically do so by
claiming that transsexuals are mentally ill, in-
competent, or delusional and, therefore, need
not be taken seriously (Winters, 2008; Serano,
2009). Autogynephilia theory exacerbates these
problems in several ways. First, the theory con-
ceptualizes and describes transsexual women as
either homosexual or autogynephilic men, thus
undermining their female gender identities and
lived experiences as women. Second, the the-
ory is extremely pathologizing, especially for
those transsexual women who are classified as
autogynephiles and, thus, lumped into a psy-
chiatric category (paraphilia) that includes sev-
eral criminal sexual offenses (e.g., pedophilia,
frotteurism, and exhibitionism) as well as other
generally consensual but unnecessarily stigma-
tized sexual behaviors. Pathologizing consen-
sual, noncriminal behaviors as “paraphilic” can
lead to considerable discrimination against in-
dividuals who express them (see Moser, 2008,
2009b). Third, the sexological literature about
autogynephilia is riddled with claims that nonan-
drophilic transsexual women routinely misrep-
resent themselves and are inherently unreliable
in their self-reports. Such claims give scientific
credence to the stereotype that transsexuals are
purposefully deceptive, which is often used to
justify violence against transgender people. For
instance, the men who murdered transgender
woman Gwen Araujo tried to justify that act by
claiming that they were victims of Araujo’s “sex-
ual deception”; similar claims have been made
by other perpetrators of transphobic violence
(Bettcher, 2007). The stereotype that transsex-
uals purposefully misrepresent themselves also
feeds into the common presumption that what
transsexuals say about their own gender identi-
ties and experiences need not be taken seriously.
MtF spectrum people are also highly sexu-
alized in our culture (i.e., others tend to focus
solely on their sexual bodies or behaviors, to the
exclusion of other characteristics). For many
decades, the media has tended to depict trans-
sexual women’s bodies and experiences in a
titillating, even lurid, fashion, and fictional MtF
characters are routinely portrayed as being sex-
ually deceptive, sexually promiscuous, sexually
deviant, and sexually motivated in their transi-
tions (Meyerowitz, 2002; Serano, 2007, 2009).
Autogynephilia theory reduces MtF spectrum
people to sexual motivation—in other words, it
seems to both draw from, and to reinforce, these
disparaging media stereotypes. Studies have
shown that individuals who are sexualized are
seen as less than human, are not treated with em-
pathy, are not taken as seriously, and are seen as
less competent and intelligent than individuals
who are not sexualized (reviewed in American
Psychological Association Task Force, 2007).
Given this, it is no surprise that those who
wish to demean, sensationalize, or discriminate
against MtF transsexuals often cite autogy-
nephilia theory in their attempts to invalidate
transsexual women’s identities (e.g., Jeffreys,
2005; O’Leary, 2009; Wilkinson, 2006).
To put this sexualization in perspective, con-
sider the following analogy: Many natal women
have sexual fantasies about being raped (re-
viewed in Leitenberg & Henning, 1995). It is
one thing to respectfully attempt to explore and
understand such rape fantasies. It would be an
entirely different thing to insist that there are
two subtypes of women—those who have rape
fantasies and those who do not; to use the label
“autoraptophiles” when describing women who
have such fantasies and to insist that they are pri-
marily motivated by their desire to be raped; to
include “autoraptophilia” as a modifier in the Di-
agnostic and Statistical Manual of Mental Dis-
orders; and to encourage the lay public to ac-
tively distinguish between those women who are
“autoraptophiles” and those who are not. Such
actions would undoubtedly have a severe, nega-
tive impact on women (who are already routinely
sexualized and marginalized in our culture). Yet,
proponents of autogynephilia have argued that
transsexual women should be viewed and treated
in an analogous manner. Such a view would
surely add to the sexualization and discrimina-
tion that MtF spectrum people already face and
would potentially jeopardize lesbian-, bisexual-,
and asexual-identified transsexual women’s ac-
cess to medical and legal sex reassignment.
In summary, as a theory of transsexual eti-
ology and taxonomy, autogynephilia seems to
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186 INTERNATIONAL JOURNAL OF TRANSGENDERISM
have little merit. For this reason, and because
its terminology is especially maligning to MtF
spectrum people, it is recommended that auto-
gynephilia theory (and the language associated
with it) should be avoided in favor of more ac-
curate (and less stigmatizing) terminology. Like
all human beings, MtF spectrum people have
rich and diverse fantasy lives. Future studies
that seek to understand the phenomena of cross-
gender arousal, or female/feminine embodiment
fantasies, should be conducted in a manner that
is respectful of this diversity, deferential to what
MtF spectrum individuals say about their own
experiences, and careful not to needlessly exac-
erbate the nonconsensual sexualization that this
population already faces in society.
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