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Identity-Defense Model of Gender-Variant Development


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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.
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In: International Journal of Transgenderism, in press.
The original publication is available at
1 To whom correspondence should be addressed at School of Psychology, Massey University,
Auckland Campus, Private Bag 102- 904, North Shore Mail Centre, Auckland 0745, New
Zealand; e-mail:
JaimieF.Veale,M.A.1, Dave E. Clarke, Ph.D.
School of Psychology, Massey University, Albany Campus, New Zealand.
Terri C. Lomax, Ph.D.
Independent researcher, Wellington, New Zealand.
This article presents a comprehensive model to explain the development of the various
manifestations of gender-variance amongst birth-assigned males and females. As a
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-Defence 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 defence mechanisms are used to repress the gender-variance. If defence mechanisms
are used, then the resultant outcome is either a non-classical transsexual or cross-dresser,
depending on the degree of gender-variance. If defence 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) Exotic Becomes Erotic developmental theory of sexual orientation.
KEY WORDS: transgender; transsexual; sexuality; crossdressers; gender identity
development; sexuality development; cross-gender eroticism; transvestism; drag.
This article introduces the Identity-Defence Model of Gender-Variance Development,
which designed to explain the development of various forms of gender-variance in Western
Jaimie Veale, Terri Lomax, and Dave Clarke 2
societies among both birth-assigned males and females. In explaining the model we refer to
gender-variant identity which we define as a subjective sense of not belonging completely to
the gender of one’s anatomic sex (derived from Docter 1988, p. 201). We use gender-
variance to refer to the behavioural expression of this identity. The terms transmen and
transwomen are used to refer to female-to-male and male-to-female transsexuals respectively.
These persons have a sustained gender identity that is discrepant with their birth-assigned sex
along with a desire to alter their bodily appearance towards that of the opposite sex (Buhrich
& McConaghy, 1978). The term drag artist will refer to those persons who dress in drag as
the opposite birth-assigned sex for the purposes of performing or entertaining. These persons
are usually sexually attracted to the same birth-assigned sex (Schneider et al., 2006). The
term cross-dresser will refer to those people who enjoy wearing the clothing that is
considered by society to be of the opposite sex. These persons are usually sexually attracted
to the opposite sex, and this definition does not include those persons who cross-dress for the
purposes of performing. These definitions of drag artists and cross-dressers exclude those
persons who are also transsexual. Although we prefer the term cross-dresser, the term
transvestite is used when reviewing previous research that uses this terminology.
To give a background to this area, two important previous theories of gender-variance
development are described before the Identity-Defence Model is introduced. Although these
two theories were only designed to include the development of transwomen, an
understanding of them gives the reader a basic grounding in concepts used in the Identity-
Defence Model.
Docter (1988) distinguished between primary and secondary transsexualism among
transwomen. He believed primary transsexualism involves lifelong feelings of gender
dysphoria, beginning from early childhood. According to Docter, these individuals are
generally sexually attracted to males (androphilic) from an early age, have more difficulty
functioning in traditionally “masculine” roles, and do not report a history of sexual arousal
associated with cross-dressing. Docter described secondary transsexuals as typically
functioning as cross-dressers and making an attempt to live in the male gender role prior to
living in the female role, which usually results in them undergoing transition later in life.
Identity-Defence Model of Gender-Variant Development 3
They also tend to be sexually attracted to females (gynephilic), and show a history of sexual
arousal associated with cross-dressing.
Docter (1988) provided a developmental theory accounting for both transvestism and
secondary transsexualism. He proposed three antecedent developmental factors that
predispose a birth-assigned male to develop transvestism. Firstly, young males are given
strict boundaries in terms of gender-appropriate behaviour and clothing, which can lead to a
curiosity and fascination with the forbidden, and result in an erotic component. Gender envy
might also develop as a result of the stresses of growing up as a boy and seeing girls having
things much easier, being beautiful, and receiving more love and security. Finally, Docter
saw inhibitions about sexual relationships with girls during adolescence as a precursor to
fetishism. Docter noted that once transvestism develops, the sexual arousal experienced in
adolescence is extremely reinforcing, even without orgasm. The “relaxing” and “calming”
effect reported by transvestites when cross-dressed may also be reinforcing. Docter’s theory
states that once independence from parental supervision occurs a gender-variant identity
develops (for example, the development of a feminine name), and this identity is either
integrated into the primary (male) self-system when persons are content with a dual identity
as is the case with cross-dressers, or causes an upheaval of the primary self to become the
dominant identity as is the case with secondary transsexuals. Thus only some of those who
Docter defined as transvestites/cross-dressers become secondary transsexuals.
In explaining the Identity-Defence Model, we will follow LeVay and Valente (2006) in
using the terms “classical” and “non-classical” transsexualism in place of primary and
secondary transsexualism respectively because we believe these terms imply less of a
hierarchy between different transsexual types.
Blanchard (1989) introduced the concept of autogynephilia, which he used to refer to “a
male’s propensity to be sexually aroused by the thought of himself as a female” (p. 616). This
concept underlies Blanchard’s hypothesis that there are two distinctive manifestations of
transsexualism in transwomen: “homosexual” and “autogynephilic.” These are similar to
Docter’s primary/secondary transsexual typology; however Blanchard gave more emphasis to
the sexual motivations of transwomen. According to Blanchard, gender dysphoria among
birth-assigned males who are non-androphilic occurs as a result of autogynephilia, and
autogynephilic transwomen are motivated by their sexuality to transition.
Jaimie Veale, Terri Lomax, and Dave Clarke 4
Blanchard gave little detail about what motivates “homosexual” (the term androphilic
is preferred here) transwomen to transition. However, it has been theorised that this group
develops femininity that is usually associated with homosexual males. This femininity is
more marked in androphilic MF transsexuals than homosexual males. It has been noted that
these individuals often have a difficult time as very effeminate homosexual males “socially,
romantically, and sexually, and their transition appears to be largely motivated by a desire to
improve their lives in these domains” (see also Bailey, 2003; Bailey & Triea, 2007, p. 524).
Similarly, Lawrence (2009) conceptualised androphilic MF transsexuals as “the most
feminine of gay men, persons who are so naturally feminine that it is easier and more
satisfying for them to live in the world as women than as men” (p. 199). In accordance with
this proposal, one study has found that androphilic MF transsexuals were subjectively
evaluated to have a physical appearance that more closely matched their gender identity than
those who were not exclusively androphilic (Y. L. S. Smith, van Goozen, Kuiper, & Cohen-
Kettenis, 2005b).
In terms of the etiology of this femininity, there are theories of childhood gender-
variance development, which, given that childhood gender-variance is a component of
Blanchard’s androphilic transsexualism, may have relevance here (Coates, Friedman, &
Wolfe, 1991; Zucker & Bradley, 1995). These theories propose an interaction between
biological determining a child’s temperament and psychodynamic factors, including parental
psychopathology and marital discord.
Blanchard believed that there is much commonality between autogynephilic
transwomen and transvestites. Blanchard’s autogynephilia concept, however, is broader than
transvestism: it includes sexual fantasies in which the wearing of women’s apparel is less
important or even absent altogether. For example, the preferred fantasy of many
autogynephilic transwomen is simply the mental image of themselves with a nude female
body (Blanchard, 1993).
Those of Blanchard’s second type, autogynephilic transsexuals, develop an error in
erotic target localisation, which means that they locate their erotic target (towards women) on
themselves rather than on other people. This, Blanchard believed is the result of a failure of
some developmental process that keeps “normal” heterosexual learning on target, possibly by
biasing sexual arousal to external instead of internal stimuli (Blanchard, 1991). When this
development fails, a person acquires sexual fantasies of themselves having some or all
attributes of the desired object. In the case of transvestism, individuals become attracted to
particular garments rather the parts of the female body that the garment is worn over (female
Identity-Defence Model of Gender-Variant Development 5
underwear and brassieres are the most striking examples here). In the case of autogynephilia,
the desired object is the female physique, and the individual in some way locates these on
their own body (Blanchard, 1991).
Blanchard stated that sexual arousal to autogynephilic fantasy may diminish or even
disappear due to age, hormone treatment, and genital surgery; and yet the desire to live as a
woman does not diminish, and often grows stronger. He saw this as a likeness to heterosexual
pair bonding: after years of marriage, sexual excitement with a partner tends to decrease,
however one continues to be just as attached to that person. Similarly the desire to have a
female body can continue in some permanent “love-bond” (Blanchard, 1991).
A significant number of transsexuals have voiced disagreement with Blanchard’s model
(Dreger, 2008; Lawrence, 2007; Veale, Clarke, & Lomax, 2009b). Veale et al. gave
transwomen the opportunity to comment on Blanchard’s theory, and found most of their
comments were negative. The most common response was that the theory is too narrow, and
does not allow for diversity outside of Blanchard’s two types. This criticism can also be
applied to the primary/secondary transsexualism distinction outlined by Docter (1988) and
the classical/non-classical distinction employed in this article. However, the Identity-Defence
Model allows for variation between these types should empirical evidence uncover the need
for this.
In this article, we use the term cross-gender eroticism in place of autogynephilia
because the term is gender-neutral which fits the purposes of our article better.
The Identity-Defence Model of Gender-Variance Development builds on Docter’s
(1988) theory and incorporates the work of Seil (1996). This title is used because the theory
proposes that two factors influence gender-variance outcomes: the degree of gender-variant
identity developed, and whether defence mechanisms are used to repress this identity.
Formulated this way, the model provides a theoretical outline of the developmental pathway
to many of the various heterogeneous manifestations of gender-variance. The model is
illustrated in Figure 1, and the eight components of the model are outlined in the following
sections. We give examples of possible predisposing factors that determine whether a gender-
variant identity develops, and whether defence mechanisms are used.
Jaimie Veale, Terri Lomax, and Dave Clarke 6
Figure 1. Diagram of the Identity-Defence Model of Gender-Variance development, showing
factors influencing gender-variant outcomes.
Some biological factors have been shown to be associated with gender-variance.
Veale, Clarke, and Lomax (in press) reviewed previous studies of these factors. They
reported evidence for a genetic component of gender-variance, based on studies of twins and
other within-family concordance, and of studies that have looked specifically at genes. They
also reported evidence that prenatal androgen levels correlate with gender-variance, from
studies of finger length ratios (2D:4D) of transsexuals, and of individuals with polycystic
ovary syndrome, prenatal exposure to anticonvulsants, and intersex and related conditions
who are more likely to have reassigned genders. Also, it seems that transsexuals have some
parts of their brain structure that is sex atypical, a greater likelihood of non-right-handedness,
and male-to-female transsexuals to have a greater number of older brothers.
A less warm, more emotionally distant, controlling or rejecting father has been
associated with gender-variant outcomes in two controlled studies (Cohen-Kettenis &
Arrindell, 1990; Parker & Barr, 1982). Studies have also shown high rates of childhood
sexual, emotional, and physical abuse among transsexuals (Devor, 1994; Gehring &
Knudson, 2005; Kersting et al., 2003; Lothstein, 1983; Pauly, 1974; Veale, Clarke, & Lomax,
2008a), although these studies did not use control groups.
Identity-Defence Model of Gender-Variant Development 7
These biological and environmental factors influence the degree of gender-variant
identity formed in the young child. If a high degree of gender-variant identity is formed, then
transsexualism is the likely outcome in adulthood. If a lower degree of gender-variant identity
is formed, then less extreme gender-variant outcomes of cross-dresser or expression of
gender through drag are the results. More commonly, if no gender-variance develops then the
child will develop no gender-variant identity. It is also likely that culture will play a role in
how gender-variant individuals see themselves and come to identify. For instance, in cultures
where there is little acceptance for effeminate homosexual males but there is a cultural place
for MF transsexualism or a third sex (e.g. Iran, Thailand), gender-variant persons will be
more likely to assume the latter identity.
Environmental influences may determine whether a young child employs defence
mechanisms to repress their gender-variant identity and behaviours and protect them from the
perceived persecution and resultant cognitive dissonance, guilt, and anxiety they would
receive from expressing it. One possible environmental influence is the tolerance of gender-
variance in the family environment the child grows up in. If the young child perceives gender
non-conforming expressions are, or would be, met with scorn and punishment then their
gender-variant identity is more likely to become ego-dystonic, and the gender-variant identity
become repressed. If these expressions are not always met with scorn and punishment, and if
they are not perceived as strictly inappropriate, or even encouraged, then the young child’s
gender-variant identity is more likely to become ego-syntonic – meaning that they do not
form defence mechanisms to cognitively avoid it.
Gagné and Tewksbury (1998) explored the conformity pressures reported by a
number of transwomen in their childhood. They summarised:
Conformity, while distressing, offers valued rewards in interactions and social
integration. The result is repression of the authentic self in the interest of preserving
valued relationships….As young children and adolescents, the people we interviewed
quickly learned that to cross-dress or act feminine was inappropriate and intolerable.
Therefore, they learned to hide their transgendered activities and feminine
characteristics and attempted to become appropriately masculine….Being a feminine
male meant being labeled [sic] abnormal, weird, sick, or homosexual. Boys were
Jaimie Veale, Terri Lomax, and Dave Clarke 8
scolded, shamed, sent to psychiatrists, and sometimes beaten by their parents for
wanting to do feminine things. (p. 87)
Bullough and Bullough (1997b) found that 93% of their sample of 372 birth-assigned
males who cross-dress were afraid of being caught cross-dressing, and 56% were never
caught. Given the young age of the reported cross-dressing – the median age of first reported
cross-dressing was 8.5, with 91% reporting their first cross-dressing incident taking place by
age 14 – this shows a strong internalisation of the wrongs of cross-dressing, and a large
amount of secrecy from this group. Långstrom and Zucker (2005) found that over 50% of
persons reporting transvestic fetishism among a population sample did not see sexual arousal
from cross-dressing as acceptable to themselves. The samples of both these studies
experience non-classical gender-variance and this is evidence for them to have cognitive
dissonance also accompanying it.
Cross-dressers, and non-classical transsexuals are less commonly seen among birth-
assigned females than birth-assigned males (Blanchard, Clemmensen, & Steiner, 1987;
Chivers & Bailey, 2000). This is accounted for in the Identity-Defence Model because birth-
assigned females experience less parental and peer pressure to conform to the gender
stereotype of their birth-assigned sex; there is evidence for this in studies of transsexuals
(Verschoor & Poortinga, 1988) and non-gender-variant populations (Egan & Perry, 2001;
Lytton & Romney, 1991). As a result, gender-variant birth-assigned females are less likely to
go through a stage of repressing their gender-variant identity, which the Identity-Defence
Model proposes is the antecedent to cross-dresser and non-classical transsexual development.
There have however been past documented reports of cross-gender eroticism in birth-
assigned females (see Veale, Clarke, & Lomax, 2009c for a review); also see Kaldera (2000)
and Devor (1993) for further discussion. It is likely that the persons in these case-reports
would have experienced a much greater level of intolerance of their childhood gender-variant
expression than they would have experienced today.
The Identity-Defence Model also predicts that in cultures where allowances are made
for gender-variance, such as in Samoa (Bartlett & Vasey, 2006) and Thailand (Winter, 2006)
then the existence of cross-dressers and non-classical MF transsexualism would be fewer.
There is evidence that this is the case (Lawrence, in press). Further discussion of this is given
by Veale, Clarke, and Lomax,(2009a)
Identity-Defence Model of Gender-Variant Development 9
Aspects of a child’s personality may also influence whether they repress their gender-
variant identity. Studies have shown that some children are more sensitive to parents’
socialisation than others (Kochanska, 1995). Pomerantz, Ng, and Wang (2004) proposed that
children who are more fearful of parental discipline are more sensitive to gender-related
boundaries enforced by parents, “with even subtle hints from parents eliciting guilt when
children have violated a rule” (p. 133). Thus, those children who repress their gender-variant
identity may be only those who are prone to guilt and sensitive to parents’ real or perceived
We believe that an introverted child is likely to have less confidence to express this
gender-variant identity, and it is also possible that children with greater impulse control,
agreeableness, or conformity are more likely to cognitively-avoid their gender-variance.
Two previous studies have reported higher levels of introversion among male cross-
dressers compared to control groups. Bentler and Prince (1969) found that cross-dressers
(non-classical gender-variance) tended to be more inhibited in social interactions and
emotional expression. Using the Eysenck Personality Questionnaire, Wilson and Gosselin
(1980) found high levels of introversion compared to male and female controls among a
group of 269 members of a cross-dresser club. Y. L. S. Smith et al. (2005a) reported classical
transsexuals of both birth-assigned genders scored higher on the extraversion scale of the
Dutch Short Minnesota Multiphasic Personality Inventory than non-classical MF
transsexuals. Relevant to the trait of agreeableness, Bullough and Bullough (1997b) found
that 67% of their sample were considered “good” children, and only 5% reported getting in
trouble and getting a “bad” label. However, there was no reference group to compare this
figure to.
The proposed personality and environment factors determine whether the defence of
repression is used to cognitively avoid a gender-variant identity. Repression is defined as the
unconsciously motivated forgetting or unawareness of internal impulses, feelings, thoughts or
wishes (derived from Vaillant, 1992, p. 276).
Previous authors have observed the defence of gender-variant identity (Bockting &
Coleman, 2007; Lawrence, 2000; Seil, 1996), and psychoanalytic authors have previously
described the development of a “false self” in childhood (Winnicott, 1965) which may be
analogous to a repressed gender-variant identity. Cramer (2006) writes:
Jaimie Veale, Terri Lomax, and Dave Clarke 10
A child may learn that the expression of certain feelings or needs would arouse a
negative reaction in the caregiver; as a result, these feelings “go underground.”
Keeping the unacceptable feelings out of awareness helps maintain a relationship
with the caregiver…. its result is the development of a “false self.” (p. 7)
The proposed repression acts through early childhood and often into adulthood. Studies
have shown that denial – a defence mechanism closely related to repression in that both
involve the refusal to believe anxiety-provoking information (Nairne, 2006) – is the most
commonly used defence mechanism for children until age seven (Glasberg & Aboud, 1982;
W. P. Smith & Rossman, 1986). Lawrence (2003) found that the mean age that a group of
mostly non-classical transwomen first realised that they wanted to change sex was eight.
Maturity, independence, and gathering of knowledge are reasons we speculate for the defence
of the gender-variant identity becoming broken down in late childhood or adulthood. After
these persons are able to confront their gender-variant identity within themselves, there is
often also a significant time lag before they are able to tell other people about it. For narrative
accounts of transwomens’ denial experiences, see Mason-Schrock (1996).
We believe this outcome is more discrete than the other major outcome variable of the
Identity-Defence Model – degree of gender-variant identity. The gender-variant identity is
either repressed or it isn’t during childhood, although we are aware it may be possible for
persons to alternate between periods of repression and conscious awareness. As noted above,
previous authors have proposed the existence of different types of transwomen, and a
taxometric analysis has found some evidence of discrete differences in sexuality among
transwomen (Veale, Lomax, & Clarke, 2007). However, room for variation between the
extremes is allowed for in the model.
This part of the model is a two-dimensional matrix of possible gender-variant
identities. If no gender-variant identity develops then an identity consistent with biological
sex is the outcome. If a gender-variant identity develops and defence mechanisms are used to
repress it then the outcomes are cross-dressers or non-classical transsexuals depending on the
level of gender-variant identity. If defence mechanisms are not used then the outcomes are
classical transsexuals or drag artists, again depending on the level of gender-variant identity.
We would like to emphasise that even though we have only given four gender-variance
“points” on the matrix, we are aware that not every gender-variant person fits neatly into
these categories. The model allows for variation between these points. An example of an
Identity-Defence Model of Gender-Variant Development 11
intermediate point between cross-dressers and non-classical transsexuals is described by
Buhrich and McConaghy (1979) as a “marginal transvestite” group.
Sexuality is strongly correlated with these outcomes. Those participants not
employing defence mechanisms (classical transsexuals and drag artists) are more likely to
develop a sexual attraction towards males (Docter, 1988). Those participants employing
defence mechanisms (non-classical transsexuals and cross-dressers) are more likely to
develop a sexual attraction to females and cross-gender eroticism (Blanchard, 1989).
Research on the sexuality of cross-dressers has found that the majority are
heterosexual (Bullough & Bullough, 1997a; Docter & Fleming, 2001; Docter & Prince, 1997;
Prince & Bentler, 1972). Studies of the sexuality of MF transsexuals have found their
sexuality to be relatively evenly split between androphilic, gynephilic, bisexual, and asexual,
among clinical samples (Blanchard, 1989; Freund, Steiner, & Chan, 1982; Johnson & Hunt,
1990; Lawrence, 2003; Veale, 2005). Studies of the sexuality of FM transsexuals have found
that the majority of them are sexually attracted to females (Chivers & Bailey, 2000; Devor,
1993; Okabe et al., 2008; Y. L. S. Smith et al., 2005b). Studies of drag artists have found that
the majority of these persons are homosexual (Taylor & Rupp, 2004).
We use Bem’s (1996) Exotic Becomes Erotic developmental theory of sexual
orientation to explain these sexual orientation patterns among gender-variant persons. Bem’s
theory suggests that instead of coding for sexual orientation, biological variables code for
childhood temperaments, which determine whether a child will favour the activities and
company of peers of the same or opposite sex. This results in children feeling different from
children of the sex they do not associate with, and perceiving them as exotic. This in turn
generates autonomic arousal to the unfamiliar/exotic peers, which later results in erotic
arousal to persons of that sex (Bem, 1998; see Bem, 2000 for articles building on his theory).
Applying this to the Identity-Defence Model, those birth-assigned males who do not
use defence mechanisms to cognitively avoid their gender-variant identity would express
more femininity in their childhood and thus more likely to prefer female activities and to
associate with females. Because of this, these birth-assigned males are more likely to view
males as exotic, and later develop a sexual orientation towards them. In contrast, those birth-
assigned males who develop defence mechanisms are more likely to conform to expectations
to participate in boy’s activities, and associate with other boys. Depending on whether these
boys also desire to participate in female activities and associate with females as well, a
Jaimie Veale, Terri Lomax, and Dave Clarke 12
gynephilic or bisexual sexual orientation will result. 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, 1988, 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. According to the model, this attraction is most commonly found
among those who employ defence mechanisms to suppress their gender identity in childhood:
cross-dressers and non-classical transsexuals. Two theories could be drawn on to account for
this phenomenon. Firstly, psychoanalytic theory proposes that fetishism develops as the result
of using defence mechanisms to guard the ego against guilt and anxiety at early stages of
development (Seil, 1996). According to Seil, the repressed gender-variance usually reappears
at puberty under the guise of erotic arousal (see also Bockting, 2008). Bem’s (1996) Exotic
Becomes Erotic theory can also be applied again for a possible explanation of the
development of this sexual attraction. Using retrospective reports from male cross-dressers,
Docter (1988) noted the strict boundaries given to them in their youth in terms of gender-
appropriate behaviour and clothing – barriers are placed in the way of using women’s
clothing and participating in female-typical activities. This results in an arousal-provoking
perception of the forbidden, which, Bem’s theory suggests can result in an erotic component.
Docter also noted that it is common for cross-dressers to describe high levels of autonomic
arousal in their early cross-dressing experiences. The key mechanism here is the autonomic
arousal as opposed to the exotic perception of the gender-variant stimuli. It is likely to be
common for young persons to find behaviour and clothing of the opposite sex “exotic” –
however, we propose that only those who repress their gender-variant identity will receive a
high level of autonomic arousal from these stimuli to result in an erotic component.
Figure 2 shows Bem’s Exotic Becomes Erotic theory applied to the Identity-Defence
Model with modifications to include cross-gender eroticism development. As with Figure 1
biological and early childhood influences determine whether a gender-variant identity
develops, and personality and environment factors determine whether defence mechanisms
are used to repress this gender-variant identity. When no gender-variant identity develops, an
erotic attraction to peers of the opposite birth-assigned sex will eventuate (left column of
Figure 2). If a gender-variant identity develops and it is repressed in childhood, an erotic
attraction to gender-variant stimuli and/or erotic attraction to peers of the opposite birth-
assigned sex will result (left and middle columns). If a gender-variant identity develops that
Identity-Defence Model of Gender-Variant Development 13
is not repressed in childhood using defence mechanisms, erotic attraction to the same birth-
assigned sex will be the outcome (right column).
Figure 2. The development of erotic attraction as proposed by the Identity-Defence model
combined with Exotic-Becomes-Erotic theory.
The Identity-Defence Model should be viewed as an expansion and integration of
previous theories. The formulation of the gender-variant identities on a continuum has been
previously proposed by Blanchard (1989) and Docter (1988), the use of defence mechanisms
to repress a gender-variant identity was originally outlined by Seil (1996), and the sexuality
outcomes of the model are explained using application of Bem’s (1996) theory.
Prospective studies of gender-variant boys have found that although some grow up to
be transsexual, the majority grow up to be homosexual (Green, 1987; Zucker & Bradley,
1995) which seems contrary to the Identity Defence Model. However, we believe the boys in
these studies do not experience a gender-variant identity to the higher level that transsexuals
do. According to our model, those gender-variant boys who grow up to be homosexual can
experience a level of gender-variance where they express it through drag and/or express
themselves in a more feminine way in their everyday life than the average male – although,
Jaimie Veale, Terri Lomax, and Dave Clarke 14
of course, not all homosexual men experience a feminine gender identity in adulthood
(Bailey, 1996). In line with this proposition, studies have shown a greater amount of
childhood gender-variance in transsexuals than homosexuals using retrospective and
prospective studies (Blanchard & Freund, 1983; Blanchard, McConkey, Roper, & Steiner,
1983; Drummond, Bradley, Peterson-Badali, & Zucker, 2008; Ehrhardt, Grisanti, &
McCauley, 1979; Freund, Langevin, Satterberg, & Steiner, 1977; Lutz, Roback, & Hart,
1984; Wallien & Cohen-Kettenis, 2008). However our model considers their sexuality as a
correlate, rather than a cause of their gender-variant identity.
Another point worthy of discussion is whether cross-dressers and non-classical
transsexuals have a gender-variant identity prior to the onset of their sexuality. Blanchard’s
and Docter’s theories both hold that this is not the case, and it is their cross-gender eroticism
which causes their gender-variant identity. Our model proposes that the gender-variant
identity is present throughout life, albeit in a repressed form in childhood for some. Although
cross-gender eroticism can precede awareness of a gender-variant identity, we propose this is
due to the onset of sexual desires at a time when the gender-variant identity has not yet
reached full consciousness. We have some evidence for this conclusion – narratives of
transwomens’ experiences with cross-gender eroticism reveal that many of these women
believed they had gender-variant feelings prior to experiencing cross-gender eroticism
(Lawrence, 1999a, 1999b). An avenue for further research on this would be to ask those who
experience a later-developing gender variant identity whether they believe their first
experiments with gender-variant expression were the manifestation of something new or
recently developed within them, or something they believe had always been there, just not
allowed into consciousness.
Before concluding this article we outline three limitations of the model. Firstly, the
model makes the assumption that gender-variant outcomes all lie on a two-dimensional
continuum with little empirical evidence to support this. Theories that cross-dressers and non-
classical transsexuals (Blanchard, 1991; Docter, 1988), and homosexual males and classical
transsexuals occur on a continuum have been previously proposed (Bailey, 2003). However,
no previous theories have proposed that all of these four gender-variance outcomes occur on
a two-dimensional continuum.
A further limitation of the model is its heavy reliance on Bem’s exotic becomes erotic
theory. Bem’s theory is far from universally accepted, and has been seriously questioned
(Nicolosi & Byrd, 2002; Peplau, Garnets, Spalding, Conley, & Veniegas, 1998). The
developmental pathway proposed by Bem (1996), however, does not need to describe the
Identity-Defence Model of Gender-Variant Development 15
universal pathway for the development of all sexual attractions to be successfully applied to
the Identity-Defence Model – the pathway only needs account for the development of a
reasonably significant portion of person’s sexualities. Bem (1996) acknowledged that his
theory was not able to explain all individual variations in sexuality development.
The Identity-Defence Model’s conceptualisation of sexuality also has difficulty
explaining the changes of sexual orientation towards androphilia reported by many
transwomen after their transition (Daskalos, 1998; Lawrence, 2005). However, this
phenomenon could be incorporated into the Identity-Defence Model’s framework if this
androphilia is a manifestation of cross-gender eroticism as Blanchard (1989) contends, or if
these women are primarily bisexual, but are consciously or unconsciously adhering to
societies norms by consistently expressing heterosexuality.
Finally, there are limitations with the definitions and subsequent categorisation
applied to the gender-variant groups in the model. There are some persons who could be
included in our definitions of drag artists and cross-dressers who do not experience a gender-
variant identity, but have various other reasons for their gender-variant expressions, such as
employment, fun, rebellion, emotional comfort, or creativity. The Identity-Defence Model
does not intend to explain the motivations for gender-variant expression in these cases, it only
explains those persons who are expressing a gender-variant identity – whether or not they are
aware of it at the time. Conversely, there are some persons who would fall under our
definitions of cross-dressers or drag artists who experience an identity of the opposite birth-
assigned sex, but may not be able to live full-time in the cross-gender role due to factors such
as personal safety, employment, or relationship requirements. The diversity within these
groups is substantial, and indeed there are likely to be gender-variant persons who do not fall
under any of the definitions we have given. However, the Identity-Defence Model allows for
gender-variant outcomes along continuum to allow for as much of this diversity as possible,
whilst still keeping the model relatively concise. Indeed, it is possible that only two
dimensions of gender-variant outcomes in the model is too simplistic, however we believe it
is prudent to propose a simpler model until more is known about possible further variables.
Despite these limitations – and even though further evidence may call for
modification or rejection of the Identity-Defence Model – we believe that the model provides
an explanation for gender-variant identity development that is as plausible as anything that
has been previously proposed. Even though the model has been presented using categorical
descriptions of gender-variant outcomes, the structure of the model allows for outcomes
along continuum. Finally, we would like to emphasise that the model does not intend to
Jaimie Veale, Terri Lomax, and Dave Clarke 16
explain a universal path to gender-variant outcomes – it is possible that these outcomes are
arrived at because of factors outside of the model. Rather, this model is proposed as a
framework that might promote a structured discussion about the importance of factors
affecting gender-variant outcomes, and a platform for investigating how apparently similar
circumstances can have widely differing outcomes.
Identity-Defence Model of Gender-Variant Development 17
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... The possibility that factors other than sexual orientation may be responsible for FEFs is further supported by Nuttbrock et al. (2011aNuttbrock et al. ( , 2011b, who found that FEFs varied considerably among trans women depending upon age and race (with the highest levels observed in older and white subjects), and that these outcomes were mediated by a history of dressing femininely in private. This finding strongly supports alternative theories that have posited that FEFs arise from, or are exacerbated by, social factors such as secretive crossdressing and/or having to hide or repress female/feminine inclinations (Serano, 2007(Serano, , 2016Veale et al., 2010); I will discuss such theories more in the following section. ...
... others will perceive them as simply 'tomboys'). Veale et al. (2010) have forwarded a similar model of crossdresser development. ...
Full-text available
It is generally accepted within psychology and among trans health providers that transgender people who transition do so because they have a gender identity that is incongruent with their birth-assigned sex, and distinct from their sexual orientation. In contradiction to this standard model, the theory of autogynephilia posits that transgender women’s female gender identities and transitions are merely a by-product of their sexual orientations. While subsequent research has yielded numerous lines of evidence that, taken together, disprove the theory, autogynephilia is still often touted by anti-transgender groups, including trans-exclusionary feminists. Here, I provide an updated overview of the scientific case against autogynephilia. Following that, I will forward an alternative ‘embodiment fantasies’ model that explains all the available findings better than autogynephilia theory, and which is more consistent with contemporary thinking regarding gender and sexual diversity. I will also demonstrate how autogynephilia theory relies on essentialist, heteronormative, and male-centric presumptions about women and LGBTQ+ people, and as such, it is inconsistent with basic tenets of feminism.
... However, paradoxically, accepting a need for gender-affirming treatment, disclosing a transgender identity to others, or beginning a medical and surgical gender-affirming treatment, can transiently increase body dysphoria and body dissatisfaction 40,43 . This phenomenon might exist because denial or neglect of the dysphoria is a coping strategy that is no longer possible when the person starts coming out for themselves and others, and when they begin to be asked questions about feelings of body incongruence by a health-care professional 103 . ...
Sexuality is important for most cisgender as well as transgender persons and is an essential aspect of quality of life. For both the patient and their clinicians, managing gender dysphoria includes establishing a comfortable relationship with sexual health issues, which can evolve throughout the course of gender-affirming treatment. Gender-affirming endocrine treatment of transgender men and women has considerable effects on sex drive and sexual function. Gender-affirming surgery (GAS) can improve body satisfaction and ease gender dysphoria, but surgery itself can be associated with sexual sequelae associated with physical constraints of the new genitals or postsurgical pain, psychological difficulties with accepting the new body, or social aspects of having changed gender. In general, a positive body image is associated with better sexual function and satisfaction, but satisfaction with sexual function after GAS can be present despite dissatisfaction with the surgery and vice versa. Factors involved in the integrated experience of gender-affirming treatment and the way in which sexuality is perceived are complex, and supporting sexuality and improving sexual function in transgender patients is, correspondingly, multifaceted. As the transgender patient moves through their life before, during, and after gender-affirming treatment, sexuality and sexual function should be considered and maximized at all stages in order to improve quality of life.
Gender identity and gender roles are complicated phenomena that are likely impacted by biology as well as psychosocial influences. Nature and nurture are commonly seen as opposing forces, when, in reality, they work in concert, and our environments influence our biological processes. Due to historical factors, current research into how gender identity is shaped primarily focuses on the effects of hormones on neurobiology. Adult hormone levels do not seem to influence gender identity, but there is some evidence that intrauterine hormone exposure may. There is also evidence that psychosocial factors contribute to gender identity. As we continue to explore the basis for our multifaceted identities, we should bear in mind that we are more than just a sum of our parts.
Cambridge Core - Sociology of Gender - Lesbian, Gay, Bisexual, Trans, Intersex, and Queer Psychology - by Sonja J. Ellis
Aim To establish what impact, if any, the gender-affirmation process, has on sexuality and sexual experiences. Introduction Sexuality is a multi-faceted construct that influences our attraction to others. Gender transition is the process of aligning our physical sex characteristics with our psychological gender. Our sexuality and our gender identity are often mistakenly assumed to be inextricably linked. It is important to consider and understand the influence of the gender-affirmation process on sexuality and sexual experiences. Method A thematic synthesis of the available qualitative literature regarding sexuality, and sexual experiences in both transgender people and their partners were appraised, and synthesised. Thomas and Harden's (2008) stepwise process for conducting a thematic synthesis was followed. Results A total of seven articles were of relevance and included in the review. Two analytical and six sub-themes were found. The two analytical themes are: ‘Re-negotiating previous ‘norms” and ‘Establishing identity’. Conclusion During the gender-affirmation process, sexuality, and sexual experiences alter. This has clinical implications for transgender people and their partners, in particular, valuable therapeutic discussion points that need to be considered during the gender-affirmation process.
This study explores the development of self and gender identity within the lived experience of transgender individuals who were assigned female at birth and now identify as male or male spectrum. A psychoanalytically informed interview technique was employed here, involving six participants, aged 20–37 for 3–4 one-hour interviews. Alongside close attention to the content and the manner of representation of self and other across interviews, the analysis was also informed by counter-transference processes. Three core themes emerged from the data: ‘What’s in a Name?’; ‘Rejected, Bullied, Ignored and Forgotten’; and ‘I’m a Boy (not a Girl)’. Recollections of traumatic experiences and the use of laughter were other notable details that appeared across participants. Links are made between the emerging themes and concepts of incongruent mirroring and the development of a false self. Directions for further research and clinical implications for working with transgender clients in a psychotherapeutic context are also outlined.
Gender identity and gender roles are complicated phenomena that are likely impacted by biology as well as psychosocial influences. Nature and nurture are commonly seen as opposing forces, when, in reality, they work in concert, and our environments influence our biological processes. Due to historical factors, current research into how gender identity is shaped primarily focuses on the effects of hormones on neurobiology. Adult hormone levels do not seem to influence gender identity, but there is some evidence that intrauterine hormone exposure may. There is also evidence that psychosocial factors contribute to gender identity. As we continue to explore the basis for our multifaceted identities, we should bear in mind that we are more than just a sum of our parts.
Full-text available
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.
Full-text available
Data was analysed for a sample of 195 Thai transgendered females (i.e., male-to-female (MtF) transgenders) who had completed a questionnaire covering, inter alia, demographics, transition histories and sexual/gender identities. Mean age was 25.4 years.For demographic data, we found that our participants were often among the youngest in their family, that females played a prominent role in their lives (often rearing them without any male help), and that around one in five brothers (natural or step) were also transgendered.With regard to transition histories, we found that many participants had transitioned very early in life, beginning to feel different to other males, and identifying as non-male by middle childhood. By adolescence many were living a transgendered life. Many took hormones, beginning to do so by a mean age of 16.3 years, and several from as early as 10 years. Many underwent surgeries of various kinds, on average in the twenties, with one undergoing SRS as early as 15 years.As to identity, most of our participants thought of themselves simply as phuying (women), with a smaller number thinking of themselves as phuying praphet song (a ‘second kind of woman’). A small number thought of themselves as kathoey (a more general Thai term embracing a variety of gender non-conformities). While most participants would prefer to be a woman, there were a few who seemed comfortable being transgendered. A few foresaw that they would not be living a transgendered life into old age. The vast majority expressed a sexual attraction to men.
In their critique of the author's Exotic-Becomes-Erotic (EBE) theory of sexual orientation (D. J. Bem, see record 1996-01742-006), L. A. Peplau, L. D. Garnets, L. R. Spalding, T. D. Conley, and R. C. Veniegas (see record 1998-01102-009) challenge his reading of the evidence concerning the antecedents of sexual orientation; they also contend that the theory neglects women's experiences. In reply, the author argues that L. A. Peplau et al. have misunderstood the critical antecedent variable of the theory and, hence, have misidentified the particular empirical findings that would serve to confirm or disconfirm its central contentions. The author also argues that the sex differences they cite are not relevant to the theory, whereas an important sex difference they do not cite is actually anticipated by it.
A developmental theory of erotic/romantic attraction is presented that provides the same basic account for opposite-sex and same-sex desire in both men and women. It proposes that biological variables, such as genes, prenatal hormones, and brain neuroanatomy, do not code for sexual orientation per se but for childhood temperaments that influence a child's preferences for sex-typical or sex-atypical activities and peers. These preferences lead children to feel different from opposite-or same-sex peers - to perceive them as dissimilar, unfamiliar, and exotic. This, in turn, produces heightened nonspecific autonomie arousal that subsequently gets eroticized to that same class of dissimilar peers: Exotic becomes erotic. Specific mechanisms for effecting this transformation are proposed. The theory claims to accommodate both the empirical evidence of the biological essentialists and the cultural relativism of the social constructionists.
Background. We prospectively studied outcomes of sex reassignment, potential differences between subgroups of transsexuals, and predictors of treatment course and outcome. Method. Altogether 325 consecutive adolescent and adult applicants for sex reassignment participated: 222 started hormone treatment, 103 did not; 188 completed and 34 dropped out of treatment. Only data of the 162 adults were used to evaluate treatment. Results between subgroups were compared to determine post-operative differences. Adults and adolescents were included to study predictors of treatment course and outcome. Results were statistically analysed with logistic regression and multiple linear regression analyses. Results. After treatment the group was no longer gender dysphoric. The vast majority functioned quite well psychologically, socially and sexually. Two non-homosexual male-to-female transsexuals expressed regrets. Post-operatively, female-to-male and homosexual transsexuals functioned better in many respects than male-to-female and non-homosexual transsexuals. Eligibility for treatment was largely based upon gender dysphoria, psychological stability, and physical appearance. Male-to-female transsexuals with more psychopathology and cross-gender symptoms in childhood, yet less gender dysphoria at application, were more likely to drop out prematurely. Non-homosexual applicants with much psychopathology and body dissatisfaction reported the worst post-operative outcomes. Conclusions. The results substantiate previous conclusions that sex reassignment is effective. Still, clinicians need to be alert for non-homosexual male-to-females with unfavourable psychological functioning and physical appearance and inconsistent gender dysphoria reports, as these are risk factors for dropping out and poor post-operative results. If they are considered eligible, they may require additional therapeutic guidance during or even after treatment.
Forty-five selfdefined female-to-male transsexuals were interviewed as part of a wide ranging sociological field study about female-to-male transsexuals. The data in this study are unusual in that they were obtained outside of any clinical settings. Questions were asked about childhood experiences of physical, sexual and emotional abuse. Sixty percent reported one or more types of severe child abuse. In the course of discussing other issues, participants also reported having experienced many of the commonly cited initial and long-term effects of child abuse, including fear, anxiety and depression, eating disorders, substance abuse, excessive aggression, and suicide ideation and attempts. It was not possible to determine to what extent the sources of these complaints lay in child abuse, in gender dysphoria, in some combination of the two, or elsewhere. While no information was solicited about dissociative responses to child abuse, I have speculated, as have some of the participants themselves, that, in some cases, transsexualism may be an adaptive extreme dissociative swival response to severe child abuse.
Few studies have focused on the prevalence and extent of childhood trauma in the transsexual population. In our study of 42 transsexual people (34 = natal males, 8 = natal females), 55% (n = 23) reported experiencing an unwanted sexual event before the age of 18, with the average age of initial sexual contact being 13. This sexual event differs from other clinical populations in that the unwanted sexual experiences in this sample were the consequence of adolescents satisfying their curiosity about the gender of the transsexual rather than for their own sexual gratification. Consequently, the sequalae of the unwanted sexual touches in our sample did not lead to sexualised behaviours described in the sexual abuse literature of clinical samples. Our sample also reported being: verbally abused (77%), insulted (81%), embarrassed in front of others (55%), made to feel guilty by their parents (58%) before their fifteenth birthday.
Research on transgendered individuals has tended to come from medical, psychiatric, or deviance perspectives, with little attention to the social context in which these individuals exist or their efforts to resist normative expectations of sex and gender. Based upon in-depth interviews with 65 masculine-to-feminine transgendered individuals, this research examines gender as a social institution. Focusing on the pressures experienced by individuals to maintain binary enactments of gender, we demonstrate how the institution of gender is taken for granted as a presumably natural aspect of social life. Social pressures to conform, experienced as desires for relationship maintenance and self-preservation, as well as the overwhelming need to actualize an identity that does not fit within the binary system of sex and gender, illuminate the gender resistance and conformity exhibited among the individuals in our sample. Our analysis is rooted in an expanded Foucauldian perspective incorporating the theoretical insights of contemporary feminists who consider social actors as active agents in the development and enactment of everyday resistance. Transgenderism is a discursive act that both challenges and reifies the binary gender system. As such, it provides important lessons about the power dynamics of gender and how such systems may and may not be resisted.