Deconstructing the Feminine Essence Narrative

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PEER COMMENTARY
Deconstructing the Feminine Essence Narrative
Ray Blanchard
Published online: 23 April 2008
Ó Springer Science+Business Media, LLC 2008
In Dreger’s history of the controversy surrounding Bailey’s
(2003) work on femininity in biological males, she refers to
the popular view of male-to-female transsexualism as the
feminine essence narrative. Because my commentary con-
siders the feminine essence view as a set of propositions
rather than as a story, I will refer to it as the feminine essence
theory.
Dreger presents the main ideas of the theory quite clearly
enough for the purposes of her history. She writes, for
example, that according to the feminine essence theory,
‘‘trans people suffer from a sort of trick of nature, whereby
they have the brain of one gender in the body typical of the
other. Thus the trans person has a sort of neurological
intersex condition, typically understood to be inborn.’’ She
does not, however, formally enumerate the distinguishable
elements and implications of the theory, an exercise that
would have taken her beyond the scope of her article. Such
an analysis is the subject of this commentary. My purpose in
writing it is to present the feminine essence theory in a form
that facilitates its comparison with other theories of male-to-
female transsexualism, including my own view.
The remainder of this commentary has three main parts.
First, I will list what I consider to be the central tenets of the
feminine essence theory. There is no ‘‘official version’’ of this
theory, and another author might come up with a shorter
or longer list of tenets, or state some of them in different
language. Second, I will explain each of the tenets as I con-
ceive them, and third, I will compare the various elements of
the feminine essence theory with my own conjectures.
Tenets of the Feminine Essence Theory
1. Male-to-female transsexuals are, in some literal sense
and not just in a figurative sense, women inside men’s
bodies.
2. There is only one type of woman, therefore there can be
only one type of (true) transsexual.
3. Apparent differences among male-to-female transsex-
uals are relatively superficial and irrelevant to the basic
unity of the transsexual syndrome.
4. Male-to-female transsexuals have no unique, behav-
ioral or psychological characteristics that are absent in
typical men and women.
Elaboration of the Tenets
Women Trapped in Men’s Bodies
The popular description of male-to-female transsexuals as
women trapped in men’s bodies has sometimes been inter-
preted to mean that they feel like women or that they wish
to be women. The feminine essence theory proposes that
they are women. This proposition is usually paired with the
notion that there exist one or more sex-dimorphic structures
of the human brain that can be regarded as the seat of gender
identity, and that key parameters of these structures (e.g.,
neuron number or density) are similar in male-to-female
transsexuals and natal females (see Bailey & Triea, 2007).
Contemporary proponents of this view also generally hold
R. Blanchard (&)
Law and Mental Health Program, Centre for Addiction
and Mental Health, 250 College Street, Toronto, ON,
Canada M5T 1R8
e-mail: Ray_Blanchard@camh.net
R. Blanchard
Department of Psychiatry, University of Toronto, Toronto,
ON, Canada
123
Arch Sex Behav (2008) 37:434–438
DOI 10.1007/s10508-008-9328-y

that the female-typical structure of the gender identity cen-
ter(s) is congenital, so that male-to-female transsexuals are
and always have been female where it counts—in the brain.
Singularity of the Feminine Essence
Human females do not occur in alternative morphs; that is,
human females do not consist of two or more discrete sub-
populations with different phenotypes, as in the damselfly or
the black bean aphid. Since there is only one type of human
female, there can be only one type of female trapped in a
male body. It follows that the notion of a taxonomy of
transsexuals with discrete diagnostic categories is almost
oxymoronic. There may be a miscellany of males who, for
whatever reason, desire sex reassignment and might even
profit from it, but without the singular feminine essence—or
its characteristic neuroanatomic substrate—they cannot be
considered to be real transsexuals.
The notion of a single, true transsexual syndrome exists
within the transsexual subculture as well as parts of the scien-
tific community. One can find, on the Internet, hostile postings
in which one postoperative transsexual derides another as a
pseudotranssexual who transitioned for the ‘‘wrong’’ reasons.
Irrelevance of Apparent Differences
Contemporary proponents of the feminine essence theory
freely acknowledge that some male-to-female transsexuals
are erotically attracted to men, both before and after sex
reassignment surgery, whereas others are erotically attracted
to women, before and after surgery. In my terminology,
which follows the individual’s chromosomal sex, these
groups are homosexual and heterosexual transsexuals, res-
pectively. In their own terms, which follow their subjective
gender identity rather than their chromosomal sex, they are
heterosexual (‘‘straight’’) and homosexual (‘‘lesbian’’) trans
women, respectively.
Research has shown that homosexual and heterosexual
male-to-female transsexuals (my terminology) differ in the
onset, course, and associated features of their disorders. Com-
pared with homosexual transsexals, heterosexual transsexuals
are less conspicuously feminine in boyhood (Blanchard, 1988;
Smith, van Goozen, Kuiper, & Cohen-Kettenis, 2005), they
approach clinicians with the request for sex reassignment at a
later age (Blanchard, 1988; Smith et al., 2005), they have a less
convincing appearance when dressed as women (Smith et al.,
2005), they have more extensive histories of penile erection
with or without masturbation during cross-dressing (Blan-
chard, 1985; Lawrence, 2008; Smith et al., 2005), and they
are more likely to report histories of erotic arousal in asso-
ciation with the thought or image of themselves as women
(Blanchard, 1989a). I labeled the propensity to be sexually
aroused by cross-gender ideation autogynephilia (Blan-
chard, 1989b), after many decades in which clinical writers
had described the phenomenon without giving a name to it
(see Blanchard, 2005).
According to the feminine essence theory, the differences
between homosexual and heterosexual transsexuals have no
bearing on the origins of transsexualism per se. There is no
more need to ask whether homosexual and heterosexual
male-to-female transsexuals have the same reasons for believing
themselves to be women than there is to ask whether homo-
sexual and heterosexual natal females have the same reasons
for believing themselves to be women.
Absence of Unique Features
The feminine essence theory is not incompatible with the
possibility that transsexuals’ behavior includes some male-
typical and some female-typical traits. Male-to-female trans-
sexuals have, after all, been subject to societal pressures to
act like males throughout most of their development. The
theory is, however, incompatible with a high prevalence of
distinctive traits that are typical of neither males nor females.
For the foregoing reason, the high prevalence of auto-
gynephilia among male-to-female transsexuals might seem
to represent a challenge to the feminine essence theory. The
simple rebuttal offered by the theory’s proponents is that
natal females commonly experience sexual arousal at the
thought of themselves as attractive women. On this view,
autogynephilia is not a generally rare trait with a strikingly
high prevalence among male-to-female transsexuals; it is a
common behavior in all women, whether they happen to be
born with male or female bodies.
Comparison With My Version of the Traditional
Clinical View
Over a period of 20 years (Blanchard, 1985, 2005), I pub-
lished a series of papers that attempted to integrate and
systematize the clinical observations and research findings
on male-to-female transsexuals published during the last
century. My conclusions were adopted, in part or in whole,
by Bailey (2003) and Lawrence (2004). The substantive parts
of Bailey’s book that contributed to his attackers’ motivation
were largely parts that were based on my writings and that
contradicted the feminine essence theory. It is therefore rel-
evant to consider precisely how the tenets of that theory con-
flict with my synthesis of the traditional clinical literature. I
will begin my comparisons with the last of the four tenets and
work my way up the list.
Arch Sex Behav (2008) 37:434–438 435
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Occurrence of Autogynephilia in Natal Females
The notion that typical natal females are erotically aroused
by—and sometimes even masturbate to—the thought or
image of themselves as women might seem feasible if one
considers only conventional, generic fantasies of being a
beautiful, alluring woman in the act of attracting a hand-
some, desirable man. It seems a lot less feasible when one
considers the various other ways in which some autogyne-
philic men symbolize themselves as women in their mas-
turbation fantasies. I recall more than one patient who
had sexual fantasies of menstruation and masturbatory rit-
uals that simulated menstruation. I recently read about an
individual who fantasized, while giving himself enemas,
that his anus was a vagina and that he was giving himself a
vaginal douche. I have listed other examples in previous
articles: an autogynephile who was sexually aroused by the
thought of helping the maid clean the house or sitting in a
girls’ class at school, an autogynephile whose favorite mas-
turbation fantasy was knitting in the company of other
women, an autogynephile who was sexually aroused by the
idea of riding a girls’ bicycle, and an autogynephile who got
an erection when he went out cross-dressed and someone
called him ‘‘ma’am.’’ These examples argue that autogy-
nephilia has a fetishistic flavor that makes it qualitatively
different from any superficially similar ideation in natal
females.
There is also the very telling phenomenon of autogyne-
philes who are involuntarily aroused by cross-dressing or
cross-gender ideation. I gave an example of that in Blanchard
(2005), and other authors had reported such observations
before I started working in the field. Buhrich (1978) repro-
duced quotes from men who regarded genital arousal as
an unwanted and bothersome by-product of changing into
women’s apparel: ‘‘When I ejaculate it is an accident and
undesirable,’’ ‘‘I can manage to ‘dress’ now and not have an
erection,’’ ‘‘I masturbate to get rid of the erection so I can get
on with dressing’’ (p. 147). It seems likely that few natal
women would give the analogous reports that they wish that
they could put on their clothes without triggering vaginal
lubrication or orgasm.
Proponents of the feminine essence theory could argue that
it is an empirical question whether heterosexual male-to-
female transsexuals manifest a higher prevalence of auto-
gynephilia than do natal females. My view, in contrast, is that
the correct control group for such (necessarily survey)
research is not natal females but rather homosexual male-to-
female transsexuals, and that the results of such research have
already shown that autogynephilia is characteristic of heter-
osexual transsexuals (Blanchard, 1989a). Thus, it is unlikely
that heterosexual male-to-female transsexuals manifest auto-
gynephilia simply because they resemble natal females. If het-
erosexual male-to-female transsexuals report sexual arousal
from thoughts of being feminine because they are like natal
women, then why don’t homosexual male-to-female trans-
sexuals report sexual arousal from thoughts of being
feminine? Homosexual male-to-female transsexuals are just
as much like natal women, perhaps more so. In summary, my
view is that male-to-female transsexuals—more specifically,
one class of them—do have at least one important charac-
teristic that is absent in both typical men and women.
Significance of Differences Among Male-to-Female
Transsexuals
In my view, the differences between homosexual and hetero-
sexual male-to-female transsexuals regarding the onset, course,
and associated features of their disorders are not superficial,
insignificant distinctions. I view them as evidence that homo-
sexual and heterosexual transsexualism probably have different
etiologies. I have stated this conclusion in several places. In
Blanchard (2005), I expressed it as follows:
There are two distinct types of cross-gender identity. The
feminine gender identity that develops in homosexual
males is different from the feminine gender identity that
develops in heterosexual males. In other words, homo-
sexual and heterosexual men cannot ‘‘catch’’ the same
gender identity disorder in the way that homosexual and
heterosexual men can both ‘‘catch’’ the identical strain of
influenza virus. Each class of men is susceptible to its own
type of gender identity disorder and only its own type of
gender identity disorder. (p. 443)
Typology of Male-to-Female Transsexualism
It will be clear, from the preceding paragraph, that I believe
there is more than one type of male-to-female transsexualism.
In this regard, I agree with the majority of previous clinical
writers. Where I depart from my predecessors is that many of
them identified one type of transsexual as true or primary and
labeled the remaining type or types as secondary.Thatisnot
to say that all previous researchers agreed on the diagnostic
criteria for primary and secondary transsexualism. They
routinely contradicted each other, in fact, about the defining
characteristics of the true (primary) transsexual.
I eschewed the primary–secondary terminology for a
variety of reasons, one being that it implies a hierarchy of
genuineness. My main reason, however, was that I believed
that transsexuals’ sexual orientations are the best basis for
classification. After a series of studies designed to identify
the number of fundamentally different types, I hypothesized
that there are only two: ‘‘All gender-dysphoric biological
males who are not homosexual (erotically aroused by other
436 Arch Sex Behav (2008) 37:434–438
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males) are instead autogynephilic (erotically aroused by the
thought or image of themselves as females)’’ (Blanchard,
2005, p. 445).
Bailey adopted my hypothesis of two discrete types, and
this became a recurring point of contention in the attacks on
his book. Bailey was criticized for his (our) stance by many
transsexuals who recalled no subjective awareness of sexual
response to men or to cross-gender ideation and who insis-
ted, on that basis, that they must belong to a third type.
I have not seen any new research studies that present com-
pelling evidence for a third, distinct type of male-to-female
transsexualism. It is quite difficult, however, to achieve com-
plete certainty in taxonomic work. I made this point in a lecture
on the parallels between gender identity disorder (GID) and
body integrity identity disorder (BIID), a condition character-
ized by the feeling that one’s proper phenotype is that of an
amputee, together with the desire for surgery to achieve this.
Most, but not all, persons with BIID report some history of
erotic arousal in association with thoughts of being an amputee
(apotemnophilia). In discussing the taxonomic problems
common to the study of GID and BIID, I noted the following:
There are some nonhomosexual male-to-female trans-
sexuals who state that they were never erotically aroused
by cross-dressing or cross-gender fantasy. Similarly,
there are some persons with BIID who claim that they
were never erotically aroused by the idea of being
amputees. I’ve published two studies that suggest at least
some transsexuals who deny autogynephilic arousal are
consciously or unconsciously distorting their histories.
That doesn’t completely solve the taxonomic problem,
however. There could still be some nonhomosexual
transsexuals whose denial of any autogynephilic arousal
is accurate. The taxonomic study of GID and BIID raises
the same problem: How does one decide when the dis-
crepant self-reports of a minority of patients indicate
psychological denial and when they indicate a bona fide
separate syndrome? (Blanchard, 2003)
The question of whether there are two or three distinct types of
male-to-female transsexualism is an interesting and impor-
tant one in its own right. There is a sense, however, in which the
difference between two, three, or even more discriminably
different syndromes of gender dysphoria is tangential to the
feminine essence theory per se. The feminine essence the-
ory implies that there can be only one kind of true transsex-
ualism; it is silent about the number of other syndromes that
might imitate its symptoms.
Transsexuals as Intersexes
In principle, one could hypothesize that there are two, three,
or more sex-dimorphic structures in the brain that influence
gender identity, and that the differentiation of any one of
them in the female-typical direction could cause a natal male
to develop as a male-to-female transsexual. This strategy
would preserve the concept of transsexualism as a kind of
intersexuality, and it would allow for the possibility of
multiple, separate but equal types of transsexualism. Such a
strategy presents certain philosophical problems for the
feminine essence theory, however. Presumably, all gender-
identity-related structures are differentiated in the female-
typical direction in the overwhelming majority of natal
females. If there are multiple types of male-to-female
transsexuals with different subsets of female-differentiated
structures, then all of them would be incomplete females.
That notion is quite inharmonious with the spirit of con-
temporary feminine essence theory, which emphasizes the
psychology of male-to-female transsexuals as that of ‘‘nor-
mal’’ women. For this reason, the ideal neuroanatomic
finding, from the standpoint of the feminine essence theory,
would be a single gender identity center that is differentiated
in the female-typical direction in heterosexual, homosexual,
and any other type of male-to-female transsexual.
My personal view—which I present here only because it
has so often been incorrectly surmised by participants in the
Bailey controversy—is that the brains of both homosexual
and heterosexual male-to-female transsexuals probably dif-
fer from the brains of typical heterosexual men, but in
different ways. In homosexual male-to-female transsexuals,
the difference does involve sex-dimorphic structures, and the
nature of the difference is a shift in the female-typical direc-
tion. If there is any neuroanatomic intersexuality, it is in the
homosexual group. In heterosexual male-to-female trans-
sexuals, the difference may not involve sex-dimorphic struc-
tures at all, and the nature of the structural difference is not
necessarily along the male–female dimension. None of this
speaks to the relative usefulness of reassignment surgery for
the two groups, which is an empirical matter that must be
decided on grounds other than etiology (Blanchard, 2000).
Conclusion
As I have previously noted, there undoubtedly exist variant
forms of both the folk and academic versions of the feminine
essence theory. Some of these variations can be understood
with regard to the four tenets that I listed. I can illustrate this
with a clinical example. I have interviewed more than one
preoperative male-to-female transsexual whose entire sexual
history had been with women, but who told me that they
expected (or hoped) that after surgery they would start to feel
attracted to men. When I asked them why they would not want
to be lesbians after surgery—which seemed like the more
probable outcome to me—they answered that (in their view)
lesbians are masculine and thus are not ‘‘real’’ women. For that
Arch Sex Behav (2008) 37:434–438 437
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reason, they felt that ending up as a lesbian after surgery would
represent a failure to achieve full womanhood. These indi-
viduals apparently subscribed to the notion of a singular
feminine essence, but they denied its presence in lesbians. By
implication, therefore, they denied the third tenet, which
asserts that ‘‘straight’’ and ‘‘lesbian’’ trans women can lay
equal claim to the designation of true transsexuals.
There may be versions of the feminine essence theory that
vary in ways not covered by the tenets I identified. One might
hope that this will stimulate other writers to compile different
and perhaps better lists of the theory’s propositions and
implications. Such a conversation may eventually help to
clarify the substantive component of controversies regarding
transsexualism.
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