Blanchard's transsexualism typology
Blanchard's transsexualism typology (also Blanchard autogynephilia theory (BAT) and Blanchard's taxonomy) is a psychological typology of male-to-female (MtF) transsexualism created by Ray Blanchard through the 1980s and 1990s, building on the work of his colleague, Kurt Freund. Blanchard divided trans women into two different groups: so-called "homosexual transsexuals," who Blanchard argued seek sex reassignment surgery to romantically and sexually attract (ideally heterosexual) men, and "autogynephilic transsexuals" who purportedly are sexually aroused at the idea of having a normative female body. The typology suggests distinctions between MtF transsexuals, but does not speculate on the causes of transsexualism. The distinction is a recurring theme in scholarly literature on transsexualism.
Supporters of the theory include J. Michael Bailey, Anne Lawrence, James Cantor, and others who argue that there are significant differences between the two proposed groups, including sexuality, age of transition, ethnicity, IQ, fetishism, and quality of adjustment. Scientific criticism of the research and theory has come from John Bancroft, Jaimie Veale, Larry Nuttbrock, Charles Allen Moser, Julia Serano, and others who argue that the theory is poorly representative of trans women, reduces gender identity to a matter of attraction, is non-instructive, that the research cited in support of the theory has inadequate control groups or is contradicted by other data, and that its proponents routinely make statements that call into question the theory's falsifiability.
The theory has been the subject of protests in the transgender and larger LGBT community, which peaked among both trans women and clinicians with the publication of Bailey's The Man Who Would Be Queen in 2003. Following the publication of Bailey's book, Blanchard distinguished between the value of the theory as a behavioral description, versus as an explanation of transsexualism and that only further scientific research could resolve latter question. The World Professional Association for Transgender Health (WPATH) currently opposes the theory due to a lack of empirical evidence for it.
The early history of the study of transsexualism is sparse; however, the concept of a categorization of transsexual people can be seen as early as 1923 with the work of Magnus Hirschfeld. In 1966, Harry Benjamin wrote that researchers of his day thought that attraction to men, while feeling that oneself is a woman, was the factor that distinguished a transvestite from a transsexual. In 1980 in the DSM III, a new diagnosis was introduced, that of "302.5 Transsexualism" under "Other Psychosexual Disorders". This was an attempt to provide a diagnostic category for gender identity disorders. The diagnostic category, "transsexualism", was for gender dysphoric individuals who demonstrated at least two years of continuous interest in transforming their physical and social gender status. The subtypes were 1. asexual, 2. homosexual (same "anatomic" sex), 3. heterosexual (other "anatomic" sex) and 0. unspecified. This was removed in the DSM IV, in which gender identity disorder replaced transsexualism. Previous taxonomies, or systems of categorization, used the terms "classic transsexual" or "true transsexual," terms once used in differential diagnoses.
Sexologist Ray Blanchard coined the term "autogynephilia" in 1989 to describe MtF transsexuals (who he believed were men) who were sexually aroused by the idea of being women. He stated that while they lacked a specific term to describe the concept, there was evidence for the concept among clinicians of the early 20th century. Havelock Ellis used the terms "Eonism" and "sexo-aesthetic inversion" to describe similar cross-gender feelings and behaviors.
The clinical literature of Freund, Blanchard, and others has consistently divided male-to-female transsexuals into two distinct groups - "homosexual transsexuals," people who are sexually attracted to (ideally heterosexual) men and supposedly desire a normative female body to attract them, and "heterosexual fetishistic transvestites" in which the transsexual purportedly finds the idea of having a normative female body sexually arousing but desires a heterosexual female partner. Kurt Freund first distinguished between these two proposed types in a 1982 research article, theorizing that the "homosexual" transsexuals were qualitatively different from the so-called "heterosexual males" with gender dysphoria. Sexologist Ray Blanchard coined the term "autogynephilia" to describe this latter category of people. In a 2005 article on the concept of Ray Blanchard noted that Freund was probably the first author to distinguish between the erotic arousal due to dressing as a woman (transvestism) versus erotic arousal due to physically transforming into a more typically female form (autogynephilia).
Blanchard's observations at the Clarke Institute began by categorizing male-to-female transsexuals into four groups based off their supposed sexual orientations: "homosexual," "heterosexual," bisexual, and asexual (i.e. trans women attracted to men, women, both, or neither, respectively.) Blanchard then conducted a series of studies on assigned male at birth people with gender dysphoria, including male-to-female transsexual people, and concluded that there existed only two distinct types. Blanchard argued that one type of gender dysphoria/transsexualism manifests itself in individuals who are exclusively attracted to men, whom he referred to as homosexual transsexuals, adopting Freund's terminology The other type he defined as including those who are attracted to females (gynephilic), attracted to both males and females (bisexual), and attracted to neither males nor females (analloerotic or asexual); Blanchard referred to this latter set collectively as the non-homosexual transsexuals. Blanchard claims that the "non-homosexual" transsexuals (but not the "homosexual" transsexuals) exhibit autogynephilia, which he defined as a paraphilic interest in having female anatomy.
Criticism of the theory of "homosexual transsexuals" is generally focused in two categories: the use of the terms "homosexual" and "non-homosexual" to refer to MtF transsexuals by their assigned sex and the data underlying the theory itself. Harry Benjamin, in his seminal work The Transsexual Phenomenon, opined that the question "is a transsexual homosexual?" had both "yes" and "no" answers depending on whether sexual anatomy or gender identity was prioritised, and in cases of post-operative male-to-female transsexuals, describing them as "homosexual men" was against "common sense and reason". The terminology has also been described as confusing and controversial among transsexuals seeking sexual reassignment, archaic, and demeaning. In 2008 sexologist John Bancroft expressed regret for having used this terminology, which was standard when he used it, to refer to transsexual women, and that he now tries to use words more sensitively.
Autogynephilia and autoandrophilia 
Autogynephilia (pron.: //; from Greek “αὐτό-” (self), “γυνή” (woman) and “φιλία” (love) — "love of oneself as a woman") is a term coined in 1989 by Ray Blanchard, to refer to "a man's paraphilic tendency to be sexually aroused by the thought or image of himself as a woman." Alternative terms proposed for this notion include automonosexuality, eonism, and sexo-aesthetic inversion. The DSM-IV-TR includes an essentially equivalent definition, and recognizes autogynephilia as a common occurrence in the transvestic fetishism disorder, but does not classify autogynephilia as a disorder by itself. Blanchard, as the chair of the paraphilias working group on the DSM 5, included autogynephilia and autoandrophilia as subtypes of transvestic disorder, a proposal that was opposed by the World Professional Association for Transgender Health (WPATH) due to lack of empirical evidence for the theory.
The analogous term autoandrophilia refers to a assigned female at birth person's tendency to be sexually aroused by the thought or image of being a man. It classified as a type of transvestic fetishism in a proposed revision to the DSM-5. Less work has been done on autoandrophilia, and in an interview with Vice, Blanchard stated that he doubted the phenomenon existed; he proposed its inclusion in the DSM 5's section on transvestic fetishism "simply in order to not be accused of sexism".
Autogynephilia is most notable for its sole use in Blanchard's taxonomy to explain the presence of gender dysphoria in "non-homosexual" (gynephilic) male-to-female transsexuals, in contrast to the gender dysphoria observed in "homosexual" (androphilic) transsexuals. Autogynephilia has also been suggested to pertain to romantic love as well as to sexual arousal patterns.
Blanchard provides case examples to illustrate the autogynephilic sexual fantasies that people reported:
Philip was a 38-year-old professional man referred to the author's clinic for assessment....Philip began masturbating at puberty, which occurred at age 12 or 13. The earliest sexual fantasy he could recall was that of having a woman's body. When he masturbated, he would imagine that he was a nude woman lying alone in her bed. His mental imagery would focus on his breasts, his vagina, the softness of his skin, and so on—all the characteristic features of the female physique. This remained his favorite sexual fantasy throughout his life.
According to Blanchard, "An autogynephile does not necessarily become sexually aroused every time he pictures himself as female or engages in feminine behavior, any more than a heterosexual man automatically gets an erection whenever he sees an attractive woman. Thus, the concept of autogynephilia—like that of heterosexuality, homosexuality, or pedophilia—refers to a potential for sexual excitation" [emphasis in original].
- Transvestic autogynephilia: arousal to the act or fantasy of wearing typically feminine clothing
- Behavioral autogynephilia: arousal to the act or fantasy of doing something regarded as feminine
- Physiologic autogynephilia: arousal to fantasies of body functions specific to people regarded as female
- Anatomic autogynephilia: arousal to the fantasy of having a normative woman's body, or parts of one
There also exist male assigned at birth people who report being sexually aroused by the image or idea of having some but not all normative female anatomy, such as having breasts but retaining their penis and testicles; Blanchard referred to this phenomenon as partial autogynephilia.
Autoandrophobia (from Greek “αὐτό-” (self), “άνδρας” (andras/man) and “φόβος” (phobos/fear) — "fear of oneself as a man") is a related but different term to autogynephilia which was coined by Moser (2010). Some male-to-female transsexual people in whom estrogen has been contraindicated (e.g., due to deep vein thrombosis) have found that antiandrogens alone were sufficient to relieve their gender dysphoria. This seems to suggest that male-to-female transsexual people are not just motivated to transition by autogynephilia, but also due to a desire to block their masculine characteristics. Such a symptom is not characteristic of other paraphilias.
Physician and specialist in sexual medicine Charles Allen Moser criticized Blanchard's theory for using an overly-broad definition of autogynephilia, being insufficiently relevant to MtF transsexual patients, failing to account for all information on sexual and romantic interests of homosexual and transsexual people, relying too heavily on the questionable practice of phallometry and lacking critical supporting data. A modified version of the typology was published in 2010 that proposed variances in gender identity were driven by biological and childhood socialization factors but personality and environment determine whether psychological defence mechanisms are employed to repress these variances. In the presence of defence mechanisms, the typology predicts cross-dressing or atypical transsexuality, while their absence results in drag artists or classic transsexuality.
In a literature review, transsexual biochemist Julia Serano noted several flaws in Blanchard's original papers, including that they were conducted among overlapping populations primarily at the Clarke Institute in Toronto without nontranssexual controls, that the subtypes were not empirically derived but instead were "begging the question that transsexuals fall into subtypes based on their sexual orientation", and that further research had found that a non-deterministic correlation between cross-gender arousal and sexual orientation. Specific criticism focused on the fact that Blanchard did not discuss the idea that cross-gender arousal may be an effect, rather than a cause, of gender dysphoria, and that he seemingly assumed that correalation implied causation; specific arguments against causality included the non-deterministic correalation found, the conflict between the accepted definition of "paraphilia" as persistent and the lacademic consensus that cross-gender arousal decreases over time, and that many individuals, including those included in Blanchard, Bailey, or Lawrence's work, experienced cross-gender identity prior to arousal. Serano theorised that the wider idea of cross-gender arousal was affected by the prominence of sexual objectification of women, accounting for both a relative lack of cross-gender arousal in transsexual men and similar patterns of gynephilic arousal in non-transsexual women.
Serano also criticised proponents of the theory for dismissing non-autogynephilic non-androphilic transsexuals as misreporting or lying while not questioning androphilic transsexuals, describing it as "tantamount to hand-picking which evidence counts and which does not based upon how well it conforms to the model", either making the theory unscientific due to its unfalsifiability, or invalid due to the nondeterministic correalation that later studies found. Further criticisms alleged that the theory undermined lived experience of transsexual women, contributed to pathologisation and sexualisation of transsexual women, and the literature itself fed into the stereotype of transsexuals as "purposefully deceptive", which could be used to justify discrimination and violence against transsexuals.
Transsexual community reaction 
The concept began receiving attention outside of sexology when sexologist Anne Lawrence, a physician and sexologist who self-identifies as autogynephilic, published a series of web articles about the concept in the late 1990s. When Bailey published The Man Who Would Be Queen in 2003, which based its portrayal of male-to-female transsexual people on Blanchard's taxonomy, an enormous controversy resulted. Transsexual activist Lynn Conway started an investigation into the publication of Bailey's book by the United States National Academy of Sciences and along with other activists leveled accusations of misconduct against Bailey. Northwestern University investigated Bailey, but did not reveal the findings of that investigation and did not comment on whether or not Bailey had been punished. According to a summary of the controversy written by intersex researcher and bioethics professor Alice Dreger, two of the four women who accused Bailey of misusing their stories were not mentioned anywhere in the book.
According to Leavitt and Berger, "transsexuals, as a group, vehemently oppose the homosexual transsexual label and its pejorative baggage." Trans man Aaron Devor wrote, "If what we really mean to say is attracted to males, then say 'attracted to males' or androphilic... I see absolutely no reason to continue with language that people find offensive when there is perfectly serviceable, in fact better, language that is not offensive." Still other transsexual people are opposed to any and all models of diagnosis which allow medical professionals to prevent anyone from changing their sex, and seek their removal from the DSM.
See also 
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