Blanchard's transsexualism typology

Blanchard's transsexualism typology is a psychological typology of gender dysphoria, transsexualism, and fetishistic transvestism, created by Ray Blanchard through the 1980s and 1990s, building on the work of prior researchers, including his colleague, Kurt Freund. Blanchard categorized trans women into two groups: "homosexual transsexuals" who are attracted exclusively to men, and who seek sex reassignment surgery because they are feminine in both behavior and appearance; and "autogynephilic transsexuals" who are sexually aroused at the idea of having a female body. Blanchard's typology broke from earlier ones in that neither of the groups were considered "false transsexuals"; both autogynephilic and homosexual transsexuals were shown to benefit from transition. Before Blanchard, the idea that some types were not transsexual at all was a recurring theme in scholarly literature.

Supporters of the typology include sexologists J. Michael Bailey, Anthony Bogaert, James Cantor, Kurt Freund, Anne Lawrence, bioethicist Alice Dreger, and others who cite evidence showing significant differences between the two groups, including sexuality, age of transition, ethnicity, IQ, fetishism, and quality of adjustment. Criticism of the typology has come from sexologists John Bancroft and Charles Allen Moser, psychologist Margaret Nichols, academics Larry Nuttbrock and Jaimie Veale. Julia Serano criticized Blanchard's choice of wording as confusing or degrading.

In the transgender community, the typology has been the subject of controversy, which drew public attention with the publication of Bailey's The Man Who Would Be Queen in 2003.

Background

Observations suggesting that there exist multiple types of transsexualism date back to the beginning of the 20th century. Havelock Ellis used the terms eonism and sexo-aesthetic inversion in 1913 to describe cross-gender feelings and behaviors, and Magnus Hirschfeld observed multiple types of such individuals. Hirschfeld divided cases into five types: homosexual, bisexual, heterosexual, asexual, and automonosexual. The term automonosexualism was coined by H. Rohleder in 1901 to refer arousal generated by one's own body; Hirschfeld used the terms to describe excitement in natal males to the thought or image of themselves as women.

Researchers used varying subsets of that typology for several decades. Hamburger used all five of Hirschfeld's types. Randall classified transsexual cases into homosexual, heterosexual, or bisexual. Walinder used homosexual, heterosexual, and asexual. Bentler also divided postoperative transsexuals into homosexual, heterosexual, and asexual, although the asexual group might be better described as analloerotic, due to their reporting high rates of masturbation.

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.

Other researchers proposed still other typologies. In 1978, Neil Buhrich and Neil McConaghy described only two types of transsexuality: "fetishistic transsexuals," who experienced erotic arousal during cross-dressing and heterosexual arousal, and "nuclear transsexuals" who did not. Alternative terms for the fetishistic type have included eonism and sexo-aesthetic inversion.

Kurt Freund argued there were two etiologically distinct types of male-to-female transsexuals: one type unassociated with fetishism and found among androphilic trans women, and another associated with fetishistic crossdressing and found among gynephilic trans women. Freund stated that the sexual arousal in this latter type could be associated, not only with crossdressing, but also with other feminine-typical behaviors, such as applying make-up or shaving the legs. Blanchard credited Freund with being first author to distinguish between the erotic arousal due to dressing as a woman (transvestic fetishism) and erotic arousal due to physically transforming into a more typically female form (autogynephilia).

The idea that there are two recurring types of trans women is a recurring theme in the clinical literature. Prior to Blanchard's studies, the two groups were described as "homosexual transsexuals" if sexually attracted to men (androphilic) and "heterosexual fetishistic transvestites" if sexually attracted to women (gynephilic). These labels carried a social stigma of mere sexual fetishism, and reversed trans women's self-identification as "heterosexual" or "homosexual".

When Blanchard began his studies, all researchers of the topic had "identified a homosexual type of gender identity disturbance [which] occurs in homosexuals of both sexes. There is general agreement, moreover, on the clinical description of this syndrome as it appears in males and females". Researchers at the time concurred "that gender identity disturbance also occurs in males who are not homosexual but only rarely, if at all, in nonhomosexual females" and that "there is no consensus, however, on the classification of nonhomosexual gender identity disorders. Authorities disagree on the number of different syndromes, the clinical characteristics of the various types, and the labels used to identify them"

Research

Blanchard conducted a series of studies on people with gender dysphoria, analyzed the files of cases seen in the Gender Identity Clinic of the Clarke Institute of Psychiatry and comparing them on multiple characteristics.

Blanchard set out initially to extend Freund's hypothesis of there being only two types, testing whether asexual and bisexual transsexualism were actually subtypes of heterosexual transsexualism. Blanchard applied a statistical technique called cluster analysis to sort cases into groups four groups—homosexual, heterosexual, bisexual, and asexual or analloerotic (not attracted to others at all)—according to their self-ratings of how attracted they were to males and to females. Blanchard then compared these four groups with regard to their responses to the question, "Did you ever feel sexually aroused when putting on females' underwear or clothing?" The great majority of each of the heterosexual, asexual, and bisexual groups said they did experience such feelings, but only few people in the homosexual group did.

Blanchard analyzed sex ratios and respective sex preferences. The results confirmed prior reports of there being larger numbers of male-to-female than female-to-male transsexuals. The results showed also that female-to-male transsexuals were almost exclusively attracted to females, whereas male-to-female transsexuals report a variety of sexual preferences, including attractions to men, women, and erotic cross-dressing. Other reported findings included that heterosexual MTFs were significantly older than either of the two homosexual groups (i.e., male-to-female's attracted to males and female-to-male's attracted to females). The heterosexual male-to-females said they felt their first cross-gender wishes around the time they first cross-dressed, whereas both the homosexual groups said their cross-gender wishes preceded cross-dressing (3–4 years on average). Where fetishistic arousal was acknowledged by over 80% of the heterosexual male-to-females, fewer than 10% of either homosexual group did. Blanchard therefore proposed that the larger numbers of trans women is not because males are more susceptible to gender dysphoria itself, but because natal males are more susceptible to fetishistic transvestism, which can, in turn lead to gender dysphoria.

The age at which trans women referred themselves to explore sex reassignment and their self-ratings of childhood femininity were also studied. Computer classification divided cases into heterosexual, homosexual, bisexual, and asexual/analloerotic, according to cases' ratings of themselves. The homosexual group was significantly younger (mean age of 23.6 years) than the groups of heterosexual (mean of 39.1), bisexual (32.3), or asexual (35.3) transsexuals. The people in the homosexual group also rated themselves as significantly more feminine during their childhoods than the other groups, which did not differ from each other.

On the basis of the different features they exhibited, Blanchard concluded that the various gender transpositions—male and female homosexuality, heterosexuality, transvestic fetishism, and gender dysphoria—are individual manifestations of two phenomena. He concluded that the first one operates both in trans women and trans men, and represents a continuum from cis-heterosexual to cis-homosexual and at the extreme, gender dysphoric with (non-erotic) cross-dressing; and the second one operates only or nearly only in trans women and represents a continuum from cis-heterosexual to transvestic fetishism (cis- but experiencing eroticism with cross-dressing), to gender dysphoria (with at least some history of eroticism while cross-dressing).

Homosexual vs. autogynephilic transsexuals

Blanchard's terminology uses the terms homosexual and non-homosexual relative to a person's sex assigned at birth, not their current gender identity. Blanchard said that one type of gender dysphoria/transsexualism manifests itself in individuals who are exclusively attracted to men (homosexual transsexuals averaged a Kinsey scale measurement of 5–6 and six is the maximum, or a 9.86±2.37 on the Modified Androphilia Scale), 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 says that the "non-homosexual" transsexuals (but not the "homosexual" transsexuals) exhibit autogynephilia, which he defined as a paraphilic interest in having female anatomy.

The homosexual type corresponds to what is known as early-onset in other sources, while the autogynephilic type corresponds to what is known as late-onset in other sources. Homosexual transsexuals are proposed to be motivated by being very feminine in both behavior and appearance, and by a desire to romantically and sexually attract (ideally very masculine) men. Autogynephilic transsexuals are thought to be motivated by their sexual desire and romantic love for being women.

According to the typology, autogynephilic transsexuals are attracted to femininity while homosexual transsexuals are attracted to masculinity. However, a number of other differences between the types have been reported. Bailey states that homosexual transsexuals begin transitioning earlier in life, generally before turning 30, which accounts for their supposedly better adjustment. He states that they are also more likely to come from poorer, non-white, or socially marginalized backgrounds, and, by definition, are exclusively attracted to men; whereas autogynephilic transsexuals are either attracted to women, exclusively or not, or asexual. Bailey also argues that autogynephilia tends to appear along with other paraphilias. Bailey argued that both "homosexual transsexuals" and "autogynephilic transsexuals" were driven to transition mainly for sexual gratification, as opposed to gender-identity reasons.

Sexologist Anne Lawrence, a proponent of the concept, argues that homosexual transsexuals pursue sex reassignment surgery (SRS) out of a desire for greater social and romantic success. Lawrence has proposed that autogynephilic transsexuals are more excited about sexual reassignment surgery than homosexual transsexuals. She states that homosexual transsexuals are typically ambivalent or indifferent about SRS, while autogynephilic transsexuals want to have surgery as quickly as possible, are happy to be rid of their penis, and proud of their new genitals. Bailey argued that homosexual transsexuals are unlikely to transition if their appearance as women would be very unattractive.

According to Bailey and Lawrence, transsexuals who are active on the internet are overwhelmingly autogynephilic; and the two kinds of transsexuals rarely interact with each other or appear in the same spaces.

According to Blanchard, most homosexual transsexuals describe themselves as having been very feminine from a young age. Bailey and Zucker write that non-transgender gay men are also often very feminine when young, but usually learn to live in a more masculine role when they grow up. They argue that homosexual transsexuals differ because they encounter early adversity that prevented them from defeminizing. Bailey writes that gay men find the femininity of homosexual transsexuals very unattractive, and that the homosexual transsexuals themselves are very attracted to masculinity that they have trouble finding in gay men; and that as a result, homosexual transsexuals may be partially motivated by a desire to attract straight men.

Autogynephilia

Autogynephilia (derived from Greek for 'love of oneself as a woman') is the term Blanchard coined for "a man's paraphilic tendency to be sexually aroused by the thought or image of himself as a woman", intending for the term to refer to "the full gamut of erotically arousing cross-gender behaviors and fantasies". Blanchard states that he intended the term to subsume transvestism, including for sexual ideas in which feminine clothing plays only a small or no role at all. Other terms for such cross-gender fantasies and behaviors include automonosexuality, eonism, and sexo-aesthetic inversion.

Blanchard expressed the view that the many late-transitioning trans women were driven to do so not by gender dysphoria, but by an extreme paraphilia characterized by an erotic interest in oneself as a woman. Trans men are not represented in the typology.

Autogynephilia has also been characterized and as a sexual orientation. Blanchard wrote in 1993 that "autogynephilia might be better characterized as an orientation than as a paraphilia". Blanchard attributed the notion of some cross-dressing men being sexually aroused by the image of themselves as female to Magnus Hirschfeld, who stated, "They [automonosexuals] feel attracted not by the women outside them, but by the woman inside them."

The concept received little public interest until the 2003 publication of The Man Who Would Be Queen by the psychologist J. Michael Bailey, though Blanchard and others had been publishing studies on the topic for nearly 20 years. Bailey's book was followed by peer-reviewed articles critiquing the methodology used by Blanchard. Later studies have found little empirical support for autogynephilia as a sexual-identity classification. In reviewing research by Blanchard and others, Charles Allen Moser concludes that "although autogynephilia exists, the theory is flawed". according to Moser, "many MTFs readily admit that this construct describes their sexual interest and motivation. Nevertheless, it is not clear how accurately [Blanchard's theory] predicts the behavior, history, and motivation of MTFs in general". As of 2013, only one empirical report had set out an alternative explanation of Blanchard's findings.

Development

Blanchard based his theory of autogynephilia primarily on trans women's responses to questionnaires. These included questions such as Have you ever become aroused while picturing yourself having a nude female body or with certain features of the nude female form? and Have you ever become sexually aroused while picturing yourself as a fully dressed woman being admired by another person? Using a statistical technique called factor analysis, Blanchard showed that such questions aligned according to three factors, which he labelled the Core Autogynephilia Scale, the Autogynephilic Interpersonal Fantasy Scale, and an Alloeroticism Scale. According to Blanchard, the Core Autogynephilia Scale confirmed the hypothesis that each of the heterosexual, bisexual, and analloerotic transsexuals experienced autogynephilia, whereas the homosexual transsexual group did not.

Following controversy over the portrayal of transgender women in The Man Who Would Be Queen, Blanchard stated that the truth or falsity of the autogynephilia concept still required further research to resolve.

Description

Blanchard provides specific 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.

Blanchard identified four types of autogynephilic sexual fantasy, but stated that "All four types of autogynephilia tend to occur in combination with other types rather than alone."

• 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

According to Blanchard, the transvestic-fetishistic type has tended to overshadow the others. He reports that anatomic autogynephilia is more associated with gender dysphoria than transvestic autogynephilia. A different pattern was reported in a sample of non-transgender autogynephilic men, where higher degrees of anatomic autogynephilia were associated with less gender dysphoria; here, it was instead interpersonal and physiological autogynephilia that predicted gender dysphoria. The men in this sample were significantly more gender dysphoric than the non-transgender male baseline.

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].

There also exist natal males 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.

Autogynephilia has also been suggested to pertain to romantic love as well as to sexual arousal patterns. Blanchard himself wrote that although autogynephilia is reflected by penile responses to erotic stimuli, it "also includes the capacity for pair-bond formation".

Other authors have also distinguished between behavioral autogynephilia and interpersonal autogynephilia, with the latter being arousal to being seen or admired as a woman or to having sex with men.

Gynandromorphophilia, an attraction to people with both male and female anatomy, has been cited as the inverse of autogynephilia, and has been reported as associated with it. Autogynephilic men are usually attracted to women and not to men. Lawrence proposes that autogynephiles who report being attracted to men are instead experiencing "pseudo-bisexuality" or "pseudo-androphilia," an interpersonal autogynephilic desire for men as part of the fantasy about being a woman.

Blanchard has suggested that "non-homosexual" trans women may deny autogynephilia in order to be seen as more socially acceptable and in order to secure a favorable recommendation for sex reassignment. While some trans women report autogynephilic arousal after their gender transition, many others do not. Blanchard and Lawrence argue that such trans women are nonetheless autogynephiles. Lawrence also argues that self-identified homosexual (androphilic) trans women who report histories of autogynephilia are mistaken. Moser disputes this, arguing that if such misrepresentations were common, the self-reported data on which the theory itself is based would be "similarly suspect". According to Moser: "It appears that substantial minorities of homosexual MTFs are autogynephilic and non-homosexual MTFs are not."

Erotic target location errors

See also: Erotic target location error

Blanchard conjectured that sexual interest patterns could have inwardly instead of outwardly directed forms, which he called erotic target location errors (ETLE). Autogynephilia would represent an inwardly directed form of gynephilia, with the attraction to women being redirected towards the self instead of others. These forms of erotic target location errors have also been observed with other base orientations, such as pedophilia, attraction to amputees, and attraction to plush animals.

Anne Lawrence argued that these phenomena provide further support for autogynephilia typology:

I believe that the existence of these analogs of autogynephilic transsexualism calls into question the most influential biological and psychoanalytic theories of nonhomosexual MtF transsexualism, because such theories should also be able to account for these analogous phenomena but cannot easily do so. For example: It is plausible that hormonal abnormalities during prenatal development could result in a male-bodied person with a brain that had developed in a female-typical direction. It is less plausible that a prenatal developmental disturbance could result in a male-bodied person with a brain that had developed like that of an amputee or a plush animal. ...

I consider it more parsimonious to theorize that autogynephilic MtF transsexualism and the analogous conditions that exist in men who are sexually attracted to children, amputees, plush animals, and perhaps real animals, all represent manifestations of an unusual type of paraphilia in which affected men feel sexually aroused by the idea of impersonating or becoming whatever category of person or thing they find sexually attractive. Their paraphilic desires, in turn, often give rise to strongly held, highly valued alternative identities that ultimately become their dominant identities.

Autopedophiles have been reported to be more likely than other pedophiles to have considered whether they would be better off as a child, and more likely to have considered hormones or surgery to look more like a child.

Autogynephilia in cisgender women

The concept of autogynephilia has been criticized for assuming that only trans women experience sexual desire mediated by their own gender identity. Julia Serano states that autogynephilia is similar to sexual arousal in cisgender women. Two studies have tested the possibility that cisgender women can also experience autogynephilia. Jaimie Veale and colleagues reported in 2008 that an online sample of cisgender women commonly endorsed items on adapted versions of Blanchard's autogynephilia scales. Moser created an Autogynephilia Scale for Women in 2009, based on items used to categorize MtF transsexuals as autogynephilic in other studies. A questionnaire that included the ASW was distributed to a sample of 51 professional women employed at an urban hospital; 29 completed questionnaires were returned for analysis. By the common definition of ever having erotic arousal to the thought or image of oneself as a woman, 93% of the respondents would be classified as autogynephilic. Using a more rigorous definition of "frequent" arousal to multiple items, 28% would be classified as autogynephilic. While Blanchard stated that "autogynephilia does not occur in women", Moser writes that both studies found "significant numbers of women" scoring as autogynephilic, using measures similar to Blanchard's.

Anne Lawrence criticized these studies' methodology and conclusions and stated that genuine autogynephilia occurs very rarely, if ever, in cisgender women as their experiences are superficially similar but the erotic responses are ultimately markedly different. Her comment was rebutted by Moser who said that she had made multiple errors by comparing the wrong items. Francisco J. Sanchez and Eric Vilain state that, as with nearly all paraphilias, characteristics consistent with autogynephilia have only been reported among men.

One case of anatomic autoandrophilia has been reported in an adult male.

Inclusion in the DSM

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 asexual, homosexual (same "biological sex"), heterosexual (other "biological sex") and 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.

The DSM-IV-TR included autogynephilia as an "associated feature" of gender identity disorder and as a common occurrence in the transvestic fetishism disorder, but does not classify autogynephilia as a disorder by itself. The World Professional Association for Transgender Health (WPATH) objected to its inclusion as an unproven theory. The paraphilias working group on DSM 5, which included Ray Blanchard, included autogynephilia and autoandrophilia as subtypes of transvestic disorder, a proposal that was opposed by WPATH, citing a lack of empirical evidence for these specific subtypes.

Moser advances three reasons to question the inclusion of autogynephilia as a sign of a clinical disorder: (1) a focus on autogynephilia may have overshadowed other factors involved in gender dysphoria, creating "a new stereotype" which patients seeking sex reassignment must adhere to; (2) some proponents of the theory suggest that trans women who do not report sexual interest consistent with their typing according to the theory are mistaken or "in denial", which is disrespectful and potentially harmful; and (3) the theory could imply that "all gender manifestations [are] secondary to sexual orientation".

In the DSM-5, published in 2013, With autogynephilia (sexual arousal by thoughts, images of self as a female) is a specifier to 302.3 Transvestic disorder (intense sexual arousal from cross-dressing fantasies, urges or behaviors); the other specifier is With fetishism (sexual arousal to fabrics, materials or garments).

Criticism

General

Blanchard's research and conclusions came to wider attention with the publication of popular science books on transsexualism, including Men Trapped in Men's Bodies by sex researcher and trans woman Anne Lawrence and The Man Who Would Be Queen by J. Michael Bailey, both of which based their portrayals of male-to-female transsexual people on Blanchard's taxonomy.

Bailey, his book, Blanchard, and his research, and anyone who wrote a positive view of that work attracted intense criticism. Transgender advocates and scholars, including self-identified trans-feminists such as Julia Serano and Talia Mae Bettcher, have challenged Blanchard's and Bailey's explanation of transgender women's motivations to seek sex reassignment. These critics have disputed the taxonomy used by Blanchard and Bailey, arguing that the theory unduly sexualizes trans women's gender identity. Blanchard's findings have also been criticized for a lack of reproducibility and as failing to control for the same traits occurring in cisgender women.

Jaimie Veale and colleagues gathered a convenience sample over the Internet of trans women's impressions of and opinions on Blanchard's typology. Of the 170 people answering the survey, 47.5% said they experienced autogynephilia, 33% said the typology was too narrow and restrictive, 15% said it did not apply to their experiences, and 5% said that the typology was driven by questionable motives such as "to encourage 'elitist divisionism'". Veale published an alternative typology in 2010 which proposes that variances in gender identity are driven by personality and social factors which determine whether psychological defense mechanisms are employed to avoid or repress gender nonconformity, resulting in the later expression of this gender nonconformity.

Criticism of the typology of "homosexual transsexuals" is generally focused in two categories: the use of the terms "homosexual" and "non-homosexual" to refer to transsexuals by their assigned sex and the data underlying the typology 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".

Charles Allen Moser, a transgender health specialist and sex researcher, states that "many of the tenets of the theory are not supported by the existing data, or both supporting and contradictory data exist". In a re-evaluation of the data used by Blanchard and others as the basis for the typology, he states, "it is not clear that autogynephilia is always present" in gynephilic trans women or "always absent" in androphilic trans women, that autogynephilia is significantly different than other paraphilias, and that there is "little reason to suggest that autogynephilia is the [primary] motivation" for gynephilic trans women to seek SRS. He concludes that the types identified by Blanchard and others may be primarily correlational, not causative, in which case "autogynephilia just becomes another trait" of some trans women, rather than their defining characteristic.

Julia Serano, a trans activist and biologist by training, writes in the International Journal of Transgenderism that there were 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 a non-deterministic correlation between cross-gender arousal and sexual orientation. She states that Blanchard did not discuss the idea that cross-gender arousal may be an effect, rather than a cause, of gender dysphoria, and that Blanchard assumed that correlation implied causation.

Serano also stated 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 autogynephilic arousal in non-transsexual women. She criticised proponents of the typology, claiming that they dismiss 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 typology unscientific due to its unfalsifiability, or invalid due to the nondeterministic correlation that later studies found. Further criticisms alleged that the typology 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. According to Serano, studies have usually found that some non-homosexual transsexuals report having no autogynephilia.

Blanchard states that while developing the typology, he found that gynephilic gender identity patients who reported never experiencing arousal to crossdressing were still measurably aroused by autogynephilic stimuli, and that autogynephilia among non-androphilic trans women was negatively associated with tendency to color their narrative to be more socially acceptable. This led Blanchard to conclude that non-homosexual trans women who reported no autogynephilic interests were misrepresenting their stories. This conclusion has been criticized for being unfalsifiable and for being based on an incorrect way of measuring autogynephilia.

T. M. Bettcher, based on her own experience as a trans woman, has critiqued the notion of "autogynephilia," and "target errors" generally, within a framework of "erotic structuralism," arguing that the notion conflates essential distinctions between "source of attraction" and "erotic content," and "(erotic) interest" and "(erotic) attraction," thus misinterpreting what she prefers to call, following Serano, "female embodiment eroticism." She maintains that not only is "an erotic interest in oneself as a gendered being," as she puts it, a non-pathological and indeed necessary component of regular sexual attraction to others, but within the framework of erotic structuralism, a "misdirected" attraction to oneself as postulated by Blanchard is outright nonsensical.

Thomas E. Bevan writes that the concept is insufficiently operationalizable and therefore fails as a scientific theory or hypothesis.

Misgendering language

The concept of autogynephilia has been criticized as being transphobic, and Blanchard's terminology has been described as confusing and controversial among transsexual people seeking sex reassignment surgery, archaic, and demeaning. Frank Leavitt and Jack Berger write: "Transsexuals, as a group, vehemently oppose the homosexual transsexual label and its pejorative baggage. As a rule, they are highly invested in a heterosexual life-style and are repulsed by notions of homosexual relations with males. Attention from males often serves to validate their feminine status."

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.

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.

J. Michael Bailey argues that this terminology is appropriate because, according to Blanchard's typology, transgender women who are attracted to men are part of the same fundamental phenomenon as the most feminine gay men.

Accusations of misconduct

See also: The Man Who Would Be Queen

Trans activist Lynn Conway blogged extensively about the publication of Bailey's book by the United States National Academy of Sciences and along with other activists accused Bailey of misconduct. Northwestern University investigated Bailey, but did not reveal the findings of that investigation and did not comment on whether or not Bailey had been exonerated. According to a summary of the controversy written by Northwestern University bioethicist and historian Alice Dreger, the accusations were unfounded and comprised an attempt by those activists to silence Bailey for expressing views that contrasted with the public image they wanted. The accusations themselves did not hold up to scrutiny, according to Dreger's analysis. For example, two of the four transsexual women who accused Bailey of misusing their stories in the book were not mentioned in the book by name.

Dreger studied the reactions of trans activists and other controversies in her 2015 book Galileo's Middle Finger. She argued that although the science appears correct that eroticism is behind the typology of transgenderism, activists in the trans community preferred the simpler narrative of literally being one sex trapped in the body of the other. Dreger says, "Autogynephilia is perhaps best understood as a love that would really rather we didn’t speak its name", in reference to the famous expression the love that dare not speak its name formerly used to refer to homosexuality.

See also

• Classification of transsexual and transgender people
• Autoeroticism
• Partialism
• Transgender sexuality
• List of transgender-related topics