Excerpt from: Lawrence AA. Autogynephilia: A Paraphilic Model of Gender Identity Disorder. Journal of Gay & Lesbian Psychotherapy 10/2008; 8(1).
Blanchard’s theory of autogynephilia helps to explain several otherwise puzzling observations about MtF transsexualism.
First, it convincingly explains why some men who are attracted to women, who have been fairly successful as men, and who appear unremarkably masculine would wish to undergo sex reassignment. Why would men who have been successful fighter pilots, construction workers, or captains of industry—men who seem not the least bit feminine, and who appear entirely comfortable being men—want to undergo sex reassignment? Attributing this solely to some long-hidden inner femininity might seem implausible. But if these individuals found the idea of being a woman sexually appealing, then their motivation would be easier to understand. The phenomenon of a middle-aged man risking his career, his reputation, and his marriage for the sake of a sexual obsession is well known. By proposing that certain types of MtF transsexualism can have sexual motivations, rather than (or in addition to) gender motivations, Blanchard’s autogynephilia theory helps to explain this phenomenon.
Second, Blanchard’s theory helps to explain the relationship between transsexualism and transvestism. Transvestism is considered to be a paraphilia, or unusual pattern of sexual arousal, in the DSM-IV-TR (APA, 2000) and has always been classified as such in the DSM. However, clinicians have long recognized that some men who previously considered themselves transvestites eventually decide to seek sex re-assignment surgery (SRS) and live full-time as women. If transvestism is purely an erotic phenomenon and transsexualism is purely a gender identity phenomenon, then there is no obvious explanation for this progression. But if both transvestism and some forms of MtF transsexualism are manifestations of autogynephilia—an erotic condition that also influences gender identity—then this progression is explained convincingly.
Third, Blanchard’s autogynephilia theory helps explain why transvestism and transsexualism are often associated with other unusual erotic interests. Sexual scientists have observed for decades that unusual sexual interests— sadomasochism, bondage, autoerotic asphyxia, interest in leather and rubber, exhibitionism, voyeurism, infantilism, pedophilia—frequently do not occur in isolation, but instead tend to co-occur. Males who have one unusual sexual interest are far more likely to have one or more other unusual sexual interests than would be expected simply by chance (Abel & Osborn, 1992; Wilson & Gosselin, 1980). And other unusual erotic interests are very common among transvestites and some MtF transsexuals. Wilson and Gosselin (1980) found that 63% of their sample of transvestites and transsexuals also described fetishistic or sadomasochistic interests. Blanchard and Hucker (1991) reported that transvestism accompanied many cases of autoerotic asphyxia. Abel and Osborn (1992) documented the co-occurrence of transvestism and transsexualism with other paraphilias. If transsexualism and transvestism are purely gender-identity-based phenomena, then these associations makes no sense. But if transsexualism and transvestism sometimes represent unusual sexual interests—as Blanchard’s autogynephilia theory proposes—then their association with other uncommon sexual interests does make sense.
Finally, the concept of autogynephilia helps to explain the unusual sexual fantasies that some transvestites and MtF transsexuals have concerning men, and the late development of sexual interest in male partners by some MtF transsexuals. Many heterosexual transvestites and formerly heterosexual MtF transsexuals have sexual fantasies about men, but usually these are not quite like the fantasies of genuine androphiles (Blanchard, 1989b). In the transsexual and transvestite fantasies, there is little emphasis on the specific characteristics of the imagined male partner. Often the imagined partner is faceless or quite abstract, and seems to be present primarily to validate the femininity of the person having the fantasy, rather than as a desirable partner in his own right (Blanchard, 1991). It is also fairly common for heterosexual transvestites to engage in sex with men when cross-dressed. Why don’t they do this at other times? Apparently, because the attraction is not to the male partner per se, but to the way in which acting like a woman in relationship to a man is sexually gratifying. Autogynephilia also explains why some transsexuals who were never interested in having sex with men before transition develop this interest after undergoing SRS. It is not because they have miraculously changed their underlying sexual orientation and now find men’s bodies arousing. Rather, it is because they can finally actualize their autogynephilic fantasy of having sex with a male.
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