What Is the Meaning and Explanatory Significance of Autogynephilia?
All of the transsexual informants who provided narratives had experienced autogynephilic arousal, but they expressed widely varying opinions concerning its meaning and significance. Many seemed to accept Blanchard’s formulation: They believed that autogynephilia was a paraphilic sexual interest that had been an important force in their lives, had given rise to their gender dysphoria and cross-gender identification, and had been an undeniable cause—albeit not necessarily the proximate or the only cause—of their wish to undergo sex reassignment.
This point of view, however, was not universal. To attribute real meaning and explanatory significance to autogynephilia is to disagree with the beliefs and attitudes held by most other MtF transsexuals and more than a few clinicians and researchers. Many autogynephilic transsexuals would understandably prefer to interpret their autogynephilic feelings in a way that would not “directly contradict basic tenets of the worldwide transgender movement” (Nuttbrock, Bockting, Mason, et al.,
2011
, p. 249). Several informants accomplished this by taking a compromise approach: They acknowledged that they had experienced autogynephilic arousal but rejected Blanchard’s explanation of its meaning and significance. This served to minimize or deemphasize any disagreement between their life histories and generally accepted ideas about transsexualism.
Informants who did not attribute great meaning or explanatory significance to their autogynephilic feelings proposed various alternatives to Blanchard’s formulation. Some suggested that autogynephilia might be only a symptom or an effect of their transsexualism or gender dysphoria, not a cause of these conditions. These informants often supported their opinions by noting that their cross-gender fantasies had begun well before puberty or had usually preceded overt autogynephilic arousal by many years. Other informants argued that autogynephilia was merely an epiphenomenon—an incidental effect of their female gender identities interacting with their unwanted male bodies or some particular aspect of their male upbringings. Still others asserted that autogynephilia was not a paraphilic condition at all but rather a normal manifestation of female sexuality that could be easily observed in natal women. A few informants expressed more than one of these points of view.
In a related vein, a few informants proposed that MtF transsexualism had a specific biologic etiology; they usually believed that an abnormal hormonal milieu during prenatal development was wholly or partly responsible. Their unstated implication was that there was no need to consider the meaning or the significance of autogynephilia, because their transsexualism could be explained in terms of hormonal abnormalities during the prenatal period.
Autogynephilia Might Be a Symptom of Transsexualism
The idea that autogynephilia might be merely an effect or symptom of one’s gender dysphoria or transsexualism rather than a cause of these conditions is an appealing one, because it denies the explanatory significance of autogynephilic arousal without denying the fact of it. Back in the days when I was trying to reconcile my belief in Blanchard’s theory with the transsexual community’s vehement rejection of it, I even proposed this idea myself (Lawrence,
2000
), although I now regard it as specious.
Some informants similarly suggested, usually without much elaboration, that autogynephilia might simply be a symptom or an effect of their transsexualism or gender dysphoria. Here are some representative comments:
I have numerous concerns with Blanchard’s analysis, but I’ll focus on just one: the assumption that autogynephilia is the cause or primary motivation for an individual’s transsexuality. I have never been adequately convinced that this is the case, and it seems just as likely to me that transsexuality causes autogynephilia, or that transsexuality and autogynephilia are the shared result of some common root cause. (121)
This erotic impulse created by the desire to be and live as a woman has probably been an important factor in my transition, although I believe, as I need to, that it is simply a manifestation of a deeper underlying condition. (110)
I strongly believe that it is misguided to view autogynephilia as the ultimate cause of gender dysphoria or the wish to undergo SRS. I feel it is something I developed or crafted as a way of dealing with my gender dysphoria. (081)
Reading about autogynephilia, I did have some strong pangs of truth, but I feel it is possibly one of the symptoms of gender dysphoria. I feel the fantasies are an escape outlet for my closed and shutdown reality and my cultural maleness. (234)
There is a certain superficial plausibility about the accounts offered in the last two narratives: if one wanted to become a woman but were unable to do so, one might understandably fantasize about becoming a woman. These accounts do not explain, however, why fantasies of becoming a woman would be so powerfully erotic.
Desires to Be Female Begin Before Puberty and Precede Autogynephilic Arousal
Children usually, if not invariably, display erotic and sexual interests and behaviors beginning in early childhood—long before puberty (Friedrich et al.,
2000
; Martinson,
1976
,
1994
; Yates,
2004
). Erotic and sexual behaviors in young children are so ubiquitous and so easily observed that they have been taken for granted in most cultures throughout human history. In recent years, however, there has developed a countervailing cultural belief, especially in the United States, that eroticism and sexuality begin only at puberty.
In their interviews with nine MtF transsexuals, Schrock and Reid (
2006
) encountered several instances in which informants invoked the idea that sexuality begins only at puberty to justify their belief that their cross-dressing could not be an erotic phenomenon:
Interviewees used cultural discourse on sexuality that paints preadolescents as asexual … as a resource to distance themselves from erotic transvestites. In telling their sexual stories, the six who had used women’s garments during masturbation drew on the notion that sexual life begins only after puberty as a resource for identity work. Erin’s account was typical: “I had been dressing for seven years before I had my first orgasm, so my reaching puberty and beginning to masturbate and becoming sexual was just coincidental with my crossdressing.” The implication was that because they crossdressed before puberty, that they were not, underneath it all, just transvestites. (p. 79)
In the current study, six informants reported that they had distinct memories of wanting to be female or cross-dressing before they went through puberty, at which time they first became conscious of autogynephilic sexual arousal. They argued, explicitly or implicitly, that this temporal sequence precluded the possibility that autogynephilic arousal was the cause of their gender dysphoria or cross-gender identity.
I have had these feelings for as long as I can remember, and that is before puberty and issues of sexual arousal ever crossed my mind. Here is an example: My parents were the co-owners of a hotel when I was younger. During the summers, I would answer the phone and take down reservations. The callers, not expecting a 9- or 10-year-old to be answering calls, would identify me as a female receptionist. Until puberty, I played this role flawlessly, cherishing every moment. At this age, sexual arousal was the last thing on my mind, but I still loved to play the female, because I already at this age understood I wasn’t meant to be a male. Though sexual arousal may play a certain role in my desire to be female, the actual concept of arousal from dressing up came many years after I figured out I wasn’t like the other boys. (235)
I had fantasies of acquiring a feminine body, and, yes, they were erotic. There is, however, something that seems inconsistent with this being my motivating factor to have SRS. I wished for SRS for several years prior to any sexual realization of myself. I have distinct memories of having wanted to be a girl beginning at age 4 or 5 years old. The sexual fantasies did not start for a good 6 years after that and were few and far between until about age 28, when I was married. I do not know if autogynephilia was more a reaction to my already strong desire to be the opposite sex (it was a product of my transsexuality) or the cause. I suspect it was a product rather than a cause, simply because it came later in life than the desire to change sex. (236)
My earliest memories of dealing with this gender issue go back to age 3 or 4. Isn’t this well before any sexual issues could be a source for these feelings? When I was about 9 or 10, I saw some Life magazine images of women who’d transitioned and I thought this is what I’d like to do. At the age of 11 or 12, I started cross-dressing in some of my mother’s clothing. For the first time I experienced erotic feelings with my desire to be a woman. The point of all of this is to provide the history of my feelings and document that they preceded any sort of sex drive. So if I’m autogynephilic, which it appears that I am, how is it that my first thoughts about wishing I was a girl had nothing to do with sex drive? (130)
I have had strong erotic fantasies around the subject of feminization. The fantasies very definitely came later than the desire to be female. As far back as I can remember, I have wanted to be a girl, but didn’t start fantasizing about it in an erotic sense until after puberty. The things I used to fantasize about before puberty were more on the order of getting rid of a particular girl at school and somehow taking over her life. (186)
My own feelings of dysphoria began at around 5 or 6 years of age, long before I experienced any sexual arousal or feelings at all. I remember thinking distinctly that I was both in the wrong body and the wrong role. Before puberty, it was almost entirely about the gender role, and the physical aspect was about form alone and was not sexualized at all. Around puberty, though, as my body became overrun with strong male hormones, I found myself constantly aroused at everything. My desire to be female quite suddenly expanded to include a new sexual aspect. So, my transsexualism predated a time when I was aroused by the idea of being female. (125)
I don’t think that autogynephilic sexuality is the reason I am transsexual. Rather, I think it is a symptom of my transsexualism. I had my first feelings of wanting to be female around the age of 3-1/2. All through childhood, I prayed that I could become a girl. I started cross-dressing around the age of 7. I was told I was a boy and would always be a boy no matter what, so I tried as best I could to get on with life as a male. Nowhere in those early years was autogynephilia present and yet my gender dysphoria was as intense, if not more intense, than it is now. It was only after puberty that autogynephilia began to display itself. (237)
In interpreting these narratives, it is useful to consider two questions: How confident can one be that the informants’ implicit or explicit denials of erotic arousal in association with prepubertal cross-dressing or cross-gender fantasies are accurate? And how confident can one be that the informants’ descriptions of their prepubertal desires to be female are accurate and not exaggerated? In both instances, I believe one should be skeptical about the accuracy of these accounts.
As several informants reported in
chap. 5
, autogynephilic arousal associated with cross-dressing or cross-gender fantasy during early childhood is not unusual. Moreover, as I noted in
Chaps. 1
,
Chaps. 4
, and
Chaps. 5
, gender dysphoric men who display physiologic evidence of autogynephilic arousal in a laboratory setting often deny having experienced it (Blanchard et al.,
1986
), and adolescents who are clinically referred for transvestic fetishism often deny autogynephilic arousal as well (Zucker et al.,
2012
). Moreover, denial of autogynephilic arousal is associated with a socially desirable response style (Blanchard, Clemmensen, et al.,
1985
). All three of these studies involved denial of autogynephilic arousal that had occurred (or putatively had occurred) fairly recently. It would not be surprising, then, if inaccurate denial of autogynephilic arousal that putatively had occurred decades earlier, or simple failure to recall such arousal, might be a common phenomenon. Please note that I am not claiming that the six transsexual informants above who denied prepubertal autogynephilic arousal are lying
(cf. Serano,
2010
, p. 181); I am simply claiming that there is good reason to believe that they might not be reporting accurately—probably unintentionally—and, therefore, good reason to be skeptical of their denials.
How confident can one be that the informants’ descriptions of their prepubertal desires to be female are accurate and not exaggerated? I have addressed the issue of childhood cross-gender wishes preceding autogynephilia in
chap. 5
, and I will do so again later in this chapter. Occasional cross-gender wishes during early childhood are not unusual, even in boys without known gender issues (Friedrich et al.,
1991
,
1998
,
2000
; Sandfort & Cohen-Kettenis,
2000
). Boys who will subsequently become autogynephilic transsexuals probably experience recurrent and perhaps frequent cross-gender wishes during early childhood and may also experience some episodes of gender dysphoria. But these symptoms do not necessarily indicate the existence of severe, ongoing gender dysphoria or strong, persistent cross-gender identification in early childhood. It is not uncommon for individuals who experience transsexualism in adulthood to inaccurately report significant cross-gender wishes occurring much earlier in life (Bancroft,
1972
; Fisk,
1974
; Lukianowicz,
1959
). Consequently, I believe that one ought to be skeptical of the reports by transsexual informants in the current study who suggested or implied that they had experienced intense, persistent cross-gender wishes during early childhood.
I am not aware of any reliable third-person accounts—as opposed to retrospective first-person accounts—or clinical case reports documenting severe gender dysphoria or strong, persistent cross-gender identification during early childhood in adult autogynephilic or nonhomosexual MtF transsexuals. A report by Wallien and Cohen-Kettenis (
2008
), however, included one male patient who had been diagnosed with GID in childhood, exhibited persistent GID in adolescence, and reported heterosexual attraction in adolescence. A subsequent report by de Vries et al. (
2011
) included three male patients with childhood and adolescent GID, two of whom reported bisexual orientation and one of whom reported heterosexual orientation in adolescence (perhaps the same patient reported by Wallien & Cohen-Kettenis,
2008
). It seems possible, then, that cases of males who met the diagnostic criteria for GID in early childhood and adolescence and later went on to developed nonhomosexual or autogynephilic transsexualism might exist; but such cases are probably very rare. In contrast, there are many reported cases of male patients diagnosed with GID in childhood who experienced persistent GID in adolescence or adulthood and developed a homosexual orientation (e.g., de Vries et al.,
2011
; Steensma, Biemond, de Boer, & Cohen-Kettenis,
2011
; Wallien & Cohen-Kettenis,
2008
). Until reliable third-person documentation exists, ideally in the form of actual case reports, I consider retrospective first-person accounts by autogynephilic transsexuals of severe gender dysphoria or strong, persistent cross-gender identification during early childhood to be suspect and possibly exaggerated—not out of willful deception, but out of the understandable need to find or create a coherent life story.
As I discussed in
chap. 5
and will discuss later in this chapter, an alternative possibility—and a more likely one, I believe—is that cross-gender wishes during early childhood in boys who grow up to be autogynephilic transsexuals are simply early indications of their autogynephilic sexual orientation.
Cross-Gender Fantasies Might Become Sexualized After Puberty
Some informants who reported that they had first experienced cross-gender fantasies or wishes in early childhood believed that their fantasies had originally been nonsexual but had become “secondarily” sexualized around the time of puberty, through the operation of some biological mechanism or psychosocial influence. Informants differed in the specific mechanisms to which they attributed the sexualization of their purportedly originally nonsexual feelings.
One informant believed that shame and fear of discovery had resulted in her cross-gender feelings and urges becoming sexualized:
Before the age of 5, I felt as if I were female and began correcting anyone who claimed otherwise. However, the idea of me being female wasn’t a sexual catalyst yet, because I wasn’t the least bit afraid or ashamed of being a girl. In fact, I thought I was a girl. But then I began to feel ashamed, afraid to let anyone know my true feelings. Soon I became extremely sexually excited at the thought of all things female—not females in particular, but female articles of clothing on my body, etc. I became sexually excited by polishing my toenails, which hitherto had not happened. Surely you get the picture. Basically, fear was my sexuality back then. I didn’t fear being a girl until I was taught to fear this, or at least taught to fear getting caught being a girl. (238)
Another speculated that her cross-dressing might have become sexualized because it was taboo:
I’m a transsexual who has recently accepted what I am. I have been aroused by cross-dressing. I am attracted to women. What I’ve questioned is: Was and am I sexually aroused for the reasons you discussed, or because I knew that it was “taboo”? Taboo subjects can be highly erotic. (196)
Yet another believed that her cross-gender behavior had become sexualized because it was forbidden:
I believe that, at least in my case, autogynephilia was a result of gender dysphoria, not a cause of it. I have realized that I had been denying my identity all along. My speculation is that the erotic response was the result of the identity conflict. It was my mind’s attempt to deal with the contradictions. When I was trying to prove what I was, through the roles I lived, the forbidden feminine side was exciting and erotic. Now my mind is no longer in a state of confusion, and the erotic nature of doing something “forbidden” has given way to the new battlefront. I feel I have crossed over from a “marginal” or controversial transsexual classification to a more recognized definition. My anatomic autogynephilia is a result of the combination of a classic “woman in a man’s body” definition of transsexuality, combined with years of self-delusion attempting to deny it. (204)
These explanations are problematic in part because they lack specificity. A wide range of behaviors in which children and adults engage or about which they fantasize—many antisocial behaviors, for example—are forbidden, taboo, prohibited, or shameful. These behaviors, however, presumably did not automatically become intensely sexualized for the informants in the way that their cross-gender behaviors did. The explanations these informants provided cannot account for the fact that cross-dressing or cross-gender fantasies in particular
became sexualized, whereas other forbidden, taboo, prohibited, or shameful behaviors or fantasies presumably did not.
In contrast to the previous informants, who theorized that their cross-gender fantasies had become sexualized because they were shameful or prohibited, another informant proposed that her cross-gender fantasies had become sexualized because they enhanced her self-esteem:
Starting with the premise of being a woman in a man’s body, sexual desire is not as simple as becoming aroused while cross-dressed, fantasizing, or role-playing. Living within a body that feels alien, and sometimes even revolting, does not necessarily promote feelings of self-esteem, attractiveness, or sexual desire. An escape from perceived unattractiveness, however, may promote feelings of sexual desire. I propose that anyone, regardless of their motivation or gender, who feels more attractive and/or desirable will also experience increased sexual arousal. This is where, I believe, the line between fetishism and transsexuality has become blurred. For some people, cross-dressing is certainly the source of their sexual desire and gratification. It is nothing more. For myself, cross-dressing was a way of creating a positive self-image, which, in turn, often promoted feelings of attractiveness and sexual desire. Today, after transition and surgery, I still feel sexual energy from dressing up and looking my best for a night on the town. I suppose this could be confused for autogynephilia, when it is actually an issue of self-esteem. (239)
Again, this explanation lacks specificity. Many things large and small can enhance a person’s self-esteem: a good haircut, a high grade on an examination, a compliment from a friend. This informant did not explain why cross-dressing in particular
, and not other self-esteem-enhancing experiences, became sexualized for her.
Another informant opined that the male sex drive could potentially sexualize nearly anything, including cross-gender fantasies:
I think that the male sex drive has the potential to be stimulated by almost anything—from the scent of a woman, through pornographic images, to the feel of latex. Almost anything one can think of has potentially erotic content and can generate arousal. It seems not at all surprising that a transsexual with a male sex drive should be aroused by the thought of having a female body and by seeing the results of, and experiencing, the feminization process. In fact, it would be surprising if this wasn’t so. (227)
This explanation similarly lacks specificity: There is no attempt to explain why cross-gender fantasies in particular
should become eroticized by the male sex drive, whereas many other fantasies, objects, and experiences presumably would not.
One informant provided an elaborate explanation of how her cross-gender fantasies had become sexualized during puberty through a process of conditioning that included exposure to her father’s pornographic magazines:
My own feelings of dysphoria began at around 5 or 6 years of age, long before I experienced any sexual arousal or feelings at all. Around puberty, though, as my body became overrun with strong male hormones, I found myself constantly aroused at everything. My desire to be female quite suddenly expanded to include a new sexual aspect. Soon after puberty began, I found a stack of Penthouse magazines in my father’s garage cabinets. In the pictures, the women appeared to be in the throes of orgasm. It seemed from the photos that the mere physical fact of having a vagina and breasts was enough to send the owner into the throes of ecstasy. I began to sexualize the idea of being a woman, meaning that I began to correlate my desire to be a woman with having an erection. Since every masturbatory session I had was naturally associated with a fantasy that I was masturbating as a female, it was only natural that an erectile reaction to the thought of being female would soon occur. Due to the nature of the material I was exposed to, I honestly believed stroking a breast, or just standing with your legs slightly apart and looking down at your closed vulva, was sexually exciting for a woman. Simply put, the women in the pictures seemed to be turned on by their own bodies, and that affected my idea of what it would be like to be female. I feel strongly that my own autogynephilia was nothing more than a side-effect of the deeper problem of gender dysphoria, set in the context of raging male hormones, the “research materials” I had available at the time (porn), and the response of my penis due to episodes of masturbation when I (naturally) imagined I was a female doing the same thing. (125)
This informant’s account is somewhat confusing, but it is helpful to highlight her recollection that “every masturbatory session I had was naturally associated with a fantasy that I was … a female.” Thus, her explanation of her autogynephilic feelings appears to be circular: it starts and ends with the fact that her experiences of sexual arousal and orgasm were invariably associated with the fantasy of being female. This, of course, is the defining feature of autogynephilia.
Another informant proposed that her desire to be female was attributable to prenatal hormonal abnormalities and that she had developed transvestic fetishism because masturbation during cross-dressing allowed her to express her repressed cross-gender feelings through an “acceptable male activity”:
I believe that I became transsexual due to some birth defect (hormonal influx during weeks 12 to 16). As I began to live my life and become more self-aware, I began to notice something was wrong. How did it express itself? In the only way that it could have: I had been trained as a male, so I expressed my repressed feelings in the only acceptable way, a transvestic fetish. I concocted this really tough, impenetrable exterior and locked all the confusing feelings deep within myself, only to be let out during ritualistic masturbation practices, which are again an acceptable male activity. (074)
One might wonder whether most men or women would agree that masturbating while wearing women’s clothing is an “acceptable male activity”—or that wearing women’s clothing and masturbating is more acceptable than wearing women’s clothing and not
masturbating.
Other informants also theorized that their originally nonsexual, identity-related cross-gender fantasies had become secondarily sexualized during or after puberty but were more vague about the mechanism involved. They characterized the sexualization of their cross-gender fantasies as subconscious, a coping strategy, or a response to having concealed their fantasies:
Why does the thought of wearing women’s clothing and being a woman turn me on? My theory is that all transgenders, whether they are transvestites or transsexuals, are born with varying degrees of female gender identity. Because we are raised as boys, this basic need we have—the need to be the sex that we subconsciously view ourselves as being—is not satisfied. As time goes on, and this basic need is repeatedly not satisfied, day after day and year after year, we subconsciously eroticize this basic, fundamental need that has been denied us. In other words, we become autogynephilic. This would explain why autogynephilia always gets more intense as we age: because our basic, fundamental need has not been satisfied for that much longer. (096)
I’ve read a few of the stories on autogynephilia and can relate to many of the experiences described. However, I believe that was because I was obsessed with wearing girls’ clothes. At the time, the only thing I understood was that I wanted to wear girls’ clothing all the time. So, as I went through puberty, I sexualized what I was obsessed with, wearing girls’ clothes. As a youngster, I didn’t have the information or vocabulary to say I was a transsexual. Instead, I engaged in the closest action that would represent being a transsexual, and that was wearing girls’ clothes. What I’m trying to say is that, to cope with being a transsexual, I sexualized the wearing of the clothing. (240)
At about age 4 or 5, I started to want to be a female. I have a twin sister and at that time, I dressed in her clothes to be a girl. As I started to develop sexually, I admit that I was getting aroused by wearing women’s clothing. When I was about 19, I started to fantasize about having a female body to attain an orgasm. I felt very guilty about my female feelings as I was growing up and locked them inside. So, what I am saying is that I didn’t start out with autogynephilic or any other sexual feelings. I just felt like I should have been born a girl. Because I locked in my feelings, they then later on in life developed into a sexual fantasy as a means of experiencing my female feelings. (241)
These explanations are so elaborate and convoluted that one might wonder whether it wouldn’t be easier to simply say, “I’ve always been turned on by the thought of being a girl, but I have no idea why,” and leave it at that. But some informants clearly believed it was important to attempt to explain their autogynephilic feelings as secondary, accidental, meaningless, or irrelevant phenomena. I believe that these explanations represent the informants’ attempts to make their autogynephilic desires seem more conventional or acceptable and thereby make their histories seem to conform more closely to generally accepted ideas about MtF transsexualism.
Comment: Signs of Eventual Sexual Orientation Are Often Evident in Childhood
As noted earlier, several informants argued that their desire to be women could not possibly be a sexual phenomenon because they first experienced that desire during early childhood, well before puberty. Their argument is superficially plausible, but it ignores the crucial fact that children usually display erotic and sexual interests and behaviors beginning in early childhood, long before puberty.
More specifically, many children display genital and nongenital manifestations of their eventual sexual orientations well before puberty. This appears to be true for both normophilic and paraphilic sexual orientations, including autogynephilia. In some cases, the prepubertal signs of these eventual sexual orientations involve genital arousal or masturbation in connection with sexual play with other children or adults (Martinson,
1976
,
1994
); usually this play involves children or adults of the opposite sex, given that most children grow up to be heterosexual. In other cases, the prepubertal signs of eventual sexual orientation involve feelings and behaviors that are not explicitly genital but are associated with sexual attraction or love. Because most adults are unable to remember childhood events that occurred before the ages of 4 or 5 years (Multhaup, Johnson, & Tetirick,
2005
), recalled experiences of childhood genital arousal, sexual attraction, or love that are indicative of eventual sexual orientation usually date from these or older ages.
Martinson (
1976
) described several cases of children between the ages of 6 and 8 who recalled genital arousal in association with sex play with other children or with romantic feelings directed toward other children or adults. He concluded that
the capacity to relate to another person in an erotically intimate way and to experience sexual feelings and satisfactions (either homosexually or heterosexually) is clearly present before puberty. And we are being conservative, for most of the capacity and many of the experiences are present by five years of age … and this in a society that is repressive of infant and child sexual behavior. (p. 255)
Children who grow up to be heterosexual often display affectionate or romantic behaviors toward specific opposite-sex peers between the ages of 4 and 8 years. In a classic article, Bell (
1902
) summarized 800 personal observations and accounts by 360 other observers (most of whom were teachers) involving 1,700 additional cases of “love between children” of the opposite sex. He concluded that:
The emotion of sex-love may appear in the life of the child as early as the middle of the third year.… The presence of the emotion in children between three and eight years of age is shown by such action as the following: hugging, kissing, lifting each other, scuffling, sitting close to each other; confessions to each other and to others, talking about each other when apart; seeking each other and excluding others, grief at being separated; giving of gifts, extending courtesies to each other that are withheld from others, making sacrifices such as giving up desired things or foregoing pleasures; jealousies, etc. The unprejudiced mind in observing these manifestations in hundreds of couples of children cannot escape referring them to sex origin. (p. 330)
Decades later, Hatfield et al. (
1988
) used the Juvenile Love Scale (JLS)—a modified version of the Passionate Love Scale used with adults—to assess feelings of affection, preoccupation, desire for physical contact, desire for future marriage, etc. directed toward a specific boyfriend or girlfriend in children between the ages of 4 and 18 years. They observed that “even the youngest children reported having experienced passionate love. In fact, young children and adolescents received surprisingly similar JLS scores” (p. 35). Hatfield et al. added that “there is no evidence to support the contention that passionate love is fueled by the hormonal changes of puberty …. It is the youngest children and the oldest children who secure the highest scores” (p. 45).
Many boys who grow up to be homosexual similarly report that they first experienced sexual or romantic feelings directed toward same-sex peers between the ages of 4 and 8 years. Savin-Williams and Diamond (
2000
) surveyed 86 young same-sex attracted men and found that their recalled mean age of first same-sex attraction was 7.7 years. Isay (
2009
) presented several case reports describing the early onset of feelings of homosexual attraction in gay male patients and concluded that “it has become clear to me from working with these and other gay men that homoerotic fantasies are often present from 5 or 6 years” (p. 29). Spada (
1979
) presented excerpts from narratives by eight gay men who reported that their first attraction to males occurred between the ages of 4 and 7 years. Kulick (
1998
) reported a similar phenomenon in Brazilian travesti
(male sex workers who wear women’s clothes but identify as homosexual men), in whom “childhood [is] recalled as a period of erotic play with other boys and attraction to other males” (p. 46). Kulick described three travesti
who stated that their sexual attraction to males had begun at age 7 or earlier.
Many adult males who have paraphilic sexual orientations also report that their paraphilic interests became manifest in early childhood. Gosselin (
1979
) found that, in a group of 100 rubber fetishists—men with an intense erotic interest in rubber items—42% reported that their interest in rubber items had begun at age 8 or earlier; the modal age of onset of their interest in rubber was 4 years. Men with transvestic fetishism—all of whom are putatively autogynephilic but many of whom are not gender dysphoric and some of whom do not have cross-gender identities of even mild intensity—often report an early onset of interest in cross-dressing. Doorn et al. (
1994
) found that, among 36 nontranssexual cross-dressing men, 8 (22%) reported that their cross-dressing began before age 7, and another 4 (11%) reported that it began between ages 7 and 10.
Thus, the earliest manifestations of sexual orientation often occur well before puberty, sometimes as genital arousal and sometimes as feelings of sexual attraction or love. In males, this has been observed for persons of heterosexual, homosexual, fetishistic, and transvestic-autogynephilic sexual orientations.
Early Cross-Gender Wishes, Guarded Conclusions
Some informants reported that their cross-gender wishes or fantasies had preceded overt autogynephilic arousal but were more guarded in their interpretations of this temporal sequence. One seemed unwilling to conclude that her early cross-gender feelings were nonsexual, given her awareness that children have sexual feelings before puberty:
Does the sexual pleasure we get when we imagine ourselves becoming women lead to the urge to be a woman, or is the urge to be a woman there already, with the sexual pleasure simply an expression and result of it? I thought I should have been born a girl and wondered how to be one long before I experienced sexual pleasure and reinforcement of my fantasies. Of course, there is the question of prepubescent sexuality and sexual pleasure. (242)
Another felt that autogynephilia was more than just an erotic phenomenon and also encompassed feelings of love and envy. Based on this broader definition, she concluded that her early childhood desires to be a girl were indeed autogynephilic:
I have interpreted autogynephilia to mean “loving” the woman inside oneself, as opposed to simply having a sexual attraction to her. If looked at that way, it seems to encompass feeling envious toward girls and wanting to be a girl long before knowing anything consciously about sex. That certainly was true for me. (243)
A similar view was expressed by a third informant: she felt that the early childhood manifestations of her cross-gender identity were indeed sexual, even if they were not yet associated with any physical evidence of sexual arousal:
I have no doubt, as I look back on my past, that when I was five and wearing perfume, or making pretty necklaces out of colored beads, or arranging flowers, or when I was 7 and volunteering to play Mother Goose in the school play, that sexual motivation was a part of what I was experiencing. But I didn’t understand that until I was 18. I didn’t even notice the physical manifestations of sexual excitement accompanying those thoughts until I was 10, and even then, I didn’t have a clue what it meant. (123)
Yet another individual distinguished between her early autogynephilic fantasies of being a girl (and her associated feelings of gender dysphoria) and her subsequent identification as a woman. She reported that her autogynephilic fantasies came first and therefore were not an effect of any preexisting cross-gender identity:
My autogynephilic fantasies long pre-dated any notion of actually identifying as being a woman. On the surface, this seems to indicate to me that autogynephilia is a cause rather than an effect. Many respondents experienced their first episodes of dysphoria at the onset of puberty. This was true with me as well. At the very moment young males are first becoming aroused by the opposite sex, there apparently is a group of us that are becoming aroused at being the opposite sex. (018)
This informant’s distinction between autogynephilic fantasies on the one hand and cross-gender identity on the other is significant. Autogynephilic persons often report the onset of cross-dressing, cross-gender fantasies, and episodic gender dysphoria in childhood or adolescence. But, as discussed in
chap. 5
and earlier in this chapter, autogynephiles do not typically develop strong, persistent cross-gender identities until adulthood—usually only after decades of cross-dressing (Docter,
1988
). In short, the existence of cross-gender fantasies does not necessarily imply the existence of strong, persistent cross-gender identity in autogynephilic transsexualism.
An Alternative View: Autogynephilia Precedes Cross-Gender Identity
Some informants accepted an explanation similar to the one proposed by Blanchard: they believed that their autogynephilic erotic feelings had preceded and had given rise to their cross-gender identities. One stated:
By the age of eight, I cross-dressed “regularly”—meaning every chance I could find. I would find reasons to stay at home when my mom went visiting friends. By about age twelve, the early-on “excitement” began to be associated with the beginnings of sexual arousal the clothing seemed to cause. By the age of fifteen, the sexual arousal was not a sufficient reason to dress in clothing designed for girls. Instead, I dearly wanted to be a girl. The thoughts or fantasies I had, and continue to have, centered on the desire to experience life as a female. This desire became much, if not most, of my fantasy life, whether sexual in nature, or in night and day dreams. I would say that these powerful sexually oriented night/day dreams largely shaped who I thought I was internally. (106)
Another informant offered a similar explanation: She proposed that, after years of experiencing autogynephilia, autogynephiles might end up believing they are female.
I would like to share my thoughts on the mechanism that causes my condition. The underlying cause is definitely sexual. I believe that, pre-puberty, gender issues result in an unusual sexuality, autogynephilia. Autogynephilia then becomes a powerful driving force; if catered to, the sexual desires then switch to the personality level and the desire to become female becomes pathological. I think you could say that autogynephilia can eventually lead to a sexuality that mimics a heterosexual female. It transfers to the personality level, so you may end up believing you are female. (244)
These informants both touched on an important point that is too often ignored: we discover who we are and define our identities by observing our erotic desires. In both paraphilic and nonparaphilic sexual orientations, “erotic intentions shape identity” (Levine, Risen, & Althof,
1990
, p. 95; see also Person,
1980
).
Correct Embodiment Feels Important; Eroticism Feels Incidental
A few informants argued that their autogynephilic feelings were incidental or unimportant phenomena. They felt that their experience of wrong embodiment and their resulting desire to imagine themselves in bodies that were congruent with their identities were the genuinely important things, whereas autogynephilia per se was unimportant by comparison.
Although I have been married for 25 years, I always fantasize that I am the woman and I need that to climax. I should have found a way earlier, but I am still a transsexual and I still want a vagina. It is not the sex, it is the thought of being just exactly what I always wanted to be. And of course with a vagina I could wear any dresses I wanted, even hot pants! I would love breasts, too. I do know that it is not a sexual thing, though, it is all about being in the right body. (120)
I am certainly aroused sexually by imagining that I am, even for a second, a female in body as well as mind. As the pleasure of orgasm approaches, I imagine myself as a woman being penetrated by a man and in that brief instant, due to the extraordinary power of the human imagination, I really am female in body and soul. That is the core of autogynephilia: pleasure heightened to the level of sexual orgasm, coupled with and associated with becoming for just a second who you really are. Is it an aberration? Some would say yes, but I think rather that it is the expression of an extreme desire to exchange this male body for my real body. (245)
These two informants disagreed on several things, notably whether their autogynephilic fantasies were sexual phenomena, but they both agreed that their sense of wrong embodiment and their desire to have bodies that felt right were at the crux of their problem. Embodiment was important; autogynephilic arousal evidently was not. Of course, it is hard to argue with the statement, “That’s simply not important.” It is interesting, however, that these informants seemed to attach so little significance to the fact that autogynephilic fantasies were either necessary to achieve orgasm or were consistently associated with arousal and orgasm.
Autogynephilic Arousal Is Infrequent, Loss of Libido Is Acceptable
One informant believed that her desire to be a woman was unrelated to sexual arousal, because her cross-dressing led to sexual arousal only infrequently. While she conceded that her gender dysphoria might have begun as a paraphilia, her willingness to lose her sexual libido—presumably as a consequence of hormone therapy or SRS—led her to conclude that her current feelings were not paraphilic:
I feel a strong desire to have a woman’s body to match my inner self, which I feel is deeply feminine. I do not feel that my desire is directly related to sexual arousal, as 99% of the time that I am feeling the need to dress in women’s clothes or wear makeup, etc., I’m not sexually aroused. My gender dysphoria has evolved slowly over the course of my life, and I feel that it may indeed have begun as a sexual paraphilia. Even today, I can still become quite sexually aroused when cross-dressing or wearing a tampon, but the majority of my waking hours are spent in a non-aroused state, wishing I was a genetic female. I have decided that I would rather lose all my sexual libido than continue to live in a male body. Since this is the case, I find it hard to consider my current condition a paraphilia. (246)
Blanchard (
1991
) addressed the observation that overt sexual arousal does not always accompany cross-dressing and cross-gender fantasy in autogynephilic transsexualism:
The relationship between the cross-gender stimulus and sexual excitement is probabilistic rather than inevitable. An autogynephile does not necessarily become sexually aroused every time he pictures himself as a 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. (p. 238)
Does an individual’s willingness to sacrifice her sexual drive in order to feminize her body imply that her gender dysphoria is not, or is no longer, a paraphilic phenomenon? Although many paraphilic men would undoubtedly prefer not to lose their capacity for sexual arousal, the definition of the term paraphilia
does not include any requirement that paraphilic arousal be valued or desired or that individuals would necessarily resist its diminution (e.g., APA,
2000
, p. 535). Money (
1988
) described the relentless compulsivity that often characterizes paraphilic arousal and emphasized the “personal and subjective discontent with having one’s life dictated by the commands of a paraphilic lovemap” (p. 142). He observed that men with paraphilias sometimes appreciate the reduction of libido that antiandrogenic medications such as medroxyprogesterone can offer. Consequently, persons who wish to diminish or eliminate their feelings of sexual arousal to unusual sexual stimuli cannot ipso facto be assumed not to be experiencing paraphilic arousal.
Autogynephilia Might Occur in Natal Women
Several informants theorized that autogynephilic arousal was a common experience among natal women and therefore that their own autogynephilic arousal was simply a manifestation of their intrinsic femininity, rather than evidence of a paraphilia.
I’m really searching for a way by which I can justify my autogynephilic tendencies as being characteristically female and thereby indicative of a bona fide link to universal femininity. Is a genetic woman’s sexual arousal more dependent on physical self-image than a man’s? If they were honest with themselves, how autogynephilic are genetic, heterosexual, so-called “normal” women? Are genetic women aroused by the thought or image of themselves as female? I’m not suggesting that they are attracted to themselves, but rather that their female self-image may contribute to their ability to be aroused or play an important role in their sexual arousal. If this were the case, it would be quite understandable that they would not publicly acknowledge this, and they might not even admit it to themselves. And this is no different than with transsexual women. (047)
Most of the time when I go all out to look as good as possible, I get aroused. I believe the sexual gratification, in my case as with many genetic females, is associated with just trying to look as beautiful as possible. (235)
I would say that the symptoms you describe are equally common among genetic women. Having fantasies about oneself, in a scenario involving a foggy partner, the presence of whom only serves to confirm one’s female identity, may seem perverted for a person who still largely sees herself as a man. But it is perfectly normal for a genetic woman. Her psychologist may not use the term “autogynephilia”, but may instead speak about “narcissism”, which is a less clinical term, thus implying that the fantasies are completely normal. (084)
For myself, fantasies about sex as a woman are important. So, strictly speaking, I am autogynephilic; but my nontranssexual women friends feel the same and were actually amazed that I had to ask them if they had such feelings, as they consider them completely normal. For me, fantasies like this are just a normal thing for me as a woman. (247)
I wonder if a correlation could be made between the erotic feelings of having a female body in pre- and post-SRS transsexual women and the erotic feelings of having a female body in natal women. That could go a long way toward legitimizing the erotic component of having a female body and enjoying it. (020)
There is a sexual motivation for my pursuit of SRS. I like being attractive. I like the comments, I like the attention. At the same time, there are women who will put on makeup and dress nicely, even if they will not see another human that day. I’m one of them as well. So, if it’s a normal woman trait, why try to rip apart when we talk about transsexual women? If a woman looks nice for herself that’s normal; if a transwoman admits to looking nice for herself, she’s autogynephilic. (090)
Having a male body and living a male life are not compatible with having a sex life for me; I can only experience sexual interest or pleasure as a female. How different is that from a lot of natal women? This leads me to wonder if I’m just experiencing a normal female reaction such as a natal woman would feel. (062)
One informant disagreed with these assessments, however:
I can gain sexual gratification through thinking of myself as a woman, both dressed and looking beautiful and naked with a vagina. I think the thought of being a woman is not in itself arousing to a genetic woman. (248)
The informants who proposed that natal women also experience autogynephilia are not alone in so theorizing. Veale et al. (
2008
) reported the responses of 127 natal women to a modified version of Blanchard’s Core Autogynephilia Scale (CAS; Blanchard,
1989b
); they found that many natal women endorsed several items from their modified scale. In another study, Moser (
2009
) surveyed 29 natal women using a scale containing modified items from Blanchard’s CAS and other scales created by Blanchard (for an analysis, see Lawrence,
2010d
); he also found that many natal women endorsed one or more items on his modified scale, although he conceded that “it is possible that autogynephilia among MTFs and natal women are different phenomena and the present inventories lack the sophistication to distinguish these differences” (p. 544).
Unfortunately, both the Veale et al. (
2008
) and Moser (
2009
) studies had serious, arguably fatal, methodological limitations. The modified scales they utilized did not adequately differentiate between being aroused by wearing sexually provocative clothing or by imagining that potential romantic partners might find one attractive (which some natal women apparently do experience) and being sexually aroused simply by the idea that one is a woman or has a woman’s body (which natal women arguably rarely or never experience). In my opinion, it remains to be demonstrated that natal women are genuinely sexually aroused simply by the fact that they are women. Moreover, with the exception of sexual masochism, paraphilic arousal of any kind is extremely rare in natal women (APA,
2000
, p. 568).
Transsexualism Might Reflect a Feminized Brain in a Male Body
A few informants proposed that their transsexualism or gender dysphoria might wholly or partly reflect a mismatch between their male bodies and their putatively feminized brains. They usually believed that their brains had become (or had remained) feminized as a result of some hormonal abnormality—perhaps inadequate exposure to testosterone—in utero:
I’ve felt for some time that the cause of transsexual needs in males was a mix of nature and nurture. I’m sure that the “feminized brain” theory is right and that stress in utero denies a budding male fetus of its due testosterone during brain formation. Studies in rats have indicated as much, with testosterone-deprived male rats taking up the female mating position when with males. Anecdotally, I feel this myself, as I naturally wrap my legs around a male partner’s buttocks during lovemaking. (115)
I am convinced that everything about gender dysphoria happens before birth, when the last surge of testosterone leaves us “half-way,” with a male body but a female brain. In that female brain is the self-image of a woman, which we will try to bring out in many ways throughout our whole life: cross-dressing, sex reassignment, etc. I think that autogynephilia reflects the women we have been inside, since we were in our mothers’ wombs. That means that we have been females always. (249)
These proposed explanations bear some resemblance to past or current biological theories of transsexualism that have been proposed in the scientific literature. Regarding the theory of a “feminized brain in a male body,” Swaab (
2007
) suggested that
as sexual differentiation of the genitals takes place in the first 2 months of pregnancy, and sexual differentiation of the brain starts during the second half of pregnancy, these two processes may be influenced independently of each other, resulting in transsexuality (p. 431).
Unfortunately, the intriguing data that underlie Swaab’s proposal and the limitations and possible interpretations of these data are too complicated to discuss in detail here. Interested readers are invited to consult a recent summary and critique (Lawrence & Zucker,
2012
, pp. 616–617) as an introduction to the topic and a source of references for further exploration. Fortunately, it is not necessary to understand all the nuances of the “feminized brain in a male body” theory to appreciate why some informants might want to invoke this theory in a discussion of the meaning of autogynephilia. The theory provides a plausible biological explanation of transsexualism that neither involves nor requires autogynephilia as a causal or motivational factor. Invoking this theory allows an autogynephilic transsexual to say, in effect: “I don’t know what my autogynephilia means or whether it means anything at all; I only know that biological factors account for my transsexualism and no further explanations are necessary.”
It is worth noting that some informants were more skeptical about the “feminized brain in a male body” theory. One implied that she had previously believed in this theory but was no longer able to do so, after realizing that the concept of autogynephilia applied to her:
I can say with certainty that the theory of autogynephilia applies in a way to me. This realization has added to my depression. It would be so much easier to believe that I was a hapless victim of a brain defect (i.e., having a woman’s brain). (218)
Another had tried to convince herself that she displayed genuine feminine tendencies but had been forced to confront the realization that she was in most ways typically masculine:
Over the years, I had started to believe that I had feminine tendencies. I had begun to form a “female identity” or a “girl within,” as autogynephiles are said to do as an attempt to rationalize their feelings. But since I discovered the concept of autogynephilia, thoughts of being an actual girl have vanished. I now realize that I am a “man trapped inside a man’s body.” My closest friends have always been male, my role models have always been male, and I am not particularly feminine. (014)
This last informant recognized one of the most significant problems with the “feminized brain in a male body” theory as it applies to autogynephilic transsexuals: if our brains are indeed feminized, that feminization somehow doesn’t seem to be very strongly reflected in our attitudes, interests, or sexual orientations. In fact, virtually the only thing feminine about autogynephilic transsexuals is our desire to be feminine. Of course, there are some MtF transsexuals who are genuinely quite feminine in their attitudes, interests, and sexual orientations, but these are homosexual MtF transsexuals, who represent an entirely different transsexual type.
The Case for Autogynephilia Having Explanatory Meaning
A chapter addressing transsexuals’ opinions about the meaning and significance of autogynephilia would be incomplete without a brief statement of the case for autogynephilia operating as a meaningful explanatory factor in the lives of autogynephilic transsexuals, whether or not it is acknowledged as such. This is easily accomplished: With the exception of cross-dressing, we autogynephilic transsexuals rarely display female-typical behaviors, attitudes, or interests during childhood or adulthood (e.g., Blanchard,
1990
; Whitam,
1987
,
1997
). Consequently, our gender dysphoria cannot plausibly be attributed to gender-atypical behaviors, attitudes, or interests. What can the gender dysphoria of autogynephilic transsexuals be attributed to? From what source does it derive? Autogynephilia provides the only obvious answer: Our gender dysphoria and our resulting cross-gender identities are direct outgrowths of our paraphilic desire to turn our bodies into facsimiles of women’s bodies.
If autogynephilia is not considered a meaningful explanatory factor, then attempts to account for the gender dysphoria and cross-gender identities that we autogynephilic transsexuals experience quickly become circular, self-referential, and slightly ridiculous:
Q: Why do you want to become a woman?A: Because I experience gender dysphoria.Q: What does that mean?A: That I experience persistent discomfort with my male sex and gender role.Q: Why are you so uncomfortable with your male sex and gender role?A: Because I want to become a woman.Q: Why do you want to become a woman?A: Because I have a strong and persistent cross-gender identity.Q: What does that mean?A: That I desire to be the other sex and live and be treated as a member of the other sex.Q: In other words?A: I want to become a woman.
I would argue that an account that treats autogynephilia as a meaningful explanatory factor offers at least a modest improvement:
Q: Why do you want to become a woman?A: Because I experience a paraphilic erotic desire to have a woman’s body.Q: Is there anything else?A: After having that desire for 20 years, I’ve started to think of myself as a woman, too.Q: Anything else?A: I love women and I have a desire to become more like the women I love.Q: I’m beginning to understand—but it makes me think your sexuality is very odd.A: You’re right; but I can only play the hand I was dealt.
Perhaps someday we autogynephilic transsexuals will be able to forthrightly acknowledge the paraphilic hand we were dealt and play that hand without equivocation or apology. I will discuss this possibility in greater detail in
chap. 12
.
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