CHAPTER 2

RABBIT HOLES

BO AND I managed to limp along together for about one more year after the Human Rights Commission hearing. In that last year of work together, we coordinated and published the first detailed consensus-based clinical guidelines for intersex pediatric care, along with a handbook for parents. By the time we finished, leaders from all of the major diagnosis-specific intersex support groups, clinicians from every relevant specialty, parents of affected children, and adult intersex activists all had signed on to the collaboration. Soothing these forty-some people into compromise over the phone for these texts damn near killed me. But when the two handbooks came out and were passed around in medical settings, even the old guard muttered appreciation. Although we lacked adequate data to know that our model was better for patients than the old way, we put forth an approach that seemed most likely to minimize harm, given what we knew historically and scientifically: For newborns with confusing sexual anatomy, assign a best-guess preliminary gender label of boy or girl, with the understanding that no surgery is required for a gender label. Provide medical and surgical care known to be needed to lower serious risk of illness or death, but hold off on all elective interventions, including elective genital surgeries, until the patient can decide. Provide ongoing psychosocial support by well-trained professionals for children and families. Above all, tell people the truth.

Right about the time we were getting ready to publish our handbooks, the big North American and European pediatric endocrinology groups decided to hold a conference on intersex care to arrive at their own “consensus.” Bo was given an invitation to the meeting, as were several clinicians now firmly on our side. After talking with each ally who was invited, I put together a confidential list of talking points and gave it to each. As we hoped, a high-level international medical consensus emerged: The specialists agreed that they needed to work harder to collect and then follow long-term-outcomes data, to provide team care featuring dedicated psychosocial professionals, to find ways to tell patients and their parents the truth without making them feel overwhelmed and helpless, to stop counting patients who grow up gay or change their gender labels as medical failures, and to hold off on at least some genital “normalizing” surgeries until the patient could decide. Although these guidelines would not end surgical normalizations of genitals in early childhood right away, this consensus did mean that parents (and their sons and daughters) finally might get serious psychological support and be told what we know and don’t know about intersex. Some of the doctors even started talking about shame, which had always been the real problem in intersex care. Moreover, they were all talking about needing to do better science to figure out what medical care really helps and what harms.

You’d think I’d have been dancing in the streets at this point, but like Bo, I was seriously worn down. For ten years, I had put up with the hardships of activism, and now the friendship with Bo that had long sustained me had started to evaporate. ISNA, once our joint baby, had morphed through its success into a sort of miserable small business, something neither of us felt especially excited about. A lot of pushing and pulling ensued. It turns out that having been through a war together doesn’t necessarily mean you come back home able to make dinner together. I finally quit.

Relinquishing ISNA to Bo felt like losing a beloved stepchild in an unhappy divorce, and losing Bo as an intimate friend felt even worse. It didn’t help that just a few months before leaving ISNA—back when I was still kidding myself that I could keep working with Bo if I could just find a way to make my workload manageable—I had also quit my tenured professorship at Michigan State University. With a lovable four-year-old at my knee, I was tired of trying to do everything the university wanted of me. (A funny thing about writing manuals for parents of intersex children: You start thinking a lot about what’s missing from your own parenting.) I just wanted to work from home, doing patient advocacy for victims of medical trauma, writing histories, and limiting my son’s day care to six hours a day.

Then, like a tsunami after an earthquake, just a few months later, Aron was suddenly pulled from his medical-faculty position into an associate dean’s chair at Michigan State, putting him essentially in charge of medical education at the university. While this meant plenty of family income to support me in my unconventional career move, it also meant that my rock of ten years had become the medical school’s quarry just when I needed his grounding most.

Fortunately, not long after I’d turned in my resignation letter to Michigan State, a couple of colleagues had talked me into taking a part-time faculty position at their place, the Medical Humanities and Bioethics Program at Northwestern University’s medical school in Chicago. The program’s director promised that I could work almost entirely from home and basically do whatever work I wanted in exchange for putting the program’s name on it. I could also have the unit’s great faculty to lean on as colleagues. Still, with Aron suddenly absent, my job officially requiring almost nothing of me, and ISNA gone from my days forever, I found myself thoroughly unmoored—stumbling around as if I kept forgetting I’d had one leg amputated.

I found myself doing what any self-respecting straight woman does when she’s disoriented by an identity-rocking emotional smash-up: I listlessly rearranged playlists and bookshelves while talking on the phone to my gay friend Paul. Paul Vasey is a Canadian scientist who spends part of the year studying the fa’afafine, biological males who live as women on the tropical island of Samoa, and part of the year studying girl-on-girl monkey action in the snowy mountains of Japan. (The Weekly World News once featured the macaque monkeys Paul researches under the headline LESBIAN MONKEY SHOCKER! Paul told me it was actually a pretty good article.) Not long after the time I was calling him three times a week for company, Paul and his colleagues conducted a formal study of “fag hags”—straight women like me who have many gay male friends. They showed scientifically what Paul demonstrated in my life that year: that gay men make their close women friends feel better about themselves. Being a hard-driving scholar like me, Paul knew—and told me bluntly—that I just needed a big new project, one that would feed my hungers for intensive historical research and social justice. Soon enough, he’d lead me into one: the Bailey transsexualism controversy.

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WHEN PEOPLE ASK ME how transgender is different from intersex, I usually start by saying that intersex and transgender people have historically suffered from opposite problems for the same reason. Whereas intersex people have historically been subjected to sex “normalizing” hormones and surgeries they have not wanted, transgender people have had a hard time getting the sex-changing hormones and surgeries they have wanted. Both problems arise from a single cause: a heterosexist medical establishment determined to retain control over who gets to be what sex.

Aside from that huge shared problem, intersex and transgender actually are quite different. By definition, intersex involves having some anatomical feature that makes one’s body atypical for males or females; it’s primarily about anatomy—your body. By definition, being transgender means rejecting the gender assignment that was given to you at birth; it’s primarily about self-identity—your feelings. Although a small minority of intersex people do reject their birth gender assignment, most don’t, and most transgender people weren’t born intersex. In the great majority of cases, medical scans won’t detect any intersex feature in a transgender person’s body. Nevertheless, many people believe that transgender must be a special form of intersex involving the brain. Here’s that popular, comforting narrative: Everyone is born either male or female in the brain. But a person might accidentally be born with the “wrong” sexual anatomy—be born with an essentially female brain in a male body, or vice versa. If this happens, the person will know from early childhood that a terrible mistake has been made. If fortunate, such a person will eventually be able to come out of the closet and use surgery, hormones, and the legal system to end up with the body and social identity she or he should have always had.

Although there is very little science to support it, this has become the most popular explanation of transgender, probably in part because it is the easiest one for uptight heterosexuals to accept. Some people appear to switch sides, but everyone can rest assured that they didn’t really switch; they just finally got sorted out correctly by having their internal gender realities externalized by transsexual hormone treatments and surgeries. In practice, this story of transgender can function as a kind of get-out-of-male-free card for men who seek to become women anatomically. When that card is played, the comforting narrative of “true selves” is preserved. Everybody really has just one true gender from birth to death, so gender seems ultimately very stable. Now, no one really gets out of being male for free—the physical, financial, and personal costs of transition are pretty high—but this narrative does give a person a way out to which other people can’t easily object, at least in America, where the quest for the true self counts as admirable, even sacred.

If Northwestern University psychology professor J. Michael Bailey had accepted this story of male-to-female transsexualism, he and I might never have met, because he never would have gotten himself into such a pickle with transgender activists. But as I was to learn, Mike Bailey has never cared for simple, politically correct stories. In fact, he liked using his research and his college classes to kick politically correct assumptions around until they were as dented as soda cans on the sidewalk. In his view, the simple “female brain in a male body” was unscientific and had to go.

In 1997—right about the time I had started helping Bo with ISNA—Bailey decided to write a book for the general public about “feminine males.” His decision came after he attended a Barnes & Nobel book-signing by a Chicago-based therapist named Randi Ettner, who was promoting her new book, Confessions of a Gender Defender. In it, Ettner pushed the politically correct “brain of one sex trapped in the body of the other” story of transgender. This rankled Bailey. Make no mistake: It wasn’t that he wanted to stop transgender people from getting access to the hormones and surgeries they wanted. Far from it. As a libertarian, he always wanted to see these folks get whatever medical technologies they needed to feel whole, just as Ettner did. But he also wanted to replace what he saw as a false picture of male-to-female transgender with what he saw as the true one. He wanted better science and progress for transgender rights, and he hoped to help push both by writing his own popularization.

It took Bailey another six years, until 2003, to complete and publish The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism. The first hint that this work would reject simplistic gender-identity stories—from transgender people or anyone else—came from the book’s provocative and insensitive cover. It featured a photo of two hairy masculine legs standing in a pair of pretty pumps, shown from the knees down—an image seen by most people (including me) as more befitting a Monty Python cross-dressing sketch than a book about science from a trans-friendly writer. (Bailey chose this cover against the advice of colleagues, who preferred a vastly less offensive alternative showing three faces, one feminine, one masculine, and one androgynous.) Meanwhile, in the text, like a lot of feminists with whom he otherwise tangled, Bailey rejected the idea of anybody being simply male or simply female in the brain. He suggested to his readers that “gender identity is probably not a binary, black-and-white characteristic. Scientists,” he complained, “continue to measure gender identity as ‘male’ or ‘female,’ despite the fact that there are undoubtedly gradations in inner experience between the girl who loves pink frilly dresses and cannot imagine becoming a boy and the extremely masculine boy who shudders to think of becoming a girl.”

Rejecting the idea that everybody is truly and easily assignable to one of two gender identities, Bailey unapologetically and aggressively introduced his readers to a generally unfamiliar understanding of male-to-female transgender. This understanding depended not on an idea of a “true female” trapped within, but on sexual orientation. Male-to-female transgender, in Bailey’s view, was more about eroticism than gender identity per se. Here Bailey was drawing on the work of Ray Blanchard, a sex researcher working at Canada’s Centre for Addiction and Mental Health in Toronto. When Blanchard considered the historical and clinical literature and his own experience working as a psychologist with hundreds of adult men seeking sex reassignment, he realized that there are two basic types of male-to-female transsexuals, very different from each other in terms of their life histories and demographics. Blanchard also realized that these two types could be recognized primarily by their sexual orientations. Blanchard concluded that male-to-female transsexualism isn’t simply about gender identity (whether you really feel yourself to be male or female) but is fundamentally about sexual orientation (whom or what you really desire).

The first of the two types of male-to-female transsexuals identified by Blanchard begin life as very femme little boys. They are “sissy boys” who like activities generally considered girly. Little boys of this type like to dress up in girls’ clothes, play house, and play games involving fashion, and many are downright averse to “boyish” rough-and-tumble sports or games of war. They seem more classically feminine than masculine in social interactions. They are highly attuned to social relations and often like helping their mothers with housework. From the moment of the development of their sexual interests, these folks are unequivocally sexually attracted to other males. Before they become women, in their behavior and their exclusive sexual interest in men, they appear to be superfemme gay men. Unfortunately, this means that their sexual opportunities are often limited while they are presenting themselves as men. Straight men aren’t interested in having sex with them because they’re male, and gay men often aren’t sexually attracted to them because most gay men are sexually attracted to masculinity, not femininity, and these guys are really femme.

Now, because they are so femme, when they dress as women, even before hormonal or surgical transition, these folks pass pretty easily (as women), which means straight men become interested in them. Needless to say, they pass even better after hormonal and surgical transition. As post-transition women, they can and happily do take straight men as their sex partners. As a consequence, for these male-to-female transgender women, sex reassignment makes possible a more satisfying sex life and a more comfortable gender presentation, as they no longer have to fight to dampen their natural femininity. Transition also means a less painful and safer life; as women, they are not as often subject to homophobic abuse and assault, always a danger for femme men.

In articulating this demographic profile among the clinical population of male-to-female transsexuals presenting for sex reassignment, Blanchard called these people homosexual transsexuals, because they are natal males sexually attracted to other males. Although scientifically precise, this is a term I generally find confusing because, when these people change their sex from male to female, they then become heterosexual. Therefore I generally use the less confusing and less clinical term that many of these folks use for themselves—transkids, a term that recognizes that in this population obvious gender boundary crossing starts early in life.

Bailey’s book contained portraits of several transkids, but the most vivid was that of an attractive Latina trans woman identified as Juanita. Juanita came across in Bailey’s prose as a seriously attractive and highly sexed woman, one who made a good living for a time as a sex worker. After her transition, she eventually landed a nice husband in the suburbs. However, Bailey reported, she finally gave all that up because she missed the excitement of the city—including the sexual variety. Juanita perfectly embodied Bailey’s understanding of transkids: She was a sexy, very feminine individual with a typically male (strong) interest in sex and a typically male (high) interest in casual sex—the kind of person, Bailey said, who “might be especially well suited to prostitution” (groan).

OK, now here drops the other shoe, the part of Blanchard’s theory that really pissed off the people who went after him: Blanchard noted that nonhomosexual transsexuals—putatively straight, bisexual, and asexual men asking for sex reassignment—looked very different from the transkids in their life histories, their habits, and their sexual interests. Members of this second group were not markedly femme in childhood. In fact, as kids they seemed to everybody like typical boys—often having been into sports, military play, and vehicles. Many of them went into fairly male-typical occupations—they were engineers, mathematicians, and scientists in heavily quantitative fields. They were exclusively or primarily sexually attracted to females, and before transition they were typically married to women and had fathered children. Unlike the transkids, these men looked to the outside world like typical straight men right up until transition. People who knew them were usually completely shocked when they announced they were going to change sex. But they didn’t feel like typical straight men do. Unlike most straight men, they felt there was a powerful, almost overwhelming feminine component of their selves. Part of that sense involved finding themselves sexually aroused by the idea of being or becoming women.

Wait—what? What does that last bit look like? Well, in terms of fantasies, it’s a variation on what each of us fantasizes about sexually, when masturbating, for example. One person might imagine oral sex with a particular movie star. Another might imagine being tied up and teased by a stranger. Another might imagine “plain vanilla” intercourse with a lover. Note that all these sexual fantasies involve gender; that is to say, when we fantasize sexually, we typically do so in ways that specify the genders of the parties involved. Gender can be seriously pleasurable for most of us. For the man who is sexually aroused by the idea of becoming a woman, the gendered component of the fantasy is brought to the fore; the simple idea of being or becoming a woman causes sexual excitement. Blanchard coined a new term for this type of male-to-female transsexualism: autogynephilia, meaning self-directed (auto) love of females (gynephilia). Pretransition, these men experience “love of oneself as a woman,” a phrase downright beautiful in French: amour de soi en femme.

Blanchard’s taxonomy of male-to-female transsexuals recognized the importance of sexual orientation in the gendered self-identities of both those who begin as homosexual males and those who experience amour de soi en femme. However, he didn’t see sexual orientation as the only thing a male factors in when deciding whether to transition. He recognized that in one environment—say, an urban gay neighborhood like Chicago’s Boystown—an ultrafemme gay man might find reasonable physical safety, employment, and sexual satisfaction simply by living as an ultrafemme gay man. But in a very different environment—say, a homophobic ethnic enclave in Chicago—he might find life survivable only via complete transition to womanhood. Whether a transkid grows up to become a gay man or a transgender woman would depend on the individual’s interaction with the surrounding cultural environment. Similarly, an autogynephilic man might not elect transition if his cultural milieu would make his post-transition life much harder.

To firmly make this point about biology interacting with environment, Bailey’s book begins and ends with the story of Danny. Bailey presents Danny at the start of the book as a femme little boy who seemed to want to be a princess and whose mother consequently came to Bailey for advice. At the end of the book, the reader learns that Danny has been growing up into a young gay man in the care of accepting and loving parents. Surprisingly—given that the author is a self-identified genetic essentialist—Bailey used Danny’s story as the frame for his book to teach the importance of culture to identity. Bailey wanted the reader to understand this: Although people are born inclined to particular sexual orientations and gendered behaviors, transgender isn’t something you’re born either to be or not to be. Contrary to the popular mainstream understanding of transgender, whether you end up living as an out gay man, a closeted gay man, or a straight transgender woman depends not only on biology, but also on cultural tolerance of various identities. Biology plus cultural environment equals the experience of identity.

Just to be clear: This interplay of biology and culture affects everyone’s experience of identity, not just transgender people’s. To take an example familiar to most women, whether it matters that my female physiology turns my occasional frustration into tears rather than punches, whether I feel denigrated or accepted as a person hormonally prone to involuntarily crying—that depends on the culture around me. So, while in a very homophobic environment Danny might have grown up to be a transgender straight woman, because his parents and community generally accepted that he would always be a male attracted to men, he was growing up instead to be a gay man.

Paul Vasey has been documenting that in Samoa little boys who are naturally very femme are welcomed into a special gender category called fa’afafine, a term that signifies living “in the manner of a woman,” and are raised like the girls. The fa’afafine grow up in female roles, tending to the family and taking men as their lovers, although they almost never alter their anatomy, because their traditional culture doesn’t require them to do so in order to live as women socially and sexually. They are transgender women without any hormone treatments or surgery. The fa’afafine are understood and accepted this way by their families and their lovers, and have been for generations. In now-Christianized Samoa, they wouldn’t be so well understood or accepted if they self-identified as gay men.

Samoa is not unique; indeed, Bailey’s book pointed out that “homosexual transgenderism” is the most common form of transgenderism around the world, found, for example, in Thailand, Mexico, Iran, and Albania. In many cultures, homosexual transgenderism has functioned for countless generations as a way to “straighten out” homosexual desires—a response that can be tolerant and progressive (as in Samoa) or repressive (as in Iran), depending on how it is enacted and experienced.

Thus, whether transkids change sex medically and surgically depends on the way their biology, their psychology, and their culture interact. As Blanchard and Bailey noted, the same is true for the men who become women by way of amour de soi en femme (autogynephilia). Whether a man who dreams erotically of becoming a woman opts to change sex hormonally and surgically depends upon the interaction of the individual’s body and psychology with the local cultural environment. Some of these folks simply fantasize about crossing into womanhood while remaining apparently typical straight men socially their whole lives. They may try to suppress the thoughts, or they may enjoy transsexual erotica, but they limit themselves to thoughts and dreams. Others will occasionally cross-dress for erotic purposes and to enjoy temporarily experiencing a deep feeling of femininity. The psychiatrist Richard/Alice Novic writes about this kind of bi-gendered life in the autobiographical Alice in Genderland. Novic spends part of the time living as Richard with his wife and children and part of the time as Alice, enjoying the company of a boyfriend who accepts and desires her as she is. Unlike Novic, a few men who experience amour de soi en femme do decide to seek medical interventions. Some opt to get breast implants or to take female hormones—to enhance their sense of being a woman and to be socially “read” as women—while keeping their male genitals. And a few autogynephilic individuals find that they can feel fulfilled only by complete hormonal, surgical, and social transition to women. For those who seek full transition, that’s what it takes to feel that they are living an authentic life, true to themselves.

In Bailey’s book, the portrait of amour de soi en femme male-to-female transgenderism came in the form of a trans woman identified as Cher, née Chuck. The reader gets the sense that Bailey likes Cher, but his portrayal of her is startling. As a boy and young man, Chuck seemed like a pretty typical guy. But unlike most guys, Chuck made elaborate pornographic films of himself dressed as a woman, complete with female masks, homemade fake breasts, and a glue-on vulva. (He pushed his penis up into his body and used an adhesive to hold it there, a feat made easier by having been born with only one testicle.) Chuck made robots to simulate heterosexual sex, so that he could experience sex as he thought a woman might. Eventually he realized he needed to be seen by all as the woman felt inside. And so, with the help of gender-affirming hormones and surgery, Cher emerged.

In Bailey’s account, Cher blossomed after transition, finally able to live out the gender identity she had long felt and desired. As is the case for transkids like Juanita, transition can make the lives of people like Cher far more fulfilling. It lets them be who they feel they really ought to be, who they really are. Life is surely a lot easier when people treat you the way you feel you should be treated in terms of your gender identity and sexual orientation. Perhaps not surprisingly, women from both groups—Juanita’s and Cher’s—report on average doing better psychologically post-transition. Blanchard is one of the researchers who has documented substantial improvement for well-screened trans women, and he has used that outcomes research to openly support, in sworn testimony, the public funding of sex reassignment in Canada. Blanchard and Bailey see trans women who begin with homosexual desires and those who begin with amour de soi en femme as radically different from each other in some ways (childhood gendered behaviors and sexual orientation) but equally deserving of quality care, human rights, and public support. But the subtlety of their position—supporting political rights for transgender people while promulgating a politically incorrect reading of male-to-female transgender—was lost on certain transgender activists, who attacked Bailey for his support of Blanchard’s theory.

Still, an outsider might wonder how Bailey’s acceptance of Blanchard’s conclusions could be read as so very offensive. Why were so many trans people willing to enlist in the army assembled to fight Bailey within days of his book’s publication? In the first pages of his book, Bailey summed up Blanchard’s taxonomy of male-to-female transsexuals in rather tender prose: “Those who love men become women to attract them. Those who love women become the women they love.” It sounds so sweet, really, all that love. But most of Bailey’s book represented male-to-female transsexuality as a matter of lust—gay lust in the case of the transkids like Juanita and self-lust in the case of autogynephiles like Cher. When Bailey talked about people like Cher, he explicitly labeled their sexual desires paraphilic—a word that to many means “sick” even when it refers to consensual, nonexploitive sexual interests.

Therein lay a real problem, one that explains why the transgender activists who went after Bailey were able to garner fairly widespread help from other transgender people, at least at first. Before Bailey, many trans advocates had spent a long time working to desexualize and depathologize their public representations in an effort to reduce stigma, improve access to care, and establish basic human rights for trans people. The move to talking about transgender instead of transsex was motivated in part by a desire to shift public attention away from an issue of sexual orientation (sexuality always being contentious) to an issue of gender. This is similar to how gay rights advocates have desexualized homosexuality in the quest for marriage rights, portraying themselves in living rooms and kitchens instead of bedrooms, in order to calm fearful heterosexuals.

The de-emphasis of sexuality among trans advocates also occurred because some of the sexologists and clinicians who had acted as gatekeepers for sex reassignment had for many years maintained the heterosexist idea that the transkids like Juanita were the only good candidates for sex reassignment. The transkids were naturally pretty femme and could be counted on to remain stably attracted to men, so they passed easily as straight women with no massive disruption of the heterosexual order. Meanwhile, many applicants for reassignment who showed any hint of amour de soi en femme—the would-be Chers—found they had to lie about their orientations and histories to get what they needed. Otherwise some clinicians were reluctant to let them get the hormones and surgeries they sought. In 1969, one clinician had indicated that a single instance of arousal by cross-dressing should eliminate a man from candidacy for sex-reassignment surgery.

Indeed, a few retrograde clinicians, like Paul McHugh, a psychiatrist at the Johns Hopkins University School of Medicine, still actively use the idea that male-to-female transgender is really about perverted sexuality and mental illness to argue against access to sex-transitional hormones and surgeries. McHugh and his ilk ignore the fact that well-screened trans women are better off after transition, as if their well-being and happiness are utterly irrelevant. McHugh (whom Bailey actually criticizes in his book) has likened sex reassignment to doing liposuction on anorexics, apparently not noticing that, um, anorexia kills people while sex reassignment for adults saves lives. All this has contributed to the mainstream trans community’s feeling that it makes more sense to emphasize issues of gender identity rather than issues of sexuality. After all, under any reasonable understanding of human rights, one’s sex life ought to be one’s own business so long as one isn’t hurting anyone else.

It’s also worth mentioning, given how often cultural sex politics play out in universities, that academic feminists have always seemed a lot more supportive of transgender than transsexuality—that is, when they’ve been supportive at all. The history of feminism and trans issues has been fraught with tension, especially since feminist Janice Raymond’s 1979 book, The Transsexual Empire, which accused trans women of actively undermining the work of “real” feminists by supposedly giving in to the heterosexist patriarchy by simply switching over from stereotypical male to stereotypical female. Raymond even claimed, “All transsexuals rape women’s bodies by reducing the real female form to an artifact, appropriating this body for themselves.” Some feminist groups, like the Michigan Womyn’s Music Festival, still shun transgender women, admitting only “womyn born womyn.” (So much for Simone de Beauvoir’s observation that women are not born, but made.)

Add to that the fact that, in many places, discrimination against trans people has been perfectly legal in housing, employment, even schooling. Then add the history of police refusing to investigate (or even participating in) gay-bashings and murders of trans people, not to mention emergency workers refusing to treat trans people with life-threatening injuries, and you get a group understandably vigilant about possible violations of their rights.

In short, there is always a lot at stake politically and socially when you’re talking about transgender. And yet, while some of Bailey’s best friends really were gay men and trans women, in his clueless privileged way, he didn’t worry about his work’s political implications for sexual minorities. He worried only about what’s right scientifically, and he decided that Blanchard’s taxonomy was right about the salience of sexual orientation to male-to-female transsexuality. Bailey gave quite sympathetic portrayals of all the trans women in his book, including Juanita and Cher, and he firmly concluded that the ultimate happiness of individual transgender people is what matters most, even if transitions leave families or communities unhappy. But Bailey made the mistake of thinking that openly accepting and promoting the truth about people’s identities would be understood as the same as accepting them and helping them, as he felt he was. Where identities as stigmatized as these are concerned, it just isn’t that simple. The shame and derision accorded trans women like Juanita and Cher doesn’t disappear just because a few scientists may be personally fine with the idea that men might become women primarily because of reasons of sexuality, not “trapped” gender identity. As I came to learn, Bailey thought sexuality was a plenty good reason for lots of actions. But the trans women who attacked Bailey for his book understood that the world would probably not agree.

And they weren’t interested in finding out. They wanted the whole business of Blanchard’s taxonomic division shot down. Transsexuality should appear only as the public could stomach it, as one simple story of gender, a tale of “true” females tragically born into male bodies, rescued and made whole by medical and surgical sex reassignment. And there should be absolutely no mention of autogynephilia or any other sexual desires that might make trans women look to the sexually sheltered like the perverts they were historically assumed to be.

To understand the vehemence of the backlash against Bailey’s book, you also have to understand one more thing. There’s a critical difference between autogynephilia and most other sexual orientations: Most other orientations aren’t erotically disrupted simply by being labeled. When you call a typical gay man homosexual, you’re not disturbing his sexual hopes and desires. By contrast, autogynephilia is perhaps best understood as a love that would really rather we didn’t speak its name. The ultimate eroticism of autogynephilia lies in the idea of really becoming or being a woman, not in being a natal male who desires to be a woman. At least in fantasy, the typical autogynephile erotically desires a complete identity transformation—to be a woman, not to be a transsexual. So when the autogynephilic psychiatrist Richard/Alice Novic talks about her boyfriend stimulating her genitals, she refers to her “clitoris,” although anatomically what she has is a penis. The erotic fantasy is to really be a woman. Indeed, according to a vision of transsexualism common among those transitioning from lives as privileged straight men to trans women, sex reassignment procedures are restorative rather than transformative, because the medical interventions “fix” what some call the “birth defect” in their natal bodies. Some even reject the label of transgender or transsexual for this reason; to themselves they are simply women, outside now as they always were inside.

For Bailey or anyone else to call someone with amour de soi en femme an autogynephile or even a transgender woman—rather than simply a woman—is at some level to interfere with her core sexual desire. Such naming also risks questioning her core self-identity in a way that calling the average gay man homosexual simply can’t. One really must understand this if one is going to understand why some trans women came after Bailey so hard for naming and describing autogynephilia. When they felt that Bailey was fundamentally threatening their selves and their social identities as women—well, it’s because he was. That’s what talking openly about autogynephilia necessarily does.

In a nutshell—and this is really indisputable—it was Bailey’s dangerous dissemination of this part of Blanchard’s work that led a prominent transgender woman named Lynn Conway to begin what became a war against Bailey from her base at the University of Michigan, where she was on the computer engineering faculty. As Conway must have understood, Blanchard’s scientific work, always written in rather dry prose and published in hard-to-access specialist journals, could never pose the threat of Bailey’s The Man Who Would Be Queen, with its intriguing scope, engaging prose, sex-positive tone, and compelling personalized portrayals. Bailey’s book constituted a serious innovation. It could well bring Blanchard’s taxonomy—including news of autogynephilia—to the masses and change the public perception of women like Conway.

And so, within days of publication of The Man Who Would Be Queen, Lynn Conway sent an urgent e-mail to a trans woman ally named Andrea James:

I just got an alert about J. Michael Bailey’s new book. It’s just been published and of all places it’s co-published by the National Academies Press, which gives it the apparent stamp of authority as “science.” . . . As you may know, Bailey is the psychologist who promotes the “two-type” theory of transsexualism. . . . Anyways—not that there is much we can do about this—but we should probably read his book sometime and be prepared to shoot down as best we can his weird characterizations of us all.

You’re probably wondering how I got that e-mail. The answer is that Conway developed what became an enormous Web site hosted by the University of Michigan for the purpose of taking down Bailey and his ideas. There she proudly and steadily recorded her efforts against Bailey, Blanchard, et al. In fact, it was her own university Web site that largely enabled me to figure out what she had really done and how Bailey had essentially been set up in an effort to shut him up about autogynephilia.

 • • • 

WHEN BAILEY’S BOOK emerged in 2003, I didn’t pay much attention to the mushroom cloud expanding over Evanston, Illinois, where Bailey was tenured in Northwestern’s Psychology Department. At that time, I was still working on intersex at Michigan State. But people I knew were increasingly trying to get my attention focused on it. Paul Vasey kept telling me he couldn’t believe what transgender critics were doing to Bailey and even to his children and girlfriend, and Lynn Conway herself was calling me to help go after Bailey. In fact, as I found out via Paul, Conway had simply added me to her Web site’s list of outraged allies, apparently assuming I would agree with her.

But in 2003 I waved both Vasey and Conway off. To Paul, I said I didn’t have it in me to feel sorry for a member of the sexology establishment, given what the bastards had done to intersex children. To Conway I was more polite. She was a major donor to ISNA, and we didn’t have a lot of those. Still, I told her to take my name off her list of Bailey opponents—I hadn’t even read the book—and I advised her to just ignore Bailey. Paying attention to him, I told her, will just help sell his book.

Conway and company didn’t give up, however. The mounting pile of national press reports on the scandal made that clear. Whereas at first the complaint was that Bailey’s book portrayed a wrong and offensive vision of men who seek sex changes, soon the complaints became less about his supposedly offensive theory and more about his allegedly unethical actions. The emerging charges looked bad: that Bailey had failed to get ethics board approval for studies of transgender research subjects as required by federal regulation; that he had violated confidentiality; that he had been practicing psychology without a license; and that he had slept with a trans woman while she was his research subject. The wildfire nature of the conflagration made me no more inclined to get near it.

In early 2006—three years after Mike Bailey published his book, just after I quit ISNA, and a few months into my Northwestern position—I made plans to meet Paul in Chicago. We had decided to edit together a special journal issue on the evolution of sex, so we were meeting to hash out the details. But Paul also wanted to use the trip to introduce me to Bailey. Paul had been telling me about him off and on for years, mostly to tell me about the hell he’d been going through at the hands of the transgender activists. Paul said that the whole experience had terrorized Bailey, that he was a different man than before the controversy.

By that time, at Paul’s request, I had read The Man Who Would Be Queen. Paul had always insisted that it was a very good book about the range of feminine males. After a careful read, I had responded to Paul that it was certainly very original and engaging—and much more explicitly supportive of gay and transgender rights than I had expected—but that it had some truly obnoxious parts in it. Granted, they amounted to just a few lines, but they grated. For example, there was the bit where Bailey claimed he could “know” much about the childhood and sexual orientation of a man he had just met, merely because the man was quite femme; the line where Bailey called one entire group of trans women (those with amour de soi en femme) not particularly good-looking; and that passage where he suggested that the other group (the transkids) might be especially well suited for sex work because after transition they supposedly possess the perfect combo of traits and interests. There was also one place where Bailey wrote this: “When [the transkid Kim] came into my laboratory, my initial impression was reconfirmed. She was stunning. (Afterward my avowedly heterosexual male research assistant told me he would gladly have had sex with her, even knowing that Kim still possessed a penis.)” I got that in this passage Bailey was trying to convince people to get over their knee-jerk transphobia—but honestly, calculating a trans woman’s attractiveness using this particular metric seemed a bit much for a book by a scientist. Then there was the dreadful cover photo. I didn’t know if the nasty things people had been saying online and to reporters about Bailey were true. But I knew it was true that the book read as if written from a place of heterosexual white male privilege even though it was surprisingly saturated with genuine affection, sympathy, and unabashed support for femme boys, gay men, drag queens, and transgender women.

In advance of meeting in Chicago, with my tense approval, Paul set up dinner for the three of us in Boystown, just a few blocks from Bailey’s home. Over appetizers and then dinner, in spite of Paul’s attempts to get us to warm up, Bailey and I treated each other with cool suspicion. Yet it quickly became obvious to me that Bailey had great affection for Paul, and vice versa, and I just couldn’t figure out what to make of this. Paul was generally a good judge of people. Was Bailey like one of those characters in a novel who is nothing like his public reputation?

It was also obvious that Bailey was completely comfortable with the gay men all around him—including, I soon realized, one of my former students from Michigan State, who was at the next table with his boyfriend and who threw his arms around me and kissed me when he realized it was me yammering away right next to him. Unlike many straight men I knew, Bailey did not seem awkward around so many gay men, nor was he trying hard to prove that he was comfortable. He just was comfortable. I recalled that in his book he’d said that the problem isn’t that gay men are, on average, more feminine in their interests and behaviors than straight men; the problem is that we think that’s a bad thing and try to deny it rather than accepting it—accepting them. Femiphobia, he called it. (Others have called it sissyphobia, a term that I think better captures the problem.) Sitting there, I realized that maybe he was right about lack of acceptance being the problem, because he seemed perfectly at ease with the great variety of masculinity—heavy and light—around us that evening. He seemed like the future of straight people’s full acceptance of gay people.

At some point during that dinner, utterly disoriented, I asked Bailey point-blank if he had slept with a trans woman research subject—the most scandalous of all the charges made against him. He looked very tense and launched into what sounded like a canned legalistic response, saying that, even if he had (and he wasn’t saying whether he had), there is nothing automatically wrong with having sex with a research subject.

Say what? I was intrigued. After dinner, we three walked over to Sidetrack, a gay bar a couple of doors down, and when Paul wandered off into the crowd for a few minutes, I told Bailey I was sorry they had gone after his kids. He just said, “Thank you,” and had another drink.

I couldn’t figure this guy out. How could someone so soft-spoken get into so much trouble? Why would someone so very polite and politically progressive write those few really obnoxious lines in his book? Could it be, perhaps, that he was not homophobic or transphobic (his book certainly wasn’t, nor did he seem to be) and not tone-deaf but merely tone-dumb? Maybe he was someone who could hear the political music around him very well but lacked the ability to sing along in tune. His book was rather like a generally elegant solo performance punctuated by a number of teeth-grinding sour notes.

In the next couple of days, I poked around a bit. I looked up Bailey’s work and saw that most of it consisted of serious peer-reviewed scientific articles, quite different from his chatty and footnote-free book. I came across his old twin studies—controversial work that had showed that identical twins are more likely to have the same sexual orientation than are siblings who are not genetically identical, strongly suggesting that sexual orientation may sometimes be inborn. Suddenly I placed his name: I had actually taught my undergraduates criticisms of Bailey’s work on twins many years before. Back in those days, saying gay people might have been born that way, as Bailey was doing, was politically unpopular among many gay-rights activists and among humanists in the academy, who were fighting any claims of unalterable or predestined “human nature.” Back then, too, Bailey had sounded proudly tone-dumb.

I dug a little more. Knowing that one of Bailey’s book’s critics had claimed Bailey had “abandoned” his wife and children, I took a close look at the personal information portion of his Web site. The Bailey clan appeared to be one of those post-divorce families that is still fundamentally a family. If Bailey was faking that, it was a convincing fake, but his critic’s claim that he had abandoned his wife and children had been very effective in skewing this wife and mother’s impression of him.

As I kept digging, I noticed something even more interesting: Many of the trans people whose scholarship and political work I had most admired in the last ten years had remained strangely silent in the Bailey controversy. They had apparently steered clear. As had I.

 • • • 

THAT WAS FEBRUARY 2006. In May I got an e-mail from Mike Bailey bemoaning the fact that Northwestern’s Rainbow Alliance, our university’s LGBT group, had invited Andrea James to speak. I confessed to Mike that I had never really sorted out the characters in his controversy and asked him to remind me who she was. He sent me a PDF documenting how, in 2003, Andrea James had downloaded pictures of Bailey’s two children, Kate and Drew, from Bailey’s Web site and put them up on her own site, www.tsroadmap.com. When the photos were taken, Kate was in elementary school; Drew, in junior high. James had blacked out the children’s eyes, making them look like pathology specimens, and asked in a caption below, whether Kate was “a cock-starved exhibitionist, or a paraphiliac who just gets off on the idea of it.” The text went on to say that “there are two types of children in the Bailey household,” namely those “who have been sodomized by their father [and those] who have not.”

I was pretty stunned. Others had told me about this tasteless stunt, but I had never seen it for myself. It was obvious James was trying to parody Bailey’s book, but to what end? What kind of person undermines a rights movement by using this kind of creepy tactic?

So I promptly wrote to the Northwestern Rainbow Alliance, first apologizing that I hadn’t previously introduced myself. I explained that being a long-distance part-timer based on the Chicago med school campus meant I had almost no interaction with the Evanston campus, where the Rainbow Alliance (like Bailey) was housed. I offered to speak sometime about intersex, and then got to why I was writing, namely to register my protest at James being invited to the campus. I said I didn’t think she was good for a scholarly institution, nor did I think she was good for trans rights. They didn’t answer. Frustrated, on the day before Mother’s Day in 2006, I blogged about this on my personal Web site. Knowing a bit about James’s tactics, I called the essay, “The Blog I Write in Fear.”

Behold the floodgates opening. Now a few people from the Northwestern Rainbow Alliance did write back to me, to take issue with my criticism of their decision, and several trans women did the same. Meanwhile, fan mail arrived from a number of sex researchers and from Bailey’s daughter, Kate, now a college student. Some trans women wrote to tell me that no matter how Bailey was wronged, he deserved whatever he got. A couple more trans women wrote to me that Bailey was right about them all, and James knew it—that that was the problem.

But the most interesting mail, from my perspective, came from trans women who wrote to tell me that, though they weren’t thrilled with Bailey’s oversimplifications of their lives, they also had been harassed and intimidated by Andrea James for daring to speak anything other than the politically popular “I was always just a woman trapped in a man’s body” story. They thanked me for standing up to a woman they saw as a self-serving bully.

In what in retrospect seems like a stupid move, I also made a point of writing to Andrea James to tell her about my blog and to suggest that she tone down her rhetoric lest she undermine the trans-rights movement. Oh, she didn’t like that. She didn’t like that one bit. She wrote back a series of nasty e-mails, including one referring to my son as my “precious womb turd.” (Paul soon took to asking after “the precious womb turd” when he called.) She also showed up at my office when she was in Chicago, leaving her card in my mailbox. Then she e-mailed me, subject line “Mommy Knows Best,” saying, “Sorry I missed you the other day. Your colleagues seem quite affable, and not as fearful as you. . . . Bad move, Mommy.” She closed, “We’ll chat in person soon.” My dean suggested I talk to university counsel, who asked that I check in with the university police.

Now that I’d learned a little more about one of Bailey’s chief critics, I knew I had to investigate this controversy. Now I really wanted to know what was going on here.

 • • • 

IT SOUNDS FUNNY TO SAY, because I had read Bailey’s book years before I met him, but it was only when I read it again alongside Blanchard’s papers, in order to start understanding the history of the controversy, that I truly became fluent in the division of male-to-female transsexuals into those who begin with homosexual desire and those who begin with amour de soi en femme. And as I did, the lives of trans women I knew personally suddenly started to make more sense. In fact, I now found one prominently featured section of Lynn Conway’s Web site—“Photos of Lynn”—sort of ironically funny. Here was this woman dedicating most of her life, it seemed, to attacking the concept of erotic arousal from the idea of being a woman as the basis for one form of male-to-female transsexualism, while simultaneously putting up—on her university Web site—multiple pictures of herself in a skimpy bikini, shot from various angles. In addition, there were pictures of Professor Conway in miniskirts, in a little black dress, and in her white bridal gown. As if that weren’t enough, Conway gave her measurements (41-32-41) and did not neglect to mention that her hair is light brown/auburn and her eyes are blue. Just your average computer engineering faculty Web site, nothing sexual, right?

But what astounded me even more than Conway’s Web pages was evidence that—before Conway had called them to arms—Conway’s two chief compatriots in the assault on Bailey’s reputation had pretty much acknowledged that they had been sexually aroused by the idea of being or becoming women. One of those two was Deirdre McCloskey, a distinguished professor of economics and rhetoric at the University of Illinois, a woman who fell in as the third musketeer to Conway and James. As I started to figure out via my roughed out timelines and character files, at the height of the controversy, McCloskey had led an aggressive charge to deny Bailey’s book a prestigious LGBT literary award for which it had been nominated, and she had helped produce at least one of the formal charges made against Bailey.

Yet in Crossing: A Memoir, published in 1999, McCloskey had written the following about Donald, her pretransition self, in the third person:

When in 1994 he ran across A Life in High Heels, an autobiography by Holly Woodlawn, one of Andy Warhol’s group, the parts he read and reread and was sexually aroused by were about Woodlawn’s living successfully for months at a time as a woman, not her campiness when presenting as a gay genetic man in a dress. Donald’s preoccupation with gender crossing showed up in an ugly fact about the pornographic magazines he used. There are two kinds of cross-dressing magazines, those that portray the men in dresses with private parts showing and those that portray them hidden. He could never get aroused by the ones with private parts showing. His fantasy was of complete transformation, not a peek-a-boo, leering masculinity. He wanted what he wanted.

An erotic desire for transformation to womanhood? Hello. Reading this passage during my research, I recalled the time I had met McCloskey, well before Bailey’s book came out, when she and I were both invited to speak on a panel at her university. McCloskey is a very smart and witty speaker. As I recall, she began her presentation by startling the audience, saying, “These are my cheekbones.” She paused while we all sat amazed at her very feminine profile. And then she added, “I paid for them.” We laughed at her joke. McCloskey then went on to list other feminine parts she had purchased.

At one point in this anatomical audit, McCloskey talked about how she had had the bone of her forehead surgically shaved back to give her a more feminine head shape. As I remember it, as she explained this, she sort of closed her eyes and talked dreamily about how thrilled she had been, the first time she was in the shower and the water ran into her eyes, as it does on a natal woman. First off, I never knew this problem had a sex difference to it. But more important—huh? Why was she saying this as though she was recalling a magnificently sensual moment? Shampoo in your eyes as sexy experience?

And then there was this 1998 e-mail from another trans woman, a letter handed to me during my research by its original recipient, Anne Lawrence, a physician and sex researcher who self-identifies as an autogynephilic trans woman. Writing to praise Lawrence’s explication of autogynephilia, the correspondent first acknowledged that many transgender people reject categorization because:

A definition is inherently inclusive or exclusive, and there’s always going to be someone who doesn’t feel they belong in or out of a definition. I got body slammed by the usual suspects in 1996 for recommending a Blanchard book. Sure, he’s pretty much the Antichrist to the surgery-on-demand folks, and I’ve heard some horror stories about the institute he runs [the Clarke Institute of Psychiatry, in Toronto] that justify the nickname “Jurassic Clarke.” However, I found many of his observations to be quite valid, even brilliant, especially in distinguishing early and late-transitioning TS [transsexual] patterns of thought and behavior.

The writer then went on to talk about herself:

I have noticed in most TSs, and in “surgery addicts” especially, a certain sort of self-loathing, a drive to efface every shred of masculinity. While I readily admit to my own autogynephilia, I would contend that my drives towards feminization seem to have a component pushing me from the opposite direction as well [i.e., away from masculinity].

The author of this 1998 letter praising Blanchard’s work and readily admitting her own autogynephilia? None other than Andrea James.

 • • • 

OK, THIS WAS FASCINATING. A prior admission to autogynephilia from James and what seemed to amount to the same from McCloskey—plus something very much like an ongoing tacit admission from Conway?—lying behind the attempts to bury Bailey. All that spoke to motivation on the part of Conway et al. Of course, it didn’t make them guilty of anything, really (except maybe self-deception). And it certainly didn’t exonerate Bailey.

So I dug into this history, never imagining it would end up involving a hundred people and the collection of a few thousand sources, never imagining that it would be like doing a dissertation all over again, only this time with a steady undercurrent of unfamiliar fear. And as I began to dig into this history, it seemed very likely to me that Bailey had, in fact, committed various offenses. I would even have bet on it. There was so much smoke—there just had to be something burning.

But at that point—near the start of the long, unsettling trip—the only thing I felt sure of was this: That now, whenever I found myself standing in the shower trying to keep the shampoo from stinging my eyes, I couldn’t help but think hard about what you’re supposed to do when the facts seem to be leading you into danger.