Summary

Psychologist Ray Blanchard tested an idea, drawn from Kurt Freund's work, that male-to-female transsexuals come in two basic types. Using routine questionnaires at a Toronto gender clinic, he grouped 163 patients by attraction to men and women. He asked whether they had ever been sexually aroused while cross-dressing. Two-thirds or more of those attracted to women, to both sexes or to neither said yes, compared with 15% of those attracted to men. Blanchard concluded that the groups not attracted only to men form one family, separate from those attracted to men. The paper became the basis of his later 'autogynephilia' theory and of a label in the main US psychiatric manual (DSM-5). Its evidence is a single self-reported question from one 1980s clinic, with small groups and no comparison group, and critics question whether the types hold up elsewhere.

Key findings

• 163 mand-til-kvinde-transseksuelle patienter på en psykiatrisk klinik i Toronto udfyldte spørgeskemaer om seksuel tiltrækning. Deres gennemsnitsalder var omkring 30 år.
• En statistisk metode, der sorterer folk efter lignende scorer, fastsat på forhånd til at finde fire grupper, gav 100 patienter tiltrukket af mænd, 35 tiltrukket af begge køn, 16 tiltrukket af kvinder og 12 tiltrukket af ingen af dem.
• Seksuel ophidselse under krydsklædning blev rapporteret af 14 af 16 tiltrukket af kvinder (88 %), 9 af 12 tiltrukket af ingen (75 %) og 23 af 35 tiltrukket af begge (66 %), mod 15 af 100 tiltrukket af mænd (15 %).
• Gruppen tiltrukket af mænd adskilte sig tydeligt fra hver af de andre grupper, mens de tre andre grupper ikke tydeligt adskilte sig fra hinanden.
• Blanchard konkluderede, at dem, der er tiltrukket af begge køn eller af ingen, er varianter af dem, der er tiltrukket af kvinder, hvilket giver to grundlæggende typer: tiltrukket af mænd og ikke (senere kaldet ‘autogynefile’).
• Studiet var udgangspunktet for Blanchards typer og hans idé fra 1989 om autogynefili, som den amerikanske psykiatriske manual DSM-5 senere brugte til en betegnelse knyttet til diagnosen krydsklædningsforstyrrelse.

Abstract

This study tested a prediction derived from the hypothesis that asexual and bisexual transsexualism are actually subtypes of heterosexual transsexualism. Two questionnaire scales measuring erotic attraction to males and females were administered to 163 male-to-female transsexuals. A cluster analysis of their scores divided the subjects into four groups: heterosexual, homosexual, bisexual, and asexual. Fisher Exact tests were used to compare the frequency with which subjects in the four clusters reported a history of erotic arousal in association with cross-dressing. As predicted, there were no differences among the asexual, bisexual, and heterosexual transsexuals, and all three groups included a much higher proportion of fetishistic cases than the homosexual group (p less than or equal to .0001, two-tailed). These findings support the view that male transsexuals may be divided into two basic types: heterosexual and homosexual.

Conclusion

The prediction that asexual and bisexual transsexuals would report a history of cross-gender fetishism about as often as heterosexual transsexuals, and much more often than homosexual transsexuals, survived what Blanchard called an objective, 'hands-off' test that could have shown it false. He argued that anyone dissatisfied with his hypothesis must offer an alternative that explains the high rates of cross-gender fetishism in the asexual and bisexual groups and makes a new, testable prediction. He concluded that male transsexuals may be divided into two basic types, heterosexual and homosexual, with the asexual and bisexual forms being variants of the heterosexual type.