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 transsexuelle Patienten von männlich zu weiblich an einer psychiatrischen Klinik in Toronto füllten Fragebögen zur sexuellen Anziehung aus. Ihr Durchschnittsalter lag bei etwa 30.
• Ein statistisches Verfahren, das Menschen nach ähnlichen Werten sortiert und vorab auf vier Gruppen eingestellt war, ergab 100 zu Männern hingezogene Patienten, 35 zu beiden Geschlechtern hingezogene, 16 zu Frauen hingezogene und 12 zu keinem hingezogene.
• Sexuelle Erregung beim Crossdressing berichteten 14 von 16 zu Frauen Hingezogenen (88 %), 9 von 12 zu keinem Hingezogenen (75 %) und 23 von 35 zu beiden Hingezogenen (66 %), gegenüber 15 von 100 zu Männern Hingezogenen (15 %).
• Die zu Männern hingezogene Gruppe unterschied sich deutlich von jeder der anderen Gruppen, während sich die anderen drei Gruppen nicht klar voneinander unterschieden.
• Blanchard folgerte, dass zu beiden Geschlechtern oder zu keinem Hingezogene Varianten der zu Frauen Hingezogenen sind, was zwei Grundtypen ergibt: zu Männern hingezogen und nicht (später „autogynäphil“ genannt).
• Die Studie war der Ausgangspunkt für Blanchards Typen und seine Autogynäphilie-Idee von 1989, die das US-Psychiatriehandbuch DSM-5 später für einen der Diagnose der transvestitischen Störung beigefügten Zusatz verwendete.

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.