What the Typology Claims

Ray Blanchard's typology is a classification of male-to-female (MtF) transsexualism developed by the Canadian sexologist Ray Blanchard at the Clarke Institute (now the Centre for Addiction and Mental Health, CAMH) in Toronto during the 1980s and 1990s. It proposes that males who seek to live as women fall into exactly two types, distinguished by sexual orientation relative to their natal sex:

• Homosexual transsexuals (HSTS): exclusively attracted to men, markedly feminine from childhood, transition young. In this typology "homosexual" refers to same-sex attraction relative to natal sex, not to gender identity.
• Autogynephilic transsexuals (AGP): attracted to women, bisexual, or asexual; their desire to transition is said to originate in autogynephilia — arousal at the thought or image of oneself as a woman.

Blanchard's central claim is that these two groups are etiologically distinct — that is, they have different causes, not just different presentations. He wrote that autogynephilia is "always (or almost always)" present in non-homosexual MtFs and absent in homosexual ones (Moser 2010).

The typology was never formally adopted as a diagnostic system. The DSM-5 (the American Psychiatric Association's diagnostic manual) dropped it, listing "autogynephilia" only as a specifier for transvestic disorder, not as an explanation of gender dysphoria.

Origin and Development

Blanchard did not invent the two-type idea from scratch. In 1982, Kurt Freund and colleagues argued there were two distinct types of trans women: one associated with childhood femininity and attraction to men, another with fetishism and attraction to women. Blanchard formalised this into a typology across several papers (1985, 1988, 1989), based on clinical data from over 200 MtF patients at the Toronto clinic.

His 1989 study of 212 MtF transsexuals divided subjects into four groups by orientation — homosexual, heterosexual, bisexual, and analloerotic (no sexual attraction to others) — and found that all three non-homosexual groups reported significantly more arousal to cross-gender fantasy than the homosexual group. He concluded that the three non-homosexual groups were variants of one underlying condition: autogynephilic gender dysphoria.

J. Michael Bailey's 2003 book The Man Who Would Be Queen popularised the typology for a general audience and added the argument that HSTS transsexuals are themselves fetishistic — they fetishise straight men — so fetishism alone cannot be used to delegitimise AGP transition.

The Two Types Compared

In Blanchard's Toronto samples, homosexual cases were roughly 25–30% of clinic presentations; the non-homosexual majority were older at first presentation by about 9–15 years.

Evidence Cited in Favour

• Blanchard's clinic data showed a strong statistical correlation between non-homosexual orientation and self-reported autogynephilic arousal. In his 1989 sample, 73% of gynephilic (attracted to women), bisexual, and asexual subjects reported sexual arousal with cross-dressing, versus 15% of androphilic (attracted to men) subjects.
• Nuttbrock et al. (2010), studying 571 MtFs in New York, found lifetime transvestic fetishism in 23% of homosexual subjects versus 82% of heterosexual and 68% of bisexual subjects — large, though not deterministic, differences consistent with the typology.
• Neuroimaging: some magnetic resonance imaging (MRI) studies find that androphilic and gynephilic trans women have different brain phenotypes. Rametti et al. (2010) found homosexual MtF brains intermediate between male and female norms; Savic and Arver (2010) found no sex-atypical structures in heterosexual MtFs. A 2016 review called for more independent studies before drawing firm conclusions.
• Fraternal birth order effect: the well-established finding that males with more older brothers are more likely to be gay appears in homosexual transsexuals but not in autogynephilic ones — consistent with HSTS being a subset of male homosexuality.

Criticisms

The typology is contested in the peer-reviewed literature and rejected by most clinicians working with trans patients today.

• Charles Moser (2010) published the first peer-reviewed critique, finding no substantial difference between "autogynephilic" and "homosexual" transsexuals in gender dysphoria, and arguing that autogynephilia is not predictive of the behaviour, history, or motivation of trans women. He notes that Blanchard's own data showed ~15% of "homosexual" transsexuals reported cross-gender fetishism, and other studies found 10–27% of "non-homosexual" trans women never reported AGP arousal.
• Unfalsifiability. If a male reports AGP arousal, that confirms the theory. If he denies it, Blanchard explains this as "motivated denial." Every outcome confirms the theory — which means it is not falsifiable in the strict sense (the trans writer and biologist Julia Serano, 2010).
• The "cis women are AGP too" rebuttal. Moser (2009) found 93% of natal women reported some arousal at "being a woman," and Veale et al. (2008) found 52% of biological females scored 6+ on the Core Autogynephilia Scale. Trans communities cite this as proof AGP is normal female sexuality. This is a category error: arousal while female is not arousal by becoming female. But the finding does show that AGP scales are sloppy — they ask about ordinary experiences (choosing clothes, feeling attractive) and inflate scores.
• Not cleanly separable by orientation. Veale et al. found AGP-classified transsexuals reported more attraction to men, not less — at variance with the theory. Blanchard's own homosexual group included a minority with fetishistic histories.
• Conflation of populations. Studies often mix erotic cross-dressers (who mostly do not transition) with gender-dysphoric patients seeking transition.
• The typology does not predict outcomes. It does not predict who will detransition, who will regret transition, or who will be satisfied — which limits its clinical usefulness.

What Detransitioners Say

Detransitioners engage with the typology from lived experience, and their views are not uniform. A recurring theme is that the typology captures something real but is too crude to be a complete explanation.

• It describes patterns, not people. "Blanchard was only exploring the two root causes for transition among males, and he did a pretty good job on that. Of course there are other causes, it's not just fetish (in AGP) and it's not just gayness (in HSTS)" (portaux, desisted).
• The categories overlap in practice. "You'll meet hsts cases and agp cases, but you'll find plenty of men fall under both... He's bisexual, desperately wants to sleep with straight men, has internalized homophobia, has sexual abuse history... and gets off to agp style feminization/sissy porn. Most people would probably say he's hsts... But he's both" (merpderpderp1, desisted female).
• It creates a hierarchy that harms everyone. "It gives people the impression that HSTS are 'real' transsexuals, while AGPs are 'fake' perverts... J Michael Bailey argues AGPs are fetishistic, but no more fetishistic than HSTS transsexuals because HSTS transsexuals fetishize straight men" (Traditional-You-4583, desisted).
• It may not describe the current cohort. "Blanchard's theory about male transitioners might be true for transitioners from back in the day, but most of the younger male (de)transitioners I have talked to don't really fit into it" (Bananawarrior2, detrans male). Another notes: "I'm not sure if Blanchard's typology accounts for the massive spike in trans population over the past decade" (Inner_Elderberry_457, desisted male).
• Neither type is "true trans." "HSTS and AGP are neither 'true transsexuals'... none of these are 'true transsexuals'. Anyone who transitions is trans. None more trans than the other" (portaux, desisted).

Extensions: Females and the Female Counterpart

Blanchard's typology was built entirely on males. He explicitly denied that a female counterpart exists, saying of the autoandrophilia specifier he proposed for the DSM-5: "I proposed it simply in order not to be accused of sexism [...] I don't think the phenomenon even exists" (Blanchard, 2018).

Yet female detransitioners describe exactly the pattern the term names — arousal at imagining oneself as male. See the autoandrophilia page for a full analysis. In 2025, Phil Illy published the first peer-reviewed paper on female autoandrophilia in Archives of Sexual Behavior, arguing it is analogous to male autogynephilia and a significant driver of female-to-male (FTM) transition.

Some writers have proposed a two-type model for females as well: androphilic trans men (attracted to men, feminine-tomboyish childhood) versus autoandrophilic trans men (attracted to women, or whose attraction to men is "meta-attraction" — wanting to be a man with a man). This extension is far less established than Blanchard's male typology and has almost no clinical data behind it.

Analysis: What Can Be Concluded

1. The typology describes real patterns. The correlation between non-homosexual orientation and cross-gender erotic arousal in males is replicated across studies. Denying this requires dismissing both clinic data and detransitioners' testimony.

2. The strong theory is underdetermined. The claim that AGP causes all non-androphilic MtF transition, is absent in women, and forms two clean types is contradicted by exceptions in Blanchard's own data and by the unfalsifiability of the "denial" hypothesis.

3. It is a typology of males only. Blanchard never studied females and disowned the female counterpart. Any application to trans men is an extension by other writers, not part of Blanchard's theory.

4. It does not predict outcomes. The typology does not tell you who will detransition, who will regret, or who will be satisfied. It classifies motivations, not results.

5. The hierarchy problem. The typology is often used to sort trans women into "real" (HSTS) and "fake" (AGP) — a use Blanchard himself did not endorse, and one that harms both groups. As detransitioners note, neither type is more "truly trans" than the other, and both can end up regretting transition.

6. What is needed. Research that separates cross-dressers from transition-seekers, uses proper female control groups, follows patients long-term, and asks about sexual motivation without shaming. The topic is politically toxic in both directions: trans spaces suppress it, and some gender-critical spaces weaponise it. Neither helps the people actually living with it.

References

• Blanchard, R. (1985). Typology of male-to-female transsexualism. Archives of Sexual Behavior, 14, 247–261. PubMed
• Blanchard, R. (1989). The concept of autogynephilia and the typology of male gender dysphoria. Journal of Nervous and Mental Disease, 177, 616–623. PubMed
• Nuttbrock, L., et al. (2010). A further assessment of Blanchard's typology of homosexual versus non-homosexual or autogynephilic gender dysphoria. Archives of Sexual Behavior, 39(2). source
• Moser, C. (2010). Blanchard's Autogynephilia Theory: A Critique. Journal of Homosexuality. source
• Moser, C. (2009). Autogynephilia in women. Journal of Homosexuality (cited in Moser 2010).
• Veale, J. F., Clarke, D. E., & Lomax, T. C. (2008). Sexuality of male-to-female transsexuals. Archives of Sexual Behavior.
• Serano, J. (2010). Autogynephilia, Ad Hoc Hypotheses, and Handwaving. source
• Lawrence, A. A. (2013). Men Trapped in Men's Bodies: Narratives of Autogynephilic Transsexualism. Springer.
• Bailey, J. M. (2003). The Man Who Would Be Queen. Joseph Henry Press.
• Illy, P. (2025). Female Autoandrophilia. Archives of Sexual Behavior, 54(8), 3005–3021. source