Definition

Homosexual transsexual (HSTS) is Ray Blanchard's term for a male-to-female (MtF) transsexual who is exclusively attracted to men. In this typology, "homosexual" refers to same-sex attraction relative to natal sex, not to gender identity — so an HSTS is a male who desires men, which Blanchard classifies as homosexual regardless of how the person identifies.

The term is clinical and dated. Most trans-identified people today would call this person a "straight trans woman." The LGBTQIA+ wiki describes HSTS as "an outdated term for straight trans individuals." Blanchard did not invent the term — it was already current in sexology — but he formalised it as one half of his two-type typology.

The HSTS Profile

Blanchard's clinical observations, drawn from over 200 MtF patients at the Clarke Institute in Toronto (now the Centre for Addiction and Mental Health) across the 1980s and 1990s, describe a consistent pattern:

• Marked femininity from early childhood. Cross-gender behaviour, preference for girls' activities, cross-dressing for play rather than arousal. Often noticed by others even when the child tries to hide it.
• Early onset of cross-sex identification, typically before or during puberty.
• Exclusive attraction to men, beginning in childhood and persisting.
• Young age at clinical presentation — teens to mid-20s.
• No fetishistic cross-dressing history. Unlike the autogynephilic (AGP) type (males aroused by the idea of themselves as women), HSTS subjects report negligible arousal at the idea of being female.
• Physical femininity. Smaller, lighter build, neotenous (youthful) features — which facilitates passing after transition.
• Higher rates of older brothers (the fraternal birth order effect), consistent with HSTS being a subset of male homosexuality.

In Blanchard's samples, HSTS cases were roughly 25–30% of clinic presentations. The rest were non-homosexual (autogynephilic).

What Drives HSTS Transition

Blanchard and later writers (notably the psychologist J. Michael Bailey and the writer Rod Fleming) argue that HSTS transition is motivated by a wish to have socially sanctioned "heterosexual" relationships with men. Cross-sex presentation is a practical means to achieve this, not a sexually titillating experience in itself. As one summary by Genspect (an international group of parents and professionals critical of gender-affirming care) puts it: "Their desire to transition appeared to be motivated by a wish to have socially sanctioned 'heterosexual' relationships with men, and cross-sex presentation was a practical means to achieve this, rather than a sexually titillating experience in itself" (Genspect, 2023).

Bailey adds a pointed observation: HSTS transsexuals are themselves fetishistic — they fetishise straight men — so fetishism alone cannot be used to delegitimise AGP transition. Both types, he argues, are driven by sexual motivation.

Evidence Cited in Favour

• Blanchard's clinic data: only 15% of androphilic (attracted to men) subjects reported sexual arousal with cross-dressing, versus 73% of gynephilic (attracted to women), bisexual, and asexual subjects.
• Nuttbrock et al. (2010): lifetime transvestic fetishism in 23% of homosexual subjects versus 82% of heterosexual and 68% of bisexual subjects in a sample of 571 MtFs.
• Neuroimaging: Rametti et al. (2010) found homosexual MtF brains intermediate between male and female norms in some regions. A 2016 review noted structural neuroimaging studies "seem to support the idea that androphilic and gynephilic trans women have different brain phenotypes," while calling for more independent studies.
• Fraternal birth order effect: present in homosexual transsexuals (odds ratio ~1.3 per older brother), absent in autogynephilic ones — consistent with HSTS being a form of male homosexuality.

Criticisms

• It pathologises gay men. The most common objection is that HSTS is simply a feminine gay man who has been told, by a homophobic society, that transition is the solution. "Upholding and reinforcing homophobia and essentially identifying yourself as a 'reformed' homosexual is gross. It's just conversion therapy, liberal edition" (merpderpderp1, desisted female).
• It creates a "true trans" hierarchy. The typology is often used to sort trans women into "real" (HSTS) and "fake" (AGP) — a use Blanchard did not endorse. "It gives people the impression that HSTS are 'real' transsexuals, while AGPs are 'fake' perverts" (Traditional-You-4583, desisted).
• The categories overlap. "You'll meet hsts cases and agp cases, but you'll find plenty of men fall under both" (merpderpderp1, desisted female).
• It does not predict outcomes. HSTS transition does not reliably produce satisfaction, and HSTS individuals do detransition. "I used to think I was a HSTS so yes, we do detransition" (deleted, r/detrans).
• 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).

What Detransitioners Say

Male detransitioners who fit or once fit the HSTS profile describe a range of experiences. A recurring theme is that transition was a way to escape the difficulties of being a gender-nonconforming gay man.

• Internalised homophobia as the driver. "They admit that they do it because they want a 'normal' relationship with a man. They're completely open about the only reason they consider themselves a transsexual: internalized homophobia" (merpderpderp1, desisted female). Another: "This is what most transwomen/gay men including myself fall into the trap of transitioning even if they do not have gender dysphoria. They want a straight relationship with a straight man... Right now, I'm learning to love myself as a male who happens to be attracted to a male. No need to transform myself just to validate that i can romantically love another man. Its internalize homophobia all this time" (Entire-Construction1, questioning own gender identity).
• Trauma in the gay male community. "A lot of HSTS' are people who have had negative experiences or experienced some form of trauma related to male homosexuality, myself included. I experienced a lot of grooming by older gay men when I was a child/teen... HSTS' aren't just blindly hateful, they do have a lot of valid criticisms when it comes to the gay (male) community" (Hedera_Thorn, detrans male).
• Transition as conformity. "HSTS criteria literally relies on... a regressive society that frowns on extremely gender non conforming men... a homophobic society that encourages/pushes those who are homosexual and gender non-conforming to transition so they can live an easier life and be 'accepted'" (DetransIS, detrans female).
• The categories are not clean. "I definitely previously fit the HSTS category pretty well, but in detransition I have found myself no longer attracted to men and now see my HSTS and more like a very early onset AGP... What was getting me off was picturing myself in the role of a woman, which at first I interpreted as homosexuality and then later transgenderism, but now I just see it as major self esteem issues" (Lumpy_Atmosphere_924, detrans male).
• Transition disguised the real issue. "Once I first started detransition I became very aware of how feminine all my mannerisms are. Transition disguised it and just made me look like a girly girl. It's a journey to accept it" (Dear-Shift-7636, detrans male).
• Not everyone fits the theory. "As a 'homosexual transsexual' (and looking to detransition) I think this is an unfair assessment... Blanchard's theory doesn't fit me. Yes, I am attracted to men and started transitioning earlier in life but I absolutely did not have the sole goal of 'looking hot and getting guys'" (deleted, detransitioner).

Analysis

1. The HSTS pattern is real. Males who are feminine from childhood, exclusively attracted to men, and who seek to live as women are documented in clinical literature and describe themselves consistently. This is not seriously disputed.

2. The cause is contested. Blanchard frames HSTS as a subset of male homosexuality — an extreme of femininity in gay men. Detransitioners more often frame it as internalised homophobia, trauma, or a response to a homophobic society. These are not mutually exclusive: a feminine gay man in a hostile environment may find transition a rational escape, whatever the underlying psychology.

3. HSTS is not "true trans." The typology is sometimes used to validate HSTS as "real" transsexuals while delegitimising AGP. This is a misuse. HSTS individuals detransition, regret transition, and report the same unmet needs as other detransitioners. Neither type is more "truly trans" than the other.

4. The category is not clean. Some individuals fit both profiles; some shift between them over time. Blanchard's own data showed a minority of "homosexual" transsexuals with fetishistic histories.

5. Clinical relevance. Whether one calls it internalised homophobia, trauma, or sexual orientation, a male who wants to transition because he desires men deserves honest exploration of that motivation before irreversible interventions. The question "would you still be with men if you didn't transition?" is worth asking.

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. Archives of Sexual Behavior, 39(2). source
• Bailey, J. M. (2003). The Man Who Would Be Queen. Joseph Henry Press.
• Genspect (2023). Typology, Classification and Diagnosis of Gender Distress. source