Summary

In this paper Ray Blanchard introduced the word 'autogynephilia': a male's tendency to be sexually aroused by the thought or image of himself as a woman. He tested the idea on 212 male-to-female transsexual patients at a Toronto gender clinic, grouped by sexual attraction, using a new questionnaire. Patients not attracted to men (those attracted to women, to both sexes or to neither) reported more of this arousal than those attracted to men. Blanchard argued that all gender dysphoria in males not attracted to men is one condition driven by autogynephilia. The idea shaped later research and a label in the main US psychiatric manual (DSM-5), and remains one of the field's most disputed ideas. The evidence is one-time self-reports from one clinic, using a questionnaire built and tested on the same patients. It shows a link, not that arousal causes gender dysphoria.

Key findings

• Blanchard acuñó la palabra 'autoginefilia' para la tendencia de un varón a excitarse sexualmente con el pensamiento o la imagen de sí mismo como mujer.
• El estudio incluyó a 212 pacientes transexuales adultos de hombre a mujer, de 17 a 63 años, del servicio de género de una clínica psiquiátrica de Toronto.
• Los pacientes se dividieron en un grupo atraído por hombres y otros tres grupos: atraídos por mujeres, atraídos por ambos sexos y atraídos por ninguno.
• Blanchard construyó un nuevo cuestionario a partir de preguntas existentes para medir la excitación ante la fantasía de ser una mujer, y comparó los cuatro grupos con él.
• Los tres grupos no atraídos por hombres tenían más probabilidades que el grupo atraído por hombres de informar de excitación sexual al imaginarse como mujeres.
• Blanchard concluyó que la disforia de género en varones no atraídos por hombres es una sola afección, la 'disforia de género autoginéfila', distinta de la disforia de género en varones atraídos por hombres.
• La idea alimentó después una etiqueta del manual psiquiátrico estadounidense DSM-5, añadida al diagnóstico del trastorno de travestismo, y sigue siendo muy discutida.

Abstract

This study tested the hypothesis that all gender-dysphoric males who are not sexually aroused by men (homosexual) are instead sexually aroused by the thought or image of themselves as women (autogynephilic). Subjects were 212 adult male-to-female transsexuals. These were divided into four groups; one homosexual and three nonhomosexual. The three nonhomosexual groups were heterosexual, bisexual, and analloerotic (unattracted to male or female partners, but not necessarily devoid of all erotic behavior). A Core Autogynephilia Scale was developed to assess a subject's propensity to be sexually aroused by the fantasy of being a woman. The four transsexual groups were compared on this measure (and on several others), using Newman-Keuls multiple-range tests at p less than .05. As predicted, all three nonhomosexual groups were more likely than the homosexual group to report sexual stimulation by cross-gender fantasy. This finding supports the hypothesis that the major types of nonhomosexual gender dysphoria constitute variant forms of one underlying disorder, which may be characterized as autogynephilic gender dysphoria.

Conclusion

As predicted, all three nonhomosexual groups (heterosexual, bisexual and analloerotic) were more likely than the homosexual group to report sexual stimulation by cross-gender fantasy. Blanchard concluded that this supports the hypothesis that the major types of nonhomosexual gender dysphoria are variant forms of one underlying disorder, which may be characterised as autogynephilic gender dysphoria, and proposed the term autogynephilia ('love of oneself as a woman') for a male's propensity to be sexually aroused by the thought or image of himself as a woman.