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 a forgé le mot « autogynéphilie » pour désigner la tendance d'un homme à être sexuellement excité par la pensée ou l'image de lui-même en femme.
• L'étude incluait 212 patients transsexuels adultes de l'homme vers la femme, de 17 à 63 ans, du service du genre d'une clinique psychiatrique de Toronto.
• Les patients ont été répartis en un groupe attiré par les hommes et trois autres groupes : attirés par les femmes, attirés par les deux sexes et attirés par aucun.
• Blanchard a construit un nouveau questionnaire à partir de questions existantes pour mesurer l'excitation liée au fantasme d'être une femme, et a comparé les quatre groupes.
• Les trois groupes non attirés par les hommes déclaraient plus souvent que le groupe attiré par les hommes une excitation sexuelle à l'idée de s'imaginer en femme.
• Blanchard a conclu que la dysphorie de genre chez les hommes non attirés par les hommes est une seule condition, la « dysphorie de genre autogynéphile », distincte de la dysphorie de genre chez les hommes attirés par les hommes.
• L'idée a ensuite alimenté une précision dans le manuel psychiatrique américain DSM-5, rattachée au diagnostic de trouble transvestique, et reste très contestée.

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.