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 patients transsexuels de l'homme vers la femme d'une clinique psychiatrique de Toronto ont rempli des questionnaires sur l'attirance sexuelle. Leur âge moyen était d'environ 30 ans.
• Une méthode statistique qui classe les personnes selon des scores similaires, réglée à l'avance pour trouver quatre groupes, a donné 100 patients attirés par les hommes, 35 attirés par les deux sexes, 16 attirés par les femmes et 12 attirés par aucun.
• L'excitation sexuelle en s'habillant avec des vêtements de l'autre sexe était rapportée par 14 des 16 attirés par les femmes (88 %), 9 des 12 attirés par aucun (75 %) et 23 des 35 attirés par les deux (66 %), contre 15 des 100 attirés par les hommes (15 %).
• Le groupe attiré par les hommes différait nettement de chacun des autres groupes, tandis que les trois autres groupes ne différaient pas nettement entre eux.
• Blanchard a conclu que ceux attirés par les deux sexes ou par aucun sont des variantes de ceux attirés par les femmes, ce qui donne deux types de base : attirés par les hommes, et non (appelé plus tard « autogynéphile »).
• L'étude a été le point de départ des types de Blanchard et de son idée d'autogynéphilie de 1989, que le manuel psychiatrique américain DSM-5 a ensuite utilisée pour une précision rattachée au diagnostic de trouble transvestique.

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.