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 pazienti transessuali da maschio a femmina di una clinica psichiatrica di Toronto hanno compilato questionari sull'attrazione sessuale. La loro età media era circa 30 anni.
• Un metodo statistico che raggruppa le persone in base a punteggi simili, impostato in anticipo per trovare quattro gruppi, ha dato 100 pazienti attratti dagli uomini, 35 attratti da entrambi i sessi, 16 attratti dalle donne e 12 attratti da nessuno dei due.
• L'eccitazione sessuale durante il travestitismo è stata riferita da 14 su 16 attratti dalle donne (88%), 9 su 12 attratti da nessuno dei due (75%) e 23 su 35 attratti da entrambi (66%), contro 15 su 100 attratti dagli uomini (15%).
• Il gruppo attratto dagli uomini differiva chiaramente da ciascuno degli altri gruppi, mentre gli altri tre gruppi non differivano chiaramente tra loro.
• Blanchard ha concluso che chi è attratto da entrambi i sessi o da nessuno dei due sia una variante di chi è attratto dalle donne, il che dà due tipi di base: attratti dagli uomini, e non (poi chiamati «autoginefilici»).
• Lo studio è stato il punto di partenza dei tipi di Blanchard e della sua idea di autoginefilia del 1989, che il manuale psichiatrico statunitense DSM-5 ha poi usato per un'etichetta associata alla diagnosi di disturbo da travestitismo.

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.