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

• トロントの精神科クリニックの男性から女性へのトランスセクシュアルの患者163人が、性的な惹かれ方についての質問票に記入しました。平均年齢は約30歳でした。
• 似たスコアの人々を分ける統計的手法を、あらかじめ4つのグループを見つけるよう設定して用いた結果、男性に惹かれる100人、両方の性に惹かれる35人、女性に惹かれる16人、どちらにも惹かれない12人となりました。
• 異性の服装をしている間の性的興奮は、女性に惹かれる16人中14人（88%）、どちらにも惹かれない12人中9人（75%）、両方に惹かれる35人中23人（66%）が報告し、男性に惹かれる100人中15人（15%）と対照的でした。
• 男性に惹かれるグループは、他の各グループと明確に異なっていましたが、他の3つのグループ同士は明確には異なっていませんでした。
• Blanchardは、両方の性に惹かれる人やどちらにも惹かれない人は、女性に惹かれる人の変種であると結論づけ、男性に惹かれる人と、そうでない人（後に「自己女性化性愛」と呼ばれる）という2つの基本タイプにしました。
• この研究は、Blanchardのタイプ分けと、1989年の自己女性化性愛の考え方の出発点であり、後に米国の精神医学の診断基準DSM-5が、異性装障害の診断に付けられたラベルに用いました。

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.