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 muntte het woord 'autogynefilie' voor de neiging van een man om seksueel opgewonden te raken door de gedachte aan of het beeld van zichzelf als vrouw.
• De studie omvatte 212 volwassen man-naar-vrouw-transseksuele patiënten, van 17 tot 63 jaar, bij de genderdienst van een psychiatrische kliniek in Toronto.
• Patiënten werden verdeeld in één groep aangetrokken tot mannen en drie andere groepen: aangetrokken tot vrouwen, aangetrokken tot beide geslachten, en aangetrokken tot geen van beide.
• Blanchard bouwde een nieuwe vragenlijst uit bestaande vragen om opwinding bij de fantasie een vrouw te zijn te meten, en vergeleek de vier groepen daarop.
• Alle drie de groepen die niet tot mannen waren aangetrokken meldden vaker dan de groep aangetrokken tot mannen seksuele opwinding bij de voorstelling van zichzelf als vrouw.
• Blanchard concludeerde dat genderdysforie bij mannen die niet tot mannen zijn aangetrokken één aandoening is, 'autogynefiele genderdysforie', los van genderdysforie bij mannen die tot mannen zijn aangetrokken.
• Het idee voedde later een label in het Amerikaanse psychiatrische handboek DSM-5, verbonden aan de diagnose van transvestitische stoornis, en blijft sterk omstreden.

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.