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 transseksuelle pasienter fra mann til kvinne ved en psykiatrisk klinikk i Toronto fylte ut spørreskjemaer om seksuell tiltrekning. Gjennomsnittsalderen var omtrent 30 år.
• En statistisk metode som sorterer folk etter like skårer, satt på forhånd til å finne fire grupper, ga 100 pasienter tiltrukket av menn, 35 tiltrukket av begge kjønn, 16 tiltrukket av kvinner og 12 tiltrukket av ingen.
• Seksuell opphisselse ved cross-dressing ble rapportert av 14 av 16 tiltrukket av kvinner (88 %), 9 av 12 tiltrukket av ingen (75 %) og 23 av 35 tiltrukket av begge (66 %), mot 15 av 100 tiltrukket av menn (15 %).
• Gruppen tiltrukket av menn skilte seg tydelig fra hver av de andre gruppene, mens de tre andre gruppene ikke skilte seg tydelig fra hverandre.
• Blanchard konkluderte med at de som er tiltrukket av begge kjønn eller av ingen er varianter av dem som er tiltrukket av kvinner, noe som gir to grunntyper: tiltrukket av menn, og ikke (senere kalt «autogynefil»).
• Studien var utgangspunktet for Blanchards typer og hans idé om autogynefili fra 1989, som den amerikanske psykiatrihåndboken DSM-5 senere brukte til en betegnelse knyttet til diagnosen transvestittisk lidelse.

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.