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 pacientes transexuais de homem para mulher em uma clínica psiquiátrica de Toronto preencheram questionários sobre atração sexual. A idade média era de cerca de 30 anos.
• Um método estatístico que classifica as pessoas por pontuações semelhantes, definido de antemão para encontrar quatro grupos, deu 100 pacientes atraídos por homens, 35 atraídos por ambos os sexos, 16 atraídos por mulheres e 12 atraídos por nenhum.
• Excitação sexual ao se vestir com roupas do outro sexo foi relatada por 14 de 16 atraídos por mulheres (88%), 9 de 12 atraídos por nenhum (75%) e 23 de 35 atraídos por ambos (66%), contra 15 de 100 atraídos por homens (15%).
• O grupo atraído por homens diferiu claramente de cada um dos outros grupos, enquanto os outros três grupos não diferiram claramente entre si.
• Blanchard concluiu que os atraídos por ambos os sexos ou por nenhum são variantes dos atraídos por mulheres, dando dois tipos básicos: atraídos por homens e não atraídos (mais tarde chamados de 'autoginefílicos').
• O estudo foi o ponto de partida dos tipos de Blanchard e de sua ideia de autoginefilia de 1989, que o manual psiquiátrico dos EUA DSM-5 depois usou para um rótulo associado ao diagnóstico de transtorno de travestismo.

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.