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

• Бланшар придумал слово «аутогинефилия» для склонности мужчины сексуально возбуждаться от мысли или образа себя как женщины.
• В исследование вошли 212 взрослых пациентов-транссексуалов «мужчина–женщина» в возрасте 17–63 лет в гендерной службе торонтской психиатрической клиники.
• Пациентов разделили на одну группу с влечением к мужчинам и три другие группы: с влечением к женщинам, с влечением к обоим полам и без влечения ни к кому.
• Бланшар составил новый опросник из существующих вопросов для измерения возбуждения от фантазии о том, что он женщина, и сравнил по нему четыре группы.
• Все три группы без влечения к мужчинам чаще группы с влечением к мужчинам сообщали о сексуальном возбуждении от представления себя женщинами.
• Бланшар заключил, что гендерная дисфория у мужчин без влечения к мужчинам — это одно состояние, «аутогинефильная гендерная дисфория», отдельное от гендерной дисфории у мужчин с влечением к мужчинам.
• Идея позже легла в основу уточнения в американском психиатрическом руководстве DSM-5, прилагаемого к диагнозу трансвестного расстройства, и остаётся резко оспариваемой.

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.