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

• 多伦多一家精神科诊所的163名男变女易性症患者填写了关于性吸引力的问卷。他们的平均年龄约为30岁。
• 一种按相似得分对人进行分组的统计方法，预先设定寻找四个组，得出100名被男性吸引的患者、35名被两性吸引的患者、16名被女性吸引的患者和12名两者都不被吸引的患者。
• 报告在异性装扮时有性唤起的有：被女性吸引的16人中的14人（88%）、两者都不被吸引的12人中的9人（75%）、被两性吸引的35人中的23人（66%），而被男性吸引的100人中为15人（15%）。
• 被男性吸引的组与其他每一组都有明显差异，而其他三组之间没有明显差异。
• Blanchard得出结论认为，被两性吸引或两者都不被吸引的人是被女性吸引者的变体，由此得出两种基本类型：被男性吸引的，以及不被男性吸引的（后来称为“自体女性性倾向”）。
• 该研究是Blanchard的类型学及其1989年自体女性性倾向（autogynephilia）概念的起点，美国精神病学手册DSM-5后来将其用于附在易装障碍诊断上的一个标签。

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.