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

• 多倫多一家精神科門診的 163 名男變女變性患者填寫了關於性吸引力的問卷。他們的平均年齡約為 30 歲。
• 一種依相似分數將人分組的統計方法，事先設定要找出四組，結果得出 100 名被男性吸引者、35 名被兩性吸引者、16 名被女性吸引者和 12 名兩者皆不吸引者。
• 穿著異性服裝時有性興奮的，被女性吸引者 16 人中有 14 人（88%），兩者皆不吸引者 12 人中有 9 人（75%），被兩性吸引者 35 人中有 23 人（66%），而被男性吸引者 100 人中只有 15 人（15%）。
• 被男性吸引的組別與其他每一組都有明顯差異，而其他三組之間沒有明顯差異。
• Blanchard 的結論是，被兩性吸引或兩者皆不吸引者，是被女性吸引者的變體，因此有兩種基本類型：被男性吸引者，以及不被男性吸引者（後來稱為「自我女性化性愛」）。
• 這項研究是 Blanchard 的類型和他 1989 年的自我女性化性愛（autogynephilia）說法的起點，美國精神醫學手冊 DSM-5 後來將其用於附加在易裝障礙診斷上的標註。

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.