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

• Blanchard 創造了「自我女性化性愛」一詞，指男性因想到或想像自己是女人而產生性興奮的傾向。
• 研究納入多倫多一家精神科門診性別服務的 212 名成年男變女變性患者，年齡 17 至 63 歲。
• 患者被分為一組被男性吸引者，以及另外三組：被女性吸引、被兩性吸引，和兩者皆不吸引。
• Blanchard 從現有的問題中編制了一份新問卷，衡量對想像自己是女人的性興奮，並比較了四組。
• 三組不被男性吸引者，比被男性吸引的組別更可能回報因想像自己是女人而產生性興奮。
• Blanchard 的結論是，不被男性吸引的男性的性別焦慮是一種狀況，即「自我女性化性愛型性別焦慮」，與被男性吸引的男性的性別焦慮不同。
• 這個想法後來成為美國精神醫學手冊 DSM-5 中附加在易裝障礙診斷上的一個標註，至今仍有強烈爭議。

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.