|
November 19, 2008
Kelley Winters, Ph.D.
GID Reform Advocates
www.gidreform.org
Dr. Blanchard’s taxonomy of
“autogynephilia” and “homosexual transsexualism” follows a long tradition of
dividing transsexual women into categorical buckets based on sexual
orientation. A premise in American psychiatry/psychology has traditionally held
that male-to-female transsexualism is a phenomenon of effeminate male
homosexuality, while the label of “transvestism” is associated with
heterosexual men. Hence, diagnostic nomenclature and research literature have
for decades favored candidates for surgical transition care who would have
heterosexual outcomes (i.e., transwomen attracted to men). [1]
In the 1960s, Dr. Harry Benjamin’s
defined two types of so-called “true transsexuals” as distinct from
“transvestites” and “non-surgical transsexuals,” based on Kinsey’s scale of
sexual orientation. Those attracted to men were labeled “high intensity,”
resembling Blanchard’s “homosexual” label. Benjamin described asexual,
“auto-erotic” and some bisexual individuals as “low intensity” or “nonsurgical
transsexual.” He
labeled transsexual women attracted to women mostly as “transvestites,” [2] and
the belief that those termed “transvestites” were not gender dysphoric or
attracted to men held until the 1980s.
While Benjamin emphasized that his
six types of MTF transsexualism “are not and never can be sharply separated,” psychiatrist.
Robert Stoller insisted on exclusive division of transsexualism from “transvestism.”
Stoller considered a single episode of cross-dressing associated with
sexual arousal sufficient to exclude a diagnosis of transsexualism [3] and
therefore denial of access to transition medical care. (Like Blanchard today,
Stoller conflated “association” with erotic causation in his literature.) This
view was reflected in the DSM-III-R, [4] where concurrent diagnosis of
Transvestic Fetishism and GID of Adolescence or Adulthood, Nontranssexual Type
(GIDAANT) or Transsexualism were not allowed [5].
In the real world, however, large
numbers of transsexual women, who were attracted to women and applied for
corrective transition surgeries, refuted the theory that assumed transsexual
women to be gay men. They were called such uncomplimentary names as “transvestic
transsexuals,” [6], “aging transvestites” [7] and “non-transsexual men applying
for SRS” [8] Where researchers in other scientific discliplines might have
questioned the premise in view of contrary data, psychiatric researchers leapt
to an incredible assumption: that there must be an additional independent
“etiology” or cause for MTF transsexualism. Early on, this second “etiology”
was described as a “regression” of transvestism into transsexualism,
inexplicably “provoked” by stress. [9] In the late 1970s, Person and Ovesey
offered a Hitchcockian psychoanalytic explanation of this process:
At times
of stress, … transvestites frantically step up the pace of acting out. Should
such reparative measures fail, they regressively fall back on the more
primitive fantasy of symbiotic fusion with the mother. It is at this point that
transsexual impulses break out and may go on to full-blown transsexual syndrome
(secondary transsexualism).” [10]
Blanchard’s theory of
“autogynephilia,” later emerged to fill this role. But is this science, or is
this a defensive response to contradicting evidence?
Deogracias, et al., recently proposed that the
similarity of transwomen, regardless of sexual orientation, supports a “concept
of equifinality,” meaning that the same effect or end state can result from completely
different causes. [11] I am very skeptical of this opinion. Data that contradict
a hypothesis most likely call the validity of the hypothesis into question. We in the physical sciences and engineering often use the principle of Occam’s Razor to discern credible from
unlikely theories. Contrary to the notion of equifinality, it asserts that simpler
parsimonious theories are more likely to be true than twisted complex theories,
if all other considerations are equal. Are we to believe that the same effect,
gender dysphoria, comes from not one but two unrelated causes depending upon
the sexual orientation of the person? Perhaps Occam's Razor would be a good Rx
for the behavioral sciences as well. [12]
Moreover, a corner-stone of
scientific methodology is the falsifiability of hypotheses -- the possibility
that a hypothesis may be refuted by evidence or experiment. Theories are widely
considered to be scientific only if they are falsifiable. By capriciously
spawning a new independent theory of “autogynephilia” to explain the existence
of transwomen who were not exclusively attracted to men, these researchers
rendered the original hypothesis of “homosexual male” transsexualism to be
unfalsifiable. In my view, this does not suggest equifinality. Rather, it is
evidence of a dubious hypothesis that conveniently metastasizes in the face of
contradicting data. It is evidence that the development of gender identity in
all people, trans and cisgender alike, is not yet understood.
In recent years, Dr. Blanchard has attempted to draw a
distinction between “autogynephilia” as a sexual phenomenon from the other
meanings associated with the term, including his own controversial theories. [13]
However, the word “autogynephilia” has evolved far beyond sexual taxonomy and
theoretical speculation to carry a negative context of its own. It has become
an offensive epithet to many transwomen. For example, Blanchard and
collaborators have grouped “autogynephilia” (lesbian, bisexual and asexual
transwomen) with pedophilia, fetishism and even apotemnophilia (desire for limb
amputation). [14, 15] This reinforces some of the most stigmatizing and
dehumanizing false stereotypes that transsexual women bear in society.
In addition, the terms
“autogynephilia” and “homosexual transsexual” have become associated with extremely
offensive remarks and stereotypes about transsexual and other transgender women.
Here are but a few examples from a very controversial book by Dr. J. Michael
Bailey of Northwestern University, entitled The Man Who Would Be Queen: The
Science of Gender-Bending and Transsexualism. [16]
- “The Man Who Would be Queen” --this
maligning description of transsexual women in the book title is
accompanied by a cover photo that offensively caricatures them.
- “men who want to be women are not naturally feminine. There is no sense in which they have women's souls."
- "The autogynephile's main
romantic target is herself." – in reference to transsexual women not
exclusively attracted to men.
- “Autogynephiles do not typically look
or act very feminine” -- ridiculing transsexual women for not fitting
the author’s image of what women are “supposed” to look like.
- “Men Trapped in Men’s Bodies” – in
reference to transsexual women labeled as “autogynephiles,” this chapter
title is a quote from Dr. Anne Lawrence. [17]
- 'but they don’t have the wrong body,
they are mentally ill'. – in reference to transsexual women labeled as
“autogynephiles,” Bailey quotes his undergraduate students.
- “homosexual transsexuals are a type of
gay man.” –in reference to straight transsexual women.
- “homosexual transsexuals are used to
living on the margins of society"
- “homosexual transsexuals might be
especially well-suited to prostitution."
Published in 2003, this book promoted inflamed a firestorm of outrage among the transgender community and supportive allies. [18-21] Bailey’s remarks about transsexual women are worse than offensive; they are gratuitously cruel.
Finally, “autogynephilia” has been
used in a punitive context to discredit critics of these theories and negative
stereotypes. For example, Bailey and Triea associated disagreement with the theory
of “autogynephilic” motivation as symptomatic of “autogynephilia:”
“although
most public transsexual activists appear by their histories and presentations to
be nonhomosexual MtF transsexuals, they have generally been hostile toward the
idea that nonhomosexual transsexualism is associated with, and motivated by, autogynephilia.”
[22]
The authors went on to name
individuals they termed “transsexual activists” and publicly speculated about
their private sexualities. Hence, “autogynephilia” has morphed from a term of
taxonomy to a political tool to suppress criticism.
To summarize, the term
“autogynephilia” means far more than a description of erotic phenomenon. “Autogynephilia,”
and its corollary “homosexual transsexualism,” have come to represent an
over-arching body of derogatory stereotypes that are promoted as science but remain
dogmatically resilient to contrary evidence:
- “Homosexual transsexual” maligns all
straight transwomen attracted only to men as “homosexual men.”
- “Homosexual transsexual” implies that
all straight transwomen were motivated to transition by their so-called
“homosexuality” or denial of it.
- “Autogynephilia” maligns all
lesbian and bi transwomen, who are not exclusively attracted to men, as
pathologically narcissistic “men.”
- “Autogynephilia” implies that all
lesbian and bi transwomen are attracted to themselves instead of other
women, which demeans and undermines these relationships and families.
- “Autogynephilia” implies that all
lesbian and bi transwomen are motivated to transition primarily by sexual
paraphilia or deviance, undermining their legitimacy and dignity as women.
- “Autogynephilia” denies that
transwomen who live happy and full lives as women, regardless of sexual
orientation, possess an inner feminine gender identity or “essence.”
- “Autogynephilia” is a politically
punitive epithet for transwomen who criticize psychiatric policies and
stereotypes.
- “Autogynephilia” is indelibly
associated with cruel dehumanizing epithets of transwomen, such as “man
who would be queen,” and “men trapped in men’s bodies.”
The term “autogynephilia” has
grown to represent an affront to the human legitimacy and dignity of many transitioned
women. It serves no constructive purpose in an evidence-based diagnostic
nosology. I strongly urge the American Psychiatric Association to remove this
offensive term from the supporting text of the GID diagnosis and refrain from
adding it to the nomenclature of paraphilias in the DSM-V.
[1] K. Winters (published under pen-name Katherine Wilson)
and B. Hammond, “Myth, Stereotype, and Cross-Gender Identity in the DSM-IV,”
Association for Women in Psychology 21st Annual Feminist Psychology Conference,
Portland OR, 1996, http://www.gidreform.org/kwawp96.html.
[2] H. Benjamin, The transsexual phenomenon, Julian
Press, pp. 23-24.
[3] K. Freund, B. Steiner, S. Chan, “Two Types of
Cross-Gender Identity,” Archives of Sexual Behavior, v. 11, n. 1, 1982, p.
55.
[4] American Psychiatric Associatio, Diagnostic and
Statistical Manual of Mental Disorders, Third Edition, Revised, 1987, pp.76-77,289.
[5] The diagnostic criteria
for Transvestic Fetishism excluded diagnosis of Transsexualism or GIDAANT, and
the criteria for GIDAANT excluded erotically motivated cross-dressing and Transvestic
Fetishism. The criteria for Transsexualism did not explicitly exclude TF, but
were assumed to do so. See Bradley, S., et al. (1991). "Interim Report of
the DSM-IV Subcommittee on Gender Identity Disorders," Archives of
Sexual Behavior, Vol. 20, 1991, No. 4, p.338.
[6] E. Person and L. Ovesey, “The Transsexual Syndrome in
Males. II. Secondary Transsexualism,” Am. J. Psychotherapy, v. 28, pp.
174-193.
[7] T. Wise and J. Meyer, “The Border Area Between
Transvestism and Gender Dysphoria: Transvestic Applicants for Sex Reassignment,”
Archives of Sexual Behavior, v. 9 n. 4, 1980, p. 329.
[8] R. Stoller “Gender Identity,” in A. Freedman, H. Kaplan,
& B. Sadock (eds.), Comprehensive Textbook of Psychiatry, 2nd
ed., vol II, Williams and Wilkins, pp. 1400-1408.
[9] Wise & Meyer, 1980, p. 340.
[10] E. Person and L. Ovesey, “Transvestism: New
Perspectives,” 1978, in E. Person, The Sexual Century, Yale University
Press, 1999, p. 167.
[11] J. Deogracias, L. Johnson, H. Meyer-Bahlburg, S.
Kessler, J. Schober, K. Zucker, “The gender identity/gender dysphoria
questionnaire for adolescents and adults,” Journal of Sex Research, v.
44 n. 4, November 2007, pp. 370-379, http://findarticles.com/p/articles/mi_m2372/is_4_44/ai_n27467813***
[12] K. Wilson (former pen-name for Kelley Winters),
"Autogynephilia: New Medical Thinking or Old Stereotype?" Transgender
Forum Magazine, April 16, 2000. http://www.gidreform.org/kwauto00.html
[13] R. Blanchard, “Early History of the Concept of
Autogynephilia,” Archives of Sexual Behavior, Vol. 34, No. 4, August
2005, p. 445.
[14] K. Freund, & R. Blanchard, R., “Erotic target
location errors in male gender dysphorics, paedophiles, and fetishists,” British
Journal of Psychiatry, 162, 558–563p. 1993, 558.
[15] A. Lawrence, “Clinical and theoretical parallels
between desire for limb amputation and gender identity disorder,” Archives
of Sexual Behavior, v. 35, 2006, 263.
[16] J. Bailey, The Man Who Would Be Queen: The Science
of Gender-Bending and Transsexualism, Joseph Henry Press, 2003, pp. xii, 172, 178,
183-185, 206.
[17] A. Lawrence, “Men Trapped in Men's Bodies:
Autogynephilic Eroticism as a Motive for Seeking Sex Reassignment,” 16th Harry
Benjamin International Gender Dysphoria Association (HBIGDA) Symposium, London,
August 1999.
[18] H. Cassell, “Controversy Dogs Sexuality Researcher,”
Bay Area Reporter, October 4 2007, http://ebar.com/news/article.php?sec=news&article=2274
[19] A. Dreger, “The Controversy Surrounding The Man Who
Would Be Queen: A Case History of the Politics of Science, Identity, and Sex in
the Internet Age,” Archives of Sexual Behavior, vol. 37, no. 3, June
2008, pp. 366-421. http://www.bioethics.northwestern.edu/faculty/work/dreger/controversy_tmwwbq.pdf
[20] L. Conway, “An investigation into the publication of J.
Michael Bailey's The Man Who Would Be Queen,” 2004, http://ai.eecs.umich.edu/people/conway/TS/LynnsReviewOfBaileysBook.html
[21] A. James, "’Autogynephilia’: A disputed diagnosis,”
Transsexual Road Map, 2004, http://www.tsroadmap.com/info/autogynephilia.html
[22] J. Bailey, K. Triea, “What Many
Transgender Activists Don’t Want You to Know and Why You Should Know It
Anyway,” Perspectives in Biology and Medicine, v. 50, 4, autumn
2007, pp. 527.
Copyright © 2008 Kelley Winters, GID Reform Advocates
|
