The Gender Identity Fallacy:
How an Irrational Concept Prevents a Rational Understanding of Transsexuality
By Alex Parkinson
"One expert told me bluntly: 'Gender identity is defined as
"the inner sense of oneself as male or female.' What the hell
does that mean?"(Bailey, 2003,p 50.)
At the center of the most popular conceptualizations of transsexuality
is the idea of "internal gender identity." It has been almost
taken for granted that people 1. have an internal gender identity not
dependent on socialization but rather something they become aware of
spontaneously and 2. that an incongruity between this internal gender
identity and an individuals physical sex is the reason why
transsexuals experience 'gender dysphoria' and chief reason why
people wish to change genders (GIRES 2003). These are sweeping claims
made with virtually no attempt at explication of what exactly
'internal gender identity' is as a phenomenon, if it can be said
to exist phenomenologically at all, and with only circular or
self-referential explanations for what 'gender identity' as a
concept which usually amount to simply rephrasing it in other terms,
such as "gender identity the inner sense of masculinity or
femininity" (Beers and Berkow 1999). This essay will attempt to
describe what the concept is, or at least how it is used, why the
concept is flawed, and how the phenomena attributed to it can be
explained in terms of a model of autogynephilia that not only
recognizes autogynephilic arousal, but also the implications of
autogynephilic desire.
Gender Identity as a concept:
For the purposes of discussing gender dysphoria, transsexualism and
gender identity disorder, "gender identity" has a fairly
specific usage. Gender identity is said to be an internal
sense of oneself as either male or female (GIRES 2003). It has
nothing to do with how one is socially regarded, how people
relate to the world, appearance or manner, but something purely
internal. This internal feeling, of feeling either male or
female, is held to be the only relevant dimension of what truly
determines an individual's gender. Further, this is said to
be not only entirely independent of phenotypical sex, but also of
whether someone is masculine or feminine in presentation and
behavior, and sexual orientation; it would have to be in order
to account for everyone who identifies a member of the
(biologically) opposite sex, as many of these biological males
with 'female gender identites' are both typically
masculine in behavior and typically heterosexual as men. Maybe
this makes a certain degree of sense because even extremely
masculine lesbians are regarded, socially as female (if highly
gender variant females), and extremely feminine gay males are
socially regarded as male, again even if gender variant.
With
this understanding of gender identity, a transsexual is said to
be someone who simply feels they are the other sex 'on the
inside.' This is commonly described as someone's internal
gender identity not matching their sexual appearance, or as
being "trapped in the wrong body." Gender dysphoria is
then said to be the angst experienced by transsexuals at being
female inside but male outside, the profound psychic pain of
the disconnect between the internal conception of oneself and
the physical and social realities. So, the assertion
frequently made is that since the state of the mind cannot be
changed and the state of the body can, transsexuals must
attempt to change their bodies to align them with their minds,
in order to resolve this mismatch. While some activities that
are said to make the male-to-female transsexual "feel more
feminine" on the outside in an effort to match their
internal gender identity, such as dressing up in women's
clothing, can offer partial relief from their gender dysphoria,
releasing the tension they feel bottled up inside of them so
that they can feel more 'at peace', the conflict is never
truly resolved until full social transition and sex
reassignment surgery.
Transsexuals who are variant in behavior
from their biological sex are said to be "expressing their
gender identity" and their femininity is said to be a way of
showing on the outside behaviorally how they feel on the
inside. A biological male who speaks or behaves in a
"feminine" way is therefore consciously expressing their
cross-gender identification, and this behavior is the product
of an identity disturbance (APA, 2000). A biological male
transsexual who on the other hand, appears very masculine in
manner and lifestyle, has the same gender identity, but decides
not to express it, (Samons, 2001a) possibly for fear of some
sort of negative reprisal. This would seem to imply then that
cross-gendered behavior is a deliberate expression of an
internal gender identity disturbance and not spontaneous,
otherwise choosing to 'express' or 'repress' a
crossgender-identification would not be an option.
This model of gender identity and transsexuality, as internal and
independent from sexual orientation and socialization is taken as
standard by GLBT organizations (HRC 2004), by the transgender or ts
organizations themselves (IFGE 2004), and increasingly the general
public and the medical community (Meyeowitz, 2002). The diagnosis of
Gender Identity Disorder in the DSM IV defines GID as a profound
internal identity disturbance, even though it acknowledges that young
ts who are attracted to men exclusively have very different symptoms
then male to female transsexuals who are attracted to women, women and
men, or neither, which it acknowledges as being autogynephilic (APA
2000).
Conceptual problems with "gender identity":
Possibly the most fundamental question to ask is, when one
says 'gender identity', what phenomenon if any is being
described. It really cannot be an "identity" in any
conventional sense of the word. Group identities are based on
socially identifying individuals as members of that group by
'identifiable' characteristics, not simply choosing to
affiliate oneself with a group (a white person cannot simply
choose to participate in black group identity because they
cannot be identified by others as black). It's impossible
to have a conventional 'identity' without a social or
external context because identities must be in reference to
something one is being identified as (a group or
characteristic). To have an identity in most senses is to be
identifiable as something, by characteristics traits or
behavior, so that people assign each other groups or
'identities' based on those characteristics. There are
of course certain group identities that one can claim simply
by self-declaration, such as political or religious
identities, but only because the membership in these groups is
defined socially by declaring an affiliation rather then any
other characteristics (e.g. To identify as a Republican, might
in fact make one a Republican, but only because Republicans as
a group are defined as a chosen affiliation rather then an
identity that society assigns people based on their
characteristics, such as being Black or being female).
So, when a biological male declares that they "identify"
as female, on what basis can they be claiming a female
identity? They can honestly say that they want to be female,
and they can potentially say that they "identify with
women" in that they experience empathy or understanding
towards females, but neither of those things make someone
female in the conventional definition of "female." In
fact, the notion that wanting to be female makes one female is
quiet paradoxical; why would someone be so distressed over
wanting to be something that they already were?
If female gender identity is really a metaphor for feeling like
a woman (APA 2000), that raises the issue of how they know what
a woman feels like. The problem with making claims about
entirely internal things, things that can only be accessed by
personal introspection and even then impossible to articulate
clearly, is that such things are by nature inaccessible to
other people, so there can be no basis for comparison. So,
working under the hypothetical assumption that there is such a
quality as an 'internal gender identity', how can one
know if their 'internal gender identity' is more like a
male's or more like a female's? For someone to know if
their 'gender identity' is male or female, they would
have to be able to feel or experience another male's
'gender identity', and another female's 'gender
identity', or have some way to access it, in order to
compare another's gender identity to their own to determine
if it was more male or more female, but since 'gender
identity' is said to be an internal state, that cannot be
even hypothetically possible to do. To say that one "feels
like a woman" requires knowing what another woman feels
like; otherwise how could someone recognize what they were in
fact feeling as 'like a woman' and not like something
else.
If a patient identified themselves to a psychologist as a
member of the British royal family, it would be basically
absurd because society has not afforded them that identity.
If they said they felt like a British royal and not like a
private citizen, how would they would not be able to know what
a British royal feels like. If they said they wanted to be a
British royal, that desire might be "reasonable" if
entirely unrealistic, if they wanted the money, the fame, the
public life, the ability to associate with the British royals,
or some other ulterior motive, but also absurd if it was
because of an 'identification' or a belief that they
'felt like a royal.' Lastly, a patient who insists that
he or she truly is a member of the British royal family when
they clearly are not, would seem to be seriously disturbed,
delusional or psychotic. The fact that there are more
individuals claiming to identify with, feel like, or actually
be, female when they are apparently male, does not make those
claims any more reasonable.
Misunderstanding the concept of gender:
Typically when sex and gender are not used synonymously, sex
refers to biological or physical state of being male or
female, such as determined by chromosomes or genitals, and
gender refers to the social status of being male or female.
However, among transgendered people, the expression "sex is
between the legs, gender is between the ears", or something
very similar, is used to articulate what sex and gender are.
This however, completely misinterprets what gender is and
redefines it in a very essentialist way that might be useful
to certain transsexuals but is entirely inconsistent with the
common understanding of gender. The way 'gender' as
opposed to 'sex' has been commonly used is to talk about
sex in a social rather then biological context, so that when
speaking of male and female social role one says "gender
role" and when speaking of male and female genetically one
says "chromosomal sex." A biologically female lesbian
woman who acts and presents herself in a very masculine way,
but is still clearly considered female based on appearance and
physicality by those around her, has a normal 'sex' but
is clearly 'gender variant' in presentation (in other
words she meets physical expectations for females but not
social expectations for females). Socially speaking, people
are classified by others as male or female based on sex and
not on gender, it's ultimately whether they appear
physically male or physically female and not whether their
behavior is closer to male or female norms. To be "gender
normative" then is when a persons social behavior and
conduct matches the expected behavior and conduct of their
apparent sex, and one is "gender variant" when it does
not.
This generally accepted notion of gender as a social
construct, or socially perceived gendered characteristics, is
based on social expectation so it is entirely external to an
individual's personal thoughts. As Kessler and McKenna
(1978 p. 39) put it:
"A person's gender is what they
are regarded and treated as, that is, the gender of someone is
the same as the gender attribution that is made about
them. Gender is, in the first place, a social fact."
There is nothing essentialist or innate or biological about this sense
of gender, it only exists in the context of social interaction. The
idea of 'internal gender identity' takes this concept and takes
it out of the social context, giving it an essentialist root. Instead
of gender being social, the concept of 'internal gender
identity' holds that gender, like sex, is independent of social
interaction (entirely distorting the concept of gender).
This gives 'gender identity' an essentialist character of
being something that is simply apparent to people rather then
something subjective interpreted by people. To illustrate this
point, consider a hypothetical view of gender that states that
"A man is just a woman with a 'y' chromosome, a woman
is just a man without one." This is an 'essentialist'
view because it takes the 'y' chromosome as the only
marker of gender, this attributes "essential' properties
to the chromosome while relegating all other properties of
gender such as physicality or social role and so forth as
'non-essential' characteristics which are not
fundamentally relevant to gender. This position on gender
identity works the same way, except in considering absence of a
'y' chromosome to be the essence of being female it
considers a 'female gender identity' to be the essence of
being female. This is problematic because it arbitrarily
attributes special significance to one characteristic of gender
making the other characteristics irrelevant (or at least
irrelevant in important ways).
This articulation of gender dismisses the social relevance of
gender reducing it to sex, but rather then judging sex by
physical appearance or genitalia or genetics, to take
'internal gender identity' seriously is to judge sex by
self declaration only. Or, even worse, actually attributing
sex to some particular structure in the brain, such as the
frequently sited (but never independently verified) study
finding a sex difference in the BSTc area of the brain, (Zhou
et al., 1995), as the essential fact in 'gender
identity', defining sex neuro-developmental condition (GIRES
2003); this gives sex a physical, biological, definition, but
instead of attributing it to genitals or chromosomes which can
be observed, it conveniently attributes it to a part of the
anatomy that can only be observed after death, allowing
essentialist appeals to anatomy without having any way to
verify those claims. If sex (or rather, gender, improperly
used) merely amounts to what sex an individual thinks of
themselves as, then it's a concept with no real substance.
This is clearly not consistent with the way gender is
understood by the general public, and it can clearly not be a
valid motivation for anyone to want to change sex; if sex is
that meaningless why go through such an effort to change it?
Autogynephilia and 'internal gender identity':
The concept of "internal gender identity" is a sort of
intellectual slight of hand which might make a certain sense
superficially but falls apart when the concept is explored at
all, let alone examined skeptically. Gender identity itself is
a sort of category error both on what gender is and how
identities are formed. Even putting that aside, the supposed
psychological consequences of gender identity are not what one
could reasonably expect to be the result of an identity. For
that matter, the supposed ontological implications of gender
identity, that gender identity is what makes someone male or
female on the most essential level, is a completely baseless
assertion. So, if gender identity is conceptually null, why is
it so widely used by transsexuals (specifically non-homosexual
transsexuals)?
There does seem to be a phenomenon of 'gender dysphoria'
where a transsexual has an intense desire to be female and a
great deal of frustration, tension, and angst at being unable
to fulfill that desire. Now, this is usually interpreted in a
transsexual narrative as frustration with a disconnect between
'internal gender identity' and physical sex, or between
'internal gender identity' and social gender.
Transsexuals who make this claim are in effect, using their
gender dysphoria as evidence of 'internal gender
identity', and there is a certain logic behind this. They
experience this intense and frustrating desire to be female,
which they realize is atypical and irrational, so they need a
way to explain it, and suggesting that gender dysphoria comes
from a mismatched internal gender identity might seem like a
reasonable implication, and one that is very emotionally
satisfying to a population who desperately wants to believe
they are "really women" on some fundamental level.
Thinking of the dilemma that gender dysphoria poses to
transsexuals intellectually makes it more understandable why
the concept of 'internal gender identity' would not feel in
conflict with these transsexual's experience (as it would
with homosexual transsexual's), but given the inherent
problems with 'internal gender identity' as already
discussed, this is not a realistic conclusion to make. In
fact, there is no logical reason to think that gender
dysphoria is caused by 'internal gender identity' at
all, even if it can be phrased in such a way that it makes a
certain sense, it's still clearly a logical leap.
This type of gender dysphoria can be explained another way,
more sensibly, as an aspect of autogynephilia. Autogynephilia
is the behavioral model describing non-homosexual males who,
instead of being physically attracted to other women, are
physically attracted to the idea of themselves as a woman
(Blanchard 1989). This model was developed to make sense of
the diversity of so called "secondary" transsexuals.
While the transsexuals who presented early for treatment, who
were persistently feminine behaviorally, markedly feminine in
appearance, and exclusively homosexual (attracted to men) did
not require much explanation as it would be superficially
obvious to anyone why such individuals might prefer to be
female (clearly being better adjusted for such a role), the
picture of transsexuality became much more complex when it was
recognized that older males, typically masculine in appearance
and manner, often heterosexual and frequently married, wanted
their sex reassigned just as badly, even if it seemed less
intuitive. A "homosexual type" (sometimes called
'primary') was the most frequently and consistently
identified category of transsexual (Blanchard 1989b) by
researchers but classification of the other more types was
more difficult because while they had little in common with
the "homosexual type" and shared characteristics, they
presented no one clinical profile. Freund et al. (1982) made
a significant observation, finding that transsexuality
nearly always either occurs with homosexuality, or is
proceeded by transvestic fetishism, but not both in the same
patients, suggesting two discreet types of transsexuality.
The notion that there are two types of transsexuals, a
distinct homosexual type, and type with a unifying feature
that includes all non-homosexuals, would predict that the
developmental histories of the non-homosexual transsexuals (at
the time classified as heterosexual, bisexual, and
analloerotic or asexual) would have commonalities with each
other but clear differences from the homosexual type .
Further research confirmed these predictions; Blanchard (1985)
found that the three non-homosexual classifications reported
transvestic fetishism with much greater frequency then
homosexuals, later finding that the three groups presented
clinically at close to the same age and significantly older
then the homosexual transsexuals, and reported similar degrees
of childhood femininity to each other and far less then the
homosexuals type (Blanchard 1988).
While these studies strongly suggested that transsexuals with
non-homosexual orientations have variations of the same
disorder, Blanchard wanted to find a single feature
characteristic of the disorder common to all three types, so he
came to develop and test the hypothesis that
'autogynephilia' was this disorder (Blanchard 1989a).
The autogynephilic transsexuals suffer from a paraphilia where
they locate the typical heterosexual love object in themselves
rather then a partner, in a complete inversion of the
psychology of a normal sex drive. Hirschfeld (1948, p167)
offered an early description of this phenomenon, "They feel
attracted not by the women outside them, but by the woman
inside them." This is a self reflective sex drive where they
are physically attracted to women as normal heterosexual men,
but instead of only being attracted to a real, external women,
they also have misdirected (and sometimes exclusively) sexual
interest in an internal woman who they wish to become, so
they can be said to have a male heterosexual orientation
directed at themselves as 'female' (Blanchard 1992). In
the DSM-IV-TR, it is noted that non-homosexual transsexuals,
(those who are either attracted to women, to both genders, or
to no one) usually report a history of autogynephilia. The
DSM-IV-TR states that these non-homosexual males with gender
identity disorder would in most cases have qualified for a
diagnosis of transvestic fetishism at some point. Transvestic
Festishism is a paraphilia where heterosexual men become
sexually aroused by symbolically feminizing themselves or
symbolically becoming female by wearing women's clothing,
which is another associated disorder caused by autogynephilia.
The DSM-IV-TR also notes that in other non-homosexual patients
with GID who do not have Transvestic Fetishism, they may
eroticize the idea of becoming female in other ways such as
fantasying that they have female anatomy or are engaged in
stereotypically female activities; so autogynephilia can be
manifest in other ways besides transvestic fetishism.
The descriptions of gender dysphoria in non-homosexual
transsexuals have many parallels with typical sexual
attraction, so they can be understood as other manifestations
of autogynephilia. While its obvious to anyone that a
non-homosexual transsexual masturbating while cross-dressed is
having an erotic experience, the same individual's
"gender dysphoria," while not as blatantly sexual, still,
if examined closely, is also a related, if less intense, erotic
experience. To see this, one has to look at the experience
these transsexuals are actually describing, rather then the way
they intellectualize their experience. Sexuality does not
merely involve having sex or having orgasms, autogynephilia
even more so because it is self-reflective. People with
typical heterosexual or homosexual orientations for instance,
have partnered sex and might have explicit sexual fantasies
about people they're attracted to, but this is just one
element of sexuality. Heterosexuals want to connect to people
of the opposite gender, and homosexual people to others of the
same gender, in so many ways apart from just having sex; they
might want emotional intimacy, closeness, friendship, romance,
ect. It should then be no surprise that people who have
autogynephilia, which is probably more accurately regarded as a
type of abnormal sexual orientation (a self directed one)
rather then a fetish (Blanchard 1992), should have erotically
related desires of a less explicit nature just as normal
heterosexuals will not only want intercourse, but also to
relate to the objects of their desire on an emotional level.
This is essentially what gender dysphoria is in non-homosexual
transsexuals, a manifestation of their abnormal sexuality in a
less then explicit way. To use an example, when 12 or 13 year
old kids (who are sexually inactive) have crushes on a boy or
girl they go to school with, they might have explicit sexual
fantasies, but more likely most of their interest is more
emotional. They want to be around the girl or boy they like,
get positive attention from them, maybe fantasize about
becoming close friends or spending time together or otherwise
attaining a sort of closeness or intimacy that does not
necessarily include anything overtly sexual (such as
intercourse), while at the same time sexuality is implied.
Pre-adolescent kids beginning to experience their sexuality on
this level might feel strongly attached to people they do not
even have a relationship with and feel their whole day is
brightened if they make eye contact and smile at them, really
longing to be together in some capacity even if they are not
completely sure of how sexual relations work. There is nothing
sexually explicit about this common experience but it is
clearly, at least from an outside perspective, related to
sexuality. And kids who will be heterosexual as adolescents
have crushes on people of the opposite sex, and the reverse for
kids who develop a homosexual orientation.
This aspect of sexuality is what needs to be appreciated in
autogynephilia in order to explain gender dysphoria in
biologically heterosexual males; only looking at the most
explicit expressions of autogynephilia like masturbation while
cross dressed, actually misses the bulk of how it's
experienced. In a lot of ways, gender dysphoria in
biologically male heterosexuals is analogous to a normal
heterosexual male with a crush on a girl they're attracted
to. The difference is that in these transsexuals, they have a
crush on an internal girl that they would like to be, rather
then an actual person, precisely as one might expect of a male
heterosexuality that was directed at ones self.
This explanation of gender dysphoria as an aspect of
autogynephilia can reasonably explain nearly all of the
commonly reported experiences (again, as opposed to
intellectualizations of those experiences) associated with
transsexuality in biologically heterosexual males.
Autogynephilia might be a very atypical "sexual
orientation" but it still has a great deal of similarity
with more common sexual orientations. For instance,
heterosexual sexual intercourse is obviously a result of and
evidence for heterosexuality but likewise is idolizing a member
of the opposite sex including their physicality and longing to
be with them (as in a crush). Likewise, transvestic fetishism
is certainly a symbolic expression of autogynephilia, but so is
idolizing the idea of oneself as a member of the opposite sex,
and longing to physically and emotionally become that idea
(gender dysphoria). Another example of where experience of
sexuality does not necessarily take the form of overt sexual
interaction, then, is sexual frustration or built up sexual
tension and then the feeling of relief when it is acted on.
The sense of 'relief' or 'peace' that these
transsexuals describe when they do things that 'make them
feel more feminine', whether its taking hormones or wearing
female clothing, is often claimed as an example of how their
dysphoria is not sexual. Transvestites, they insist,
experience only sexual exhilaration rather then this 'peace
with oneself'. However, this relaxation or feeling of peace
and satisfaction could be awfully similar to the sense of
relief that normal heterosexual men experiance when they're
sexually satisfied by a female partner after a prolonged period
of sexual frustration.
Another aspect of this type of internal gender dysphoria which
points to autogynephilia as the cause is the way these
transsexuals become aware of it. Gender dysphoria is something
that they become spontaneously aware of; few things are
unprompted and 'self evident' and sexual interest is one
of them. To simply want to be a woman as a self-evident good
then might be similar to simply wanting to be with a woman: a
heterosexual man cannot describe what compels him to want to be
with a woman, it's a basic desire that he becomes aware of
through his physiology rather then through any rationalization.
That these transsexuals become aware of their gender dysphoria
in a similar way, which in human experience is really quite
rare, might suggest common causes.
It is important to keep in mind that a sexual orientation is
not only experienced in terms of physical arousal or explicitly
sexual encounters when considering an atypical sexual
orientation. The largest component of personal sexual
experience may be desire, lust, wanting someone, which is not
necessarily arousing in the conventional sense but certainly
rooted in a person's sexuality. Arousal is short lived but
desire can be persistent, and unfulfilled desire can be
frustrating. Given that autogynephilia would appear to be not
a fetish but a sexual orientation consisting of self-directed
heterosexual arousal, (Blanchard 1992), one would then think
that such an orientation would not only have states of arousal
but also states of desire and states of sexual frustration, as
do typical heterosexual or homosexual orientations. With this
in mind, it should not be hard to see how the desire of a
non-homosexual male to become female is an autogynephilic
sexual desire even if it is not accompanied by any arousal, and
the phenomenon of gender dysphoria is best conceptualized as
autogynephilic sexual frustration.
Homosexual Transsexuality and Gender Identity:
If the dominant view of 'internal gender identity' were
true, then one would expect that the most persistently and
pervasively feminine of mtf transsexuals, the ones that are
most convincingly female in appearance and manner, would
surely have the clearest 'internal gender identities';
after all, they're said to be expressing their
'crossgender-identification' in their markedly feminine
behavior so their identity disturbance would appear to be the
most profound. This turns out not to be the case however,
these transsexuals in fact tend not to report any kind of
internal gender dysphoria and do not conceptualize their gender in
terms of an 'internal gender identity.'
As previously mentioned, the transsexuals who are most likely
to display more feminine characteristics and begin transition
young are homosexual (Blanchard 1988). This is consistent
with the very strong and well established correlation between
childhood femininity in males and homosexuality as
adolescents and adults (Zucker 1990). Children who display
noticeably cross-gender behavior in the great majority of
cases will, when followed up later, have developed a homosexual
orientation (Green 1979, 1985). Likewise, adult homosexual
men report significantly more feminine behavior as children
then heterosexual counterparts, and these self reports are
consistent with other people's recollection of them
(Bailey et al. 1995). The DSM-IV text revision also notes
that homosexual male transsexuals show signs of transexualism
in their childhood or early adolescence whereas the
heterosexual, asexual, and bisexual transsexuals usually
start having symptoms in early to mid adulthood (APA 2000).
As an aside, the DSM IV TR notes that virtually all female
transsexuals are homosexual transsexuals, biological women
attracted to other biological women, non-homosexual female
transsexuals are extraordinarily rare but have been known to
exist. Chivers and Bailey (2000) found that these
non-homosexual female transsexuals (ftm who are erotically
interested in men) are less masculine and more feminine, so
they may, in interesting ways, parallel non homosexual mtfs).
The DSM IV TR continues that the young boys with symptoms of
transsexualism (or rather 'gender identity disorder' as
it is problematically termed) have feminine mannerisms and
speech patterns which lead to peer ostracism and social
isolation, leading to poor self esteem (APA 2000). Most of
these boys develop sexual attraction to males in puberty but
have fewer overt feminine behaviors and no gender identity
disturbances (APA 2000) though one may question whether any of
them had an identity disturbance in the first place since
sufficient feminine behavior in a male could warrant a
diagnosis of childhood gender identity disorder regardless of
whether the boy reported an identity disturbance or not.
Otherwise, according to the DSM IV TR, it can lead to
"adult gender identity disorder" where males attracted
to other males simply do not grow out of their feminine
childhood presentation and present for treatment in
adolescence or early adulthood (APA 2000).
It is a fact that there are boys who behave in a distinctly
feminine way and most of them grow up to be gay men and some
of them 'never grow out of it' and choose to be straight
women instead; but it is a wild and highly questionable
inference to think that these people's behavior and
"marked distress and impairment," "represents a
profound disturbance of the individual's sense of identity
with regard to maleness or femaleness" (APA 2000 p.580).
For that matter, stating the desire to be a member of the
opposite sex really does not imply a profound identity
disturbance either: there could be any number of reasons why
being a member of the opposite sex might seem preferable to
someone besides a disturbance of that sort. The DSM IV TR
early noted that these children's behavioral non-conformity
would result in social ostracism that could lead to isolation
and self esteem problems, so it's not hard to imagine that it
could also lead to "marked distress and impairment", so
the distress would be the result of peer (or adult for that
matter) reaction to these behaviors rather then the cause of
those feminine behaviors. A seven year old boy who is unable
to present himself as in any way masculine is unusual and a
likely subject for ridicule, but a 14 or 16 or 18 or 20 year
old boy who appears to others as completely non-masculine, is
a good deal rarer and therefore likely to be caused a lot more
social distress by it.
Bartlett et al. (2000) point out that cross gender behaviour
and cross gender identification are two separate and distinct
concepts. The overlap between the two is tenuous at best,
calling into question the validity of CGID as a mental
disorder by the DSM's standards (Bartlett et al. 2000),
recommending a change in the diagnostic criteria. For that
matter, the belief that feminine behaviour is somehow a
deliberate expression of female identity does not make a great
deal of intuitive sense. These are young children and young
adolescents, how likely are they really to think through every
single action they take, sentence they speak, mannerism, and
adjust it deliberately to seem more "feminine" when this
behaviour and manner is so pervasive, rather then simply
acting naturally and such behaviour being spontaneous.
There is however a far more fundamental problem with the
DSM's assertion that feminine behaviour is caused by or is
an expression of a female gender identity. Behavioral
femininity is very strongly correlated with another variable
in males, homosexuality, and homosexuality is not strongly
correlated with female gender identity. Homosexual males are
in most cases somewhat too markedly feminine whether adults
(Bailey et al 1997) or children (Green 1979, 1985) so there is
a clear correlation between the two whereas only a tiny minority
of homosexual males self identify as female. Female gender
identity however, does not have a clear correlation with
behavioral femininity. Autogynephilic transsexuals can claim
to have an intense female gender identity but their behavior
is not especially feminine (Blanchard 1988) and in a great
deal of cases at least as masculine as other heterosexual men
(Samons 2001a) or even more masculine then the average
heterosexual man (Brown 1988). Given that homosexuality has a
correlation with feminine behavior but not with female
identity, and female identiy has no correlation with feminine
behavior, there is every reason to think that feminine
behavior is an entirely independent variable from female
gender identity, with no causal link and no strong connection.
One can only conclude that the Gender Identity Disorder
definition in children is based on entirely false premises and
"symptoms" of a normal sexual variation (homosexuality)
are being falsely attributed as symptoms of a profound
identity disturbance, when such behavior is not even
symptomatic of that disorder.
So if homosexual transsexuals do not have an internal gender
identity disturbance why do they want to be female?
Essentially for reasons external to their feelings about
themselves and their own psychology, they transition because
they are in fact, very female-like individuals in affect,
appearance, and behavior from an outsider's perspective and
therefore find they have a great deal of outside incentive for
becoming female and very little for remaining male. The two
places where they have the most to gain are predictably in
terms of social success in general and sexual and romantic
success in particular.
On the specific sexual and romantic aspects of homosexual
transsexual motivation, they are to some extent considering
partner preference and to a greater extent considering their
ability to attract a partner willing to have a meaningful
relationship with them. As partner preference, homosexual
transsexuals can be attracted to straight acting masculine gay
men, but are generally turned off by effeminacy in males and
likely to prefer heterosexual men for this reason (Bailey
2003), which obviously gives a certain added appeal to living
as a straight woman. What perhaps plays a larger role is in
terms of their relative attractiveness to straight men as
women when compared to their attractiveness to gay men as men.
Gay men are on average more feminine then straight men, but
among gay men there is a range of femininity; since they are
attracted to men and masculinity in men, the more masculine
'straight acting' gay men are considered much more
desirable as partners then queer acting un-masculine gay men
(Bailey et al. 1997). Homosexual transsexuals as gay boys,
are really very undesirable to other gay males, and certainly
not people who the type of gay males they could be interested
in would find attractive. However the same feminine
characteristics that turn off gay men to homosexual
transsexuals are considered sexually desirable by straight
men, whom homosexual transsexuals prefer anyways. Bailey
(2003 p. 180) remarks that:
"There is the rare exeption, but
for the most part, autogynephilic transsexuals aspire (with
some success) to be presentable, while homosexual transsexuals
aspire (with equivalent success) to be objects of desire.
Homosexual transsexuals have been models and actresses."
Clearly for people in such a position transitioning to female
from male gives them considerable advantages in finding a male
partner because they are much more valued as female then they
would be as male. Bailey continues that (2003 p 181.):
"as men the
homosexual transsexuals look and act extremely feminine, and
that presentation is not very marketable among gay men. They
are far more fetching as women."
and comments that homosexual transsexuals would by their own account
not want to transition if they were not going to be attractive and
capable of that type of success as women.
Even though Harry Benjamin (1966) was writing before the
taxonomy of transsexuals was understood as well as it came to
be in the 80s he knew that there were several types of
transsexuals and attempted to classify them. However, he could
not find classifications that presented unified symptomologies
and developmental patterns so his "true transsexual" type
for instance had one pattern of symptoms found in adolescents
with the condition (matching homosexual transsexual
symptomology) and another pattern of symptoms in adults with
"true transsexuality" loosely matching autogynephilic
transsexual's symptoms. So he still appeared to have seen
both types of transsexuals but was unable to put them into a
scientifically significant taxonomy; perhaps in large part to
an inability to recognize heterosexual attraction to females in
transsexuals despite older married transsexuals. In any case
he recognized that while a so called "gender motive" was
significant to older transsexuals, another way of perhaps of
trying to describe gender dysphoria of the type experienced by
autogynphiles, he ascribed sexual and social motives to young
transsexuals (Benjamin 1966). He claimed that a sexual motive
that "concerns particularly younger transsexuals" where
they are "strongly attracted to normal heterosexual men"
and "marriage and adoption of children is a goal for
most" leads many to seek sex reassignment surgery so their
genitals would not come in the way of having a relationship.
One should not, ethically, be prejudiced against homosexual
transsexuals for the frankly sexual aspects of their decision to seek
sex reassignment. The fact that a group of adolescents and young
adults want to have sexual partners should really not be surprising.
They do not have any sort of paraphilia, fetish or other abnormal
sexuality, they are simply attracted to men (Blanchard 1989a) and want
to have relationships with them just as normal homosexual males or
heterosexual females do. Homosexual transsexuals are not as as
occasionally suggested ego-dystonic homosexuals trying to resolve some
kind of guilt over their same sex attraction (McHugh 2004), they tend
to be very happy and comfortable with their sexual orientation and
usually live for a short period of time as 'gay boys' (Bailey 2003)
which does not cause them any inner emotional turmoil or conflict,
it's simply unsatisfying and frustrating because they do not frankly
make very successful gay boys. Everyone should be able to have
meaningful romantic relationships, it's one of the most important and
fulfilling parts of most people's lives and such serious handicaps to
that as homosexual transsexuals possess represent serious issues that
they have to address in order to have a real chance of happiness. The
fact that homosexual transsexuals principle interest in sex
reassignment surgery is being able to have sexual intercourse with men
(Benjamin 1966) and not to 'bring their bodies in harmony with their
minds' should in no way be seen as a contradiction to surgery. A
pre-operative homosexual transsexual presenting socially as a woman
essentially has a serious sexual dysfunction that prevents her from
having satisfactory sexual relations. If any heterosexual man needed
a surgery to correct a sexual dysfunction and allow him to have
satisfactory intercourse, it would be hard to imagine that being seen
as an illegitimate reason for genital surgery. For that matter, it is
rather inconceivable that one would want any kind of elective genital
surgery for reasons other then sexual ones. Some autogynephilic
transsexuals may correctly state that they would still like to have
sex reassignment surgery even if they could not have sexual relations
(Bailey 2003) but it is still a fundamentally sexual request, simply
one that satisfies more esoteric sexual desires. At least homosexual
transsexuals want the surgery to make it easier to have normal healthy
relationships with men rather then satisfying a paraphilia. In this
sense the surgery increases their functionality by changing genitals
that they don't use anyways to genitals that they do use.
These transsexuals also have very significant social
motivations apart from romantic relationships. The same
reasons that make homosexual transsexuals better suited to life
sexually and romantically as females, also make them better
adapted to all social interactions as females. As males, they
are very gender deviant, queer, homosexual, and in some cases
all together sexually ambiguous and difficult for strangers to
determine their gender; it is not a situation very conducive to
a well adjusted healthy life. Benjamin (1966 ch.7) offered
this account of social motivation in young extremely feminine
transsexuals:
The fourth motive is a social one and applies only if the transsexual
patient happens to have a conspicuous feminine physique, appearance,
and manners. It may constantly embarrass him through snickering,
pointed remarks, and knowing looks. It has even endangered some of
them through physical attacks by moronic, would-be "he-men," sometimes
undoubtedly latent homosexuals who were "protesting too much." The
appearance of the very feminine-looking young man could also be a
serious handicap in procuring a job.
"I hated to go out with my son," a mother once remarked to me. "He
embarrassed me no end by his looks. Now he made the change and lives
and works as a girl (waiting and hoping for the operation). Now I am
proud of my new and attractive 'daughter.' A former nasty remark from
someone is now - if anything a wolf whistle. I love to be seen with
her." xFrom personal observation, I could certainly verify the
attractiveness of this otherwise completely inconspicuous "young
lady."
Benjamin (1966 ch.7)
This gives a good insight of the more general social motivation apart
from romantic relationships that homosexual transsexuals have to
transition. Very conspicuously feminine biological males may simply
be a lot better socially adjusted living life as female then they
would if they attempted to live as males in the long term. So in
homosexual transsexuals, it is not a singular drive to transition as a
good in of itself (as in autogynephilic ones perhaps) but a decision
that they might logically weigh the benefits and risks of according to how
much better adjusted socially they will predictably be. Bailey puts
it this way (Bailey p. 182):
"Sex reassignment is not necessarily an
inevitable, unwavering goal for the homosexual transsexual. Rather,
sex reassignment has a rational choice component: 'can I make it?
Will I be happier as female? Will I be more successful getting
straight men as woman than I am at getting gay men as a man?'"
This rational choice approach to "gender issues"
is clearly very different from the popular notion of 'internal
gender identity' as the driving factor behind transition, and also
very different from the inner desires of autogynephilic transsexuals
to be female.
This distinct lack of any "inner gender identity"
conventionally assumed to motivate transsexuals and instead the
presence of a practical "rational choice" decision in
the case of homosexual transsexuals, was confirmed by Winter
and Udomsak (2002) in their study of homosexual transsexuals
mostly in their early 20s in Thailand. Winter (2002) writes
that his subjects "display an androgynous or
non-differentiated self-concept." In fact, instead of
trying to alter their behavior to mimic femininity as
autogynephilic transsexuals in the west do (as Winter 2002
puts it "the slavish pursuit of the female sterotype" )
the homosexual transsexuals in the Winter and Udomsak (2002)
study actually tend to wish to be somewhat less
stereotypically feminine then they currently are. Winter
(2002) quite aptly observed that the homosexual transsexuals
in his study "appear to pursue some carefully considered
goals for personal growth that transcend common conceptions of
MtF gender transition, and indeed gender itself." This
would seem to be consistent with the rational choice model for
homosexual transsexual motivation Bailey (2003) described.
Homosexual transsexuals are in a rare situation where they have
very little to lose and a great deal to gain, objectively, by
deciding to live as female rather then male. They are
pervasively feminine in manner (Bailey 2003), are significantly
smaller in stature and build then average men and
autogynephilic transsexuals (Blanchard et al. 1995), and often
otherwise much more physically attractive as women then they
could be as men (Bailey 2003). Given these circumstances, a
decent and fulfilling life as a male would be difficult for
them, not because of any internal gender conflict or identity
disturbance, but because of their feminine behavior and
appearance, an utterly un-masculine presentation, compromises
their ability to be successful socially and romantically, but a
meaningful life as female is a viable alternative. If they
choose to transition, they transition young (Blanchard 1985,
Bailey 2003) avoiding much of the masculinizing effects of long
term exposure to testosterone, and only do so if they believe
they can 'pull it off' and be convincing as females
socially (Bailey 2003). In this regard, they do not value sex
reassignment itself as autogynephilic transsexuals do,
rather they view it as a means to facilitate other things they
want out of life such as a long term boyfriend or husband,
fitting into social groups naturally, or being valued for who
they are instead of scorned for it, as their distinguishing
qualities are socially considered undesirable in men and
desirable in women. If they can be said to have gender
dysphoria, it is the recognition (shared by those around them)
that they are not very well equipped for or capable of life as
males, so they are likely marginalized and socially
unsuccessful for it, which is entirely different from the inner
gender dysphoria autogynephilic transsexuals experience
(Homosexual transsexual's angst could perhaps be more
generally termed 'loneliness'). Likewise any 'gender
identity' is not internal gender identity at all but simply
an identity in the common sense; they are in appearance and
behavior more feminine and female-like then masculine, so when
people identify them as such homosexual transsexuals learn this
to be the case that way. So this is an identity from external
sources of social interaction and discourse, not from any deep
inner feeling. Their behavior is not some deliberate
expression of 'gender identity' but natural and
spontaneous behavioral aspects of their personality and manner
that they are unable to change or hide the same way that more
typical homosexuals often cannot conceal that they are not
straight (Bailey 2003). Their choice to transition then is not
a result of any identity disturbance but rather a rational
choice decision based on a realistic assessment of what will
benefit them most externally in the future.
Can an Autogynephilic and Homosexual model take the place of
Gender Identity:
The 'internal gender identity' model may not hold up well to
criticism, but in order to consider the autogynephilic and homosexual
model a valid and sound alternative, there are a number of common
objections that ought to be addressed. The most common perhaps is
that while many non-homosexual transsexuals openly admit to
autogynephilic eroticism and readily recognize their desires as
sexual, many (perhaps most) deny any sexual involvement at all. There
are probably a number of issues going on around this self report, the
most obvious being that these transsexuals may simply be deluding
themselves and deceiving others because they (probably correctly)
believe that other people will look poorly on them if they understand
their sexuality in that detail, that autogynephilia is not socially
desirable. A study demonstrated that non-homosexual gender patients
who ascribed themselves more socially desirable traits also were more
likely to deny autogynephilia, to systematically distort descriptions of
themselves (Blanchard et al. 1985). Blanchard later found that
heterosexual gender patients who denied eroticism from cross dressing,
were all still physically aroused by descriptions of crossdressing
activity (whereas a control group of heterosexual males was not
aroused), showing that autogynephilic arousal clearly occurs even when
the transsexual is unable or unwilling to acknowledge it (Blanchard et
al. 1986). There is also however, the possibility that these
non-homosexual transsexuals who deny sexual aspects to their gender
issues are not being intentionally deceptive at all, but are rather
honestly unable to recognize their desire to possess a female body and
female role as a sexual desire. As has been discussed, such
experiences are not necessarily intuitively sexual, and given how
profoundly unusual autogynephilic sexuality is, it might be reasonable
to believe that many transsexuals experiencing autogynephilia do not
have adequate words to describe it (the descriptions of their desires
often become very abstract or mysterious when one gets past the
"women trapped in a man's body" metaphors), and without the
ability to articulate their experience clearly at all it would be
understandable that they might have only limited insight into the
nature of those desires. One could ask how many non-trans people at
the verge of their self awareness at the beginning of puberty would
recognize their feelings are sexual ones except in
hindsight; autogynephilics may never develop that recognition because
their sexuality is not part of the common peer or media discourse on
sexuality, so it may stay an experience they have no way to explain.
There is one somewhat silly objection sometimes made by strict
proponents of the gender identity model of transsexualism,
aimed more at the homosexual transsexuals in the model. It is
that they are "really" gay boys masquerading as women.
This is because they do not have a "female inner gender
identity" (never mind that they lack an inner male gender
identity either). However, to even make any argument
along these lines one would have to maintain a strict and
exclusive commitment to gender as purely "inner gender
identity" and nothing else. The problem with this is that
virtually no one besides certain autogynephilic transsexuals
actually adopt this view of themselves or their own
identities. Imposing a rather esoteric notion of gender on
other people is really not much of an argument about anything
but simply a rhetorical device (a similar one might be
suggesting that the term "homosexual transsexual"
implies that those transsexuals are gay men; It does not, it
simply refers to their etiological similarities with
homosexuals, they are straight women for all intents and
purposes after transition.) Such an argument can be replied to
with a more conventional and common sense definition of gender
identity, such as the one proposed by Kessler and McKenna
(1978 p. 9):
"The equating of gender and gender identity is
understandable, however, since the question 'Are you male
or female?' can either be interpreted as 'What do you
feel yourself to be?' or 'How are you categorized by
others?' The reason most people do not have difficulty
interpreting the question is that in the common-sense world
there is no reason to distinguish gender identity from gender
attribution. There is just gender."
Likewise for a homosexual transsexual, like most non-trans people,
they would self identify as others saw them, so a transitioned
homosexual transsexuals "gender" is certainly female, perhaps in ways
that most autogynephilic transsexuals are unable to manage socially.
Other objections involve the sexual diversity of autogynephilic
transsexuals. While homosexual transsexuals have very simple
straightforward sexualities, their only sexual interests are in
men and their sexual orientation never changes, autogynephilic
transsexuals may self-identify as "lesbian" (heterosexual
as men), asexual, bisexual, or even exclusively
"androphilic"(heterosexuals as women). Since
autogynephilia is understood as a misdirected heterosexuality
(Blanchard 1992) so called "lesbian" transsexuals simply
have heterosexual (as males) desire for women that is not
misdirected at themselves concurrent with their misdirected
autogynephilic sexuality; or alternatively they may have an
autogynephilic interest in engaging in lesbian relations,
possibly having fantasized about themselves as a lesbian while
engaging in heterosexual sex as men as some transsexuals do
(Norman and Stroller 1974). The "asexual" transsexual
population on the other hand are autogynephiles who's entire
sex drive is fixated on themselves, with no real sexual
interest in other people (Blanchard 2000). Transsexuals who
are self identified as bisexuals on the other hand have a
greater interest in autogynephilic "interpersonal
fantasy" then 'lesbian', asexual, or homosexual
transsexuals, (Blanchard 2000) so their "bisexuality" is
not necessarily from true attraction to men but from the desire
for a man to symbolically validate their womanhood (much the
same way that transvestic fetishism symbolically validates them
as females). Bailey (2003) gives an anecdote where a
transvestite man reported a sexual fantasy of being taken out
on a romantic date and treated "like a lady" by a man,
despite having no primary attraction to men; the man in his
fantasy is not the chief objects of his sexual desire (as in
homosexual fantasies) but as Bailey puts it "merely a
prop." Lawrence (2000) suggested, quiet aptly that the
existence of transsexuals who were both "genuinely
androphilic" and "genuinely autogynephilic" would
contradict Blanchard's view of autogynephilia as a
misdirected heterosexuality, noting that in several studies
small portions of the 'androphilic' subjects reported
sexual arousal while crossdressing. As Lawrence notes, some of
the 'androphilic' transsexuals who are aroused while
crossdressing may simply be misreporting their interest in men
because it is socially desirable given the circumstances
(Blanchard 1985). But why then would they admit to autoeroticism
which is also socially undesirable? There is still however, a
very compelling explanation for this discrepancy: if there are
some autogynephilies who have no significant interest in other
women (the 'asexuals'), and there are some
autogynephilies who are erotically interested in experiencing a
heterosexual woman's role with a man (the
'bisexuals'), then there would seem to be no reason why
both versions of autogynephilia could not coexist in the same
transsexual, in which case they would have no interest in other
women and an autogynephilic interest in relationships with men.
This would seem to lead to truthful self reports of both
interest in men and autoeroticism. Additionally, a significant
number of transsexuals report shifts in their sexual
orientation according to their gender role, where as men they
are attracted to women and as women they are attracted to men
(Samons 2001b), claiming to be 'heterosexual' both before
and after transition (unlike homosexual transsexuals who were
homosexual as men and heterosexual as women). A "sexual
orientation" of this sort is clearly very different from
that of homosexual transsexuals who are directly aroused by the
sight and feel of male bodies (Blanchard 1989a) apart from how
men relate to them, so their sexual interest has nothing to do
with their gender role or their sense of themselves. This
phenomenon of changing sexual orientation, something very
common in originally heterosexual transsexuals and
extraordinarily rare in others, could then be explained as not
a true shift in sexual orientation but a shift in the type of
autogynephilic interest, from simply being fascinated with
being a woman to fascination with having a woman's social
and romantic role, representing another developmental path for
pseudo-androphilia in autogynephilic transsexuals.
It has been suggested that while autogynephilia and
transsexualism in non-homosexual males is correlated,
autogynephilic eroticism may not represent a cause of gender
dysphoria but simply an effect of a related phenomenon
(Lawrence 2000). If this were true then observations of
autogynephilia could be reconciled with many non-homosexual
transsexual's conviction that their desire to transition was
not sexually motivated. However, there has to be a reason why
it is so important to change one's gender, and "internal
gender identity" can clearly not provide a motivation.
Non-homosexual transsexuals do not have any external reasons to
transition the way homosexual transsexuals do, they do not gain
social advantage but rather tend to sacrifice their social
position, trading an average hetero-normative gender-normative
life for gender variant one. Even if they claim a preference
for a female gender role as opposed to a female body, without
an external reason for that preference it is still an
irrational personal desire that must have other motivations
(the most obvious being "behavioral" autogynephila where
a transsexual desires the social role of a woman to make him
feel symbolically "more female" satisfying his
autoynephilic urges much the same way as dressing in female
clothing does in autogynephiles who have a more
"transvestic" arousal pattern(Blanchard 1991)). So
regardless of how one wants to frame their gender dysphoria, it
must come down an internal desire to be female (which they
usually term gender dysphoria) if there is no external
advantage. That desire would be completely ridiculous and
irrational if it were arbitrary and these are not generally
psychotic people, so it would appear to be very intense and
very much more essential to personal fulfillment then more
typical goals in life (because many non-homosexual transsexuals
give up friends, family, spouses, children and jobs all for
transition). This also means that they must regard it as
somehow pleasurable or satisfying in and of itself (whereas
homosexual transsexual transition just facilitates getting
other things they want but they do not regard transition or
being female as separate goals abstracted from their social
lives). The only desire of this type of the intensity needed
is sexual, so autogynephilia is not only the most reasonable
explanation for why non-homosexual men want to be women, but
the only explanation one can rationally expect to find. Nothing
else is going to satisfactorily fit the actual phenomenon of
non-homosexual transsexuality because there is such a very
limited set of conceivable ways doing something like changing
gender could actually make sense to someone.
Given that autogynephilia, when viewed as a misdirected sexual
orientation and not simply in terms of explicit autoerotic episodes,
can account for gender dysphoria as a whole, with no plausible
alternative explanation there is every reason to think that
autogynephilia is not merely a symptom of gender dysphoria or
concurrent syndrome but the underlying cause. This reasoning would
also account for another of Lawrence's critiques of Blanchard, that
some who admit to autogynephilic eroticism also claim to have had
gender dysphoria long before they experienced autogynephilic arousal
(Lawrence 2000). If gender dysphoria in non-homosexual transsexuals
is an aspect of autogynephilic desire (like a crush) rather than
autogynephilic physical arousal, so gender dysphoria that
predates autogynephilic arousal can still originate in an
autogynephilic orientation. In this understanding, autogynephilia is
not a sexual aspect of gender dysphoria but rather gender dysphoria is
an aspect of autogynephilic sexuality.
Conclusion:
Gender identity is a concept appealed to in an attempt to unify the
two conditions, homosexual transsexuality and autogynephilic
transsexuality, under one common disorder. This is not one disorder
with a late-onset symptomology and an early-onset symptomology, or
with a symptom pattern for homosexuals and a symptom pattern for
heterosexuals, but two entirely distinct and unrelated conditions.
Describing homosexual transsexuals in terms of "gender dysphoria" is
incorrect because their discomfort is with their social position
rather then any sort of internal pathology. Describing non-homosexual
transsexual's symptoms in terms of "gender dysphoria" is perhaps more
accurate in that it actually corresponds to a real feature of their
disorder, but it is misleading in that what is said to be "gender
dysphoria" is simply autogynephilic sexual frustration. When clinical
psychologists and so called "gender therapists" apply the 'internal
gender identity' model of transsexuality, often flatly 'confirming'
that their autogynephilic patient is truly female, they are
participating in and deepening a delusion, something that a
psychologist would never intentionally do for any other patient making
delusional claims to rationalize behavior caused by a paraphilia.
When psychologists working in this model apply it to homosexual
transsexuals, they are completely misunderstanding their psychology
and personal issues, making any sort of therapy impossible.
The idea of gender identity as an internal state of being or
experience is impossible and the concept of internal gender
identity is entirely contradictory to the common usage of the
term 'gender.' Homosexual transsexuals do not experience
anything that could be considered an 'internal gender
identity,' rather their experience of 'gender' is one
derived from social interaction, and any identification they
have is an external one based on their apparent similarity
with females, not a true identity disturbance at all. They
are motivated instead for social (and associated sexual)
reasons and the only 'gender identity' that's
significant to them is one assigned by others, their public
identity and not a private psychological condition. The
phenomenon of 'internal gender dysphoria' can be better
explained in autogynephilic transsexuals as part of their
atypical sexuality. Continuing to treat transsexuality as a
problem of 'gender identity' confuses the issues and
makes an accurate description of the psychology of
transsexuality impossible. Gender Identity Disorder is a
flawed merger of two conditions, homosexual transsexuality and
autogynephilia, neither of which are identity disorders, but a
condition of social and sexual development and a paraphilia,
respectively.
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