HomeFAQEssaysAboutScience BlogLinks

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.


             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.


-American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision. Washington, DC; American Psychiatric Association; 576-582.
-Bailey, Michael (2003), The Man Who Would Be Queen, Gender-Bending and Transsexualism, Washington, D.C., Joseph Henry Press.
- Bailey JM, Nothnagel J, Wolfe M. (1995) "Retrospectively measured individual differences in childhood sex-typed behavior among gay men: correspondence between self- and maternal reports." Arch Sex Behav. 1995 Dec;24(6):613-22.
-Bailey JM, Kim PY, Hills A, Linsenmeier JA, (1997) "Butch, femme, or straight acting? Partner preferences of gay men and lesbians," J Pers Soc Psychol. 1997 Nov;73(5):960-73.
-  Bartlett, N. H., Vasey, P. L., & Bukowski, W. M. (2000). Abstract of "Is Gender Identity Disorder in children a mental disorder?"  Sex Roles, 11/12, 753-785.
-Beers MH, Berkow R, (1999) eds. The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station, NJ: Merck & Co.; 1999.
-Benjamin, Harry (1966), The Transsexual Phenomenon New York; The Julian Press; chapter 7.
-Blanchard, Ray (1985), "Typology of male-to-female transsexualism." Archives of Sexual Behavior. Vol 14(3) Jun 1985, 247-26
-Blanchard, Ray (1988) "Nonhomosexual gender dysphoria." Journal of Sex Research. Vol 24 1988, 188-193.
-Blanchard, Ray (1989a), "The concept of autogynephilia and the typology of male gender dysphoria," Journal of Nervous and Mental Disease, 177, 616-623.
-Blanchard, Ray. (1989b), "The classification and labeling of nonhomosexual gender dysphorias", Archives of Sexual Behavior. Vol 18(4) Aug 1989, 315-334.
- Blanchard, Ray. (1991), "Clinical observations and systematic studies of autogynephilia," Journal of Sex & Marital Therapy. Vol 17(4) Win 1991, 235-251.
-Blanchard, Ray (1992), "Nonmonotonic relation of autogynephilia and heterosexual attraction," Journal of Abnormal Pyschology, 101, 271-276
-Blanchard, Ray (2000) "Autogynephilia and the taxonomy of gender identity disorders in biological males." Unpublished paper presented at the Symposium on Phenomenology and Classification of Male-to-Female Transsexualism (Chair - J. M. Bailey), the meeting of the International Academy of Sex Research, Paris, June, 2000.
-Blanchard Ray, Clemmensen L, Steiner B (1985) "Social desirability response set and systematic distortion in the self-report of adult male gender patients." Arch Sex Behav. 14(6), 505-516.
-Ray Blanchard, I.G. Racansky, and Betty W. Steiner (1986), "Phallometric detection of fetishistic arousal in heterosexual male cross-dressers," Journal of Sex Research, 22, No 4 452-462.
-Blanchard, Ray; Dickey, Robert; Jones, Corey L (1995) "Comparison of height and weight in homosexual versus nonhomosexual male gender dysphorics.", Archives of Sexual Behavior. Vol 24(5) Oct 1995, 543-554.
-Brown GR. (1988) "Transsexuals in the military: flight into hypermasculinity." Arch Sex Behav. 1988 Dec;17(6):527-37.
-Chivers ML, Bailey JM, (2000) "Sexual orientation of female-to-male transsexuals: a comparison of homosexual and nonhomosexual types." Arch Sex Behav. 2000 Jun;29(3):259-78.
-Freund K, Stiener BW, Chan S (1982) "Two types of cross-gender identity. Arch Sex Behav 1982, 11:49-63
-Gender Identity Research and Education Society (GIRES) "Definition and Synopsis of the Etiology of Adult Gender Identity Disorder & Transsexualism" GIRES, 2003
-Green, Richard, (1979) "Childhood cross-gender behavior and subsequent sexual preference." Am J Psychiatry. 1979 Jan;136(1):106-8.
-Green, Richard, (1985) "Gender identity in childhood and later sexual orientation: follow-up of 78 males." Am J Psychiatry. 1985 Mar;142(3):339-41.
-Hirschfeld, Magnus, (1948) Sexual Anomalies, New York: Emerson.
-Human Rights Campaign, (2004), "Transgender Basics" [accessed on December 7 2004]
-International Foundation for Gender Education (2004), "International Foundation for Gender Education FAQ " [accessed on December 7 2004]
-Kessler S, McKenna W, 1978) Gender: An Ethnomethodological Approach. New York: John Wiley & Sons.
-Lawrence, Anne, (2000) Transsexual Women's Resources, 2000, "Sexuality and Transsexuality: A New Introduction to Autogynephilia" [accessed on December 9 2004]
-McHugh, Paul, (2004) "Surgical Sex", 2004 First Things 147 (November 2004): 34-38
-Meyeowitz, Joanne, (2002) How Sex Changed: A History of Transsexuality in the United States. Cambridge: Harvard University Press. 
-Newman LE, Stroller RJ (1974) "Nontranssexual men who seek sex reassignment." American Journal of Psychiatry 1974, 131:437-441
-Samons, Sandra (2001a), Abstract of "Closets: The Use of External Structure to Reinforce Internal Structure for Suppression of Transgender Feelings and Behaviors," paper presented at XVII Harry Benjamin International Gender Dysphoria Association Symposium, 31 October - 4 November 2001, Galveston, Texas, U.S.A.
-Samons, Sandra (2001b), Abstract of "Sexual Orientation of MtF Transgendered People," paper presented at XVII Harry Benjamin International Gender Dysphoria Association Symposium, 31 October - 4 November 2001, Galveston, Texas, U.S.A.
-Winter, Sam (2002) Research and discussion paper: some thoughts on cross-cultural research into transgenderDivision of Learning, Development and Diversity, Faculity of Education, University of Hong Kong, Hong Kong, [accessed on monday december 13 2004]
- Winter S, Udomsak N (2002) Male, Female and Transgender : Stereotypes and Self in Thailand.IJT 6,1,
-Zhou JN, Hofman MA, Gooren LJ, Swaab DF. (1995) "A Sex Difference in the Human Brain and its Relation to Transsexuality," Nature. 1995 Nov 2;378(6552):68-70.
-Zucker Ken, (1990) "Psychosocial and erotic development in cross-gender identified children." Canadian Journal of Psychiatry. 1990 Aug;35(6):487-95.


Love us? Hate us? Confused? We welcome your questions and comments. Write us at: (transkids.us)

Copyright 2004 transkids.us