On the Science of Changing Sex


Posted in Book Reviews by Kay Brown on April 24, 2017

Book Review: The SAGE Encyclopedia of LGBTQ Studies

When I was a young teen in the early ’70s, I scoured our home library (larger than most middle-class households) for anything that could help me with my horrible feelings that we now label “gender dysphoria”.  We had a number of college psychology, biology, human anatomy texts, and one medical encyclopedia.  I found exactly one reference of interest, but it declaimed, “There is no such thing as a ‘sex change’.”  That’s it, one line reference in the negative.  Of course, it was both a true statement and a lie of omission.  It failed to explain that there was medical help, if only superficial.  But superficial or not, hormones and SRS were good enough to make my life worth living.  But before I found much better, and truthful, references at our local public library, that one reference left me despairing and despondent for my future.

As I’ve researched our collective  LGBT history and science (especially when I was teaching my class on Transhistory through the Harvey Milk Institute), and of course, through my decades of LGB – and especially – T activism, I’ve read and collected many books and references.  So one could imagine my delight in finding the SAGE Encyclopedia of LGBTQ Studies.  But that was very short lived.

The first thing I do when I look at such purportedly comprehensive works is to see how they treat transsexual and transgender subjects.  In this case.  OMG!  What a &^%$#@! mess!  It is more than simply disappointing.  It is deja vu.  Consider the section on “Controversies”, the only section that deals with the central nature of transgender etiology,

Autogynephilia  –  The term autogynephilia was first used in 1989 by Ray Blanchard, a sexologist, to describe a purported class of transgender women.  Classifications of transgender women prior to this time tended to divide this group into those who were sexually and romantically interested in men as “homosexual transsexuals” and those who were sexually and romantically interested in women were classified as “heterosexual fetishistic transvestites.”  Critiques of these classifications noted that the “homosexual” and “heterosexual labels were applied incorrectly, failing to recognize the gender identities of transwomen themselves.  –  These classifications also reflected mainstream stigma around transgender identity as they resigned many transgender women to little more than sexual fetishists.  The autogynephilia label only intensified this view of some transgender women as sexual fetishists.  The theory of autogynephilia asserted that many of the trans women classified into the “heterosexual fetishistic transvestites” category were primarily attracted not to women but to the idea of themselves as women.  In this way, autogynephilia was proposed as a type of primary sexual-identity category for transgender women.  Subsequent research has found little empirical basis for such a classification, and many researchers have criticized the classification as transphobic.  –  One particular critique of this classification system concerns its failure to recognize the way in which all sexual attraction depends on one’s own gender identity.  For example, a critical component of both homosexual and heterosexual attraction among many cisgender men involves an erotic charge around one’s own manliness or manhood.  To assume that such attachments to (and sexual desire motivated through) one’s own gender identity and expression, in relatation to another’s, exists only among transgender women, is misguided.  Despite a relative lack of empirical support for the diagnoses of autogynephilia among transgender women, some segments of the radical feminist community endorse this diagnostic category in their own writing as well.  …  The most outspoken critiques of the theory of autogynephilia ahve emerged from self-identified transfeminist academics (e.g. Julia Serano and Talia Mae Bettcher), who have highlighted not only the lack of empirical support for these theories but also the underlying biases and assumption revealed in the very foundations of the theory itself.”

I highlighted three phrases as they demonstrate a rhetorical trick, repeat a lie three times and people will tend to believe it.  Yes, I bolded the text because these are bald faced lies.  The material claims that there is no empirical evidence for autogynephilia in transwomen.  But we have numerous studies that put the lie to these statements, some of which were conducted by transwomen ourselves.  To make this assertion is academic misconduct of the worst sort.

Because I know that most readers will only read this one page, I feel I need to point out that we have such empirical evidence in abundance, both prior and subsequent to Blanchard coining the term “autogynephilia” to replace the earlier terms “fetishistic femmiphilia” and “fetishistic transvestism”.  Science depends upon repeatability, and these results regarding sexual orientation and autogynephilia have been replicated by Buhrich (1978), Freund (1982), Blanchard (1985, 1987, 1988, 1989), Doorn (1994), Smith (2005),  Lawrence (2005), Veale (2008), and Nuttbrock (2009), in separate studies spanning four decades, collectively involving over a thousand transsexuals to date.  In fact, this is one of the most repeated and reconfirmed scientific finding regarding transsexuality.  The largest study, Nuttbrock et al. found that fully 82% of gynephilic transwomen acknowledge being autogynephilic, specifically, being sexually aroused by wearing women’s clothing.  I have essays on this blog that extensively survey and discuss these papers and their abundant empirical evidence supporting the “assertion” that many transwomen are autogynephilic.   Let me say this again in another way, we have empirical study after study after study that shows that the vast majority of gynephilic (attracted to women) transwomen fully admit to being autogynephilic.  How much more plain empirical evidence do we need, proof using phallometry to measure the amount of sexual arousal?  We have that too!

The section also includes misleading statements regarding the nature of autogynephilia, trying to confuse the issue with non-autogynephilic sexuality.  With deceptive cleverness this writer has substituted the usual “women are autogynephilic too” meme by referencing men instead.  But here too, we see that they use the classic rhetorical trick of confusing the map for the territory.  Here, they suggest that non-transmen, both homosexual and heterosexual, experience autoandrophilia.  But in fact, this deliberately conflates, or rather confuses, pride or even vanity in one’s masculinity with sexual arousal to one’s own maleness.  This can only be done because the casual reader doesn’t know the exact nature of autogynephilia and autoandrophilia.  These men are not getting turned on by simply being men.  They are not being turned on by simply wearing men’s clothing, although autogynephiles do exactly that.  (As I pointed out, the vast majority fully admit to sexual arousal to wearing women’s clothing.)

So, we’ve caught them out in a outright lie, in misleading statements meant to confuse the issue, but what about lies of omission?  Oh yes, this they have done as well, in that they totally fail to include any mention of transsexual and transgender scientists and writers who support the two type taxonomy and the role that autogynephilia plays in the etiology of one of the types.  Where in all of this encyclopedia is Dr. Anne Lawrence?

Actually, they do reference her.  But in safety, only mentioning her letter regarding the need for better transgender medical care.  But where are her papers, book chapters, and even a book discussing the nature and role of autogynephilia in transwomen’s lives?  How can they simply make such an important transwoman’s work on the subject disappear and call this work “encyclopedic”?

(This is especially ironic in that Lawrence has written material, currently in press, entitled, “Gender dysphoria: Overview; Gender dysphoria: Diagnosis; Gender dysphoria: Treatment; Sex reassignment surgery. In A. Wenzel (Ed.), The SAGE encyclopedia of abnormal and clinical psychology)

There is one other lie of omission… where in this “encyclopedia” is the voice of the exclusively androphilic and known to be non-autogynephilic transwomen?  By printing this disinformation the editors of this work have given voice to only one of the two types of transsexual, and only the minority that are in denial of their autogynephilic nature at that, completely silencing the other.  For an academic work that purports to give voice to the LGBTQ communities, this is a very serious cultural and political offense.

Finally, not content with outright lies, misleading comments, and lies of omission, they top it off with calumny, “underlying biases and assumption revealed in the very foundations of the theory itself.”  That is to say, that this supposed academic work tops it off with character assassination of those of us, scientists and transsexual activists, who recognize the abundant (and socially obvious) empirical evidence for the theory, by implying that we are “transphobic” and “biased”.

I cannot condemn this work in any greater terms, knowing how deeply distorting it is of an area in which I have some knowledge.  It leads me to distrust any areas where I may not have the in-depth knowledge to recognize any other lies it may contain.

I have to wonder, is deep disgust, how many transfolk are going to read this material in despair.  As M. Taylor Saotome-Westlake, an autogynephilic and gender dysphoric (but not yet transitioned) individual wrote in reference to his own experience,

“A brief note on why all this matters. Independently of whether the two-type taxonomy is in fact taxonic, there are obvious political incentives to dismiss the explanatory value of autogynephilia, because it could be construed as invalidating trans women. I get that.

But here’s the thing: you can’t mislead the general public without thereby also misleading the next generation of trans-spectrum people. So when a mildly gender-dysphoric boy spends ten years assuming that his gender problems can’t possibly be in the same taxon as actual trans women, because the autogynephilia tag seems to fit him perfectly and everyone seems to think that the “Blanchard-Bailey theory of autogynephilia” is “clearly untrue”, he might feel a little bit betrayed when it turns out that it’s not clearly untrue and that the transgender community at large has been systematically lying to him, or, worse, is so systematically delusional that they might as well have been lying.”

For more information:


List of publications by Anne A. Lawrence, M.D.

Book Review: Men Trapped in Men’s Bodies Narratives of Autogynephilic Transsexualism by Anne A. Lawrence

Website written by exclusively androphilic / non-autogynephilic transsexuals about the negative social, political, and medical impact of autogynephilic transsexual denialism



Two clinically discrete syndromes of transsexualism. Buhrich N, McConaghy N. British Journal of Psychiatry. 1978 Jul;133:73-6.  Abstract online

Two types of cross-gender identity. Freund K, Steiner BW, Chan S. Archives of Sexual Behavior. 1982 Feb;11(1):49-63.  Abstract online

Typology of male-to-female transsexualism. Blanchard, Ray. Archives of Sexual Behavior. Vol 14(3) Jun 1985, 247-261.  Abstract online

Heterosexual and homosexual gender dysphoria. Blanchard, Ray; Clemmensen, Leonard H; Steiner, Betty W. Archives of Sexual Behavior. Vol 16(2) Apr 1987, 139-152.  Abstract online

Nonhomosexual gender dysphoria. Blanchard, Ray. Journal of Sex Research. Vol 24 1988, 188-193.  Abstract online

The concept of autogynephilia and the typology of male gender dysphoria. Blanchard, Ray. Journal of Nervous & Mental Disease. Vol 177(10) Oct 1989, 616-623.  Abstract online

Nonmonotonic relation of autogynephilia and heterosexual attraction. Blanchard R. J Abnorm Psychol. 1992 May;101(2):271-6.  Abstract online

Varieties of autogynephilia and their relationship to gender dysphoria. Blanchard R. Arch Sex Behav. 1993 Jun;22(3):241-51.  Abstract online

C. D. Doorn, J. Poortinga and A. M. Verschoor, “Cross-gender identity in transvestites and male transsexuals” http://www.springerlink.com/content/u63p723776v57m11/

Transsexual subtypes : Clinical and theoretical significance Smith Yolanda L. S.; Van Goozen Stephanie H. M.; Kuiper A. J.; Cohen-Kettenis Peggy T.; Psychiatry research (Psychiatry res.) 2005, vol. 137, no3, pp. 151-160  Abstract online

Anne A. Lawrence, “Sexuality Before and After Male-to-Female Sex Reassignment Surgery” 2005  http://link.springer.com/article/10.1007/s10508-005-1793-y

Jaimie F. Veale, Dave E. Clarke and Terri C. Lomax, “Sexuality of Male-to-Female Transsexuals”  http://www.springerlink.com/content/bp2235t8261q23u3/

A Further Assessment of Blanchard’s Typology of Homosexual versus Non-Homosexual or Autogynephilic Gender Dysphoria, Nuttbrock, et al. Archives of Sexual Behavior

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