American-Canadian sexologist Ray Blanchard proposed a psychological typology of gender dysphoria, transsexualism, and fetishistic transvestism in a series of academic papers through the 1980s and 1990s. Building on the work of earlier researchers, including his colleague Kurt Freund, Blanchard categorized trans women into two groups: homosexual transsexuals who are attracted exclusively to men and are feminine in both behavior and appearance; and autogynephilic transsexuals who experience sexual arousal at the idea of having a female body (). Blanchard and his supporters argue that the typology explains differences between the two groups in childhood gender nonconformity, sexual orientation, history of fetishism, and age of transition.
Blanchard's typology has attracted significant controversy, especially following the 2003 publication of J. Michael Bailey's book The Man Who Would Be Queen, which presented the typology to a general audience. Many scientists say that the typology is unfalsifiable because Blanchard and other supporters regularly dismiss or ignore data that challenges the theory. According to these same scientists, Blanchard failed to do a proper control against cis women rather than against cis men, and when such a control is performed, there is not a significant difference between cisgender women and transgender women on measures of autogynephilia. The American Psychiatric Association includes with autogynephilia as a specifier to a diagnosis of transvestic disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (2013); this addition was objected to by the World Professional Association for Transgender Health (WPATH), who argued that there was a lack of scientific consensus on and empirical evidence for the concept of autogynephilia.
History
Background
Beginning in the 1950s, clinicians and researchers developed a variety of classifications of transsexualism. These were variously based on sexual orientation, age of onset, and fetishism. Prior to Blanchard, these classifications generally divided transgender women into two groups: "homosexual transsexuals" if sexually attracted to men and "heterosexual fetishistic transvestites" if sexually attracted to women. These labels carried a social stigma of mere sexual fetishism, and contradicted trans women's self-identification as "heterosexual" or "homosexual", respectively.
In 1982, Kurt Freund and colleagues argued there were two distinct types of trans women, each with distinct causes: one type associated with childhood femininity and androphilia (sexual attraction to men), and another associated with fetishism and gynephilia (sexual attraction to women). Freund stated that the sexual arousal in this latter type could be associated, not only with crossdressing, but also with other feminine-typical behaviors, such as applying make-up or shaving the legs.
Freund, four of his colleagues, and two other sexologists had previously published papers on "feminine gender identity in homosexual males" and "Male Transsexualism" in 1974. They occasionally also used the term homosexual transsexual to describe transgender men attracted to women. Blanchard credited Freund with being the first author to distinguish between erotic arousal due to dressing as a woman (transvestic fetishism) and erotic arousal due to fantasizing about being female (which Freund called cross-gender fetishism).
Early research
Blanchard conducted a series of studies on people with gender dysphoria, analyzing the files of cases seen in the Gender Identity Clinic of the Clarke Institute of Psychiatry and comparing them on multiple characteristics. These studies have been criticized as bad science for failing to sufficiently operationalize their definitions and as unfalsifiable. They have also been criticized for lacking reproducibility, and for a lack of a control group of cisgender women. Supporters of the typology deny these allegations.
Studying patients who had felt like a woman at all times for at least a year, Blanchard classified them according to whether they were attracted to men, women, both, or neither. He then compared these four groups regarding how many in each group reported a history of sexual arousal together with cross-dressing. 73% of the gynephilic, asexual, and bisexual groups said they did experience such feelings, but only 15% of the androphilic group did. He concluded that asexual, bisexual, and gynephilic transsexuals were motivated by erotic arousal to the thought or image of themself as a woman, and he coined the term autogynephilia to describe this.