I’ve engaged this topic in other places, but I thought I might say something about autogynephila here on my own. I’m not interested in debating the utility of the diagnosis, not really anyway, as I think it maybe *does* make sense for some people. Maybe not trans people per se, but that’s conflating a patient’s real problems with imaginary ones; it doesn’t mean that autogynephilia is complete hogwash, just maybe not applicable the way that some people think it is.

I bring this up because there’s a new draft of the DSM. (Thanks to Zoe Brain over at A.E. Brain for the heads-up.)

There are really good analyses elsewhere on the web that look at this concept in excruciating detail. For starters, there’s Zoe’s blog (in the parenthetical link above). She does a fantastic and thorough job of examining the intellectual incestuousness of the DSM GID working group, looks at the problems inherent in the revision, and gives a nice step by step analysis of the good and the bad. There’s also this site which outlines the actual differences in the diagnostic criteria for GID between the DSM IV and the draft version of the DSM V, but without a lot of the commentary.

As general primers on autogynephilia, there’s this website maintained by Dr. Wyndzen, and of course, ts roadmap. Those are all excellent resources, and if you spend any time looking through them, you’ll notice that a lot of trans people take exception to Blanchard’s pet idea.

Specifically, there are allegations that the theory isn’t supported by data, or at least that there’s enough bias in Blanchard’s sample selection methods that the theory is basically supported only through sloppy methodology. I think that maybe presumes a little *too much* bad faith on Blanchard’s part, but I don’t actually know him, and won’t stick up for him the way I would a friend or colleague who maybe can’t just see the forest for the trees.

The main problem is that a lot of trans women don’t like being treated like they only want to transition because of misdirected sexual desires*. Come to that, I don’t either. I’m not transitioning because I’m a pervert. I hesitate to say that transition isn’t sexually motivated at all because I think it’s impossible to say that any of our actions aren’t influenced at least to a small degree by our sexual(ized) behavior.

Let me explain a little bit: when we talk about transvestic fetishism or autogynephilia, and we use a person’s sexual arousal as a diagnostic criterion, there are going to be false positives. Transvestic fetishism is a type of crossdressing that is sexually motivated. Autogynephilia is a paraphilia where the subject is aroused through thoughts or images of himself as a woman. Those are the definitions for those terms, and as long we rely on a person’s sexual behavior for the diagnosis, we’re going to miss some of the subtle nuances within each individual’s sexuality.

For myself, and I apologize if this is TMI (though I think I crossed that boundary about two months ago), some of my earlier experiences with crossdressing definitely had sexual components to them. For example, when I was in my twenties, I had a great collection of fetishwear– latex skirts, six inch platform heels, corsets, even a pair of ballet boots (great for wearing in bed, not so much for walking around). I think, personally at least, that it’s impossible to not have a sexual reaction to wearing clothing that is explicitly sexualized. That’s part of the whole point of lingerie in general: the ConRev down the freeway does *damn good* business every year around Valentine’s Day because of it. Lingerie is supposed to be sexy, alluring and arousing. The woman wearing it is supposed to feel desired, sexy, alluring, powerful. The woman (or man) for whom this is displayed is supposed to be aroused, attracted to their partner, and pretty much want to shag them all the time.

To bring this back to transvestic fetishism, if we put a man in lingerie, he might feel silly. If we put a crossdresser in lingerie, they might feel turned on, but that’s certainly not the only emotion crossdressers ever experience. Lastly, if we put a transsexual in lingerie, they’re going to cry (or at least they might. Or at least I did, sometimes.) because the clothing fits with their internal identity but not with their body. As someone who identifies as female, lingerie makes me feel gorgeous and kinky. I hate the way my body is, and wish, as I’ve said before, that I could just be a normal girl, hence the tears. But there’s more to clothes than feeling sexually aroused: they’re an attempt, through the social construct of gender, specifically what society deems to be gender-appropriate clothing, to express something about myself that I feel internally. Sometimes a skirt is just a skirt. Even among crossdressers, trying to simplify this to the point of making it all about sex is an example of reductio ad absurdum: if a person were so controlled by their sexually based behavior, they’d essentially be unable to function, and that doesn’t explain most of the crossdressers I know.

Based on that explanation of sexualized crossdressing, you can probably guess at what I’m going to say regarding autogynephilia: I’d say that every woman is afflicted with this at one point or another during their lives. Let me explain by way of asking some personal questions: what do you think of during your sexual fantasies? Are you male or female? Would you say that you’re turned on by your femininity (or masculinity, as the case may be)? Part of making sexual activity into an ego-syntonic act is having a body that coincides with your sexual desires.

For example, a woman may not think of herself as being turned on by her own femininity, but if she were inappropriately masculine, she might be turned off by that. And I think that’s how it is for a lot of us trans people. The fantasies that we have involve us having bodies that are congruent with our gender identity; the amazement we feel in our private fantasy life over what it’s like to have sex the right way is life altering. Experiencing sex is not our primary motivation for transitioning, but I think it would be dishonest of me to claim that it wasn’t in the “Pro” column when I was trying to figure out if I should transition. Sometimes, there’s nothing I want more than my wife to finger-fuck me, and we can’t, I can’t, and it’s all spirals into sadness and depression from there.

What I’m trying to say is that sex is important. It’s ridiculous to try and claim that it’s not, but it’s equally absurd for Blanchard and the other proponents of autogynephilia to pretend that it’s the entire story. The ways we view, understand and feel about our bodies are important, too. I hate needles, shots and the thought of surgery makes me cringe. I don’t know if I like sex enough to go through all the blood tests, hormone injections and ultimately a life altering surgery just for sex. I mean, I like sex, but I don’t think I like it that much. Rather, feeling at home in every experience, like this body isn’t completely foreign to me, makes the needles and the anxiety worthwhile. It’s not just about sex: it’s about getting up for work in the morning, having lunch at a restaurant, or going out to dinner or a movie or the supermarket or even sitting on my couch at home and not feeling like there’s a wrongness to the world, to the way I relate to my wife, or to me.

* The reason a lot of trans women take issue with this etiological theory is that this obsession over our sexual desires can be (and has been) used against us. Previously, a heterosexual male who thought she was a transsexual female would be classified as an autogynephile under Blanchard’s criteria. In other words, there are no lesbian transsexuals.

Most recently, the IRS accused Rhiannon O’Donnabhain of being an autogynephile (and not a “true transsexual”) and that her transition-related expenses shouldn’t have been tax deductible because they were not medically necessary (that was the court case she won, and the autogynephilia slander was the IRS’s defense for the deduction denial). In other cases, trans women have been denied access to transition-related care (such as hormones or surgery) because their medical professionals bought into this concept of autogynephilia and decided that they weren’t true transsexuals and therefore, shouldn’t be transitioned. I think doctors should be involved in the decision making process, but come on, we’re not petulant children. Treat us like adults and let us make our own choices about the best way forward.