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Blanchard's transsexualism typology

Blanchard's transsexualism typology is a controversial theory proposed by American-Canadian sexologist Ray Blanchard which classifies transgender 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 proposed the typology in a series of academic papers through the 1980s and 1990s, building on the work of earlier researchers such as Kurt Freund. Blanchard and his supporters argue that the typology explains differences between the two groups in childhood gender nonconformity, sexual orientation, history of sexual fetishism, and age of transition.

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). These studies have been criticized as bad science for being unfalsifiable, as observations inconsistent with the theory are assumed to be the result of a false denial They have also been criticized for lacking reproducibility, and for a lack of a control group of cisgender women. Studying patients who had felt like women at all times for at least a year, Blanchard classified them according to whether they were attracted to men, women, both, or neither. The concept of autogynephilia in particular received little public interest until Bailey's 2003 book, though Blanchard and others had been publishing studies on the topic for nearly 20 years. Bailey's book was followed by peer-reviewed articles critiquing the methodology used by Blanchard. Both Bailey and Blanchard have since attracted intense criticism by clinicians and transgender activists. == Autogynephilia ==
Autogynephilia
Autogynephilia (derived from Greek for "love of oneself as a woman") is a term coined by Blanchard Other terms for such cross-gender fantasies and behaviors include automonosexuality, eonism, and sexo-aesthetic inversion. Autogynephilic sexual arousal has been reported by some transsexual women and some cisgender men. and have argued that the concept of autogynephilia unduly sexualizes trans women's gender identity. Some fear that the concept of autogynephilia will make it harder for gynephilic or "non-classical" MtF transsexuals to receive sex reassignment surgery. Lawrence writes that some transsexual women identify with autogynephilia, some of these feeling positively and some negatively as a result, with a range of opinions reflected as to whether or not this played a motivating role in their decision to transition. In a 2011 study presenting an alternative to Blanchard's explanation, Larry Nuttbrock and colleagues reported that autogynephilia-like characteristics were strongly associated with a specific generational cohort as well as the ethnicity of the subjects; they hypothesized that autogynephilia may become a "fading phenomenon". As a sexual orientation Blanchard and Lawrence have classified autogynephilia as a sexual orientation. Blanchard attributed to Magnus Hirschfeld the notion that some cross-dressing men are sexually aroused by the image of themselves as female. (The concept of a taxonomy based on transsexual sexuality was refined by endocrinologist Harry Benjamin in the Benjamin Scale in 1966, who wrote that researchers of his day thought attraction to men while feeling oneself to be a woman was the factor that distinguished a transsexual from a transvestite (who "is a man [and] feels himself to be one"). Later studies have found little empirical support for autogynephilia as a sexual identity classification, and sexual orientation is generally understood to be distinct from gender identity. Elke Stefanie Smith and colleagues describe Blanchard's approach as "highly controversial as it could erroneously suggest an erotic background" to transsexualism. Serano says the idea is generally disproven within the context of gender transition as trans women who are on feminizing hormone therapy, especially on anti-androgens, experience a severe drop and in some cases complete loss in libido. Despite this the vast majority of transgender women continue their transition. Erotic target location errors Blanchard conjectured that sexual interest patterns could have inwardly instead of outwardly directed forms, which he called erotic target location errors (ETLE). Autogynephilia would represent an inwardly directed form of gynephilia, with the attraction to women being redirected towards the self instead of others. These forms of erotic target location errors have also been observed with other base orientations, such as pedophilia, attraction to amputees, and attraction to plush animals. Anne Lawrence wrote that this phenomenon would help to explain an autogynephilia typology. Cisgender women The concept of autogynephilia has been criticized for implicitly assuming that cisgender women do not experience sexual desire mediated by their own gender identity. Research on autogynephilia in cisgender women shows that cisgender women commonly endorse items on adapted versions of Blanchard's autogynephilia scales, suggesting that the phenomenon might simply be a reflection of erotic self-focus. Moser created an Autogynephilia Scale for Women in 2009, based on items used to categorize MtF transsexuals as autogynephilic in other studies. A questionnaire that included the ASW was distributed to a sample of 51 professional cisgender women employed at an urban hospital; 29 completed questionnaires were returned for analysis. By the common definition of ever having erotic arousal to the thought or image of oneself as a woman, 93% of the respondents would be classified as autogynephilic. Using a more rigorous definition of "frequent" arousal to multiple items, 28% would be classified as autogynephilic. Moser responded that Lawrence had made multiple errors by comparing the wrong items. Transfeminist critique Critics of the autogynephlia hypothesis include transfeminists such as Julia Serano and Talia Mae Bettcher. Serano describes the concept as flawed, unscientific, and needlessly stigmatizing. According to Serano, "Blanchard's controversial theory is built upon a number of incorrect and unfounded assumptions, and there are many methodological flaws in the data he offers to support it." She argues that flaws in Blanchard's original studies include: being conducted among overlapping populations primarily at the Clarke Institute in Toronto without nontranssexual controls; subtypes not being empirically derived but instead "begging the question that transsexuals fall into subtypes based on their sexual orientation"; and further research finding a non-deterministic correlation between cross-gender arousal and sexual orientation. She states that Blanchard did not discuss the idea that cross-gender arousal may be an effect, rather than a cause, of gender dysphoria, and that Blanchard assumed that correlation implied causation. Activist and law professor Florence Ashley writes that the autogynephilia concept has been "discredited", and that Bailey's and Blanchard's work "has long been criticised for perpetuating stereotypes and prejudices against trans women, notably suggesting that LGBQ trans women's primary motivation for transitioning is sexual arousal." == Typology and clinical relevance ==
Typology and clinical relevance
At its core, the theory proposes a typology of transgender women into two distinct classes based on sexual orientation, with consequential differences such as childhood femininity and age of first recognition of dysphoria. A body of research finds average group differences between gynephilic and androphilic trans women on these traits, which supporters argue supports a typology. Sexuality is now considered clinically relevant in transgender care only insofar as it impacts minority stress. Among professionals who work with transgender patients, autogynephilic and associated theories are often referred to as "discredited" or "unsupported by scientific evidence". Neurological differences The concept that androphilia in trans women is related to homosexuality in cisgender men has been tested by MRI studies. Cantor interprets these studies as supporting Blanchard's transsexualism typology. A 2021 review examining transgender neurology found that while most brain features can be grouped by birth sex, in some areas trans women's brains resembled cis women's brains and in some areas trans men's brains resembled cis men's brains. It was not possible to consistently identify traits that differentiated trans people from cis people, or gay people from straight people. == Terminology ==
Terminology
The concept that trans people with different sexual orientations are etiologically different goes back to the 1920s, but the terms used have not always been agreed on. Blanchard uses the term "homosexual" relative to the person's sex assigned at birth, not their current gender identity. This use of the term "homosexual" relative to the person's birth sex has been heavily criticized by other researchers. demeaning, pejorative, and heterosexist. Many authorities, including some supporters, criticize Blanchard's choice of terminology as confusing or degrading because it emphasizes trans women's assigned sex, and disregards their sexual orientation identity. Leavitt and Berger write that the term is "both confusing and controversial" and that trans women "vehemently oppose the label and its pejorative baggage." Blanchard says that the "non-homosexual" transsexuals (but not the "homosexual" transsexuals) exhibit autogynephilia, --> Alternative terms Professor of anatomy and reproductive biology Milton Diamond proposed the use of the terms androphilic (attracted to men) and gynephilic (attracted to women) as neutral descriptors for sexual orientation that do not make assumptions about the sex or gender identity of the person being described, alternatives to homosexual and heterosexual. Frank Leavitt and Jack Berger state that the label homosexual transsexual seems to have little clinical merit, as its referents have "little in common with homosexuals, except a stated erotic interest in males"; they too suggest "more neutral descriptive terms such as androphilia". Sexological research has been done using these alternative terms by researchers such as Sandra L. Johnson. Both Blanchard and Leavitt used a psychological test called the "modified androphilia scale" to assess whether a transsexual was attracted to men or not. Sociologist Aaron Devor wrote, "If what we really mean to say is attracted to males, then say 'attracted to males' or androphilic ... I see absolutely no reason to continue with language that people find offensive when there is perfectly serviceable, in fact better, language that is not offensive." == Other traits ==
Other traits
According to the typology, autogynephilic transsexuals are attracted to femininity while homosexual transsexuals are attracted to masculinity. However, a number of other differences between the types have been reported. Cantor states that "homosexual transsexuals" usually begin to seek sex reassignment surgery (SRS) in their mid-twenties, while "autogynephilic transsexuals" usually seek clinical treatment in their mid-thirties or even later. Blanchard also states that homosexual transsexuals were younger when applying for sex reassignment, report a stronger cross-gender identity in childhood, have a more convincing cross-gender appearance, and function psychologically better than "non-homosexual" transsexuals. Bentler reported that 23% of homosexual transsexuals report a history of sexual arousal to cross-dressing, while Freund reported 31%. In 1990, using the alternative term "androphilic transsexual", Johnson wrote that there was a correlation between social adjustment to the new gender role and androphilia. argues that homosexual transsexuals pursue sex reassignment surgery out of a desire for greater social and romantic success. Lawrence has proposed that autogynephilic transsexuals are more excited about sexual reassignment surgery than homosexual transsexuals. She states that homosexual transsexuals are typically ambivalent or indifferent about SRS, while autogynephilic transsexuals want to have surgery as quickly as possible, are happy to be rid of their penis, and proud of their new genitals. This phenomenon is called the "fraternal birth order effect". In 2000, Richard Green reported that androphilic trans women tended have a later-than-expected birth order, and more older brothers than other subgroups of trans women. Each older brother increased the odds that a trans woman was androphilic by 40%. == Transgender men ==
Transgender men
Blanchard's typology is mainly concerned with transgender women. However, when other sexologists extended Blanchard's work, they coined the phrase autoandrophilia as the counterpart to autogynephilia in those assigned female at birth. Gynephilic transgender men In 2000, Meredith L. Chivers and Bailey wrote, "Transsexualism in genetic females has previously been thought to occur predominantly in homosexual (gynephilic) women." According to them, Blanchard reported in 1987 that only 1 in 72 trans men he saw at his clinic were primarily attracted to men. They observed that these individuals were so uncommon that some researchers thought that androphilic trans men did not exist, or misdiagnosed them as homosexual transsexuals, attracted to women. They wrote that relatively few studies had examined childhood gender variance in trans men. In a 2005 study by Smith and van Goozen, their findings in regards to trans men were different from their findings for trans women. Smith and van Goozen's study included 52 female-to-male transsexuals, who were categorized as either homosexual or non-homosexual. Smith concluded that female-to-male transsexuals, regardless of sexual orientation, reported more GID symptoms in childhood, and a stronger sense of gender dysphoria. Smith wrote that she found some differences between homosexual and non-homosexual female-to-male transsexuals. Smith says that homosexual female-to-males reported more gender dysphoria than any group in her study. == Inclusion in the Diagnostic and Statistical Manual of Mental Disorders ==
Inclusion in the Diagnostic and Statistical Manual of Mental Disorders
In the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) (1980), the diagnosis of "302.5 Transsexualism" was introduced under "Other Psychosexual Disorders". This was an attempt to provide a diagnostic category for gender identity disorders. The diagnostic category, transsexualism, was for gender dysphoric individuals who demonstrated at least two years of continuous interest in transforming their physical and social gender status. The subtypes were asexual, homosexual (same anatomic sex), heterosexual (other anatomic sex) and unspecified. The DSM-IV-TR included autogynephilia as an "associated feature" of gender identity disorder and as a common occurrence in the transvestic fetishism disorder, but does not classify autogynephilia as a disorder by itself or list it as a paraphilia. The paraphilias working group on the DSM-5, chaired by Ray Blanchard, included both with autogynephilia and with autoandrophilia as specifiers to transvestic disorder in an October 2010 draft of the DSM-5. This addition has been criticized as a conflict of interest. When published in 2013, the DSM-5 included With autogynephilia (sexual arousal by thoughts, images of self as a female) as a specifier to 302.3 Transvestic disorder (intense sexual arousal from cross-dressing fantasies, urges or behaviors); the other specifier is With fetishism (sexual arousal to fabrics, materials or garments). == Societal impact ==
Societal impact
Litigation In the 2010 U.S. Tax Court case ''O'Donnabhain v. Commissioner'', the Internal Revenue Service cited Blanchard's typology as justification for denying a transgender woman's tax deductions for medical costs relating to treatment of her gender identity disorder, claiming the procedures were not medically necessary. The court found in favor of the plaintiff, Rhiannon O'Donnabhain, ruling that she should be allowed to deduct the costs of her treatment, including sex reassignment surgery and hormone therapy. In its decision, the court declared the IRS's position "at best a superficial characterization of the circumstances" that was "thoroughly rebutted by the medical evidence". Anti-LGBT groups According to the Southern Poverty Law Center (SPLC), autogynephilia has been promoted by anti-LGBT hate groups. These include the Family Research Council (FRC), United Families International (UFI), and the American College of Pediatricians (ACPeds). Nic Rider and Elliot Tebbe characterize Blanchard's theory of autogynephilia as an anti-trans theory that functions to invalidate and delegitimize transgender individuals. Feminists Serano writes that trans-exclusionary or gender-critical feminists have embraced the idea of autogynephilia beginning in the 2000s. The concept of autogynephilia became popular on gender-critical websites such as 4thWaveNow, Mumsnet, and the Reddit community /r/GenderCritical. == See also ==
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