What is Autogynephilia, Anyway?

Why "orientation" is not a terrible analogy

Photo by Armand Khoury on Unsplash

When my ex-husband Jamie first began to crossdress, I was unconcerned. We'd been together fourteen years; surely we could integrate this—whatever this was—into our relationship. If it was a means of self-expression, no big deal. If it was a sexual interest, we could rotate it into our sexual repertoire, as we'd done before with other interests of his and of mine, and as I'd done with other lovers in the past. And for a while, that's exactly how things went. But around eight months in, things changed.

Jamie's crossdressing became all-consuming. He stopped thinking of clothing as fashion and started to see it as an extension of his identity. He lost interest in hobbies, like backpacking, that prevented adequate expression of his “feminine side.” He dismissed everyone and everything that stood in the way of feminizing his body, including me, our intimacy, his job, his family, his friends and his safety. His sexual desire became laser-focused upon one and only one thing: role-playing as a woman.

I didn't understand why crossdressing—even sexual crossdressing—should undo fourteen years of a loving, reciprocal relationship, nor why it should upend our former peaceful and sane life.

Then I read sexologist Anne Lawrence's Becoming What We Love. And I understood. Jamie wasn't pursuing a mere erotic thrill. If that were the case, I’m sure we could have worked around it. Jamie had developed something much closer to a sexual orientation. Something that superseded not only our sex, but our love; something that undermined his former heterosexuality itself.

I tend to avoid using the word “autogynephilia.” This in line with my policy of using plain language in general. Better to let the facts speak for themselves, in most situations. Jargon, technical terminology, in-group language—these lead to misunderstandings and facilitate guilt-by-association and strawman attacks. This word is no exception. The condition to which it refers is greatly misunderstood, so the term’s become a catch-all for any and all deviant behavior performed by men who crossdress.

Nonetheless, autogynephilia, as described by clinicians like Lawrence, perfectly mirrors what I saw in Jamie. Having witnessed the phenomenon up close and personal, I've been frustrated for some time by mischaracterizations of it. So writing this article has been on my to-do list for some time. In light of the recent “AGPgate” scandal at Genspect's conference in Denver, and my appearance on two different podcasts to talk about it, its time has come.

It's important to note that an accurate articulation of autogynephilia is not a defense of autogynephilia. Frankly, I find autogynephilia more corrosive to a relationship than a kink—people sometimes successfully integrate kinks into their lives and relationships without undo disruption. Autogynephilia is narcissistic and anti-social, at best, and it’s psychologically unhealthy for the sufferer as well as a drain on others in his life.

Rather, truth matters. For all the usual reasons that truth matters.

And truth matters in particular when it comes to sexual dysfunction, which thrives in shame, which is in turn nurtured by misinformation. Shame is inevitable when a person can't see a way out of his predicament, perhaps because all options have been closed off: he can't figure out how to get rid of his propensity, he can't practice it, he can't find resources on it, he can't talk it through, and the societal message—from several disgusted corners—is that he should be “thown in a pit to die”—an actual response, paraphrased from memory, to the subject of the now-deleted tweet from Genspect that started the whole kerfuffle.

Autogynephilia is sweeping the Western world, bringing emotional and physical dysfunction with it, and drawing in children too young to properly process it. It is imperative that we understand it.

Before we talk about what autogynephilia is, we need to talk about what it isn’t. It isn’t transvestic fetishism. It isn’t a kind of fetishism at all. It isn’t exhibitionism. Sure, people with one issue can have other issues—that shop teacher is probably an example—but there’s nothing to be gained by conflating concepts. Autogynephilia is its own paraphilia. Paraphilias are “persistent and recurrent sexual interests, urges, fantasies, or behaviors of marked intensity involving objects, activities, or situations that are atypical in nature.” Thus, fetishes are paraphilias but paraphilias are not necessarily fetishes.

Perhaps you can't bring yourself to care about the fine details of a grown man’s sexual dysfunction. Fair enough. But I invite you to care about the young boys treading this path for whom healthy personality integration is still an option. They need our fearless investigation into this vexing medical condition, our empathy, our willingness to help them find a path forward. Understanding the relevant medical literature is a part of that.

Here’s another thing autogynephiles aren’t: men who are “faking it.” They aren't opportunists with a Machiavellian plan to dominate resources meant for women (even if that's the result). Opportunists exist, of course. But Lia Thomas? Judging by the faraway look in his eyes, I’d wager that he, like my ex-husband, believes he's a “literal” woman (however strange that may seem to the sane). Nor is the autogynephile someone who lacks the desire for medical intervention. Indeed, the pioneers of this field of study find that autogynephiles want to “[acquire] a woman's body through… permanent, physical transformation” even more than do homosexual “trans women.”

Finally, there's the oft-repeated claim that autogynephiles “draw” others into their “fetish.” This is an idea that originated in activist circles, as far as I can tell. It has no basis in research or reality. Again, autogynephilia is neither fetish nor exhibitionism. Further, the autogynephile is likely too self-involved to properly notice others—including his own frustrated partner—much less to “include” them in his inwardly-focused sexuality, whatever that would entail. In fact, autogynephilia is more often observed in men without “high levels” of interest in actual women.

So what is an autogynephile? As readers probably know, sexologist Ray Blanchard first described the phenomenon after working for decades with male-to-female transsexual patients. He noticed a particular cohort of men seeking transition: they were largely heterosexual, they presented with gender distress late in life, and they were often quite masculine looking, presenting a challenge for doctors charged with helping them “pass.” Per Blanchard, autogynephilia “described the propensity of certain males to be erotically aroused by the thought or image of themselves as women.” This is in contrast to the experience of homosexual transsexuals, who transition because they're already perceived as feminine and/or to facilitate relationships with men. Per Blanchard, “transvestite” is not an accurate description for this cohort, as the term “fails to capture the wide range of erotically arousing cross-gender behaviors and fantasies in which women's garments per se play a small role or none at all.”

One of the most insightful parts of Blanchard’s discovery is that autogynephila resembles a sexual orientation. Men with this propensity, he finds, suffer an “erotic target location error,” finding both sexual desire and romantic love within themselves instead of with someone else.

More on this in a bit.

First, I want to say that I get why the choice of the word “orientation” is causing a stir within certain circles. I really do. There is resistance to using the term beyond its reference to sex-based attraction: heterosexual, homosexual, bisexual. What’s next, people wonder. Creating a sexual orientation for those who like redheads? Or worse, for those whose paraphilic behaviors are criminal?

But words are imperfect proxies for concepts, and sometimes we choose the closest one available. And “orientation,” by its simpler definition, is the “direction” of a thing—in this case, of a person’ sexuality. Which directions are included within the term is a social decision. Some, fearing the slippery slope, say sex is the only reasonable basis for inclusion. And I am certainly sympathetic with the argument that “sapiosexuality” and the like are absurd constructions; are utterly dissimilar to, say, homosexuality; and exist within one of the three sexual orientations.

But I suggest the strength and intractability of the direction are fair considerations, as is the fact that both “erotic and affectional” aspects, as I’ll soon explain, are involved. As well, an orientation towards oneself is significantly different from an orientation that is directed toward other people. How heterosexual is a man who prefers himself to a woman?

In any case, whether one wishes to adopt the word is a semantic matter. I have no particular interest in influencing others’ language. I’m more interested in clarifying the peculiar, all-encompassing, more-than-sexual nature of this condition.

“Autogynephilia is basically a sexual orientation,” writes Blanchard, “and once present does not go away.” Lawrence agrees: “Autogynephilia can more accurately be conceptualized as a type of sexual orientation and as a variety of romantic love, involving both erotic and affectional or attachment-based elements.”

Additionally, says Lawrence:

“Many [have an] an overly narrow conceptualization of [the model of] autogynephilia... autogynephilia can easily be misunderstood as a purely erotic or lusty phenomenon, devoid of any of the other elements, such as admiration, affection, beneficence, and desire for closeness, that are usually associated with the word love, broadly construed, and that are considered to be expressive of a person’s sexual orientation. Imagine how heterosexual men would respond to the assertion that their attraction to their lovers, fiancées, or partners was based solely on erotic desire or lust and nothing more: I suspect that most would not only regard such a description as woefully incomplete, but would consider it insensitive at best and deeply offensive at worst... MtF transsexuals... seem to be saying something very similar: 'Our desire to change our bodies and live as women involves much more than just erotic desire or lust.'”

Autogynephiles, Lawrence further notes, report a continued “comforting” and “nonsexual” feeling toward “the idea or reality of being female” long after they cease to “experience sexual arousal to the idea.” Many report the feeling as “natural” or “comfortable” rather than sexual.

Narcissistic? Absolutely. Fetishistic? Not so much.

This pervasive interest—arguably best described as an orientation—explains why my ex-husband couldn't integrate his crossdressing into our marriage. Autogynephilia, per Blanchard, “coexists with and simultaneously competes with sexual attraction toward women.”

It also explains why he sped toward transition with “little concern for possible consequences.” Just as acquiring a romantic partner “becomes an essential and unifying theme” for a normal person’s life, Lawrence writes, acquiring sexual reassignment surgery serves a similar purpose for the autogynephile. It “becomes their first priority, while other elements of life—family, friends, employment—typically assume secondary importance.” Sex reassignment is “given first claim on the transsexual’s time, energy, and resources.”

Gender dysphoria is part of the autogynephilic experience. Blanchard speaks of dysphoria in autogynephiles here, here and here, and he developed his typology partly to determine whether transition would help alleviate it. In fact, autogynephiles may have worse dysphoria than their homosexual counterparts. Per Lawrence:

“The [autogynephiles] I have seen in my practice typically want to undergo sex reassignment surgery as quickly as possible and want their new genitals to resemble as closely as possible the female genitals they love and idealize. After surgery, these transsexuals are not only relieved to be rid of their male genitals but are delighted with their female-appearing genitals and are often eager to display them to other people (e.g., at transgender support group meetings). They are proud to more closely resemble what they love. Their attitude is in marked contrast to that of the homosexual MtF transsexuals I have seen, who do not experience romantic love for women, do not idealize women’s genital anatomy, and often seem indifferent or ambivalent about undergoing sex reassignment surgery. One of my homosexual MtF transsexual patients who had undergone sex reassignment surgery was, for example, unwilling to perform vaginal dilation to prevent postoperative vaginal stenosis, because she regarded her new female genitals as 'too ugly' to look at or touch.”

A female “identity” is also part of the autogynephilic experience. Lawrence notes that just as sexual orientation is “[significant] to the creation of personal identity in persons with ordinary sexual orientations,” i.e. “heterosexual, bisexual, or homosexual,” it's similarly important to those with an autogynephilic orientation. “This isn’t primarily a sexual thing for me,” reports one of Lawrence's patients. “It’s about my identity as a woman.”

Understanding the nature of this condition—rather than reducing it to a fetish—is essential to treating young people who may be in its grip. In particular, parents—who are too often reluctant to acknowledge their sons’ sexuality even when it’s developing normally—must appreciate the complexity of this condition if they hope to address it in a healthy way. Orlando, author of Since 2010 and a recent visitor to this substack, makes a great point:

“[There is a] presumption that autogynephilia [means] an excess of sexuality, or sexual maturity, when the phenomenon is likely to result in the opposite: as autogynephilia is directed inwards (analloerotic), it can nullify outwards (alloerotic) gynephilic (attraction towards women) interest, or mean that such interest is delayed.”

Knowledge is power. My hope is that those who use the term “autogynephilia” will do so with a full understanding of this complex and difficult-to-treat condition.