Who Has Gender Dysphoria?

It's not just that skinny gay boy

The Problem

I've been seeing a misconception reiterated on Twitter, in substack comments, and especially in radical feminist spaces. I believe it comes from a misunderstanding of sexologist Ray Blanchard's now famous typology of transsexuals.

If you don't know about Blanchard's two types of transsexuals, here's a brief synopsis. The first type, he says, is the homosexual transsexual. He is a stereotypically feminine male who has felt distressed about his sex from a young age. The second type is the nonhomosexual (often heterosexual, but sometimes with bisexual leanings). This type is often stereotypically masculine and acquires his distress later in life. Blanchard calls the two types HSTS (homosexual transsexual) and AGP (autogynephilic)—but let's put that aside for now.

What Blanchard did not say, it should be noted, is that one group exhibits gender dysphoria and the other does not.

That's where the misconception comes in. I frequently see social media commentators expressing sympathy for the “tiny minority” of “true transsexuals” with “actual dysphoria,” which is then contrasted with folks intermittently called fetishists, cross-dressers, autogynephiles, fakers, trans-trenders and various other descriptors. The latter group, it is assumed, lacks gender dysphoria.

Blanchard's typology, however, was not intended to separate “true” transsexuals from “fake” ones. Nor did it suggest that one group suffered more greatly from gender dysphoria than the other—quite the contrary. One need only consider Blanchard's own words, in both his seminal work (no pun intended) and in subsequent papers and interviews. Blanchard's typology was meant only to predict who, if anyone, should be recommended for sex reassignment surgery. The homosexual group was favored; they tended to “pass” better after surgery than the other group and their dating lives were deemed less adversely affected.

This is not an article about whether Blanchard's typology actually resulted in the better surgical outcomes to which it aspired. It's not an article on autogynephilia, though I'd love to explore that topic another time. This is an article on gender dysphoria, alone. Granted, gender dysphoria is a slippery term, and probably presents differently in one cohort versus another. But for our purposes, let's call it a persistent psychological distress about one's sexed body.

Gender Dysphoria

Blanchard's elucidation of the transsexual typology itself assumes gender dysphoria in both groups:

"All gender-dysphoric biological males who are not homosexual (erotically aroused by other males) are instead autogynephilic (erotically aroused by the thought or image of themselves as females)" – Ray Blanchard, Early History of the Concept of Autogynephilia

As well, Blanchard speaks casually in later works of “nonhomosexual gender-dysphoric males,” and on twitter alludes to “severely gender dysphoric autogynephiles.”

Here’s more. Sexologist Anne Lawrence, a self-described autogynephile who has interviewed hundreds of sexually-motivated transsexuals, finds them even more dysphoric than their homosexual counterparts:

“The nonhomosexual MtF transsexuals 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)... 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.” – Anne Lawrence, Becoming What We Love

My experience confirms the observations of Blanchard and Lawrence. My ex-husband Jamie was largely heterosexual. He was masculine in appearance and in behavior with male-typical hobbies. He was aroused by crossdressing and “tranny porn,” as he called it. It's clear which category he belongs in. And yet, Jamie very clearly exhibited gender dysphoria, even though acquired late in life:

“In the evening I see you standing in the foyer, examining yourself in the mirror. You stroke your jawline and frown. You look at your hands. You’re not happy with your body anymore. A few months ago, that wasn’t the case. What happened between then and now?

'I’m drawn to mirrors,' you write in your blog. 'But I want a reassurance they refuse to provide.'” - 18 Months

Why It Matters

People sometimes scoff at my attempt to clarify this matter. They say I'm excusing predatory behavior or pitying someone who deserves no pity. But that isn't the case at all.

Truth is truth, after all, whether or not it fits a convenient narrative. Sexually-motivated heterosexual men can be gender dysphoric. It's been discussed at length by the experts. It's been observed by those of us who've lived with these individuals.

This matters for several reasons.

First, those who consider people like Jamie their political opponents would do well to steelman his position. You do yourself no favors, in any debate, by closing your ears and eyes to the facts on the other side. You'll look clueless at best. At worst, you'll seem intellectually dishonest and unfair. Personally, I’m a fan of compassion and an advocate for the principle of charity. But if you can’t be compassionate, you still need to be strategic.

Second, we can't devise public policies that grant privileges to only the “truly dysphoric.” Not only is this impossible, but it divides this community in unpredictable ways, only further hampering our efforts to thwart predatory behavior.

Third, and most importantly, we can't figure out how to properly treat people in gender distress—especially kids—unless we fearlessly examine and seek to truly understand gender dysphoria—even in its discomfiting manifestations.