For Ray Blanchard, autogynephilia is “formally defined as a male’s propensity to be sexually aroused by the thought or image of himself as a female” . It refers to “to the full gamut of erotically arousing cross-gender behaviors and fantasies“ . Autogynephilia springs from what he calls a type of “erotic target location error”: it is in fact a form of “paraphilia”, a condition in which the erotic focus of an individual is not directed towards another person, but to an object or fantasy or, unusually in the case of autogynephilia, an idea. In everyday language, paraphilias are described as “sexual fetishes”.
Blanchard’s ideas have been taken up by a number of supporters. Michael Bailey, of Northwestern University, published a controversial book, “The Man Who Would be Queen” , which expounded Blanchard’s hypothesis that there were essentially two types of mate to female transsexual – homosexual and autogynephilic transsexuals – in a more populist form. It provoked a storm of protest from trans activists, to which Bailey has responded . Alice Dreger, a colleague, weighed in both to defend the central hypothesis expounded in Bailey’s book and also to raise concerns about the personal and rather vitriolic nature of attacks upon Bailey, which she argued deflected attention away from the core scientific questions .
Anne Lawrence, a male-to-female transwoman who self-identifies as an autogynephile [http://www.annelawrence.com/], has become a prominent proponent of Blanchard’s ideas. However, she has abandoned the circumspection that is evident in his 2005 paper, in which he notes that while the phenomenon of autogynephilia is well established, a generalized theory of gender dysphoria based on autogynephilia is still lacking . Instead, Lawrence goes further: not only is autogynephilia the unifying theory with which to understand gender dysphoria, but “it can be conceptualized as both a paraphilia and a sexual orientation” . She asserts that the desire for sex reassignment is the consequence of a mental dysfunction  and that:
“MtF transsexuals…do not have female core gender identities, nor do they have well developed cross-gender identities that precede and act as the driving force behind their desires to turn their bodies into facsimiles of women’s bodies. Rather, nonhomosexual MtF transsexuals gradually develop cross-gender identities after years or decades of erotic cross-dressing, accompanied by the autogynephilic wish to turn their bodies into facsimiles of women’s bodies. In this sense, cross-gender identity in nonhomosexual MtF transsexuals is a secondary phenomenon or epiphenomenon.” 
Blanchard’s use of the language of fetishism, the less nuanced works of his admirers, and the willingness of Lawrence and others to see autogynephilia as both the essence of gender dysphoria and at the same time a disorder, a sexual orientation and even a secondary “effect” of an underlying paraphilia have angered transgender activists who are anxious to make the claim that gender and sexuality are entirely different things. Illustrative examples of the responses of transgender activists to the concept of autogynephilia can be found on Julia Serano’s web site  and at the Transexual Road Map web site . The perception that society sees paraphilias (fetishes) as at best kinky and at worst (eg. paedophilia) illegal adds to the sense that the theory of autogynephilia is a form of professionalized “slut-shaming”. I would argue that the idea that gender dysphoria results from the individual being “a woman trapped in a man’s body” is untenable. However, this is a long way from the radical reduction of the whole phenomenon to a sexual fetish.
A few things seem to be clear to me in this complex area. First, the outright rejection of the notion of autogynephilia by transgender activists seems unsupportable. In his 2005 paper, Blanchard is a little more circumspect than many of his apologists. He notes that a comprehensive theory of gender dysphoria is lacking, but asserts that there is strong evidence to support the existence of the phenomenon of autogynephlia. I believe that this hypothesis is corroborated by a substantial body of data, including his own case studies, and the widely discussed Lawrence narratives . Perhaps more persuasive for me, however, even though much less scientific, is evidence from many transgendered friends who, when I have explained Blanchard’s theories to them, have quickly and cheerfully said “Oh yes, that’s me”.
Second, I believe that Blanchard’s work provides a way to rationalize all sorts of behaviours among members of the transgender community that I once found puzzling. For example, why do so many t-girls say things like “I’m a normal heterosexual male, because I only have sex with men when I’m dressed [as a woman]”? Superficially such statements make no sense at all. Blanchard’s explanation is that the male partner in their sexual adventures simply provides a means to realise their fantasy of being a woman – it seems to make perfect sense, and to explain a lot of otherwise inexplicable behaviour. A number of male “admirers” are found to hang around the transvestite scene. These men are on the whole far from what a typical woman would regard as a great catch; often inarticulate and sometimes downright creepy, but quick to tell t-girls how desirable they are. For autogynephiliacs seeking to realise a fantasy, a complex interpersonal relationship is not required and these individuals are perhaps all that is required.
Third, I am unable to accept that the hypothesis of autogynephilia explains all forms of gender dysphoria. Just as a number of friends have cheerfully told me that their experiences are explained by autogynephilia, many others have not. These are thoughtful, reflective people. I see no reason to doubt the candid accounts they have shared of their own exploration of their gender identity. Their experiences and assertions resonate with my own experiences. I have reflected long and hard, and I am unable to find any sense in which I can understand or explain my own feelings and experiences within the framework of Blanchard’s hypothesis. At root the issue for me, as for many of my friends, is that this sense of being transgendered lacks any erotic element. If we are driven by erotic fantasies, they are fantasies so disappointing and lacking in excitement that real life appears almost infinitely more exciting.
To summarise, Blanchard began with the hypothesis that males exhibiting cross-gender behaviour were thought to be two principal types: “transvestites (heterosexual males who engage in cross-gender fantasy or behavior only when they are erotically aroused), [and] transsexuals (men have a long-standing and nonfluctuating desire to possess a female body and to live permanently in society as women)” . It seems to me that Blanchard has largely corroborated this binary understanding of gender dysphoric individuals, but with additional refinements. The principal achievement of his work has been to identify autogynephilia as the underlying explanation for fetishistic cross-gender behaviour. Blanchard has additionally added the qualification that non-fetishistic (ie. non-autogynephilic) transsexuals are homosexuals. The consequence of this is to assert that non-autogynephilic individuals woul are gynephilic do not exist. In an area as complex as human sexuality this seems to be quite bold, and I would contend that the evidence of my own experience, and of close friends who have shared theirs, is not consistent with such a conclusion.
- Blanchard, R. “Clinical Observations and Systematic Studies of Autogynephilia”, Journal of Sex & Marital Therapy, 1991, 17, 235-251.
- Bailey, J. Michael “The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism” Joseph Henry Press, 2003. ISBN 978-0-309-08418-5.
- Dreger, A. D. Galileo’s middle finger: heretics, activists, and the search for justice in science. New York: Penguin Press, 2015. ISBN 9781594206085.
- Blanchard, R. “Early History of the Concept of Autogynephilia”, Archives of Sexual Behavior, 2005, 34, 439–446.
- Lawrence, A. “Autogynephilia: A paraphilic model of gender identity disorder”, Journal of Gay & Lesbian Psychotherapy, 2004, 8, 69-87.
- Lawrence, A. “Men Trapped in Men’s Bodies”, Springer-Verlag, New York, 2013. ISBN 978-1-4614-5181-5.
- Blanchard, R. “Typology of Male-to-Female Transsexualism”, Archives of Sexual Behavior, 1985, 14, 247-261.