For many years, 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)” . Ray Blanchard introduced the concept of autogynephilia,“formally defined as a male’s propensity to be sexually aroused by the thought or image of himself as a female” , and argued that it was at the core of all non-homosexual transsexualism. Thus he retained a binary model for gender dysphoria, but based around the distinction between autogynephilic and androphilic forms.
There is no doubt that many transgendered people appear to fit the description of an autogynephile. Indeed, many known to me have cheerfully indicated that they feel that they fit this description. In this sense, therefore, Blanchard’s contribution has undoubtedly been to deepen greatly our understanding of gender dysphoria. However, it remains to be seen whether his framework is complete.
The persistent counterfactual claims of many with gender dysphoria that their condition is not, at root, erotically motivated need to be addressed if Blanchard’s binary model of gender dysphoria is to be supported. For Blanchard’s supporters, his 1986 paper  provides decisive evidence. However, as I have explained elsewhere, there are deficiencies in this paper (in particular the flimsy discussion, lack of detailed analysis of the quantitative data, the small sample sizes and the fact that a group of gender dysphoric individuals supposedly selected for their heterosexual orientation appear to be more aroused at the idea of being with a man than a woman). To this I have added my own experience.
The importance of addressing this important question has been addressed by some of Blanchard’s apologists. For example, Lawrence offers the following:
“Alternatively, the feelings and sensations that accompany autogynephilic arousal might sometimes be too mild to be consciously perceived, or if perceived might be interpreted as something other than sexual arousal. The mild sexual arousal that accompanies the earliest stage of the sexual response cycle (Masters & Johnson, 1966, pp. 4-7) might not be noticed by some autogynephilic individuals. Nevertheless, as Docter (1988) emphasized, “the fact that an individual reports that no sexual ‘turn-on’ is experienced [with cross-dressing] does not necessarily mean that no components of the sexual response pattern are operative” (p. 117). Misinterpretation of feelings of sexual arousal is another possibility. Docter (1988) proposed that “another hypothesis might be that the mild sexual arousal that may accompany . . . fetishistic cross-dressing is subjectively interpreted as calming despite what may be mild physiological arousal” (p. 117).” 
In the sciences we tend to apply Ockham’s razor: where there are two alternative explanations for a phenomenon, the simpler of the two is usually the best. The above explanations strike me as flimsy to say the least. Given that I experience rapid and ready arousal with my wife, how could I possibly be deluded into spending so much time and effort, not to mention the concomitant risk to my reputation and challenges in my marriage, in pursuit of an erotic interest which repays my endeavours so poorly? I could get more return from a quick snog with my wife!
I think there are two much more likely explanations. The first, and perhaps the simplest of all, is that this really is all down to a gender identity problem: something occurs during development that leads to a difficulty for an individual in identifying with their biological gender (or perhaps with society’s expectations of gender-typical behavior). In my own case this extends far beyond cross-dressing. At primary school I was always on the outside of whatever other boys were doing, and always much more comfortable in the company of girls. At work, equality and diversity training has forced me to consider behavioural differences between men and women in the workplace, and I have been repeatedly struck by the similarity between my behaviour and stereotypical feminine behavior. All my life I have been keenly aware that my mind does not work like that of other men; it has felt a burden to try to be “one of the boys” although with effort it has been achieved with some success at various stages.
A further possibility, that is merely my own speculation, unsupported by academic literature, is that Blanchard’s second category, homosexual transsexuals, is not exclusively androphilic. Perhaps it consists largely of homosexuals because it reflects experiences in development, or brain structure, that also tends to cause homosexuality, but perhaps those same traits can in some individuals create a form of gynephilic gender dysphoria. Blanchard is himself aware of the possibility of exceptions to his binary model, and indeed provides some intriguing counterfactual illustrations of his own. For example, while remarking that female-to-male transsexuals are almost always homosexual (ie. gynephilic), he has described reports of exceptional cases where female-to-male transsexuals fantasised about becoming gay men .
There is a lot more that can be said. There is an abundance of academic work that is highly critical of Blanchard’s model, and I cannot attempt to review all of that literature here. My personal evaluation is that while Blanchard’s model of autogynephilia may be very helpful in understanding gender dysphoria, and the phenomenon may lie at the root of many expressions of gender dysphoria, it does not seem helpful or relevant in understanding my own experiences which seem to be much better explained by the development, perhaps in childhood, of a variant gender identity through another mechanism. I do not claim to be a woman; I am biologically male. However, my brain believes itself to be feminine in a way that appears not directly connected to my sexuality or to my sexual relationships. My relationship with my wife is perfectly straightforward, and as husband, I am completely content to play a masculine role. That’s not to say we don’t compare notes on pretty frocks occasionally, and of course, I’m much more help than the average guy when it comes to picking a nicely coordinated outfit.
- Blanchard, R. “Typology of Male-to-Female Transsexualism”, Archives of Sexual Behavior, 1985, 14, 247-261.
- Blanchard, R.; Racansky, I. G.; Steiner, B. W. “Phallometric Detection of Fetishistic Arousal in Heterosexual Male Cross-Dressers”, Journal of Sex Research, 1986, 22, 452-462.
- Lawrence, A. “Autogynephilia: A paraphilic model of gender identity disorder”, Journal of Gay & Lesbian Psychotherapy, 2004, 8, 69-87.
- Blanchard, R. “The Classification and Labeling of Nonhomosexual Gender Dysphorias”, Archives of Sexual Behavior, 1989, 18, 315-334.