The core of Blanchard’s research on autogynephilia was reported in three studies published in 1985, 1988 and 1989 [1-3]. Blanchard’s initial interest was to simplify the diverse “classification schemes for gender identity disorders in biological males”. 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)” .
In his 1985 study , Blanchard analysed 163 individuals selected using questionnaires. In particular, all individuals selected for the study said that they had felt like a woman “at all times and for at least one year”. Blanchard categorized the subjects using Hirschfeld’s scheme (homosexual, heterosexual, bisexual and asexual) based on the results of standard questionnaires designed to measure androphilia (attraction to men) and gynephilia (attraction to women). These questionnaires, reproduced in his 1985 paper, are rather detailed. Blanchard then compared responses of these different groups to the question “did you ever feel sexually aroused when putting on females’ underwear or clothing?” He found that while there was no statistically significant difference between the responses of the heterosexual, bisexual and asexual transsexuals, the response rate was markedly lower for the homosexual (androphilic) transsexuals. From these data he drew the conclusion was that the former three categories were more similar to each other, and to transvestites, than any of them is to the homosexual, or androphilic type.
Blanchard argued that these data supported the hypothesis that male-to-female cross-gender behaviour could be collapsed into two broad categories: androphilic (homosexual) transsexualism and behaviour motivated erotically. Thus the causative mechanism for non-androphilic transsexualism and for fetishistic transvestitism is erotic attachment to the idea of the self as a woman – fetishisation of a cross-gender identity. It may seem surprising to assert that hetero- and bi-sexual transsexuals are motivated by the same erotic object. However, Blanchard argues that for bisexual transsexuals attraction to men has a different origin from attraction to men in homosexual transsexuals; it comes not from erotic attraction to the male form but from “the thought of being female, which is sympbolised in the fantasy of being penetrated by a male”. In asexual transsexuals “cross-gender fetishism…so overshadows, or competes with, the erotic attraction to women that the individual appears to have little erotic attraction to other persons at all”.
One might make a few rather obvious responses to this study. The argument that among gynephilic subjects there is a much higher incidence of erotic arousal associated with wearing female clothing is clear. However, the number of responses from the androphilic group is not zero. Moreover, the question asked was an extremely simple one, with a yes/no answer. Therefore it would not differentiate subjects who had occasionally felt mildly aroused while wearing female clothing, and others who routinely felt intensely aroused.
Blanchard’s 1988 paper  revisits the questions explored in his 1985 paper and additionally examines the age of first clinical presentation and questionnaire data relating to the degree of cross-gender identification as children. He reports that androphilic (homosexual) transsexuals first presented at a significantly younger age than the other three groups (gynephilic, bisexual and asexual transsexuals). He also reported that androphilic transsexuals reported significantly less female presentation as children than did the other three groups, although disappointingly, neither the questionnaire nor the data were presented in the paper, which rather undermines the conclusion.
Noting the similarity he had identified between non-homosexual types of transsexualism, Blanchard introduced the term “autogynephilia”, or “love of oneself as a woman”, in a 1989 paper. He had already noted the objection that some transsexuals claim that they do not experience erotic arousal in an earlier work. This objection was dismissed on the grounds that those subjects were mistaken or concealing the truth. Nevertheless his 1989 definition is framed so as to try to include transsexuals who dress as women full-time and experience only occasional arousal:
“It should be noted that the concept of autogynephilia does not imply that autogynephilic males are always sexually aroused by the thought of themselves as women, or by dressing in women’s clothes, or by contemplating themselves cross-dressed in the mirror – any more than a man in love always obtains an erection at the sight of his sweetheart, or pair-bonded geese copulate continuously.” 
My view is that this aspect of Blanchard’s work is rather flimsy, and the topic is addressed in detail elsewhere. Wht come through powerfully in Blanchard’s work is the hypothesis that at root, non-homosexual types of transsexualism are erotic in motivation.
In a later paper he elaborates:
“The concept of autogynephilia-or something very like it-is needed to fill a gap in our current battery of concepts and categories for thinking about gender identity disorders. There is no other term for designating erotic arousal in men associated with the thought or image of themselves as women; there is no other conceptual basis for classifying erotic fanta- sies as diverse in form-but similar in meaning-as menstruating, breast- feeding, making love to a lesbian as a gay woman, making love to a man as a straight woman, sitting in a girls’ class at school, knitting, and possessing shaved legs. The concept of transvestism does not meet this need.” 
Blanchard developed the concept of autogynephilia at length in his 1989 paper . It may have a variety of manifestations, he notes.
“The notion of autogynephilia points toward an unexplored, multiform array of cross-gender behaviors that must eventually be explained by any comprehensive theory of gender identity disorders.” 
“Transvestites [may be] understood as autogynephiles whose only – or most prominent – symptom is sexual arousal in association with cross-dressing and who have not (or not yet) become gender dysphoric”. 
To some extent, autogynephilia interferes with the erotic attractions of affected individuals. Heterosexual autogynephiles suffer the least alteration, but Blanchard asserts that “many…are able to maintain potency with their wives only by means of cross-gender fantasy during intercourse” . For bisexual transsexuals, penetration by men actualises the fantasy of being a woman, while for asexual transsexuals (or analloerotic transsexuals, as Blanchard prefers to describe them), “‘the woman within’ completely supplants her fleshly rivals”. In contrast, homosexual transsexuals are aroused by the male body – the erotic object is without and not within.
Of particular interest was the nature of the erotic fantasies reported by autogynephiles. He found that some men are simply aroused sexually by the idea of wearing women’s clothes, while some men are aroused by the idea of having a woman’s body; this latter group tend to imagine themselves as naked women in their sexual fantasies, and they are found to be the most likely to seek gender reassignment surgery. [5,6] Blanchard suggests that the desire for surgery among this group “appears as logical as the desire of heterosexual men to marry wives” . It represents the logical extension of his definition of an autogynephile as a man who is in love with the idea of himself as a woman.
An interesting and superficially surprising finding was that men who were sexually aroused by the idea of being fully clothed in women’s attire were more dysphoric than men who were aroused by the idea of wearing women’s underwear. This latter group were found to have a greater tendency to sadistic and masochistic behavior . While one might imagine a temporal progression, from fantasizing about being a naked woman, to fantasizing about being partially clothed and finally fully clothed, Blanchard reports no evidence for a temporal progression of gender dysphoric individuals in this regard; indeed, those who fantasise about being a naked woman tend to present younger at the clinic.
Blanchard presents the following overview at the end of his 1989 paper:
“The narrow focus of many modern investigators on fetishistic cross-dressing…has not been especially productive of new ideas or new findings. It has, for example, failed to suggest any plausible link between an individual’s masturbating in women’s garments at one stage of life and earnestly pursuing vaginoplasty at another. The findings of this study suggest that returning to a broader conception of the underlying erotic phenomenon might have greater heuristic value at this time. “ 
While for Blanchard this points to the possibility of obtaining a thoroughgoing understanding of gender dysphoria, for many of his critics it has precisely the effect that he appears to warn against in the passage above: the entire phenomenon – a spectrum of causes, behaviours and sexualities – is telescoped into an erotic fantasy of the self as a woman.
- Blanchard, R. “Typology of Male-to-Female Transsexualism”, Archives of Sexual Behavior, 1985, 14, 247-261.
- Blanchard, R. “Nonhomosexual Gender Dysphoria ”, Journal of Sex Research, 1988, 24, 188-193.
- Blanchard, R. “The Concept of Autogynephilia and the Typology of Male Gender Dysphoria”, Journal of Nervous and Mental Diseases, 1989, 177, 616-623.
- Blanchard, R. “The Classification and Labeling of Nonhomosexual Gender Dysphorias”, Archives of Sexual Behavior, 1989, 18, 315-334.
- Blanchard, R. “Clinical Observations and Systematic Studies of Autogynephilia”, Journal of Sex & Marital Therapy, 1991, 17, 235-251.
- Blanchard, R. “Varieties of Autogynephilia and their Relationship to Gender Dysphoria”, Archives of Sexual Behaviour, 1993, 22, 241-251