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The Blanchard, Bailey, and Lawrence theory is an informal name for a controversial behavioral model of male-to-female transsexualism. This taxonomy claims there are two types of males who wish to transition: those who exhibit homosexuality and those who exhibit autogynephilia. According to the concept, "Homosexual transsexuals" are attracted to males exclusively, and "autogynephilic transsexuals" exhibit a paraphilia in which they are attracted to the thought or image of themselves as women. Because this concept uses transsexual sexuality as its organizing principle, it conflicts with central tenets of other models of gender variance, especially the concept of gender identity.

The main assertions of the theory are:

  • Sexual orientation is not changed by medical procedures. [2] Male-to-female transsexual people who switch from female to male sex partners after transition are nonhomosexual and hence autogynephilic, and are "lying" if they claim otherwise.
  • Sex is not changed by medical procedures, and a postoperative male-to-female transsexual person who has had sex reassignment surgery is simply "a man without a penis." [3]
  • Most gender patients lie to present themselves in the most sympathetic light possible, especially autogynephilic transsexual people, a concept described as "systematic distortion." [4]

In essence, the theory suggests a sexual motivation for any transition, either due to extreme homosexuality or an extreme form of misdirected heterosexuality. [5] Many transsexual people and mental health professionals object to the taxonomy because of the problematic operational definitions and the claim that those who object to the terminology are lying. This concept was originated by Ray Blanchard of Toronto's Clarke Institute in 1989 [6]. The two primary advocates of Blanchard's concept, J. Michael Bailey and Anne Lawrence, have come under fire for controversial statements as well as ethical issues.

Origin of the concept

Blanchard's concept follows observations by earlier sexologists such as Magnus Hirschfeld [7], Harry Benjamin, [8] and Blanchard's collaborator Kurt Freund, who had previously published about two types of cross-gender identity. [9] Freund concluded that gender identity disorder is different for homosexual males and heterosexual males. Blanchard notes that "Freund, perhaps for the first time of any author, employed a term other than 'transvestism' to denote erotic arousal in association with cross-gender fantasy." [10] Blanchard's observations at the Clarke Institute began with four types based on sexual orientation: "homosexual, heterosexual, bisexual, and asexual (i.e., transsexuals attracted to men, women, both, or neither, respectively.[11] He eventually concluded that there are only two types; "homosexual" and everything else "nonhomosexual." [12] [13]

In the 2000 revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), the section on gender identity disorder specifies transvestic fetishism as a related paraphilia. [14] [15] Though advocates of the concept have gotten it mentioned in the DSM, some psychologists object to the pathologizing of gender variance and paraphilia. [16]

Blanchard's categories

According to Blanchard there are only two broad categories of male-to-female transsexual people:


Main article: Autogynephilia

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Wiktionary: autogynephilia

According to the diagnosis, males with autogynephilia are heterosexuals with an extreme variation of transvestic fetishism, or heterosexuality directed to the self. Bailey's 2003 book The Man Who Would Be Queen describes those with autogynephilia as typically masculine boys and very masculine men, often serving in the military or holding typically masculine occupations and married with children (pp. 168-175). [17] Blanchard classified four subtypes:

  • Transvestic autogynephilia: arousal to the act or fantasy of wearing women's clothing
  • Behavioral autogynephilia: arousal to the act or fantasy of doing something regarded as feminine
  • Physiologic autogynephilia: arousal to fantasies of female-specific body functions
  • Anatomic autogynephilia: arousal to the fantasy of having a woman's body, or parts of one [18]

Homosexual transsexuals

Main article: Homosexual transsexual

According to proponents of the taxonomy, homosexual transsexuals were found to be younger when applying for sex reassignment, reported a stronger cross-gender identity in childhood, had a more convincing cross-gender appearance, and functioned psychologically better than nonhomosexual transsexuals. Blanchard found them comparatively shorter, lighter, and lighter in proportion to their height than nonhomosexuals.[19] Psychologist Yolanda Smith concluded that a distinction based sexual orientation appears theoretically and clinically meaningful, and that different factors influence each group's decision to apply for sex reassignment, noting a lower percentage of homosexual transsexuals reported being (or having been) married and sexually aroused while cross-dressing. [20] Other proponents have observed several correlations to homosexual transsexuals, including lower IQ, lower social class, immigrant status, non-intact family, non-Caucasian race, and childhood behavior problems, which are unrelated to gender identity disorder. [21] Bailey states that about 60% of homosexual transsexuals he studied were Latina or black, about three times the rate of ordinary gay men (p. 183). He states that most learn to live on the streets, often resorting to prostitution, shoplifting, or both (p. 184).

Controversy and criticism

The concept had not received much attention outside of sexology until sexologist Anne Lawrence, who self-identifies as an autogynephile, published a series of web articles about the concept in the late 1990s. [22] Lawrence has since published and lectured about the concept and has helped shape autogynephilia as a political identity. [23] The concept received wider attention with the 2003 publication of Bailey's popular psychology book The Man Who Would Be Queen. The book does not cite sources, figures, or statistics to support the assertions made; instead Bailey uses anecdotal evidence to illustrate the concepts. The book contains his casual observations as well as quotations from casual conversations.

At first, Lynn Conway and Andrea James responded to Lawrence's essay. Conway started an investigation into the publication of Bailey's book by the United States National Academy of Sciences. Accusations of all sorts of misconduct on the part of Bailey were leveled. Eventually, Bailey resigned from his position as head of psychology at Northwestern University.

Psychologist Madeline Wyndzen notes several possible scientific concerns with Blanchard's model:

  • Correlational evidence is used to make causal claims. Rather than causing transsexualism, transsexuals may fantasize about being their target sex to compensate for feeling disconnected from their identities.
  • No comparisons are made with control groups of typically-gendered women. Those attracted to their own sex, regardless of if they are transsexual, may pay more attention to themselves as sexual beings.
  • Correlations with sexual orientation are not sufficient to assert that there are two types of transsexual women. The evidence for two types of transsexuals may instead be correlations with sexual orientation that can also be found among non-transsexual.
  • Furthermore, the distributions of sexual orientation among transsexuals do not reveal two categorically distinct groups.

Wyndzen notes that a significant concern raised by the history of this theory may be that it begins by assuming there is something wrong with transsexual people. This may distort what is meant to be scientific account. A scientific theory might begin with the objective question, "What is transsexualism?" Instead, Wyndzen notes that Blanchard asks in his research, "What kind of defect in a male's capacity for sexual learning could produce anatomic autogynephilia, transvestitism, ..." [24]


  1. Carey, Benedict (2005). Straight, Gay or Lying? Bisexuality Revisited. New York Times
  2. Lawrence AA. (1999) Change of sexual orientation in transsexuals. Archives of Sexual Behavior 28(6): 581-583. Lawrence claims "there is no evidence of a true change in sexual orientation" as stated in an earlier paper published in that journal. See Daskalos CT. Changes in the Sexual Orientation of Six Heterosexual Male-to-Female Transsexuals. Archives of Sexual Behavior, Volume 27, Number 6, 1 December 1998, pp. 605-614(10).
  3. Armstrong J (2004). The body within, the body without. The Globe and Mail, 12 June 2004, p. F1.
  4. Blanchard R, Clemmensen LH, Steiner BW (1985). Social desirability response set and systematic distortion in the self-report of adult male gender patients. Archives of Sexual Behavior, 1985 Dec;14(6):505-16.
  5. Freund, Kurt, Blanchard Ray (1993). Erotic target location errors in male gender dysphorics, paedophiles, and fetishists. British Journal of Psychiatry. Apr;162:558-63.
  6. Blanchard, Ray (1989). The Concept of Autogynephilia and the Typology of Male Gender Dysphoria. The Journal of Nervous and Mental Disease, 177 (10), 616–623. Retrieved August 21, 2006.
  7. Hirschfeld M (1923). Die intersexuelle Konstitution. Jarhbuch fuer sexuelle Zwischenstufen. 1923: 3-27
  8. Benjamin H (1966). The Transsexual Phenomenon. The Julian Press ASIN: B0007HXA76
  9. Freund K, Steiner BW, Chan S (1982). Two types of cross-gender identity. Archives of Sexual Behavior, 1982 Feb;11(1):49-63.
  10. Blanchard R (2004). Origins of the concept of autogynephilia via
  11. Blanchard R (1985). Typology of male-to-female transsexualism. Archives of Sexual Behavior. Vol 14(3) Jun 1985, 247-261.
  12. Blanchard R (1988). Nonhomosexual gender dysphoria. Journal of Sex Research. Vol 24 1988, 188-193.
  13. Blanchard R (1989). The classification and labeling of nonhomosexual gender dysphorias. Archives of Sexual Behavior. Vol 18(4) Aug 1989, 315-334.
  14. American Psychiatric Publishing (2000). Diagnostic and Statistical Manual of Mental Disorders. 4th ed (text revision) ISBN 0-89042-025-4
  15. Wyndzen, Madelyn DSM IV, gender identity disorder, and transvestic fetishism. via
  16. Moser C, Kleinplatz PJ (2002). Transvestic fetishism: psychopathology or iatrogenic artifact? New Jersey Psychologist, 52 (2) 16-17.
  17. Bailey JM (2003). The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism. Joseph Henry Press, ISBN 0-309-08418-0
  18. Branchard R (1993). Varieties of autogynephilia and their relationship to gender dysphoria. Archives of Sexual Behavior Volume 22, Number 3 / June, 1993
  19. Blanchard R, Dickey R, Jones CL. Archives of Sexual Behavior 1995 Oct;24(5):543-54.
  20. Smith, Yolanda; van Goozen, Stephanie (15 December), "Transsexual subtypes: Clinical and theoretical significance", Psychiatry Research 137 (3): 151-160, doi:10.1016/j.psychres.2005.01.008, 
  21. Gender-Dysphoric Children and Adolescents: A Comparative Analysis of Demographic Characteristics and Behavioral Problems. Clinical Child Psychology and Psychiatry, Vol. 7, No. 3, 398-411 (2002)
  22. Lawrence AA (1998). "Men Trapped in Men's Bodies:"An Introduction to the Concept of Autogynephilia. originally published at, October 1998. Retrieved August 21, 2006)
  23. Ekins R, King D (2001). Transgendering, Migrating and Love of Oneself as a Woman: A Contribution to a Sociology of Autogynephilia. International Journal of Transgenderism Volume 5, Number 3
  24. Wyndzen MH (2004). A Personal & Scientific look at a Mental Illness Model of transsexualism (PDF) Division 44 Newsletter, v.20(1), 3, American Psychological Association

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