Blanchard's Transsexualism Typology - Scientific Criticism of The Theory

Scientific Criticism of The Theory

In "Autogynephilia in Women" (2009), Charles Moser applies an analogue of Blanchard's autogynephilia criteria for "non-homosexual" transsexual people to natal (anatomically from birth) women. 93% were classified as autogynephiles. Even using a much more rigorous standard, 28% still fit the classification. Moser concludes that since "autogynephilia" may be found in many natal women, and that it is not obviously a paraphilia but might instead be a manifestation of normal female sexuality no more prevalent among MtF transsexual people than it is within the general female population, the theory raises questions that require further study. Lawrence criticized Moser (2009) for not accurately representing Blanchard's autogynephilia questionnaire. Moser, in turn, defended his questions and accused Lawrence of making inaccurate comparisons.

Veale, Clarke, and Lomax (2008) did a similar, but larger scale test of Blanchard's theories, with a different set of equivalent autogynephilia questions than Moser. Veale found that while both autogynephilic and non-autogynephilic transsexual people averaged higher rates of autogynephilia than natal women in the study, they also showed a stronger incidence of childhood female gender identity (essentially identical for both autogynephilic and non-autogynephilic transsexual people). 52% of biological female subjects scored a six or higher on the Core Autogynephilia scale and 3 or greater on the Autogynephilia Interpersonal Fantasy scale, compared to Blanchard's mean of 6.1 and 2.7 for "autogynephilic" non-homosexual transsexual people. In stark contrast to Blanchard's data, Veale found no difference between autogynephilic and non-autogynephilic MtF transsexual people in terms of sexual orientation; 68% of those classified as non-autogynephilic scored the highest possible score on the Sexual Attraction to Females scale. Veale's conclusion is that while Blanchard's categorization of two groups of transsexual people may have merit in some cases, it does not completely represent the diversity among MtFs. Dr. Anne Lawrence (2013) describes the methodological limitations of both the Veale et al (2008) and the Moser (2009) studies, and states that in her opinion it remains to be demonstrated that autogynephilia occurs in natal women.

Nuttbrock et al. (2010) attempted to reproduce Blanchard's studies from Toronto in the 1980s in modern times with 571 MtF transsexual people from New York City. For the study, autogynephilia is assumed to be equivalent to transvestic fetishism. The study did confirm Blanchard's findings of three times higher rates of transvestic fetishism among non-homosexuals versus homosexuals, but the correlation was too weak to be considered deterministic. Blanchard (1992)'s finding of the highest level of transvestic fetishism being found with an intermediary level of gynephilia could not be reproduced. Age and ethnicity were found to be correlated with sexual orientation. Being caucasian was found to correlate with transvestism. Transvestism results overall are significantly lower than Blanchard's, prompting the hypothesis that transvestic fetishism is a historically fading phenomenon. Nuttbrock concludes that, "These limitations notwithstanding, we nonetheless conclude that a classification of the MtF population, based solely on sexual orientation, is fundamentally limited."

Moser (2010) conducts a wide-ranging review of the literature on the subject as a critique of Blanchard's theory over a range of issues. His claims include:

• Blanchard's use of "ever" to define autogynephilia, including those who have only had a few incidents of arousal long ago, is akin to classifying someone as homosexual for ever having been aroused by a member of the same sex in their life.
• Blanchard (1989)'s claim of clinical importance for autogynephilia because "it interferes with normal interpersonal sexual attraction" is contradicted by his own work in Blanchard, Clemmensen, & Steiner (1987). "Autogynephilias as an orientation" (Blanchard 1993) is criticized in that autogynephilic MtFs interest in transitioning does not overshadow interest in courtship, love, and cohabitation with a partner of the preferred sex, with most reporting stable partnered relationships after SRS (Lawrence, 2005). No cases were found in the literature of differences between the gender dysphoria of homosexual and non-homosexual MtFs, or response to anti-androgens, or the clinical utility of distinguishing the two. Data on rates of regret for both groups of transsexual people is contradictory, and is low in either regard (Lawrence (2003) and Olsson & Moller (2006)).
• Blanchard's statement, "All gender dysphoric biological males who are not homosexual ... are instead autogynephilic ..." is contrary to Blanchard's own data; examples include Blanchard (1993), Blanchard (1985), Bentler (1976), Leavitt and Berger (1990), Lawrence (2005), and others.
• Lawrence (2005, 2006)'s claim that self-identified homosexual transsexual people are misrepresenting themselves (evidenced by a history of marriage to a woman) ignores that 20% of self-identified "white homosexual men" have a history of marriage to a woman, 14% had heterosexual coitus in the last year, and 52% in their lifetime (Bell & Weinberg, 1978). The claim that MtFs deny their autogynephilia to win favorable SRS recommendations is contradicted by the fact that Blanchard's clinic did not discriminate between the two types, and in some cases autogynephilia could lead to a more favorable diagnosis.
• Blanchard et al.'s reliance on phallometry is noted to be controversial, as per APA (2000) and Marshal & Fernandez (2000). Blanchard, Racansky, & Steiner (1986) is criticized for studying cross-dressers but attributing the results to transsexual people, for omitting any chance for the subject to test positive for a lesbian identity, and for offhand dismissing results that contradict the theory. Moser notes that Blanchard, Lynkins, et al. (2009) interprets results in the opposite manner.
• The treatment of autogynephilia as a paraphilia is criticized for failing to match with sex drive. That is, paraphilias are rare in natal women (autogynephilia was found in women in Veale et al. (2008) and Moser (2009)); decline with age (non-homosexual MtF transsexualism does not); and should correspond with a decreased interest in transition and discomfort under the presence of anti-androgens. This is often the case with transvestites, but non-homosexual transsexual people generally report unabated interest and a feeling of relief from the anti-androgens, even without estrogens. "Autoandrophobia" is suggested as an alternative explanation.
• While Blanchard (1991) claims that "autogynephilia ... is the main correlate of transsexual tendencies and also of diminished capacities for heterosexual relationships and pair-bond formation", Lawrence (2005) found that 83% of MtFs interested in female partners before and after SRS were in a stable, partnered relationship versus 36% of those interested in males. Lawrence (2005)'s claims of transsexual people having trouble finding partners after SRS is criticized for using an older age range than the national baseline she compares to, as age is inversely correlated with sexual partners. Using a similar age range, the rate of sexual partners is similar. Contrary to Blanchard (1989a, 1991)'s claims that male partners of "non-homosexual" transsexual people are "faceless" and not "desirable partners in their own right", Lawrence (2005) shows 71% in stable partnered relationships post-SRS versus 64% for "homosexual" transsexual people, with an average number of post-SRS male partners of 2.8 versus 8.4, respectively.
• Bailey (2003)'s claims that "homosexual transsexuals" are extremely feminine gay men, and Lawrence (2004)'s claims that homosexual MtFs transition because it "seems obvious" for "greater social and romantic satisfaction and success" are criticized for lacking in supporting data and for the notion of amputation of one's genitals being an "obvious" route to sexual success.

Veale, Lomax, and Clarke (2010) proposed an alternative theory called the identity-defense theory to explain the sexuality development of transsexual people and other persons with gender-variant identities. This theory proposes that different personality and environment factors influence whether a person will initially suppress their gender-variant identity. This will lead to persons with gender-variant identities having experiences similar to those proposed by Blanchard in his typology. Veale et al. (2010) proposed that the differences in sexuality development are related to the differences in early experience using Daryl Bem's exotic becomes erotic theory.