Original Paper

Archives of Sexual Behavior

, Volume 40, Issue 2, pp 247-257

First online:

A Further Assessment of Blanchard’s Typology of Homosexual Versus Non-Homosexual or Autogynephilic Gender Dysphoria

  • Larry NuttbrockAffiliated withNational Development and Research Institutes Email author 
  • , Walter BocktingAffiliated withProgram in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota
  • , Mona MasonAffiliated withNational Development and Research Institutes
  • , Sel HwahngAffiliated withNational Development and Research Institutes
  • , Andrew RosenblumAffiliated withNational Development and Research Institutes
  • , Monica MacriAffiliated withNational Development and Research Institutes
  • , Jeffrey BeckerAffiliated withNational Development and Research Institutes

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In a series of important but now highly controversial articles, Blanchard examined associations of sexual orientation and transvestic fetishism among male-to-female (MTF) transgender persons in Toronto, Canada. Transvestic fetishism was rare among the homosexuals but prevalent among the non-homosexuals. Subtypes of non-homosexual MTFs (heterosexual, bisexual, and asexual) were consistently high with regard to transvestic fetishism. Non-linear associations of a continuous measurement of sexual attraction to women (gynephilia) and transvestic fetishism were interpreted in terms of an etiological hypothesis in which transvestic fetishism interferes with the early development of heterosexuality. Blanchard concluded that homosexual versus non-homosexual sexual orientation is a dominant and etiologically significant axis for evaluating and understanding this population. We further assessed these findings among 571 MTFs from the New York City metropolitan area. Using the Life Chart Interview, multiple measurements of transvestic fetishism were obtained and classified as lifetime, lifecourse persistent, adolescent limited, and adult onset. Large (but not deterministic) differences in lifetime, lifecourse persistent, and adolescent limited transvestic fetishism were found between the homosexuals and non-homosexuals. Contrary to Blanchard, differences in transvestic fetishism were observed across subtypes of the non-homosexuals, and linear (not curvilinear) associations were found along a continuous measurement of gynephilia and transvestic fetishism. Age and ethnicity, in addition to sexual orientation, were found to be statistically significant predictors of transvestic fetishism. The clinical, etiological, and sociopolitical implications of these findings are discussed.


Gender identity disorder Transsexualism Sexual orientation Transvestic fetishism Autogynephilia