Archives of Sexual Behavior

, Volume 40, Issue 2, pp 247–257 | Cite as

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

  • Larry NuttbrockEmail author
  • Walter Bockting
  • Mona Mason
  • Sel Hwahng
  • Andrew Rosenblum
  • Monica Macri
  • Jeffrey Becker
Original Paper


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 



Supported by a grant from the National Institute of Drug Abuse (NIDA) (1 R01 DA018080) (Larry Nuttbrock, Principal Investigator).


  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.Google Scholar
  2. Bailey, J. M. (2003). The man who would be queen: The science of gender-bending and transsexualism. Washington, DC: Joseph Henry Press.Google Scholar
  3. Bem, S. (1993). The lenses of gender: Transforming the debate on sexuality. New Haven: Yale University Press.Google Scholar
  4. Bem, D. (2000). Exotic becomes erotic: Interpreting the biological correlates of sexual orientation. Archives of Sexual Behavior, 29, 531–548.PubMedCrossRefGoogle Scholar
  5. Benjamin, H. (1966). The transsexual phenomenon. New York: Julian Press.Google Scholar
  6. Blanchard, R. (1985a). Typology of male-to-female transsexualism. Archives of Sexual Behavior, 14, 247–261.PubMedCrossRefGoogle Scholar
  7. Blanchard, R. (1985b). Research methods for the typological study of gender disorders in males. In B. W. Steiner (Ed.), Gender dysphoria: Development, research, management (pp. 227–257). New York: Plenum Press.Google Scholar
  8. Blanchard, R. (1988). Nonhomosexual gender dysphoria. Journal of Sex Research, 24, 188–193.CrossRefGoogle Scholar
  9. Blanchard, R. (1989). The concept of autogynephilia and the typology of male gender dysphoria. Journal of Nervous and Mental Disease, 177, 616–623.PubMedCrossRefGoogle Scholar
  10. Blanchard, R. (1991). Clinical observations and systematic studies of autogynephilia. Journal of Sex and Marital Therapy, 17, 235–251.PubMedGoogle Scholar
  11. Blanchard, R. (1992). Nonmonotonic relation of autogynephilia and heterosexual attraction. Journal of Abnormal Psychology, 101, 271–276.PubMedCrossRefGoogle Scholar
  12. Blanchard, R., & Clemmensen, L. H. (1988). A test of the DSM-II-R’s implicit assumption that fetishistic arousal and gender dysphoria are mutually exclusive. Journal of Sex Research, 25, 426–432.CrossRefGoogle Scholar
  13. Blanchard, R., Clemmensen, L. H., & Steiner, B. W. (1985). Social desirability response set and systematic distortion in the self-report of adult male gender patients. Archives of Sexual Behavior, 14, 505–516.PubMedCrossRefGoogle Scholar
  14. Bolin, A. (1998). Transcending and transgendering: Male-to-female transsexuals, dichotomy and diversity. In D. Denny (Ed.), Current concepts in transgender identity (pp. 63–96). New York: Garland.Google Scholar
  15. Bornstein, D. (1994). Gender outlaw: On men, women and the rest of us. New York: Routledge.Google Scholar
  16. Boswell, H. (1998). The transgender paradigm: Shift toward free expression. In D. Denny (Ed.), Current concepts in transgender identity (pp. 56–61). New York: Garland.Google Scholar
  17. Bower, H. (2001). The gender identity disorders in DSM-IV classification: A critical evaluation. Australian and New Zealand Journal of Psychiatry, 35, 1–8.PubMedCrossRefGoogle Scholar
  18. Buhrich, N., & McConaghy, N. (1977). The discrete syndromes of transsexualism. Archives of Sexual Behavior, 6, 483–495.PubMedCrossRefGoogle Scholar
  19. Bullough, B., & Bullough, V. (1997). Are transvestites necessarily heterosexual? Archives of Sexual Behavior, 26, 1–12.PubMedCrossRefGoogle Scholar
  20. Cole, S., Eyler, D., & Samons, S. (2000). Issues of transgender. In L. Szuchman & F. Muscarella (Eds.), Psychological perspectives on human sexuality (pp. 149–168). New York: John Wiley.Google Scholar
  21. Doorn, C. D., Poortinga, J., & Verschoor, A. M. (1994). Cross-gender identity in transvestites and male transsexuals. Archives of Sexual Behavior, 23, 185–201.PubMedCrossRefGoogle Scholar
  22. Dreger, A. D. (2008). The controversy surrounding The Man Who Would be Queen: A case history of the politics of science, identity, and sex in the Internet age. Archives of Sexual Behavior, 37, 366–421.PubMedCrossRefGoogle Scholar
  23. Ellis, H. (1936). Studies in the psychology of sex. New York: Random House.Google Scholar
  24. Freund, K., Steiner, B. W., & Chan, S. (1982). Two types of cross-gender identity. Archives of Sexual Behavior, 11, 47–63.CrossRefGoogle Scholar
  25. Garber, M. (2000). Bisexuality and eroticism in everyday life. New York: Routledge.Google Scholar
  26. Hirschfeld, M. (1910). Die Transvestiten. Berlin, Germany: Alfred Pulver Macher.Google Scholar
  27. Hwahng, S. J., & Nuttbrock, L. (2007). Sex workers, fem queens, and cross-dressers: Differential marginalizations and HIV vulnerabilities among three ethnocultural male-to-female transgender communities in New York City. Sex Research and Social Policy, 4, 36–59.CrossRefGoogle Scholar
  28. Lawrence, A. A. (2008). Societal individualism predicts prevalence of nonhomosexual orientation in male-to-female transsexualism. Archives of Sexual Behavior. doi: 10.1007/s10508-008-9420-3.
  29. Lippa, R. A., & Tan, F. D. (2001). Does culture moderate the relationship between sexual orientation and gender-related personality traits? Cross-Cultural Research, 36, 65–87.CrossRefGoogle Scholar
  30. Lyketsos, C., Nestadt, G., Cwi, J., Heithoff, K., & Eaton, W. W. (1994). The life chart interview: A standardized method to describe the course of psychopathology. International Journal of Methods in Psychiatric Research, 4, 143–155.Google Scholar
  31. Moffitt, T. E. (1993). Adolescent-limited and life-course persistent anti-social behavior: A developmental taxonomy. Psychological Review, 100, 674–701.PubMedCrossRefGoogle Scholar
  32. Nanda, S. (1994). Hijras: An alternate sex and gender role in India. In G. Herdt (Ed.), Third sex, third gender: Beyond sexual dimorphism in culture and history (pp. 373–417). New York: Zone Books.Google Scholar
  33. Nuttbrock, L., Hwahng, S., Bockting, W., Rosenblum, A., Mason, M., Macri, M., et al. (2009). Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. Journal of Sex Research. doi: 10.1080/00224490903062258.
  34. O’Kobe, N., Sato, T., Matsumota, Y., Ido, Y., Terado, S., & Kuroda, S. (2008). Clinical characteristics of patients with gender identity disorders at a Japanese gender identity clinic. Psychiatric Research, 157, 315–318.CrossRefGoogle Scholar
  35. Ovesey, L., & Person, E. S. (1976). Transvestism: A disorder of the sense of self. International Journal of Psychoanalytic Psychotherapy, 5, 219–235.PubMedGoogle Scholar
  36. Pauly, I. (1990). Gender identity disorders: Evaluation and treatment. Journal of Sex Education and Therapy, 12, 2–24.Google Scholar
  37. Prince, V. (1976). Understanding cross dressing. Los Angeles: Argyle Books.Google Scholar
  38. Rossi, A. (Ed.). (1994). Sexuality across the life course. Chicago: University of Chicago Press.Google Scholar
  39. Rothblatt, M. (1994). The apartheid of sex: A manifesto on the freedom of gender. New York: Crown Publishing.Google Scholar
  40. Schachter, S., & Singer, J. E. (1962). Cognitive, social, and physiological determinants of emotional state. Psychological Review, 69, 379–399.PubMedCrossRefGoogle Scholar
  41. Smith, Y. L. S., van Goozen, S. H. M., Kuiper, A. J., & Cohen-Kettenis, P. T. (2005). Transsexual subtypes: Clinical and theoretical significance. Psychiatric Research, 137, 1–16.CrossRefGoogle Scholar
  42. Tsoi, W. F. (1988). The prevalence of transsexualism in Singapore. Acta Psychiatrica Scandinavica, 78, 501–504.PubMedCrossRefGoogle Scholar
  43. Whitlock, K. (1996). The transgender outlook. San Francisco: Author.Google Scholar
  44. Wise, T. M., & Meyer, J. K. (1980). The border between transvestism and gender dysphoria: Transvestic applicants for sex reassignment. Archives of Sexual Behavior, 9, 327–342.PubMedCrossRefGoogle Scholar
  45. Wolchik, S. A., Beggs, B. E., Wincze, U. P., Sakheim, K. D., Barlow, D. H., & Mavissakalian, M. (1980). The effect of emotional arousal on subsequent sexual arousal in men. Journal of Abnormal Psychology, 38, 595–598.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Larry Nuttbrock
    • 1
    Email author
  • Walter Bockting
    • 2
  • Mona Mason
    • 1
  • Sel Hwahng
    • 1
  • Andrew Rosenblum
    • 1
  • Monica Macri
    • 1
  • Jeffrey Becker
    • 1
  1. 1.National Development and Research InstitutesNew YorkUSA
  2. 2.Program in Human Sexuality, Department of Family Medicine and Community HealthUniversity of MinnesotaMinneapolisUSA

Personalised recommendations