This report suggests systematic strategies for the descriptive classification of nonhomosexual gender identity disorders, based on clinical observations and research findings. The classification of biological males is considered first. A review of cross-gender taxonomies shows that previous observers have identified and labeled a homosexual type far more consistently than any other category of male gender dysphoric. It is suggested that the apparent difficulty in differentiating reliably among the nonhomosexual types results from the sharing of many overlapping characteristics by the various groups. This is supported by a review of informal, mostly clinical, observations and by the findings of three studies designed to test the hypothesis that the nonhomosexual gender dysphorias, together with transvestism, constitute a family of related disorders in men. It is concluded that the main varieties of nonhomosexual gender dysphoria are more similar to each other than any of them is to the homosexual type. Two recommendations, based on the foregoing review, are offered for the classification of male gender dysphorics in research studies. When the number of subjects is small, they may be classified simply as homosexual or nonhomosexual. When the number is larger, the nonhomosexual cases may be classified as heterosexual, bisexual, or analloerotic (unattracted to male or female partners, but not necessarily devoid of sexual drive or activities).
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
American Psychiatric Association. (1980).Diagnostic and Statistical Manual of Mental Disorders 3rd ed. APA, Washington, DC.
American Psychiatric Association. (1987).Diagnostic and Statistical Manual of Mental Disorders 3rd ed., rev., APA, Washington, DC.
Benjamin, H. (1966).The Transsexual Phenomenon Julian, New York.
Benjamin, H. (1967). Transvestism and transsexualism in the male and female.J. Sex Res. 3: 107–127.
Bentler, P. M. (1976). A typology of transsexualism: Gender identity theory and data.Arch. Sex. Behav. 5: 567–584.
Blanchard, R. (1985). Typology of male-to-female transsexualism.Arch. Sex. Behav. 14: 247–261.
Blanchard, R. (1988). Nonhomosexual gender dysphoria.J. Sex Res. 24: 188–193.
Blanchard, R. (in press). The concept of autogynephilia and the typology of male gender dysphoria.J. Nerv. Ment. Dis.
Blanchard, R., Clemmensen, L. H., and Steiner, B. W. (1985a). Social desirability response set and systematic distortion in the self-report of adult male gender patients.Arch. Sex. Behav. 14: 505–516.
Blanchard, R., Steiner, B. W., and Clemmensen, L. H. (1985b). Gender dysphoria, gender reorientation, and the clinical management of transsexualism.J. Consult. Clin. Psychol. 53: 295–304.
Blanchard, R., Racansky, I. G., and Steiner, B. W. (1986). Phallometric detection of fetishistic arousal in heterosexual male cross-dressers.J. Sex. Res. 22: 452–462.
Blanchard, R., Clemmensen, L. H., and Steiner, B. W. (1987a). Heterosexual and homosexual gender dysphoria.Arch. Sex. Behav. 16: 139–152.
Blanchard, R., Legault, S., and Lindsay, W. R. N. (1987b). Vaginoplasty outcome in male-to-female transsexuals.J. Sex Marital Ther. 13: 265–275.
Blanchard, R., Steiner, B. W., Clemmensen, L. H., and Dickey, R. (1989). Prediction of regrets in postoperative transsexuals.Can. J. Psychiat. 34: 43–45.
Buhrich, N., and McConaghy, N. (1978). Two clinically discrete syndromes of transsexualism.Br. J. Psychiat. 133: 73–76.
Coates, S., and Zucker, K. J. (1988). Gender identity disorders in children. In Kestenbaum, C. J., and Williams, D. T. (eds.),Handbook of Clinical Assessment of Children and Adolescents, Vol. 2, New York University Press, New York.
Coleman, E., and Bockting, W. (1988). “Heterosexual” prior to sex reassignment—“homosexual” afterwards: A case study of a female-to-male transsexual.J. Psychol. Hum. Sex. 1: 69–82.
Coleman, E., Bockting, W., and Gooren, L. (1988). Homosexual and bisexual identity development in female-to-male transsexuals. Paper presented at the meeting of the International Academy of Sex Research, Minneapolis.
Eber, M. (1982). Primary transsexualism: A critique of a theory.Bull. Menninger Clin. 46: 168–182.
Freund, K. (1974). Male homosexuality: An analysis of the pattern. In Loraine, J. A. (ed.),Understanding Homosexuality: Its Biological and Psychological Bases Medical and Technical Publishing, Lancaster, England.
Freund, K. (1985). Cross-gender identity in a broader context. In Steiner, B. W. (ed.),Gender Dysphoria: Development, Research, Management Plenum Press, New York.
Freund, K., Steiner, B. W., and Chan, S. (1982). Two types of cross-gender identity.Arch. Sex. Behav. 11: 49–63.
Hamburger, C. (1953). The desire for change of sex as shown by personal letters from 465 men and women.Acta Endocrinol. 14: 361–375.
Hirschfeld, M. (1906). Vom Wesen der Liebe [The essence of love].Jahrb. Sex. Zwischenstufen 8: 1–284.
Hirschfeld, M. (1910).Die Transvestiten [Transvestites], 1st ed., Alfred Pulvermacher, Berlin.
Hirschfeld, M. (1918)Sexualpathologie [Sexual Pathology], Vol. 2, Marcus & Weber, Bonn.
Hirschfeld, M. (1925).Die Transvestiten [Transvestites], 2nd ed., Ferdinand Spohr, Leipzig.
Hirschfeld, M. (1948).Sexual Anomalies Emerson Books, New York.
Hoenig, J., and Kenna, J. C. (1974). The nosological position of transsexualism.Arch. Sex. Behav. 3: 273–287.
Laub, D. R., and Fisk, N. (1974). A rehabilitation program for gender dysphoria syndrome by surgical sex change.Plast. Reconstr. Surg. 53: 388–403.
Levine, S. B., and Lothstein, L. (1981). Transsexualism or the gender dysphoria syndromes.J. Sex Marital Ther. 7: 85–113.
Lothstein, L. M. (1983).Female-to-Male Transsexualism: Historical, Clinical and Theoretical Issues Routledge & Kegan Paul, Boston.
Lothstein, L. M. (1985). Maternal issues in female-to-male transsexuals who have delivered and reared their children. Paper presented at the meeting of the American Psychological Association, Los Angeles.
Lukianowicz, N. (1959). Survey of various aspects of transvestism in the light of our present knowledge.J. Nerv. Ment. Dis. 128: 36–64.
Meyer, J. K. (1974). Clinical variants among applicants for sex reassignment.Arch. Sex. Behav. 3: 527–558.
Meyer, J. K. (1982). The theory of gender identity disorders.J. Am. Psychoanal. Assoc. 30: 381–418.
Money, J., and Gaskin, R. J. (1970–1971). Sex reassignment.Int. J. Psychiat. 9: 249–269.
Newman, L. E., and Stoller, R. J. (1974). Nontranssexual men who seek sex reassignment.Am. J. Psychiat. 131: 437–441.
Pauly, I. B. (1974). Female transsexualism: Part I.Arch. Sex. Behav. 3: 487–507.
Person, E., and Ovesey, L. (1974a). The transsexual syndrome in males. I. Primary transsexualism.Am. J. Psychother. 28: 4–20.
Person, E., and Ovesey, L. (1974b). The transsexual syndrome in males. II. Secondary transsexualism.Am. J. Psychother. 28: 174–193.
Person, E., and Ovesey, L. (1978). Transvestism: New perspectives.J. Am. Acad. Psychoanal. 6: 301–323.
Person, E., and Ovesey, L. (1983). Psychoanalytic theories of gender identity.J. Am. Acad. Psychoanal. 11: 203–226.
Randall, J. B. (1959). Transvestism and trans-sexualism: A study of 50 cases.Br. Med. J. 2: 1448–1452.
Rohleder, H. (1901).Vorlesungen über Geschlechtstrieb und Geschlechtsleben des Menschen [Lectures on the Sexual Drive and Sexual Life of Man], Fischers medizinische Buchhandlung, Berlin.
Stoller, R. J. (1968).Sex and Gender. Hogarth, London.
Stoller, R. J. (1975).The Transsexual Experiment. Hogarth, London.
Stoller, R. J. (1980). Gender identity disorders. In Kaplan, H. I., Freedman, A. M., and Sadock, B. J. (eds.),Comprehensive Textbook of Psychiatry,, Williams & Wilkins, Baltimore.
Stoller, R. J. (1982). Near miss: “Sex change” treatment and its evaluation. In Zales, M. R. (ed.),Eating, Sleeping, and Sexuality Brunner/Mazel, New York.
Wålinder, J. (1967).Transsexualism: A Study of Forty-Three Cases Scandinavian University Books, Gothenburg, Sweden.
Webster's Third New International Dictionary. (1981). G. & C. Merriam, Springfield, MA.
Rights and permissions
About this article
Cite this article
Blanchard, R. The classification and labeling of nonhomosexual gender dysphorias. Arch Sex Behav 18, 315–334 (1989). https://doi.org/10.1007/BF01541951
- gender dysphoria
- gender identity