American Psychological Association
Division 44 Newsletter Spring, 2004
A Personal & Scientific look at a
Mental Illness Model of Transgenderism
Madeline H. Wyndzen, Ph. D. (pen name)
Editor’s Note: Ms. Wyndzen originally submitted a brief letter to the editor in response to a recent book review of The Man Who Would Be Queen in this Newsletter. I invited her to expand on that letter here.
If a man sought therapy due to unhappiness over his attraction to other men, a therapist would likely diagnose him with Depression. If a transsexual sought therapy due to unhappiness over his or her biological sex, a therapist would almost certainly diagnose him or her with Gender Identity Disorder. Whereas gay men and lesbian women are diagnosed for how they suffer, transsexuals are diagnosed for who they are. As a psychologist and transsexual, I find that the mental illness label imposed on transsexuality is just as disquieting as the label that used to be imposed on homosexuality.
Similar to antiquated ideas suggesting that homosexuality is a deviant sex-drive, Ray Blanchard (1989, 1991) proposed that transsexuality is a mis-directed form of either heterosexuality (named “autogynephilia”) or homosexuality. Rather than asking the scientifically neutral question, “What is transgenderism?” Blanchard (1991) asks, "What kind of defect in a male's capacity for sexual learning could produce … autogynephilia, transvestitism …?" (p. 246).
Blanchard’s model is featured prominently and uncritically in J. Michael Bailey’s (2003a) recent book, The Man who would be Queen: the Science of Gender-Bending and Transsexualism. A balanced portrait of Blanchard’s key empirical findings (1989) would reveal that they: (1) have never been replicated, (2) failed to include control groups of typically-gendered women, (3) failed to covary the acknowledged age-differences from ANOVA, and (4) drew conclusions about causality from entirely observational data.
Inconsistencies between transsexuals’ self-portraits and Blanchard’s model are reconciled by Bailey (2003a) with the suggestion that some transsexuals are deceptive: “There is one more reason why many autogynephiles provide misleading information about themselves that is different than outright lying. It has to do with obsession” (p. 175). Aware of concerns that some may be troubled by his portrayal of them, Bailey has said, “I cannot be a slave to sensitivity” (quoted in Wilson, 2003), and “ There is good scientific evidence that says you should believe me and not them” (quoted in Dreier & Anderson, 2003). In a critique of Bailey’s book available on my website, I provide alternate interpretations of this evidence:
Bailey (2003b) contends that negative reactions to his book are merely “identity politics” that are a "hindrance" to "scientific truth" (Bailey, 2003b). Contrasting his objectivity with others’ politics reminded me of “81 Words,” a radio documentary about the removal of homosexuality from the DSM (Spiegel, 2002). Those who diagnosed ‘homosexuality’ as a mental illness genuinely felt that they were helping their clients. I know that Ray Blanchard, J. Michael Bailey, and others are similarly concerned about the welfare of transsexuals. I only wish they would see the bias in their theories and diagnoses. When I listened to “81 Words,” I was struck by how foreign it sounded to talk about being gay or lesbian as a disorder. I am too young to remember that time. My hope is that someday my children will think it just as unfathomable that I was once diagnosed and treated for “Gender Identity Disorder.”
Bailey, J. M. (2003a). The Man who would be queen: the science of genderbending
and transsexualism. Joseph Henry Press, Washington DC.
Bailey, J. M. (2003b, July 19). Identity politics as a hindrance to scientific truth,
presented at the conference of the International Academy of Sex Research.
Abstract retrieved July 16, 2003, from
Blanchard, R. (1989). The Concept of Autogynephilia and the Typology of Male
Gender Dysphoria. The Journal of Nervous and Mental Disease, 177(10),
Blanchard, R. (1991). Clinical Observations and systematic studies of
autogynephilia. Journal of Sex and Marital Therapy, 17(4), 235-251.
Dreier, S. and Anderson, K. (2003, April 21). Prof’s book challenges opinions of
human sexuality. The Daily Northwestern, retrieved December 31, 2003,
Spiegel, A. (2002, January 18). 81 words. This American Life, retrieved January
18, 2002 from http://www.thislife.org/pages/descriptions/02/204.html
Wilson, R. (2003, June 20). Dr. Sex’: A human-sexuality expert creates
controversy with a new book on gay men and transsexuals. Chronicle of
Higher Education, retrieved June 27, 2003, from