Transvestic fetishism, also called "autogynephilia" for a while by Blanchard, Bailey and Lawrence (BBL): Are these labels or stigmata?

[A sub-page of the TS informational page, by Lynn Conway]

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Some intensely transvestic males become troubled by feelings of addiction to cross-dressing and masturbation and seek help from counselors to contain this addiction. This group has long been labeled by psychiatrists (in their DSM manual) as suffering from a "mental illness" called "transvestic fetishism". There is no known cause for this condition - nor any cure either, other than helping the person stop worrying so darn much about it and just accept it and have fun doing it.
Sadly, this psychiatric label has a very negative image and has the iatrogenic effect of intensifying guilt and shame in the very people who go to psychiatrists for help. The practice of defamatory labeling by psychiatrists thus causes much of the unnecessary pain felt by crossdressers about their condition (and also insures a steady income stream for those psychiatrists). The situation got even worse for a few years (from about 2000-2004), during which a clique of sexologists tried to pin a variant of that old stigmatizing label onto almost all transsexual women too.
Here's how it happened: 
During the 1980's, Ray Blanchard of The Clarke Institute in Canada (now CAMH) coined the new word "autogynephilia" for transvestic fetishism, explaining it as the condition of "becoming aroused into masturbation by seeing or fantasizing oneself as a woman".  He declared this to be a "sexual paraphilia" (i.e., a "perversion") on a par with pedophilia and bestiality, and began talking about this invented word as if it amounted to a major scientific discovery.  He then set out to "scientifically prove" that masturbation while thinking of oneself as a woman was a basic cause of transsexualism, and in the process denied the existence of cross-gender identities.
Under Canada's medical system, most Canadian transgender people had to go through Blanchard's clinic in order to get medical help. Under his regime, transgender clients were grilled incessantly about their self-pleasuring habits, having no idea they were being exploited as research subjects to prove Blanchard's theory (perhaps Blanchard believed the myth that "masturbation makes you crazy"?).  Any report of masturbation while "thinking of oneself as a woman" was considered firm evidence of "autogynephilia", even if the person wasn't masturbating in a male way and was instead thinking of herself as a woman because she simply saw herself as one. As we know, almost everyone masturbates from time to time, including natal women and transsexual women.  Thus as time went by Blanchard diagnosed "autogynephilia" in most of his transsexual clients. 
Sadly for Blanchard, his theory went nowhere and by the mid-90's was a mere historical curiosity outside The Clarke.  Transvestic fetishists continued to pass through various gender clinics but few were approved for SRS except after diagnosis at the Clarke. After all, most fetishistic men have the common sense to know that castration isn't going to enhance their male type of sexuality.  Furthermore, fetishistic men who've undergone SRS were often reported to become unhinged afterwards - as in cases such as Gregory/Gloria Hemingway (see also Lynn's SRS Warning Page).
[Even so, some clinics such as the Clarke continue to specialize in cases of older non-GID fetishists such as Gregory/Gloria and approve some for SRS. It can be hard on gender dysphorics who join such groups. Thinking at first that these other patients are trans women, GID sufferers can get a shockingly false impression of what their own future might be like. The mantra of counselors in such clinics is that transsexuals are mentally ill men, and that gender transition will ruin your life. If a counselor uses these words, find another counselor! Find someone who helps transitioners make good decisions and prepare for a good outcome instead of a bad one. ]
Then, during the mid-1990's, an obscure psychology professor at Northwestern University named J. Michael Bailey became infatuated with Blanchard's old theory (perhaps being in awe of Blanchard, then a political power-figure in sexology circles). Bailey had been studying gay men, but knew nothing about transsexual women. In order to gain an aura of credibility as doing research on transsexualism, Bailey interviewed a tiny handful of transsexual research subjects. He attracted these pre-op women to meet with him by offering to write SRS approval letters for them. He then began interacting with Blanchard to re-promote Blanchard's old theory. 
Around 1999, Anne Lawrence, M.D. also became enamored of Blanchard's theory.  A recently transitioned (non-GID) fetishist who maintained a well-known transsexual women's medical support website, Lawrence began describing her experience as being a "man trapped in a man's body" who wanted to sexually enjoy "himself" by becoming a man in a woman's body. Widely proclaiming herself an autogynephile, Lawrence promoted Blanchard's theory on her website and began accusing almost all other trans women of either being autogynephiles or of lying about it.
It wasn't long before Blanchard, Bailey and Lawrence (BBL) joined forces, intent on turning Blanchard's theory into a scientific fact by constant assertion - perhaps with scientific fame as their goal. By sheer force of personality and a lot of bullying, they managed to get a stranglehold on theoretical transsexualism in sexology circles during the 1999-2003 time-frame, resurrecting Blanchard's theory by all means possible. No one dared to stand up to them, so to them it must have seemed as if their theory was "gaining acceptance".  Along the way Bailey got himself promoted to Chairman of Northwestern's psychology department, very likely with Blanchard's strong recommendation.

Gaining confidence from these successes, BBL went public in a big way in early 2003 by getting their theory published by the prestigious National Academy Press in a book by Bailey. Under the highly stigmatizing title The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism, the book included gonzo cover art of a very masculine man's hairy, gnarly legs in high heels.  Incredibly, Blanchard's theory was asserted in the book as if it were a scientific fact. There was no mention of the much more recent research indicating the existence of biologically gendered identities. The stage was thus set for a huge controversy between the BBL clique and almost the entire trans community.

This became a defining moment for the transsexual community.  Upon reading the many transphobic statements in the book, trans people all around the world organized by means of the internet to investigate, critique and counter the ideas that BBL were propagating.  Upon investigation, a mass of evidence was uncovered indicating that Bailey had not conducted his research and publication work in conformity with accepted norms and ethical guidelines for scientific research. 

Numerous complaints were then filed by Bailey's research subjects with Northwestern University with the help of volunteer trans investigators.  Bailey was accused of not informing his subjects that they were research subjects, of publishing details of their confidential case histories in his book without permission, of seducing a grateful research subject (for whom he'd written a letter of approval for SRS) into having sex with him following her surgery, and other similarly major misconduct. 

As a result, Northwestern opened a formal investigation into Bailey's ethical conduct and research methods. In the process, HBIGDA (the international professional organization of researchers and clinicians who set the standards of care for transsexual people) wrote an open letter to Northwestern denouncing Bailey's book for its very damaging impact on relations between sex-researchers and the trans community.  Stunned by HBIGDA's rebuff of his protégé (and by implication of his theory), Blanchard resigned from HBIGDA in a huff, rather than face having many members turn their backs on him. 

The prestigious Southern Poverty Law Center then denounced Bailey's book as "Queer Science", in a special investigative report on violence against trans women. Blanchard's theory and early research papers were then deconstructed and shown to be fatally flawed by Madeline H. Wyndzen, Ph.D., in an extensive analysis published on the internet.  Investigations then revealed that Lawrence had earlier been forced to resign her position as an anesthesiologist under the cloud of an investigation into moral turpitude. Finally, as a result of Northwestern's secretive internal investigation, Bailey was forced to resign his intellectual leadership position as Chairman of the Psychology Department in the fall of 2004.  Stepping back down into a regular faculty position, Bailey was silent about what had happened. His and Northwestern's silence spoke volumes for the disgrace that he'd brought upon himself.

For more about the Blanchard's theory, Bailey's book and the subsequent decline and fall of Bailey, Blanchard and Lawrence - see Andrea James' BBL Clearinghouse, Lynn Conway's Investigative report on Bailey's book and Joan Roughgarden's essay "Psychology Perverted".  Scholars, ethicists and historians of science will find further detailed documentation of this scientific fiasco in the online timeline of events and links to evidence.

Unfortunately, this was only the latest in a long series of rogue theories of transsexualism by psychiatrists, academics and sexologists.  In the future, instead of inventing highly stigmatizing labels for transsexual women and incessantly arguing amongst themselves about the meanings of those labels, sexologists should do something more productive:  They should conduct real-world follow-ups of actual gender transitions, and help us learn which factors lead to positive transition outcomes and which do not.

Meantime when you hear the word "autogynephilia", translate it back into "transvestic fetishism".  Then ask yourself:  Did that term have any real meaning either?  Or was it also merely a stigmata parading as a scientific label?   For more enlightenment about invented words that define non-existing phenomena to be "mental illnesses", you might also read about the the non-existence of "nymphomania" and its parallels with the non-existence of "autogynephilia":


Nymphomania and Autogynephilia:

The Invention of Mental Illnesses by Psychiatrists

For a further critique of the whole issue of "labelling", return to the TS information page and see the section "Getting beyond labels". > TS Information > Transvestic Fetishism and Autogynephilia: Labels or Stigmata?