Readers of Galileo’s Middle Finger have been asking me some questions about autogynephilia, particularly since Vanity Fair’s coverage of Caitlyn Jenner. I encouraged one reader who contacted me by Twitter today to send her questions by email, and she was kind enough to do so. Below are answers to her questions.

First, for folks who haven’t read the book, I’ll just mention briefly that autogynephilia is the name sex researcher/psychologist Ray Blanchard coined for a particular type of sexuality he observed clinically among a portion of natal males seeking what are now called gender-affirming interventions (i.e., cross-sex hormone replacement therapy and sex-changing surgeries). The term “autogynephilia” denotes being sexually aroused by the idea of being or becoming a woman. (Auto=self; gyn=female; philia=love of.) I explain in Galileo’s Middle Finger why this idea has been so controversial and in particular what happened to J. Michael Bailey for promoting Blanchard’s ideas in his book, The Man Who Would Be Queen. (You can get a free PDF of Bailey’s book by clicking here. Warning: it is a big download.)

Here are the questions I received today:

1. “To what degree do you think that the trans experience can be divided into the two categories suggested by Blanchard: i.e., are transgender individuals either gay or autogynephilic?”

First, it’s important to point out for those new to this that Blanchard and Bailey were only looking at male-to-female transgender individuals, so we are only talking about transgender women. I also need to explain for novices that Blanchard suggested (and Bailey agreed) that there are two types of male-to-female transgender individuals, the one being autogynephilic and the other what Blanchard called “homosexual transsexuals.” These are natal males who are androphilic, i.e., attracted to males.

As I say in the book, I find Blanchard’s term “homosexual transsexual” confusing, because after transition, these individuals are women having sex with men. Calling them “gay” is even more confusing to me than calling them “homosexual.” If I had my way, we’d talk about androphilic and autogynephilic.

So let’s do that, and answer the reader’s question: To what degree do I think the male-to-female transgender experience can be divided into these two types—androphilic and autogynephilic?

I think it is certainly possible there are other ways you can get to be a transgender woman, but I think what I’ve seen from the scientific clinical literature and socioculturally suggests this division makes sense. I want to emphasize that I think both of these developmental paths are perfectly legitimate ways to become women, and regardless of how someone becomes a woman, if she identifies as such, we owe her the respect of recognizing her identity and addressing her appropriately.

It seems to me unfortunate that sexual phobias have caused many transgender people over the years to feel they must only talk about their genders and never their sexualities. This, I think, has been extremely oppressive and lacking in respect and understanding. My suspicion is that what happens for transgender women is true for almost all of us—namely that gender and sexual orientation are intimately related to each other. (When I’m having sex with my partner, I am doing so as a woman.) So I don’t think it should surprise us that there is an erotic component to gender transition decisions.

I hope that someday we can mature enough as a society to recognize that sexual orientations that are relatively less common don’t need to scare us or cause us to act in ways that are obnoxious. I think there is little evidence that anyone “chooses” his or her sexual orientation. For me, the moral question with regard to sexual orientation only comes into play when we are talking about whether a partner has consented in the way adults are capable of sexual consent. I don’t care if you are turned on by hanging from the ceiling and peeing on your partner from above after you’ve eaten asparagus; if your partner consents, from a moral point of view I’m fine with it.

2. “Do you think autogynephilia might be a part of the female experience, trans or cis? I've seen some (very preliminary) theorizing about it as well as a paper with a tiny sample size that suggest that cis women also experience sexual arousal at the thought of themselves as women.”

I’ve talked with Blanchard, Bailey, and also Anne Lawrence about this, and my impression is they all doubt cis (non-transgender) women experience sexual arousal at the thought of themselves as women. Clinically, Blanchard observed autogynephilic natal male individuals who were aroused, for example, at the ideas of using a tampon for menses or knitting as a woman with other women. I have never heard a natal woman express sexual arousal at such ideas. I’ve never heard of a natal woman masturbating to such thoughts.

That said, I am not convinced that natal women can’t be aroused in autogynephilic ways, particularly in light of the fact that women are subject to so many sexualized images of women as we grow. I think we need to understand this better.

Bailey has said to me that what happens, for example, when a natal woman dresses up in lingerie and becomes aroused is that she’s thinking about the man or woman she is going to be with—which would be androphilic or gynephilic but not autogynephilic. I am not entirely convinced that is what natal women always think about as they become aroused in dressing up for sex, for example. I think we understand remarkably little about female sexualities. (And the feminist in me suspects that the assumption that we are thinking about our partners when we are getting aroused may be a projected male fantasy about us.)

At the end of the day, this is an empirical question—it doesn’t really matter what I think, it matters what the reality is. And right now, we don’t have an answer to it.

3. “Do you think that men, cis or trans, experience autoandrophilia? Would it be called that? Blanchard apparently said that he doesn't think it's a thing.”

Again, this is an empirical question, and right now we don’t have an answer to it. I think it is quite possible. I do find it interesting that some gay men seem to be quite specifically attracted to gay men who have the same body types as them. Such individuals might be good subjects for a study of the possibility of autoandrophilia.

Incidentally, we should note here that some if not most autogynephilic individuals are attracted to other individuals in addition to being aroused by the thought of themselves being or becoming women. So, some are gynephilic (attracted to females) as well as being autogynephilic, and some seem to be bisexual (although there are questions about whether the attraction to males is really a manifestation of autogynephilia). Autoandrophilic individuals might well be aroused by the thought of being men and also be aroused by other males. Again, this is an empirical question that hasn’t been adequately explored, and again I want to emphasize that for most of us, it seems our genders are connected to our sexual orientations.

4. “As someone who pushes hard against the needless pathologizing and medicalization of body variance, do you think sexual arousal at the thought of being a lady constitutes a philia, and should it be classified that way? Is it good science? Is it good advocacy? Is it both or neither?”

Great questions! A “philia” is by definition just a sexual orientation. I think which ones count as pathological is ultimately a social definition. Some have tried to argue that any philia that couldn’t lead to procreation is pathological. You can make that argument, but I think it is a social argument, as is true with so much of disease categorization in medicine, necessarily.

It makes sense to me to maintain a strong legal concept of which behaviors are allowed—again, it’s about consent. But in medicine, we should recognize that which sexual orientations we consider pathological depends a huge amount on cultural beliefs.

I’ve come to believe that sexual orientations are like knees: on close examination, they all look bizarre. Let me give one example: Homosexual people are attracted to people with the same basic genitals as their own. By contrast, heterosexual people are attracted to people with different ones and are often downright phobic about having sex with someone with the same genital type as their own, even though they typically get plenty of pleasure out of their own genitals. This, it seems to me, makes heterosexuality look quite bizarre compared to homosexuality. I’m not saying heterosexuality is weirder than homosexuality—I’m saying they’re all knees to me at this point.

Is sexual arousal at the thought of becoming a woman a philia? Looks like it to me, in the sense that it seems like a real arousal pattern and not changeable. I think the science on this has been pretty good.

Is naming it a philia good advocacy? As I note in the book, I don’t think we can have sustainable social policy that’s based on wrong facts. Therefore advocacy has to look at the facts. To me, there is nothing about Blanchard’s conception of male-to-female transgenderism that needs to get in the way of full advocacy for the rights of all transgender women. I think he feels the same way, given that he’s personally advocated for public funding of gender-affirming interventions for adult transwomen.

Therefore, nothing about Blanchard’s work, so far as I can see, is fundamentally inconsistent with good advocacy for trans rights. Might it require some education of people with regard to getting over their sexual phobias? Yes. But we achieved that with gay and lesbian rights, and I think we can achieve that here, too. Allowing transgender people to openly have sexualities that matter to their genders, it seems to me, is part of giving them full human rights.

Just to be clear: While it is scientifically interesting to think about where sexual orientations come from and what they look like, I think it makes sense, given what we know about gender and how subjective the experience can be, to decide to respect people’s self-identities in terms of gender regardless of how their orientations may have played into how they got there. In other words, while transgender people should be allowed to talk about how their sexualities matter to their gender identities, their self-declarations of gender identity should be all that matter to us in terms of their social gender identities. I have written and fully believe the state should get out of the business of marking who is what gender. (Read more.)

I understand that it is hard for a lot of people to grasp that Bailey and Blanchard are pro-trans rights, but they are both clinical pragmatists who believe medical interventions should be aimed at leaving people better off. There is good evidence (some of it collected by Blanchard) that well-screened, well-treated transwomen are left better off psychologically after transition.

One more thing on this subject: An important part that is often missed about Blanchard’s and Bailey’s work on this subject deals with the fact that not all natal males with autogynephilia need transition to do well, just as not all femme androphiles need transition to do well. Some absolutely do. Some don’t. This is where good therapists who are respectful and don’t behave in knee-jerk, identity-categorizing ways are important. The therapist who thinks that every natal male aroused by cross-dressing is really a transwoman who must transition is as dangerous as the therapist who thinks arousal to cross-dressing is a sick perversion that must be stomped out.

In practice, our sexual orientation identities manifest from a complicated interaction of biology and culture. (Read more.)

5. “I feel as though your take on the Bailey situation had more to do with your interest in academic freedom than your conviction in his research, and I feel that what got lost in the public interpretation is that your opinion on this is probably more complex than the public image surrounding Bailey. So: what do you think?”

When I was publishing my work on Bailey in its first instantiation, I was agnostic on the question of Blanchard’s ideas. As an historian, I was interested in the historical truth, not the science per se. That’s where I put my focus.

But the more the years went on, the more Blanchard’s interpretation of male-to-female transgender made sense to me. I could see, for example, how it explained why sociocultural demographics differed among androphilic and autogynephilic transgender women, and why we are now seeing more androphilic white transgender women and more autogynephilic transgender women of color. I could also understand better why autogynephilia was so stressful for many marriages that began as apparently simple heterosexual marriages.

I also heard from so many transgender women (including old friends) who said Blanchard was spot-on and who said that if you tried to say so as a transgender woman, you’d be subject to the kind of relentless harassment Bailey had been subject to. And then there was the fact that, as I show in my book, at least two of Bailey’s critics had recorded what seemed pretty clearly to be admissions of autogynephilic orientations—that what was at issue was a killing of a messenger, not a wrong or even dangerous message. I do think Bailey has sometimes been unnecessarily obnoxious, as with the cover of his book, and I’ve said so.

I know people try to write me off sometimes as a “terf” – “trans-exclusionary radical feminist.” I don’t think I am. Following MLK, I think we should judge people not by how they were born (skin) but by how they behave towards others (content of character). If someone is in a woman-only space and she is being a jerk, then however she got to be a woman, she should be ejected. If she’s treating other people well, she should be allowed to stay, however she came to be a woman.

Incidentally, maybe it’s just because of the relative numbers of each type, but I have been sexually harassed and mistreated by far more natal women in women-only spaces than by transwomen in women-only spaces. I don’t think natal women should get to say “I was born this way” as an excuse to be jerks, any more than trans women should get to.

To sum up:

Scientifically, I find sexual orientation and gender identity development fascinating. I think research into these subjects must be protected with academic freedom protections.

In terms of clinical care, understanding the development of these aspects of our beings may well be relevant to seeking the successful achievement of patient-centered outcomes. Therefore we need the science, including in terms of how development plays out in terms of well-being if you take one route or another.

But socially, if you tell me you’re a woman, I believe progressivism (which is political)—and in particular a respect for human rights—means you’re fully entitled to join me in the bathroom I usually use. (I say “usually” because I use the men’s when there’s too long a line at the women’s. You’re welcome to join me there, too. The guys are usually quite nice about it if you first seek consent to enter and don’t stare at their penises once you’re in.)

Thanks for these great questions.