How and why did this change happen?

As the medical procedures available to people wanting to change gender became more sophisticated, research was done by psychologists into the type of people seeking such procedures and what type of individuals were most suitable. It was always recognized that there were different conditions which led to gender dysphoria, and since Harry Benjamin's The Transsexual Phenomenon psychologists have been attempting to classify gender dysphoric patients in different taxonomies.



These psychologists generally understood transsexuality in terms of of the young, effeminate homosexual patients presenting for treatment, and the obviously masculine and heterosexual patients with transvestic fetishism, as not transsexuals but something else. At the time, they didn't have the conceptual understanding of autogynephilia to see why these typically older often married patients might in fact benefit from gender reassignment, and only saw the very apparent benefits to young homosexual patients who could successfully integrate as the opposite gender, so they denied agp transsexuals treatment under their obligation to do no harm.



The problem with this was that it encouraged autogynephilic TSs to lie to their therapists about their history of transvestic fetishism, about their sexuality, about why they appeared so apparently masculine, about how they managed to live as socially, romantically, and professionally successful males for so many decades, and so forth. They would devise elaborate reinterpretations of their history, explanations that were generally implausible but that well intentioned and genuinely sympathetic psychotherapists often accepted. As these AGPs found success in using the system, more of them did so, people who were previously simply transvestites were tempted to transition. The psychological communities perception of transsexuality began to shift as their research population went from being nearly exclusively hsts to having both hsts and agps. The notion of primary and secondary symptomology and agp symptomology was well recognized with a great deal of research but without a proper theoretical understanding of how those conditions behaved.



Ray Blanchard, after clinical research at the Clark institute, gave a research based conceptualization of the two conditions that lead to gender dysphoria and coined the terms homosexual ts and autogynephilic ts to replace primary and secondary with something both more etiologically meaningful and more politically correct. At the time the growing agp based "transgender" community was reacting against the term "secondary" so the new term "autogynephilic" would have seemed a more accurate and less inflammatory label since it had no value judgement suggesting one type was more real then the other and also suggested that both types benefit from gender reassignment.



However by this time the most socially and economically advantaged sector of the transsexual population consisted of autogynephilic transsexuals and they found it psychologically and culturally advantageous to embrace an articulation of autogynephilia in terms of a concept of "gender identity" which maintained that one could have an internalized and hidden feminine "gender" while simultaneously living a seemingly normal social and sexual life as a man. Pragmatically, it was expedient to erase the distinctions between types of transsexuals.



These new narratives were incorporated into the therapeutic process and were eventually acknowleged by the American Psychoanalytic Association in the DSM III when the diagnosis of Gender Identity Disorder replaced Transsexuality. The HBIGA (now WPATH - editor) which sets the standards of care for the medical community dealing with gender reassignment in its two most recent additions acknowledges that the patients lied and psychologists believed them on a very large scale, but instead of this drawing the validity of the current "gender identity" model question, they conclude that the hsts or "true" transsexuals as they were known at the time, must not have existed at all (except among ftms).



So given that the "transgender" community is controlled entirely by autogynephilic transsexuals who have a vested interest in this "gender identity." model and the medical community of surgeons, endocrinologists, and gender therapists, is now tailor built around their needs, both are resistant to any acknowledgement of Blanchard's theory or the acknowledgement of homosexual transsexuality as a separate condition.



If Blanchard.s understanding of autogynaphilia were accepted, it would undermine the "transgendered" communities construction of gender identity which they view as a route to legitimacy and acceptance. If hsts were acknowleged it would be even more damaging because it would reveal inconsistencies in agp personal narratives and the understanding of their own condition. Since their political and social identity is built around the notion that they were always really "female" because they "feel like women on the inside", that hsts who present far more cross gender attributes pre-transition, and are more convincing as women post-transition, do not share their unique psychology, would undermine the credibility of the way they think about their own disorder.



So, many of the most prominent resources, organizations, activists and web page hosts among the AGP centered community have devoted a very aggressive effort to condemning and surpressing Dr.Ray Blanchard's theory. Dr. Anne Lawerance who was previously the most prominent figure among the AGP community caused a controversy when she accepted Blanchard's position and recognized herself as an autogynephilic transsexual. Dr. Michael Bailey's book The Man Who Would be Queen, written primarily about hsts but also describing agps, ignited an even more aggressive controversy in the agp community, to the point that most large sites on transsexuality now have pages and pages of material condemning the book and Bailey. Several individuals who are the most active in organizing agp ts events who run popular websites have even go so far as to go to Chicago to attempt to stir up allegations to get Bailey fired.



