Autogynephilia: cure or manage?

Autogynephilia or AGP, ‘a man’s propensity to be aroused by the thought or image of himself as a woman’ is one of the two possible causes of Gender Dysphoria. It is the cause of all non-homosexual Gender Dysphoria in males. It is completely different in nature from Homosexual Gender Dysphoria (HGD), which leads to Homosexual Transsexualism or HSTS. This article only discusses AGP, the men affected by it and possible treatment strategies. None of will apply to HSTS or HGD. I have written this in response to an increasing number of requests on my website and my YouTube channel, in order to try to help.

Autogynephilia can be a massively debilitating condition that may completely disrupt the life of the subject and his family. It can lead to depression, suicidality, alcoholism and a range of other disorders. It frequently results, especially in the Western profile, in loss of career, family, home and in financial ruin. Divorce and estrangement from wife and children are commonplace. People close to the subject are invariably traumatised by an adult transition and there is simply no support for them. There is absolutely no doubt that Autogynephilia is real and devastating.





There is no cure for autogynephilia that I am aware of. A major problem with developing one is that those affected by the condition would have to actually recognise that they had a disorder for any treatment to have a hope of success. But AGPs are habitually in denial, especially in the overt stages of the condition. They go to extreme lengths to deny the very existence of the condition, or that they are subject to it. Worse, they are encouraged in this by ignorant professionals and ‘therapists’ who are not doctors or psychologists and who do not understand the condition.

Transition is much vaunted as a ‘cure’ but that could only be for those who wish to do so; persuading AGPs to follow this path is clearly unethical. Yet I routinely receive communications from men who tell me that they are hectored on to the ‘transition express train’ even by real doctors. There can’t be any justification for such behaviour

The unethical nature of this policy is especially so since we do not know the actual success of transition in AGPs, in therapeutic terms, since the AGP lobby actively tries to block any such research, an aim in which it is succeeding.

In an act of utter cowardice, universities have acquiesced and research has practically stopped now.

Earlier this year, Bath University axed a research project, which had previously been approved, that aimed to establish a reliable baseline for AGP desistance (detransition). The University withdrew its support in case it might ’cause upset’ in the ‘trans community’. Imagine if psychopaths demanded we stop researching psychopathy for fear of hurting their feelings!


There might be an innate propensity towards AGP, which manifests in pre-pubertal autogynephilic arousal. This shows as ‘crushes’ on the self as a girl. Other evidence suggests that events at or around the time of puberty may have triggered the condition. These seem to be associated with very early masturbation and orgasmic experiences.

In other cases, AGPs have reported a strict upbringing wherein masturbation was forcefully opposed as something that only ‘dirty little boys’ did. It would seem simple to conclude that the subject might have got round this opprobrium by imagining himself as a girl, rather than a boy. Others used plush animals and somehow this became connected to the sense of self as a girl. (Exactly how this mechanism works is not clear but it seems to be something like ‘masturbating using a girl’s toy makes me a girl’ — and autogynephilia does the rest.)

In other cases, it is clear that porn was implicated. In the modern context there does seem to be a correlation between exposure to ‘shemale’ porn and AGP; here the porn seems to act like a trigger. Given that this form of porn is still increasing in popularity and if there is a such a correlation, it seems likely that AGP, either overt or covert, should continue to increase too. Again, however, research is next to impossible due to resistance from AGPs.

In one internet narrative, the subject explained that after discovering ‘shemale’ porn, he began to identify with the transwomen portrayed during his masturbation and so came to be aroused by the idea of himself as a transwoman. This then fuelled his transition as he desired to have sex with women, again, as a transwoman. This actually appears to be quite common.

This is certainly not a comprehensive list but just a sample; Dr Anne Lawrence’s ‘Men Trapped in Men’s Bodies’ is a must-read here. These potential triggers and propensities would not be mutually exclusive, of course; one characteristic of AGP is the huge array of variations it has.


With no cure in sight and any attempt to find one being blocked by those it would help most, if you have AGP then your best recourse is to find a way to manage it. Ideally I would suggest psycho-analysis to explore what triggered the disorder, to begin with. Unfortunately, my correspondents tell me that finding such a therapist, who is not fully on board with the ‘transition express train’, can be extremely difficult. Some have even asserted that several therapists, instead of trying to help them manage and control the disorder, instead tried to get them to accept the inevitability of transition.

There is no such inevitability. Countless men have managed AGP throughout their lives, without transitioning.

How can it be managed?

For a person over 25 I would suggest that transition be an absolute last resort; even MtF HSTS, who are vastly more feminine, generally transition before that. This counter-indication just gets more severe, the older the subject. Creating a person who cannot pass successfully as a woman, and then calling that person one, causes as many problems as it might cure.

In terms of treatment, some clinicians report success using testosterone-suppressing drugs; but there are no widespread trials of this therapy. Again, this is because the AGP lobby has completely hijacked the debate and does its best to prevent any research into autogynephilia.



It is possible that orchiectomy (removal of the testes) might help relieve autogynephilic urges. It is likely this element of Genital Reconstruction Surgery (GRS), sometimes called ‘SRS’ or ‘sex change’ that provides some relief from AGP feelings, rather than the removal of the penis — although I would not expect a post-operative AGP to admit to that.

If this were to be carried out, however, it would be imperative to harvest and safely store sufficient samples of sperm to allow the subject to father children, if he later desisted. Once again, we have no real idea of desistance rates, post-surgery.  In addition, orchiectomy can lead to an increase in suicidality and, because AGPs are men, there is a higher risk of successful completion. One acquaintance of mine died in exactly this way, but it is far from rare. Orchiectomy would have to be approached with great care.

Controlling the mental urges

No autogynephilic male, anywhere, is a woman. Therefore, the obsession that he is must be a mental condition. It follows that techniques of mind-training might be useful, especially where the more conventional avenues of assistance have either failed or are a part of the ‘transition express train’.

If you are religious then you might talk to a priest. It’s unlikely that any of the Protestant denominations could help, but priests in the Catholic Church are generally better trained. Alternatively, consider investigating a religion that develops self-control, like Buddhism. Meditation, yoga, T’ai Chi and other methods may also help. All should be tried till one is found that works.

Autogynephilia, Narcissism, Addiction

Autogynephilia, in many ways, behaves exactly like narcotics addiction. Rewarding it releases endorphins which the body will increasingly crave. People who combine narcissistic personalities with addictive ones appear to be particularly prone to completely succumbing to the condition.

In a provocative study, “Narcissism as Addiction to Esteem,” Roy Baumeister and Kathleen Vohs argued that narcissism is, in fact, more like an addiction than a life-long personality trait. They applied the cycle of addiction—cravings, increasing tolerance, and withdrawal—to narcissism and found that, indeed, “craving to feel superior and the indulgence of those cravings may be the defining feature of narcissism,” and narcissists appear to be “constantly on the lookout for new and greater triumphs that bring them greater glory.” Finally, the authors address withdrawal: “When narcissists receive something other than the admiration they crave—indifference, criticism, disrespect—they exhibit considerable distress.”

Psychology Today

These comments ring  true of Autogynephilia and it would therefore seem reasonable that successful methods for treating Addicted Narcissists might also be helpful here.

Craig Malkin, a therapist and author of Rethinking Narcissism (explained)  “When someone has narcissistic personality disorder and a substance abuse problem,” he said, “it’s not enough for them to beat their drug addiction; they also have to beat their addiction to feeling special.”

Psychology Today

Substitute ‘autogynephilia’ for ‘substance abuse’ and again, the statement seems uncannily accurate.

Practical management

In terms of day-to-day management there are two basic approaches: using drug therapy as discussed above to reduce the intensity of the symptoms; and partial satisfaction of the condition to do the same thing.

However,  AGP, as seen above, is a narcissistic personality disorder that shows similarity to addictive disorders. Extreme care must be taken to ensure that any technique of partial satisfaction does not trigger an addictive binge. The subject here is very much like an alcoholic; one drink and he goes on a bender.

Binge and Purge

This explains why so many AGPs ‘binge and purge’. That is, they buy women’s clothing — often extremely sexualised like basques, frilly underwear, stockings — to masturbate with. (If you think that’s extreme. Mike Bailey, in his book ‘The Man Who Would Be Queen’ describes an AGP who used a prosthetic vagina to hide his penis during his sessions — and such items are readily available on-line.)

After building up to an intense peak of autogynephilic arousal and satisfaction, the subject, just as the alcoholic does, dives into a slough of despond, becomes depressed and ‘swears off’. He then gets rid of all his props and promises never to repeat his ways; but after a few weeks the urge gets too great, he steals a pair of panties from his wife and the cycle is kicked off again.

If the addictive response can be controlled, then management may work.

For example, some men wear women’s underwear or a pair of stockings under male work clothes. Others may isolate AGP behaviourally, confining the indulgence to particular times and places. This latter may be in company with other AGPs (Be warned: these can turn into full sex orgies, so make sure you know what you’re getting into, especially if you’re younger and cuter, as a woman.)

Remember that excessive reward of AGP will make it worse, so that it might take over. The idea here is to control and regulate it, not to encourage it. AGP is not, in itself, either immoral or necessarily bad; it is the massive destruction it can cause to the subject’s life, and those of the people around him, that we should be concerned about.

The good news is that many men succeed in this; it’s only in the last few decades that they have been encouraged to succumb to a pernicious, invasive condition, often by so-called professionals. Until then, most AGPs were covert and died keeping their secret, although there were always a few who ‘came out’. We still do not know what the relative proportions of overt/covert AGP are.

Some AGPs engage the services of trans prostitutes. Many such actually advertise their willingness to participate in ‘dressing’ play and to penetrate their partners, something that AGPs, while ‘en femme’ frequently desire.

Finally, partial or complete social transition might work.  In this, the subject ‘dresses’ in public and may even take feminising hormones. The French artist Marcel Duchamp, for example, had a transvestite alter ego he called ‘Rrose Selavy’. However, he was operating in a Bohemian milieu in New York, where artists were expected to do odd things. It might be harder to get away with in a small town.

I cannot stress strongly enough that Genital Reconstruction Surgery, GRS, also called SRS or ‘sex change’ should be avoided. All AGPs are actually heterosexual men with a personality disorder and removing their manhood is a step neither they, nor their advisers, should ever countenance. (This is the very opposite from HSTS, where GRS is a reasonable therapy.)


AGP is NOT like Homosexual transsexualism or HSTS.

HSTS is a function of Sexual Inversion, or, feminine male homosexuality and masculine female homosexuality. These are also called ‘transgender homosexuality’. While the precise cause is not established, there is significant evidence that it is due to abnormalities in hormone delivery in the womb. Where boys don’t get enough testosterone, they are partially feminised and where girls get too much, they are partially masculinised.

In the most complete forms of Sexual Inversion, full transition is usually required, although this is, to some extent, socially conditioned; in many parts of the world, where the idea of a girl having a penis is at least tolerated, most simply transition socially, that is, they grow their hair, dress as woman, take feminising hormones and probably have minor cosmetic surgeries.

Where GRS is desired and indicated, in the case of HSTS, then, if it is carried out at a young age, the subject will usually pass easily in the target gender and have a full life. All they really need is a nice man to love them and a social place that accepts them. (If MtF, opposite for FtM.)

AGP is a disorder, not a variation

AGP is not a natural variation of sexuality and subjects are no more feminine than the average related male. It is a narcissistic mental disorder and even in places where AGPs transition young and can feminise themselves more effectively, they still rarely ‘pass’. The classic middle-aged profile, most common in the West, has absolutely NO CHANCE of passing, in 95% of cases. Their recourse is to bully others into ‘accept’ them as what they are not — women. Some people, and I am one, find this level of coercion unacceptable and I would urge those affected not to indulge in it. It loses you allies.

Management of AGP must provide a method of satisfying the paraphilia sufficiently such that it does not have severe consequences like suicidality, depression, alcoholism and so on, while maintaining an understanding, on the part of the subject, that he is a man and can never be a woman. He must learn to control his impulses and channel his sexual energy, which is at the root of this, in more positive directions. That will be difficult, especially in the ongoing atmosphere of prudishness typical of the US, which it is, sadly and as usual, exporting, alongside the ‘transition express train’.

Adolescent AGP: an exception to the rule.

The one possible exception to this might be adolescent-appearing AGP. This was not discussed by Blanchard in his original research, because then, it was very rare, but it is described in the DSM.

Teenage-transition AGP is more common in areas like southeast Asia, however. Here, AGPs can become strikingly beautiful transwomen, because they begin hormones at 12-16 years old and come from ethnicities where features tend to be naturally softer. But they are dependent on cultural conditions in the area they live, which are too complex to discuss here and, in any case, simply are not present in the West.

Further, in my experience, many such AGPs will desist (detransition) when their looks fade, typically in their mid-to-late 30s. They may then marry and become fathers. (HSTS don’t; if they ‘desist’, it’s a matter of presenting as highly effeminate gay males rather than transwomen. But I know HSTS here who are well into their 50s, going strong and looking good.)

An AGP in this position obviously should not undergo GRS.

Full transition is a mistake for most AGPs.

Finally, AGPs themselves are  told by many, including clinicians, that the best path to take is just to transition. This is a catastrophic mistake for a Western AGP anything much over about 20-25 years old. AGPs are not differentiated morphologically from the broader male population, as HSTS are. Even by 20 they will be noticeably masculinised. They will not slip easily into the social role of a woman.

Transition will cost an AGP everything

An AGP who is married, has a career, children, a house, a car, may look forward to losing ALL OF THAT. The LOT. Although the Western AGP lobby is keen to showcase those instances where women have been loyal enough — or weak enough — to stay with their transitioned husband, this is rare. The price of transition, for most AGPs, is the complete loss of everything they have worked to establish.

To put it bluntly, it’s madness.

Also published on Medium.

5 Replies to “Autogynephilia: cure or manage?”

  1. The devastation caused to families by AGP is unimaginable, even those families which are trying to be understanding.
    Take a look at the case of Debbie Hayden

    Watch Debbie’s wife’s face and reactions when discussing this an tell me she doesn’t exhibit signs of Stockholm syndrome! Only a complete narcissist would do this to somebody they profess to love.

    1. Hi Amanda
      That woman is in shock. I don’t know if you’ve read any of Sam Vaknin’s work on narcissistic personality disorder but it’s chilling. Narcissists really don’t care about the damage they do.

      1. Rod No I haven’t read Vaknin not really something which affected me or those around me personally. I did watch a YT interview the otherday on Benjamin A Boyce’s channel where he interviewed a AGP TS called Robynne M. Complete Narcissist.
        Holy Christ! I had my head in my hands the whole time. No wonder we go stealth if that is what people associate with us.

  2. How does this explain the pubescent boy who fantasizes about sex with other boys? Who enjoys giving oral sex or being penetrated and, is not physically attracted to men.
    He fits the AGP profile except for a few points:
    If he transitioned young, he would have passed because when he had long hair was in fact mistaken for being a girl.
    He liked playing both typical gender games.
    He hated fighting yet was not a sissy.
    He was very empathic to others.
    Who feels if he was born a girl he would have been happier?

    1. Hi J

      That sounds like AGP. IN SE Asia, where AGPs do transition young, they are often remarkably feminine (even if they are six foot!) The tell is really the lack of a homosexual component in your profile. HSTS are always strongly attracted to the same sex; it’s not a matter of ‘being happier as a girl’, they actually are girls (if born male.)

      Having said that. AGP, along with its female counterpart, Autoandrophilia, is on the narcissistic personality disorder spectrum. Narcissists are rarely empathetic, though AGPs may appear to be so, towards women. (But this is a sexual gratification strategy.) If your subject were empathetic towards women and girls but not towards men and boys, I would think that telling.

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