Originally posted 2017-09-10 12:28:09.
In 2009 Dr Charles Moser entered the discussion about Blanchard’s Typology of transsexualism. It is worth revisiting Moser because his mischievous intervention not only hindered the progress of the science of transsexualism, but damaged some people, while favouring others.
As you may know, Blanchard separates male-to-feminine (MtF) transsexuals into those attracted to their own sex from their earliest arousal, and those who are either not attracted to their own birth sex or who develop such an attraction, usually partially, in later life. These are called, using Blanchard’s terminology, ‘HomoSexual Transsexuals’ or HSTS and ‘Autogynephilic Transsexuals’ or AGPs. (We will later quote studies that call the latter ‘non-homosexual’.)
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Blanchard’s underlying thesis is that both these forms of transsexualism are stimulated by male sex drive. MtF HSTS are, essentially, seen as extremely feminine homosexual males. This is relatively easy to understand and this type was formerly known as the ‘Primary’ or ‘True’ type. The other type is much more complex and shares an aetiology with fetishistic cross-dressing men. These individuals are romantically or sexually attracted to themselves, but as women.
Blanchard’s Typology.
Blanchard’s Typology, first developed 30 years ago, has been under constant criticism from certain MtFs who would be identified by Blanchard as AGP. This reached fever pitch when J Michael Bailey published ‘The Man Who Would be Queen’, which I wrote a retrospective review of HERE.
It is into this battlefield — and the word is not ill-chosen — that Moser forayed.
Moser employed two methods; one was a small study he designed which proposed to test whether autogynephilia, which was defined by Blanchard as ‘a man’s propensity to be sexually aroused by himself, as a woman’ actually existed. To do this, he simply asked some women academic colleagues if they would complete the Questionnaire that Blanchard had devised to diagnose autogynephilia in men.
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This is where we get the first indication of the nature of Moser’s scholarship. It operates by decontextualising the subject. Blanchard was not a theoretical researcher, he was a practising clinician. He was responsible for either providing, or not providing, letters justifying MtFs’ desire to have a physical sex change, as was required by the Standards of Care.
Blanchard was concerned that many individuals were coming forward who did not fall into the Primary or Homosexual type of MtF but who were obviously still in need of help. Blanchard needed to study what he was seeing in order to be able to provide a scientifically sound basis for awarding them a recommendation for Genital Reconstruction Surgery.
Blanchard devised his test to study men, not women.
So the first thing to understand is that Blanchard devised his test to study 
men, not women. It was intended to be used to assist MtFs who otherwise, because they were not homosexual, could not receive any help at all. They could not be recommended for surgery because there was no scientific basis do to so.
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Blanchard needed to formulate an explanation that would allow him, ethically, to provide letters of recommendation for non-homosexual MtF transsexuals so that they could have the surgery that they desired. Blanchard was a clinician trying to help a specific group of individuals — who were not women.
Moser’s use of the test
was designed to attack Blanchard’s definition of autogynephilia as a propensity only of men. He has no objection, apparently, to the concept itself.
But would it have demolished Blanchard’s Typology, as histrionic AGP activists at once claimed it did, even if it were true that significant numbers of natal women experience autogynephilia? No. The men with autogynephilia would have still been autogynephilic men, it would just have been the case that some women also had it. However, subsequent to Moser’s mischievous intervention, the test was redesigned by Drs J Michael Bailey and Anne Lawrence, to make the chance of false positives, by natal women using, it less likely.
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Moser’s ‘survey’ does not challenge Blanchard’s Typology.
In addition, suppose it were to be shown, using the new instrument, that women do exhibit autogynephilia. This would not address the distinction between men whose sense of themselves as women is due to it, and those whose sense derives from their profound and intense desire for men. There would still be two types and they would still be classed as they are. This makes the misuse of the test appear even more mischievous. Moser’s ‘survey’ does not challenge Blanchard’s underlying Typology — but then Moser acts as if it did. Tsk tsk, doctor.
Moser is a clinician whose practice is in treating people with transsexualism, many of whom are autogynephilic men. It is safe to assume that he makes a deal of money out of this. Because of certain activists, many AGPs now reject the notion of autogynephilia and prefer the ‘brain sex’ theory.
Moser’s mischievous intervention was probably designed to align himself with 
this. ‘There there,’ he could say to the 6 foot plus sports jock in front of him. ‘Real women have autogynephilia too. So you really are a really real woman. Come to my clinic and I can help you.’ Well Dr Moser may have a lovely bedside manner and he has great taste in bow-ties, but he’s not much cop at science, as we shall see.
Moser’s next line of attack
was a kind of scholarly, or indeed literary, criticism. He castigates Blanchard for using the word ‘ever’ in his questionnaire. For example, ‘Have you ever been aroused by the thought of yourself wearing women’s clothing?’ Moser makes much of this and in such a way as to suggest that Blanchard was guilty of entrapment — that one event of fetishistic cross-dressing would ‘condemn’ the subject for life. But this is again, Moser’s mischievous mind at work.
Blanchard’s instrument was meant to be used in a face-to-face interview with a subject who was distressed and needed help. It is possible that using the world ‘ever’ was, in strictly research terms, overstepping a line. But Blanchard was not acting principally as a researcher, but as a clinician trying to help people.
AGPs often have extreme difficulty in talking about their feelings.
Furthermore, it is a well observed fact that AGPs often have extreme difficulty in talking about their feelings or desires. Blanchard’s wording should be seen as a way in which a genuinely helpful and kind man could empathise with his patients — which is what they were, first.
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Field research is never simple. Anyone who has carried out interviews knows that getting to the truth is not easy. When designing a standardised pro-forma — which one must, in order to be consistent — that pro-forma’s style must not alienate the subjects. It must be friendly and non-threatening.
Slamming the dock.
Think of the difference between a counsel for the prosecution slamming the dock and demanding of the accused ‘Did you EVER suggest such a thing,’ and a rather pleasant man in a lab coat with the title ‘Doctor’ asking, ‘Did you ever think this might apply to you?’ Moser’s misrepresentation of Blanchard is essentially ad-hominem, and such attacks reveal a weakness in the a priori argument.
Remember that the MtFs Blanchard was dealing with were men seeking help to become women. Blanchard was not denying them, he was actively making it possible for them to get what they desired. Does that sound like the action of the trickster that Moser paints him to be?
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Moser criticises Blanchard for using words like ‘paraphilia’ with no proper definition. This is a similarly specious assault. Blanchard did not provide such definitions because he was using those that were already present in the then-current edition of the Diagnostic and Statistical Manual, as was right and proper. Blanchard was a clinician first and was doing exactly as a clinician should do.
Moser goes on to make various other semantic criticisms of Blanchard which may be regarded in a like vein. They serve the purpose of decontextualising Blanchard’s research and of diverting attention away from the fact that Blanchard was a working clinician trying to help people, and instead to suggest that he was a sloppy theoretical researcher.
The great sexologists.
Blanchard was not conducting randomised tests on controlled subject groups: he was trying to learn from his patients. This technique has been used since the 19th century by all the great sexologists. Without it we should have very much less information than we do about the nature and complexity of human sexuality. The practise of medicine has long benefited from the activities of field practitioners studying their own patients, not just in this but in all fields. It is quite impossible to imagine that surgery, for example, could have got as far as it has without surgeons actively developing their ideas on living subjects.
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Magnus Hirschfield, Havelock Ellis, Harry Benjamin — all of these contributors to knowledge were clinical practitioners. They reported on what they were seeing and tried to make sense of it for the benefit of other clinicians. Their ultimate purpose was, as was Blanchard’s, the amelioration of the condition of patients.
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Curiously, perhaps, Moser is a medical doctor. One would have thought that such a person, of all people, would have sympathised with the constraints of trying to break new ground in research while at the same time treating real patients. Yet apparently not.
A telling line
in one of Moser’s papers is here: ‘I could not find reports of … a difference between the response to anti-androgens by homosexual and non-homosexual MTFs (contradicting the implication that sexual motivation is present in one and absent in the other).’ (My emphasis.)
http://www.tandfonline.com/doi/pdf/10.1080/00918369.2010.486241
Yet again, this is simply a misrepresentation of what Blanchard says: it is central to his Typology that both forms of MtF transsexualism, HSTS and AGP, are caused by male sexuality. There has never been an ‘implication’ that sexual motivation is present in one and not the other. Either this is just Moser setting up more mischievous straw men to knock down, in order to make a weak case appear strong, or he genuinely does not understand Blanchard.
Fortunately, we finally know just how weak Moser was, how much based in manipulated evidence, semantics and wishful thinking.
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This month we have seen a minutely researched review paper by Guillamon, Junque and Gomez-Gil, which you can read for yourself HERE. Be warned, it is heavy going. I refer you to Kay Brown’s excellent site for further analysis, and I am sure I shall come back to it too.
The hard science at last.
This paper brings together all the ‘hard science’ — the autopsy studies, brain 
scans and MRI testing done over the last 20 years and dissects them. Its conclusion?
I quote:
‘The review of the available data seems to support two existing hypotheses: (1) a brain-restricted intersexuality in homosexual MtFs and FtMs and (2) Blanchard’s insight on the existence of two brain phenotypes that differentiate “homosexual” and “nonhomosexual” MtFs.’ (My emphasis.)
In other words, Blanchard, a thoughtful clinician trying to help his patients, was right. ‘Brain sex’ if it exists, only does in homosexual transsexuals, and there are indeed two completely different types of MtF transsexual, HSTS and AGP. I hope Dr Blanchard feels the warmth of vindication.
I think Dr Moser owes some apologies. To Ray Blanchard first, of course, and to all the other professionals and commentators who have been victimised by a hegemony of AGP bullies for supporting him; they have used Moser’s mischievous intervention as ammunition. But also to all the transsexuals, and their families and friends who have been misled by it. Who have been confused about who, and what, they really are.
‘Brain sex’ and SOGIE are debunked.
We now know that the ‘brain sex’ theory that AGP activists have relentlessly promoted is simply not true of them, even if it may be of other transsexuals. At the same time, the nonsense of ‘SOGIE’, another bogus conjecture beloved by AGPs, that pretends that sexual orientation and ‘gender identity’ are not related, has been shot down in flames.
All Charles Moser did was to help those who deny the truth in their campaign to erase those weaker than themselves. He must have known that his intervention would be seized on by a group of science-denying fantasists determined to silence all opposition. But, perhaps to further his own career, he went ahead and damaged science by attacking the scientist, to the benefit of pseudo-science and touchy-feely, Politically Correct, Post-Modernist woo.
At the same time, Moser has made himself very wealthy pandering to the delusions of autogynephilic males. We are forced to wonder if this is not the real reason behind his shoddy, unscientific and unscholarly intervention. Mischievous and shameful behaviour, doctor.
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Mischievous Links
Lawrence, Dr Anne A. Erotic Target Location Errors are Easy to Mischaracterize: A Reply to Moser. 2009 http://www.tandfonline.com/doi/abs/10.1080/00224490903230061
https://www.researchgate.net/publication/26660017_Autogynephilia_in_Women
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894986/
http://www.tandfonline.com/doi/pdf/10.1080/00918369.2010.486241
http://link.springer.com/article/10.1007/s10508-016-0768-5
https://sillyolme.wordpress.com/2016/07/
More links to the science of transsexualism and transgender are here