Autogynephilia (AGP) is ‘a man’s propensity to be aroused at the thought or image of himself as a woman’ (Blanchard) and it is the cause of all non-homosexual gender dysphoria in males. But what actually causes it? The key to this lies in first understanding that there is nothing at all unusual about a male with AGP, other than the AGP itself.
AGP has five recognised forms, transvestic, anatomical, physiological, behavioural and interpersonal, and these may occur in combination. Men with it have three sexual orientations: they may be gynephilic (heterosexual, attracted to women), analloerotic (having no sexual relations at all with others or pseudo-bisexual, (pursuing sex with men but only when in role as a woman). In the last case, where the individual lives full-time as a woman, he may only have relations with men, but these are still pseudo-bisexual. In Blanchard’s testing, the proportions were about 60:20:20, but this may have changed and also appears to be culturally dependent. All forms, however, are principally gynephilic. As Blanchard said, ‘You have to be gynephilic to be Autogynephilic.’
This leads to a surprising degree of variation in presentation. Most people would assume that all AGPs are transvestic, or that they desire to transition, but this is far from the truth. A significant number have no such desire and obtain gratification in other ways. For example, a man may present as a man but desire to be penetrated, by another man, a willing trans woman or a cis woman with a dildo. In this way he experiences what he thinks is ‘sex as a woman’, being the recipient in sex.
There are other practices that play much the same role, like wearing women’s underwear, sanitary pads, feminine products and so on, or even just indulging in what the man regards as feminine activities. Men have been recorded as getting sexual relief from knitting, for example. Others simply surround themselves with women and avoid the company of other men.
This really is an extremely varied condition, therefore. But none of the above, which describes the symptoms of AGP, actually addresses the cause and this has resulted in much speculation. Causation, as has been said, is key. But before understanding causation, we need to learn how AGP actually works.
Men are sexual-target oriented and extremely visual (this is why the transvestic form of AGP is prevalent.) All men develop, in their minds, a mental model of their ideal female partner. This is their Erotic Target. It is part of the larger mental model that we all inhabit.
In most men, this Erotic Target remains outside the self; it is the image of someone we are looking for. But in some men, this image, instead of becoming associated with another person, in this case a flesh and blood woman, becomes associated with the self that created it. Blanchard called this the Erotic Target Location Error or ETLE. Notice that the Erotic Target does not necessarily have to be a woman; many other targets are available. Homosexual males will normally develop targets who are men, but others target plush animals — giving us ‘furries’ — anime characters, children and so on.
So what this tells us is that the mechanism that powers AGP is actually present in all men, more or less, since the erotic targeting system appears to be universal. The question becomes, therefore, what causes the Location Error? Why is it reflected back onto the self?
There is much debate, often angry, about the development of the condition. Many who would quickly be diagnosed as having it deny its very existence and even attempt to suppress investigation. A classic example would be the orchestrated and malicious attempt to smear Dr J Michael Bailey after he published a book, The Man Who Would Be Queen, discussing Blanchard’s theories. The leaders of this attack, which was unwarranted, were three transitioned AGPs, Lynn Conway, Andrea James and Deirdre McCloskey. Other AGPs, such as Jamie Veale and Julia Serano — both readily identifiable as AGPs under Blanchard — have penned article after spurious article trying to discredit the theory.
Thankfully, once the mechanism by which AGP works is understood, the condition itself ceases to be mysterious. It is provoked by the misdirection of a normal male erotic targeting system, such that the target is the self, but envisioned as a woman. (There are examples of lesbian women who appear to exhibit something very similar, but I’ll discuss that in another article; heterosexual women do not.)
Gender Dysphoria is a sense of unease or discomfort at presenting in the gender which we do. Consider, if you are a heterosexual man, without AGP, how you might feel if you were obliged to walk down the High Street in a pink mini-dress and heels, with long hair and makeup. Most such men would feel highly uncomfortable; well, people with Gender Dysphoria experience that all the time.
The Gender Dysphoria that non-homosexual males with AGP feel is specifically related to appearance, measured against the idealised Erotic Target, which is the self. While again it’s important to remember that by no means all men with AGP dress as or desire to appear to be women in public, this example is readily understandable. So imagine that your Erotic Target is yourself, as a woman. Remember that you are a heterosexual male. Suppose that you look at yourself in a mirror: do you see the beautiful woman who is your erotic target or do you see a man — which repulses you, because, as a heterosexual man, masculinity does that?
Of course, you see a man; the illusion is shattered and a sensation similar to that experienced in coitus interruptus sets on. This can lead to severe depression and even suicidality, but it can also lead the man to try to bring himself into line with his Erotic Target, a beautiful woman. He will soon be buying outsize women’s clothing from discreet online sources and he is, without realising it usually, on the way to a major change of life.
This is because the Erotic Target is not seen by the self as a part of itself, even though it is. It is seen as a separate character, with its own personality. It is the ghost in the machine, the ‘woman inside’. We might call this the ‘AGP artefact’, because it is entirely constructed by the man’s own Autogynephilia, which has hijacked his normal targeting system.
As the man indulges it, the artefact will grow in strength. Usually, at some point, he will name it. This is a secret name that only he knows, until the day the invented character can be ‘set free’. But in his dreams and private life, it — now she — will become increasingly dominant.
She will be a powerful character; she has to be, because she is in competition with the male host and to overwhelm him she must be stronger than he is. Unfortunately, this, which he sees as her strength, is actually her ability to browbeat and intimidate her male host. This proclivity, if the individual transitions, is all too often translated to dealings with other people.
In other forms of AGP, the man will desire to experience himself as a woman (or as he thinks a woman is) through other means. These will usually become increasingly intense or spill over to other forms. He may become addicted to being penetrated anally; men who like this may move on to desiring this while dressed as a woman and soon, wish to transition. He may seek to reshape his body, through the use of prosthetics, to resemble his Erotic Target’s; seek to insert himself into women’s social and sporting activities or political causes and so on.
AGP sets on at puberty, unlike HSTS, which becomes apparent in early childhood. Often AGPs will claim childhood incidents that they suggest prove that their AGP began in childhood, but these are usually unverifiable. Some are cases of precocious puberty, some are false memories invented by the AGP character and some are simply childhood role-play, indulged in by healthy children, which only appear to be associated with the later AGP through hindsight. They’re coincidental, rather than causative.
There is also evidence that it is associated with high testosterone levels, which are typical of male puberty from the onset until around twenty-one. Indeed, it is moot whether the relief reported by men with AGP, who have undergone genital reconstruction surgery (GRS) to invert the penis and form a pseudo-vagina, is actually caused by removing the source of testosterone in the body. This is especially likely where the man is neither pseudo-bisexual nor has Anatomical AGP, since these men will not use their neo-vagina to accommodate their lovers and have minimal dysmorphia regarding their penises. This begs the question, of course, whether it might be enough to prescribe anti-androgens to provide relief from Gender Dysphoria, and Bailey has reported cases histories that appear to support this.
The end is always the same: the creation of a semi-autonomous alter ego that takes control over the host. Generally, when the severe Gender Dysphoria caused by this sets on, some degree of transvestism will occur, even if it is not the root stimulus.
So what is the specific trigger? What causes a perfectly normal erotic targeting system to fail in this manner? Some have proposed a theory of ‘masochistic emasculation fetish’ emasculation, but while many AGPs certainly do exhibit this — indeed there is a case for making it a Type alongside the existing five — this does not answer the question, it just shifts it. Why is it happening in the first place?
The truth is that there are as many potential triggers as there are cases of Autogynephilia. However, from the information we have, the many case histories collected by Dr Ann Lawrence and the interviews I’ve conducted myself, together with the accepted wisdom of the Diagnostic and Statistical Manual (DSM-5) we can be sure that this is something that first sets on at puberty and so either the condition must be innate and appears at that time, or that events surrounding puberty trigger it.
That suggests that we must be aware of the potentially triggering factors that boys might be exposed to at around that age. One obvious example would be pornography, which is now ubiquitous; any boy with an internet connection can access huge amounts of it. But more importantly today, I believe, is the ongoing condemnation of men, being male and masculinity, which is directed at boys from the moment they enter school. This is something we have to wake up to and take seriously.