A Full Life Uninterrupted By Transition

This essay, which looks in detail at the different types of transgendered behaviours, was my contributon to the book ‘Transgender Children and Young People’, published by Cambridge Scholars. Since then, the phenomena of ‘Rapid Onset Gender Dysphoria‘ has gained attention, and my chapter may be read in context of ROGD being another type of transgender identity that primatily affects girls and young women, yet it subjected to the homogenisation with other forms of trans by trans lobbyists.

A Note On Language

Language within this field, like any political arena, can be fraught with difficulty and sensitivity, not least because language is sometimes used to obscure meaning. In the interests of clarity and consistency, the use of the word “transgender” is always used as an umbrella term to describe anyone of a range of identities whereby someone claims to “identify” with a sex class other than which they were born into. The word “transsexual” is more tightly defined, being someone who undertakes a surgical, medical and social transition in order to attempt to live permanently as a member of the sex opposite to which they are born. Natal or biological sex is always inferred from female or male, so a “transgender female” would be a natal female who claimed a “male identity” and “transgender male” a natal male who claimed a “female identity”. Likewise, a “transsexual  female” would be a natal female who has transitioned to live “as a man” and “transsexual male” a natal male who has transitioned to live “as a woman”.

A Modern Epidemic

In the UK, the national centre for the assessment and treatment of gender dysphoric children and young adults is the Tavistock and Portman NHS Foundation Trust. In 2009/10, the number of referrals of males was 56 with 40 referrals of females, with a single referral of a child “of transsexual parent” with no apparent attempt to identify sex, total 97, split 58.3% male and 41.7% female. (The Tavistock and Portman NHS Foundation Trust 2016).

In 2011/12 the number of females referred surpassed males and this remained so for each subsequent year until the latest reported figures for 2015/16 which show a total of 1,419 referrals split between 490 male and 929 female and a shift in composition to 65.5% female and 34.5% male. This represents a huge increase in the numbers of children and young adults seeking help for gender non-conformity and cross-sex identification, as well as a significant change in the sex composition of children and young adults seeking help; historically, the reported incidences of males seeking such help has far outstripped the numbers of females, yet this appears to no longer be the case.

Is it unreasonable to ask why it is that there has been a fifteen-fold increase in referrals of children and young people over a six year period, and why does this represent a 23-fold increase in girls against just an 8.75 increase in boys? Why in 2015/16 have referrals of children aged eight or younger risen to 101, compared to ten in 2009/10, with twenty aged five or less (2009/10 – six), with no apparent reason offered to explain these changes?

If this were as result of a pathogen, there’s little doubt it would be treated as an epidemic. Within this chapter, the argument will be made that the vector motivating these increases originates from a group whose interests and histories are unrelated to these children. It will also be shown that both the existing scientific knowledge we have about the etiology of transsexualism and further enquiry and debate around this is being prevented by that same group through tactics of threats and intimidation.

What is the etiology of “transgender identity”?

The Tavistock and Portman “Gender Identity Development Service” (“GIDS”) runs a specialist website under its own marque. The remit of the GIDS is explained as follows (The Tavistock and Portman NHS Foundation Trust 2016(2)):

We recognise how complex ideas around gender can be and that there is a huge range of human diversity in how people feel about and express their gender. Young people who are developing an understanding of their own gender that is different from what everyone had first expected can sometimes find things very tough. Both young people and their families can experience high levels of distress as their gender identity evolves.

On the GIDS website, the service freely admits it is at a loss as to why any children would be struggling with their ‘gender’ or ‘gender identity’ indeed the website’s own glossary makes no attempt to define either (The Tavistock and Portman NHS Foundation Trust 2016(3)):

If you are asking about why you are questioning your gender or why you feel that you are transgender, then the honest answer is we do not know exactly why this happens to some people… some people feel strongly that they are “born this way” when it come to their gender identity, and they might find the idea of having, for example, “a boy’s brain in a girl’s body” helpful in explaining their experience… we know that how people experience and show their gender, and how people respond to gender non-conformity, is linked to the culture and the time in which they live.

A section on ‘current debates’ hints (The Tavistock and Portman NHS Foundation Trust 2016(4)):

Young people are understanding gender in an increasingly diverse way. For example, Facebook now allows users to choose from an “extensive list” of pre-populated gender identities, or to enter their own preferred terms. Each individual can add up to 10 terms describing their gender to their profile and can customise how public this information is made. Young people who we meet at GIDS have often familiarised themselves with a large range of different identity labels in discussions online or with their peers.

The existence of cultural aspects of gender are acknowledged, for example the cultural response to non-conformity and the effect of a shifting understanding of what ‘gender’ means to young people. Yet these pages leave the reader with little apparent understanding of why it is that anyone would be transgender. Is this really the case? Are transgender individuals “born this way”? Is it meaningful to talk of “a boy’s brain in a girl’s body”?

What is gender?

In common use, the word “gender” is often taken to be associated with sex, we talk of gendered clothing, toys or even nouns, and these are coded as masculine, feminine or even neutral. Of course, we don’t mean that the clothing, toys or nouns are actually male or female, what we mean is that these are culturally associated with the state of being male or female; these cultural ideas are attached to a particular sex by culture. And this is what is meant when feminists say that gender is socially, or culturally, constructed, that it is a result of society imposing what is culturally acceptable upon a particular sex. A distinction may therefore be drawn between sex, as a biological state, and gender as cultural norms associated with that state. The World Health Organisation separates sex and gender as follows (World Health Organisation Undated):

“Sex” refers to the biological and physiological characteristics that define men and women. “Gender” refers to the socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for men and women. To put it another way: “Male” and “female” are sex categories, while “masculine” and “feminine” are gender categories. Aspects of sex will not vary substantially between different human societies, while aspects of gender may vary greatly.

Sex distinctions exist outside of culture, but what exists within the convention of gender exists only because human beings say so; this is why we say that gender is socially constructed. Biological sex itself is a material reality, membership of a sex class is based upon perceived reproductive potential as producers of large gametes (female, child-bearers) or small gametes (males, those who impregnate the child-bearers). The biological consequences of being a member of each sex follow.

A small number of individuals are born with an intersex condition. These are a result of chromosomal or genetic abnormalities. A body is taken to be ‘chromosomally male’ if it the body’s cells have a Y chromosome, however the masculinisation of features may not happen because of, for example, SRY abnormalities (on the gene itself) or through androgen insensitivity syndrome (where the body does not respond to expressed androgens). In this case, male bodies are apparent with female primary sex characteristics and the underlying sex of the individual generally only comes to be recognised after investigation, usually in the teenage years. There are other chromosomal abnormalities affecting males for example XYY, XXY, XXXY and even XXXXY, it should be noted these are still male by the Y chromosome, and many such males successfully father children.

The examples of gender quoted by the WHO illustrate a factor about gender leading to the “feminist analysis of gender”. Of the four examples chosen, three have negative consequences for women (although an example about smoking is negative, in that “smoking has not traditionally been considered appropriate” shows that in Viet Nam the prohibition on women smoking may be culturally interpreted  as being negative). The feminist interpretation of gender is that it is a hierarchical system used to oppress women, as the positive and active stereotypes are reserved for the men while negative and submissive stereotypes are imposed upon women.

When transgender individuals talk about gender, it is usually in the context of “gender identity”. This term itself arose in psychoanalysis (Stoller, A Contribution to the Study of Gender Identity 1964) which defines “gender identity” as follows:

Gender identity is the sense of knowing to which sex one belongs, that is, the awareness “I am a male” or “I am a female”… (g)ender identity seems to be produced in normal human beings by the following elements: first, the anatomy and physiology of the external genital organs, by which is meant the appearance of and the sensations from the external, visible, and palpable genitalia; second, the attitudinal influences of parents, siblings, and peers. Whether these consider a child a boy or a girl will ordinarily play an extremely important part in establishing and confirming the gender identity.

Stoller’s definition is primarily based upon the biology of the subject, and secondly upon cultural aspects, and underlining the importance of the influence of “parents, siblings and peers”. A typical definition from a transgender support group would be as follows (Gender Spectrum 2016):

One’s innermost concept of self as male or female or both or neither – how individuals perceive themselves and what they call themselves. One’s gender identity can be the same or different than the sex assigned at birth. Individuals are conscious of this between the ages 18 months and 3 years. Most people develop a gender identity that matches their biological sex. For some, however, their gender identity is different from their biological or assigned sex.

This separates the concept of “gender identity” from biological reality and the child’s social environment, which as Stoller defined it is foundational upon the perception of that child’s sex by “parents, siblings and peers”, and appears to suggest this identity is something else, which one becomes aware of as consciousness matures. It states that the developed “gender identity” may be different from the child’s sex but is silent to the mechanism, implying this may be a matter of luck (or misfortune).

When transgender individuals speak of their “gender” it is usually taken to mean the internal sense of self, rather than the external reality of what that person physically may be. A consequence of this is that it is not uncommon to encounter masculine males, sometimes fathers, claiming to be female based upon how they feel inside, yet everything else about them suggests otherwise, they may have a flowing beard. This is, of course, an extreme; there are many individuals who are female (or male) who identify as members of the opposite sex and, it could be argued, bear more of a resemblance to those whom they claim to identify with. This ‘gender expression’ is often through behaviour, clothes and personal grooming, and with transsexuals accompanied with the external intervention of synthetic hormones or even surgery upon the genitals, torso, face and hairline. Is this, though, what makes ‘a woman’, or ‘a man’?

In her 1949 book ‘The Second Sex’, the French philosopher Simone de Beauvoir famously wrote:

One is not born, but rather becomes, a woman. (de Beauvoir 1949)

de Beauvoir with Jean-Paul Sartre founded the existentialist philosophical movement. Existentialism does not presuppose that we have an innate soul or essence; rather what we are is the sum of our opportunities and experiences. There is no ‘female essence’ or ‘male essence’ or spirit, and a philosophically honest interpretation of de Beauvoir’s words are that being a woman is a whole life experience based upon her biology, the effect of being a woman in a world of men, and what society does to her.

Although a woman may be taken as ‘an adult human female’, words often have more than one meaning and this reflects what de Beauvoir was getting at; she becomes what she is through being a woman living in a world within the system of gender. Making a distinction between sex and gender, it makes a woman a product of both her sex and of the system of gender. (Butler 1986)

It is interesting to examine the commonalities between the lives and experiences of those who claim a “transgender” identity. Historically, stories that made the media consisted mainly of adult males who announced to the world their new identity, however recently we are seeing more evidence of young children and adolescents as well as females “transitioning” to male. We will look first at the narratives of transgender children (“transkids”) and then transgender adults (“adult transitioners”).

Commonality in the “transkids” narrative

The narratives of children that are claimed to be transgender are startlingly similar. Based upon a review of a small sample of ‘human interest’ stories on the Daily Mail website (a widely-read conservative British newspaper) which told the stories of these children and their parents, the histories of young transgender males (boys who ‘want’ to be girls) show a strong consistency on a number of points which may be taken as culturally stereotyped behaviour of boys and girls. For example, these included a preference for pink (7/7 cases), feminine hair (6/7), playing princesses and wearing dresses (5/7), preferences for ‘toys for girls’ (5/7). (Yardley 2017)

This narrative is not unique to the source. Interviewed in 2015, Susie Green, CEO of the transgender children’s charity Mermaids Gender recounted a similar narrative for her son Jack, who has transitioned to Jackie (Albert 2015) and is reflected in another significant narrative on the British National Health Service website (NHS Choices 2009). In the latter case, the parent procured testosterone blockers for her son from a doctor in the USA when the child was just thirteen.

A review of equivalent narratives for transgender girls (natal females) suggests a different emphasis. In contrast to the transgender boys, who usually are pre-teens, the age of the subject is often old enough for them to be able to indicate their sexual orientation which shows itself to be the striking commonality; in each of the four narratives reviewed, prior to transition the girl has identified as a homosexual female, a lesbian. (Yardley 2017)

Although other cultural preferences are evident for boys, every single one of those narratives indicates a childhood preference for pink. The nature of pink for girls and blue for boys is cultural and so changes, both across cultures and through time, indeed gender-neutral clothing was popular until around 1985 when gender-specific clothing became identified as being another way businesses could make money out of parents, “the more you individualize clothing, the more you can sell” with the availability of prenatal testing being a major motivator (Maglaty 2011).

Devoid of culture, pink has no meaning with respect to the preferences of children, or even adults, of either sex. Notably in the stories for young transgender females, many include a rejection of pink, dresses and princesses, the diametric opposite of the stories from transgender males. As noted above the transgender females shared homosexual sexual orientation. This has been noted by feminist commentators who have framed the transitioning of young girls and boys as a form of gay eugenics (Gerlich 2017).

There are many lesbians today who say that if gender identity politics were as prevalent when they were young as they are now, that instead of growing up to recognise and embrace their gender non-comformity and same-sex attraction, they would have thought they were boys… (i)ndeed, there are many critics of transactivism who say that this new trend for medicating young people on the basis of gender identity is a form of gay eugenics… Transactivist Scout Barbour-Evans said, himself, on RadioLive, that gender is a “social construct”, and he was right about that. And when young people are medicated, to the point of sterilisation, just to better align with and conform to social constructs – that is eugenics. And because gender conformity has so much to do with compulsory heterosexuality – it’s a form of gay eugenics.

If we can accept that “gender identity” is a preference for the cultural conventions applicable to a particular sex, is it such a leap to suggest that for girls who are masculine (or boys who are feminine), such personality traits are being interpreted as an indicator that the child’s “gender identity” is not correspondent with the child’s sex? Is this not tantamount to suggesting that personality determines sex? Of course, children’s preferences can change suddenly and just as cultural ideas of gender are not stable over time, neither is the gender non-conforming behaviour of children. In a review of eleven follow-up studies from 1972 to 2013, James Cantor concluded that 60–90% of trans- kids turn out no longer to be trans by adulthood. (Cantor 2016)

If we can agree that masculinity in females is socially coded as being lesbian and femininity in males is socially coded as gay (as Gerlich observes) there is a real danger that gender non-confirming behaviour in children is being interpreted not as this being a child who will grow up to be homosexual, rather our feminine boys and masculine girls are being perceived to be and treated as being “transgender”. Should children continue to transition at the increasing rates we have been seeing, there is a danger this will annihilate our lesbian and gay population.

Do later transitioners follow the ‘transkids’ narrative?

We can compare the narratives of transsexuals who did not transition young and establish what if any commonality there is between each of these, and the narratives claimed for the ‘transkids’. Taking the frank, published accounts of three male transsexuals who did not transition as children, none of whom identify as ‘homosexual transsexuals’ (whose romantic/sexual history is stated as either bisexual or heterosexual), we can see there is another force with some types of transsexual that differs from those claimed by ‘transkids’.

In ‘Other Lands’ (Roche 2016) a powerful piece from someone who transitioned in their forties, the author details their experiences shortly after gender reassignment surgery (creation of a neovagina through a surgical process on penile tissue). In place of the descriptions of stereotypically feminine behaviours and preferences from young children, we have the recollection of teenage fantasy, describing the author’s erotic dream of having female genitals, and the description of their own or other person’s interaction with this feminised version of the young man they were. The language used is overly sexual, seemingly colloquial to pornography, with the vagina described as a “moist slit” and the plea, ‘Silence of the Lambs’-style, “I’m a beautiful pussy fuck me.”

Another piece talks of the consumption of transgender pornography (Williams 2016) which had followed a history of cross-dressing fetishism:

I did have a history of cross-dressing fetishism, with a particular predilection for nylon. In a nutshell, I would wear women’s clothing and become aroused… In highschool and college, I discovered porn with trans women. If I was having sexual fantasies at all back then, it was probably about trans women, not myself as a woman with a vagina living in a female gender role… I eventually came to realize that the reason I was so fascinated by trans woman porn was that I was projecting myself into the bodies of the trans women as I watched and identifying with them. I realized over time that I wanted the body of a non-op trans woman. I liked that aesthetic. I wanted that for myself. I am becoming what I love.

Another piece discusses how the author discovered their transgender identity (Egan 2016):

Anyone who knew me growing up knew that I was fascinated with women. I was the first of my friends to think that Playboy was a must-have magazine; I even remember begging my mom to buy me a copy for my 10th birthday… my interest wasn’t just erotic. What I was never able to explain until recently was the confusion in my head between being attracted to a beautiful woman, and wanting to actually be one. As a result, I spent so many years wondering if I was the only guy that felt this way, or if all guys did and no one was willing to talk about it. But it turns out, that like sexual preference, gender identity is also a spectrum.

The internet is rife with narratives connecting the consumption of pornography, particularly involving transgender people and self-realisations of being transgender. For example, in a thread on Reddit “Question About Porn” the answers posted to the question “Did anybody masturbate to transgender porn before they realized they were trans?” (Reddit.com 2016) drew an almost unanimously positive response.

   There are strong erotic aspects within each of these narratives and fantasy-based visualisations of the transsexual male as having female anatomy. These narratives have little in common with the ‘transkids’ narrative, yet certainly do themselves share commonality: there is an influence of pornography either intimated through use of language, explicitly admitted and even hypothesised as motivation for transition.

The Two-Type Model of Transsexualism

The existence of an erotic component to a type of transsexualism has been documented for over a hundred years where what was described as an ‘automonosexual streak’ amongst transvestites was identified that was not just confined to cross-dressing (Hirshfeld 1918). Existence of two discrete types of transsexual, differentiated by sexual orientation and age was hypothesised sixty years later (Buhrich 1978) and it was suggested that transsexualism more common in males than females because of fetishist arousal through cross-dressing. It was also suggested that even among fetishistic cross-dressers, there were discrete behavioural types.

In 1985, sexologist Ray Blanchard suggested that there exists a fundamental difference between homosexual transsexuals (homosexual males romantically and sexually attracted to males) and non-homosexual transsexuals (which includes heterosexual, bisexual and asexual transsexuals) and on this basis there are two different types of transsexual differentiated by sexual orientation: transsexuals may be grouped into homosexual and non-homosexual transsexuals, and that the latter group contains a number of subtypes which could be taken to correspond to an ordinal degree of fetishistic transvestisism. These observations are supported by empirical evidence; the difference is manifest in “a much higher proportion of fetishistic cases than the homosexual group” and so Blanchard confirms the identification of two types of male transsexual, who are differentiated by sexual orientation, with one group displaying a fetishistic, or paraphilic history (Blanchard 1985).

Blanchard became a key figure in the history of investigation into transsexualism a few years later where he attempted to impart meaning and rigor into the terminology surrounding the taxonomy of transsexuals, as part of systematic study into this phenomena, he coined the term “autogynephilia” as a clearer description of something that had hitherto been described as part of automonosexualism. This is what has become known as “Blanchard’s transsexual typology” or the “two-type transsexual typography” (Blanchard 1989).

Autogynephilia is not something that is always on the mind, nor is it something that is confined solely to cross-dressing. Furthermore, the fetishist cross-dresser can be, or become, gender dysphoric. (Blanchard 1989)

Classifying this behaviour in terms that lie outside of transvestic fetishism allowed Blanchard to apply his systematic study to a wider spectrum of behaviour observed within transsexuals, and he explained the etymology of “autogynephilia” based upon “a male’s propensity to be sexually aroused by the thought or image of himself as a female” (Blanchard 1991) and identifies four different types of autogynephilic behaviour:

Autogynephilic fantasies and behaviors may focus on the idea of exhibiting female physiologic functions, of engaging in stereotypically feminine behavior, of possessing female anatomic structures, or of dressing in women’s apparel. The last-mentioned class of fantasies and behaviors represents the familiar form of autogynephilia, transvestism. All four types of autogynephilia tend to occur in combination with other types rather than alone. (Blanchard 1991)

This typological framework allows researchers to model or systematically analyse the behaviours of male transsexuals that separates these into homosexual and non-homosexual transsexuals, the latter who tend to be autogynephilic and exhibits one or more types of paraphilic behaviours. Blanchard has compared these paraphilic behaviours to a sexual orientation (Blanchard 1993).

The homosexual transsexuals are what one may consider the more ‘classic’ popular image of the transsexual, with the non-homosexual transsexuals making lives that encompass successful careers as men as well and marriages and children, before transitioning later in life (Lawrence 2004); the homosexual transsexual and the non-homosexual transsexual have different lives and experiences, although there is commonality in they are both transsexual with similar levels of experienced gender dysphoria. Psychologist J Michael Bailey (Bailey 2003) lamented:

To anyone who has seen members of both types and who has learned to ask the right kinds of questions, it is easy to tell them apart. Yet the difference has eluded virtually everyone who cares about transsexuals: talk show hosts, journalists, most people who evaluate and treat them, and even most academics who have studied them… (t)he most interesting reason why most people do not realize that there are two types of transsexuals is that members of one type sometimes misrepresent themselves as members of the other. I will get more specific later, but for now, it is enough to say that they are often silent about their true motivation and instead tell stories about themselves that are misleading and, in important respects, false.

From soon after birth, the homosexual male-to-female transsexual behaves and feels like a girl. Unlike most feminine boys… these transsexuals do not outgrow, or learn to hide, their femininity. Instead, they decide that the drastic step of changing their sex is preferable. They unambiguously desire and love men, especially heterosexual men, whom they can attract only as women… one type of transsexual man is a kind of homosexual man.

Honest and open autogynephilic transsexuals reveal a much different pattern. They were not especially feminine boys. The first overt manifestation of what led to their transsexualism was typically during early adolescence, when they secretly dressed in their mothers’ or sisters’ lingerie, looked at themselves in the mirror, and masturbated. This activity continued into adulthood, and sexual fantasies became increasingly transsexual—especially the fantasy of having a vulva, perhaps being penetrated by a penis. Autogynephilic transsexuals might declare attraction to women or men, to both, or to neither. But their primary attraction is to the women that they would become.

Bailey’s interpretation of the motivation to change sex of homosexual transsexuals is to attract heterosexual men; we could consider given the choice in a homophobic society of living as a feminine gay man or as a woman, the homosexual transsexual may opt for the latter. While identifying the autogynephile’s motivation for many behaviours, he stops short of hypothesising why the autogynephile would transition; surely, the prospect of castration and removal of the penis would be an irrational course of action for someone whose sexual identity was so invested in this? This, however, would be based on the misconception that autogynephilia is exclusively erotic. Anne Lawrence suggested the autogynephile’s motivation may be compared to romantic love (Lawrence 2003):

…purely erotic aspects of autogynephilia have received the greatest emphasis, while the aspects related to “amatory propensity,” “sexual orientation,” and “love” have received comparatively little. Love has been conspicuously absent in most discussions of autogynephilia, whether by its advocates or by its critics… individuals are often especially inclined to seek out passionate love experiences, or to allow themselves the possibility of entering into them, in middle age and in times of crisis. This is consistent with the life histories of many, if not most, nonhomosexual MtF transsexuals, who tend to seek sex reassignment in their 40s or later, sometimes in association with a midlife crisis … (t)heir decision to undergo sex reassignment is not uncommonly preceded by some significant loss or reversal, such as unemployment, physical disability, or the end of an important relationship… (f)or individuals who experience autogynephilia, deciding to become what one loves can represent an attempt to cope with adverse life circumstances, just as deciding to pursue a love affair with another person can for individuals with more conventional sexual orientations… the process of changing one’s body and living as a woman offers an identity, a program of action, and a purpose in life.

Interpretations of “gender identity” and autogynephilia

We have established a concept of “gender identity” being the individual’s inner feeling of male or female, which is taken to be influenced by biology and cultural effects, for example how the individual is treated by the people around them (Stoller 1964). Referring to a later paper (Stoller 1968) Lawrence suggests claims that gender identity is set young in a biological and cultural context and that the “core gender identity” of non-homosexual is always male (Lawrence 2013). A different interpretation is offered by Julia Serano in “Whipping Girl”, Serano’s “transfeminist manifesto” (Serano 2007):

When I hit puberty, my newly found attraction to women spilled into my dreams of becoming a girl. For me, sexuality became a strange combination of jealousy, self-loathing, and lust. Because when you isolate an impressionable transgender teen and bombard her with billboard ads baring bikiniclad women and boys’ locker room trash talk about this girl’s tits and that girl’s ass, then she will learn to turn her gender identity into a fetish… my thirteen-year-old brain started concocting scenarios straight out of SM handbooks. Most of my fantasies began with my abduction: I’d turn to putty in the hands of some twisted man who would turn me into a woman as part of his evil plan. It’s called forced feminization, and it’s not really about sex. It is about turning the humiliation you feel into pleasure, transforming the loss of male privilege into the best fuck ever.

Serano claims to visualise fantasies of having a female body as well as independently arsing forced feminisation fantasies. This is an interesting claim to make, in that Serano claims the embodiment fantasy may have been culturally motivated, turning their own “gender identity into a fetish” yet Serano also suggests their own feminisation fantasy to be not just a priori, but the resultant loss of male privilege is “the best fuck ever”. In terms of the autogynephilia model, there is a co-existence of behavioural, transvestic fetishist and anatomical autogynephilia, and also note the use of language that is rather masculine. The apparent fetishisation of the loss of male privilege (“best fuck ever”) is ideologically anti-feminist as it pictures the ‘woman’ as helpless and submissive, and based on Blanchard and Lawrence’s observations unconvincing.

                In spite of claiming such a narrative where they are literally discussing “becoming what they love”, Serano takes the view that autogynephilia is itself stigmatising, and suggests a rebranding  as “Female/Feminine Embodiment Fantasies (FEFs)” (Serano 2015).

To counteract perceived stigmatisation of autogynephilia, it has been suggested the phenomena exists in women (Moser 2009), this study makes a claims that in some cases 93% of women could be interpreted as being autogynephilic. The study is not without its critics: the survey questions which form the basis of the study are not directly comparable to those used to assess autogynephilia in males (Lawrence 2017) and the data collection was based upon handing out fifty-one questionnaires in a hospital foyer at random, of which twenty-nine were returned, described as a “convenience sample”. Owing to the non-random nature of this sample, inferences cannot be drawn (Price 2013). At the heart of this work is a logical flaw; as autogynephilia is described in terms of a male bodied individual fantasising about a female body, behaviours, physiology or anatomy; attributing a (female bodied) woman fantasising about being female bodied does not appear to be comparing like for like (for example “I have dressed in lingerie, sexy attire or prepared myself shaving my legs, applying make-up, etc. before masturbating”). We may conclude that whatever this study is claiming, it is not “autogynephilia in women” (Dreger 2015).

In support of his “two type model”, Blanchard suggested there may be differences between the brain structures of male transsexuals and “typical heterosexual men”, with homosexual transsexuals exhibiting sex-dimorphic structures, and differences with non-homosexual transsexuals that neither involve sex-dimorphic structures nor lie along the male-female dimension (Blanchard 2008). Empirical investigation suggests this to be the case (Rametti, et al. 2010), (Savic and Arver 2010), (Cantor 2011) with transsexual brains being characterised based upon sexual orientation; transsexual homosexuals have a similar brain structure variation from transsexual heterosexuals in the same way that non-transsexual homosexuals vary from heterosexual transsexuals.

 “Gender identity” as a concept is as we have seen not universally agreed and does itself have a number of philosophical problems, many of which arise from the use of the term in common language and through what are known as “identity politics” (Reilly-Cooper 2015) although what Reilly-Cooper observes is more informed by inconsistencies in the way the term is used by those who claim such identities, and how these differ from how “gender identity” has been defined in the literature by reference to biological sex and socialisation (Stoller 1964). Reilly-Cooper also comments on the essentialist and subjective nature of “innate gender identity”, which is consistent with de Beauvoir’s non-essentialist existential approach.

Reilly-Cooper draws a distinction between the two most common popular interpretations of what “being transgender” means, the idea of an unprovable “soul or some other non-material entity” and the idea of someone having the brain of one sex inhabiting the body of another. The argument about sexed brains and in particular the connection of cultural artefacts to innate biology merits a book of its own, much has been written on this matter, some of which include assessment of the methodology of the work that leads to such claims (Fine 2010).

                Blanchard has addressed what he called “the feminine essence theory” in some detail (Blanchard 2008) setting out the “tenets” of such a theory based on his own observed observations of what has been claimed, in the absence of a single “official version”. Summarising this “feminine essence theory”, Blanchard makes some key observations, including what may be seen as a fundamental shift in what, for want of a better expression, may be described as “transgender ideology”:

The popular description of male-to-female transsexuals as women trapped in men’s bodies has sometimes been interpreted to mean that they feel like women or that they wish to be women. The feminine essence theory proposes that they are women.

This echoes what has become the rallying cry of today’s transgender rights movement, “trans women are women” which is justified as follows:

the notion that there exist one or more sex-dimorphic structures of the human brain that can be regarded as the seat of gender identity, and that key parameters of these structures (e.g., neuron number or density) are similar in male-to-female transsexuals and natal females… Contemporary proponents of this view also generally hold that the female-typical structure of the gender identity center(s) is congenital, so that male-to-female transsexuals are and always have been female where it counts – in the brain.

This has commonality with another common claim, that of “sex is what is between the legs, gender is what is in the brain”. With what Blanchard calls “singularity of the feminine essence”, he demonstrates this idea is incompatible with a two-type model of transsexuals:

Human females do not occur in alternative morphs… do not consist of two or more discrete subpopulations with different phenotypes… (s)ince there is only one type of human female, there can be only one type of female trapped in a male body. It follows that the notion of a taxonomy of transsexuals with discrete diagnostic categories is almost oxymoronic… (t)here is no more need to ask whether homosexual and heterosexual male-to-female transsexuals have the same reasons for believing themselves to be women than there is to ask whether homosexual and heterosexual natal females have the same reasons for believing themselves to be women.

As transsexual males who have spent most of their lives conforming to societal convention to act masculine thus demonstrate male traits, the existence of both male and female traits in transsexuals does not itself challenge the “feminine essence theory”, however the theory is incompatible with a high incidence of distinctive traits that are neither male nor female coded. The high incidence of autogynephilia amongst male to female transsexuals does itself challenge the “feminine essence theory” indicates why transsexuals and their allies have sought to characterise autogynephilia as an expression of female sexuality (Moser 2009) however Blanchard suggests the this is likely because of there being two distinctly different etiologies to each distinct type of transsexualism: (Blanchard 2008).

Blanchard has considered the existence of a “third type” of transsexual and framed this within the context of body integrity identity disorder (BIID), noting the apparent absence of evidence to support this phenomena and connecting this to the common incidence of erotic arousal. He earlier noted the self-reported histories of both individuals with BIID and gender identity disorder distort their history (Blanchard 2003). Ultimately, however, he considers the concept of a third type of transsexual unhelpful to this “feminine essence theory” as the corollary of this is there can only be one kind of “true transsexualism”.

Although there have been attempts to discredit Blanchard’s typology, these have individually and collectively failed to diminish the value of the two-type typology in separating the population of male transsexuals into two distinct groups based upon sexual orientation. (Lawrence 2017).

The flag-bearers of transgenderism

As we have already seen, the media loves a “transgender coming out story”, and in particular it will run with sensational stories based on males who transition after making a career in a typically masculine profession. These stories are often high on affirmation and sensation, with little analysis as to what it means for a man who is in his sixties, and fathered children, to suddenly declare themselves to be ‘a woman’. Contemporary examples of both these being boxing promoter Kellie (Frank) Maloney or reality television star and former athlete Caitlyn (Bruce) Jenner.

                In 2014, boxing promoter Kellie Maloney was effectively forced by the British press to make their transition to Kellie public. Some of the press coverage echoed what has become the language of transgender advocacy. For example, writing in The Independent, transgender activist Paris Lees, under the headline “Kellie Maloney has always been female” suggested that Maloney had always been “a woman” because he “felt different inside” (Lees 2014). There is no attempt made within the feature to justify these claims, despite the fact that Maloney was on their second marriage and had fathered three children inside these two marriages.

Early in 2015, former Olympic decathlete Bruce Jenner ended years of speculation by announcing they too would be undertaking a ‘transition’, although some months passed between the initial admission of their transition to be, a dramatic announcement came from the style magazine Vanity Fair which placed Jenner on the cover and, in a matter of a few hours, the newly opened Twitter account for Caitlyn Jenner amassed over a million followers. Lees followed this announcement with a gushing, uncritical feature in The Guardian under the headline “Caitlyn Jenner: a life-affirming, provocative and downright fabulous Vanity Fair cover” (Lees 2015), even going so far as to paint Jenner a victim of a cruel society that would not allow that incredibly wealthy, successful man to live the life he wanted; in spite of having six children from three marriages, a career as a top-flight Olympic gold winning athlete winning gold at the 1976 Montreal Olympics in the decathlon, an event that was not (and still is) open to women, and a subsequent career in reality television we are expected to view the preceding sixty-five years of Jenner’s life as being incomplete.

Writing in The Morning Star, my own take on this was different. The sexualised cover shot of Jenner is represents the end product of the industry that has grown to fulfil the demand for cosmetic surgery for transgender individuals, in this case someone whose consent to surgery was made after a life that by anyone else’s standards would already have been both full and successful. Yet, we are now expected to believe that Jenner spent the last sixty-five years in torment, hiding the person they really are, and (for reasons unspecified) can only now become free. How do the lives of Jenner and Maloney relate to the lives of the fifty-two percent of the population born and raised as women? (Yardley 2015).

In April 2014, Jenner was interviewed by Diane Sawyer on ABC news programme ‘20/20’, and when questioned as to their motivations for transition, Jenner claimed ownership of a “female brain.” The existence of inherently differently sexed male and female brains is scientifically contentious and there is no significant generally accepted evidence that points to neurological differences in males and females that would explain, for example, an affinity for pink (Maglaty 2011) or wanting to wear a dress or makeup (Fine 2010). Individual preferences for cultural artefacts do not exist in a vacuum and are meaningless without context. This display was summarised as follows (Yardley 2015):

Jenner is not a “gender outlaw” breaking down boundaries and a mechanism for positive change. Jenner represents the status quo, in opposition to the positive, progressive force and changes that decades of women’s suffrage and activism have fought for… this image of Jenner as being not “a man becoming a woman” but… “a man becoming a man’s idea of what a woman should be”… an idealised body is presented clothed only in lingerie, the makeup is done to perfection, and every flaw is magically Photoshopped out of existence. Pandering to the male gaze, the body language is coy, seductive, submissive. This is not liberation, this is not revolution, this is not life-affirming. This is the crass stereotyping of what it means to be a woman, meeting every reactionary, culturally conservative ideal of what a woman should be — passive, objectified, dehumanised.

We should not need to be reminded that Maloney and Jenner are very different types of transsexuals to our feminine, likely pre-homosexual boys. Yet these transitions are used within Lees’s Guardian piece to argue in favour of children’s transition with no indication given as to the etiology of someone “being transgender”, nor any acknowledgement there could be a reason for these adult’s transition that is fundamentally different to what we are seeing with young children (Lees 2015). The piece raises more questions than it answers: what sort of society makes people hide from the world who they are for most of their lives? How can a man who transitions in his 60s know anything about the lived life experience of “being a woman”? How can either have “always been a woman… even when they were ‘fathering’ children”? How can these statements have any coherent meaning in what we know about ourselves, or the reproduction of other mammals? What do statements like this mean for homosexuals and homosexuality if, for example, a transgender male “identifies” as a lesbian? Is our understanding and acceptance of what it is to be homosexual now framed within a structure that now includes heterosexuals?

If the vectors that lead to the transition of children and adults are so different, why would anyone pretend different? The reason for this is, of course, because of what it means for the adults. Until publication of Bailey’s book (Bailey 2003) there was very little public knowledge of the existence of Blanchard’s “two-type model” or the concept of “autogynepilia”. There was an incredible backlash by a number of prominent American transgender activists that resulted in attempts to public discredit Bailey’s work and unprecedented acts of harassment against him, his children and other members of his family. The events surrounding this were documented meticulously by Alice Dreger in “The Controversy Surrounding The Man Who Would Be Queen: A Case History of the Politics of Science, Identity, and Sex in the Internet Age” (Dreger 2008), identifying the start of problems for Bailey first when his book was announced as a finalist for the Lambda Literary Award then cataloguing threats, intimidation, malicious communications to his employer and colleagues, and malicious content created on the internet alleging impropriety against his own children.

Lawrence contextualised attacks as a display of narcissistic rage (Lawrence 2008), referencing earlier work by Kohut (Kohut 1972) and characterising fanatic revenge as the response to narcissistic hurt. Lawrence makes a number of points which enable us to understand why Bailey’s book resulted in the reaction it did, encapsulating some of the fall-out we see even today, providing an indication as to why the media portrayal of transgender issues is often so positive. Even those who fall under the transgender umbrella themselves are subjected to campaigns of harassment that prevent any meaningful debate over what it means to be transsexual or transgender (Yardley 2014). Activists routinely try to silence media debate around transgender issues, for example early in 2017, campaigners petitioned for the BBC to not show a documentary detailing the work and dismissal of child gender dysphoria researcher Ken Zucker (Singal 2017).

That the media depictions of transgender issues are so uncritically positive and focused on children have the same cause, the need of the autogynephilic transsexual to receive societal and interpersonal validation for their claimed identity, which is threatened when this is characterised as a paraphilia. Dreger notes central to this is concern that treatment for autogynephilic transsexuals may even become harder to procure (Dreger 2008). This has led to a universally widespread misunderstanding of what it actually means to be transsexual and, by extension, transgender. The idea of ‘feminine essence’ has been used for political purposes to subvert the scientific understanding of what lies behind transsexuality to the detriment of not just transsexuals but science itself with the result that autogynephilic transsexuals are central to the promotion of transgenderism to younger children, in spite of the two types of transsexual having little in common (Bailey and Triea 2007):

Transsexuals who have successfully accomplished the MtF transition sometimes see themselves as mentors to younger people attempting or considering this path. They may feel that public acceptance of the feminine essence narrative will facilitate the transition for these younger individuals. For example, parents may be more accepting of a child whom they think of as a female unfortunately born with a male’s body than of one whom they think of as a male erotically aroused by the idea of being female… postoperative transsexuals whose desire and attachment to being women persists as their sex drive diminishes with age may come to doubt that this desire has anything to do with eroticism… this pattern is explicable via autogynephilia.

The concept of the “transgender child” is therefore central the campaigning of transgender activism. One of the most telling admissions of this instrumentalisation in contained in an interview published on YouTube between TransYouth Family Allies executive director Kim Pearson and transgender activist Autumn Sandeen (Sandeen and Pearson 2010) with this transcription taken from the “GenderTrender” website (GallusMag 2012):

Autumn Sandeen: “I’ve always said there are two groups that are going to make change in transgender legislation and the “gender identity and expression” related language in legislation. It’s going to be trans youth because they take, you know, they demystify it and take the sex right out of the trans experience.”

Kim Pearson: “They do. They do.”

Sandeen: “And then, transgender veterans – or people doing service like police. But it’s going to be military, veterans, police, fire, those kind of folks who are serving to send a message- especially veterans. It’s hard to tell a veteran, you know, “we don’t appreciate your service because you’re transgender”.

Pearson: “Right. And it’s hard to say no to kids, and the needs of kids and “keeping kids safe”. And you know, “being respected in schools” and things like that. It’s really hard for people to say no to that.”

Where do we go from here?

Having reached this point, we have established the existence of two types of male transsexual, the homosexual and non-homosexual transsexual who are differentiated by sexual orientation and the existence of an inwardly-directed paraphilia (autogyephilia) (Blanchard 1985) and come to understand that the concept of “gender identity” may be historically be interpreted as relating to biological sex, social environment and culture (Stoller 1964) and for transsexuals tied to sexual orientation (Blanchard 2008) and (Cantor 2011). In contemporary use is can be interpreted as an innate “feeling” (Lawrence 2013) although this is not without ideological or philosophical objections (Reilly-Cooper 2015) and may not be supported by empirical evidence, even when claimed (Fine 2010). We have seen how the narratives of transgender children appear to share a commonality based on culture, which is transient (Maglaty 2011), and particularly for girls, sexual orientation. We have seen that the cross-sex identification of children often desists, with the child growing up into a homosexual adult (Cantor 2016). We have also seen that some narratives of transgender individuals who were not “transgender children” prima facie appear influenced by pornography (Williams 2016) and sexual fantasy (Roche 2016). It should be abundantly clear from this analysis that the feminine pre-homosexual “trans kids” have markedly different lives and lived experiences from the non-homosexual transsexual (Blanchard 2008) (Bailey and Triea 2007) and that concerns expressed that the transition of children will deplete the lesbian and gay population be taken seriously, based on the evidence we have seen around sexual orientation (Gerlich 2017).

I would suggest that any treatment protocol for children be evidence-based and dependent upon an agreed etiology for transsexualism. The present situation where the scientific enquiry and reporting of this is tightly politically controlled, in particular the attacking of any activity that is seen as being anything other than affirmative, is completely unacceptable and we should be able to have meaningful and rigorous enquiry on what it is that makes individuals ‘identify’ as the opposite sex. Within this field, scientific enquiry should no longer be obstructed and the routine harassment, vilification and intimidation of professionals within the field cease so that research is able to be conducted without personal or professional risk to those conducting such work, who should be free to investigate areas that at the moment would prove politically sensitive including for example investigating links between pornography consumption and autoynephilia, and childhood desistance rates. This of course can happen only with significant cultural change, especially from the transgender communities themselves.

Such cultural change can only happen if we are honest about what we already know about the etiology of transsexualism. That female and male transsexuals are different needs to be recognised and accepted, and that there are two types of male transsexual differentiated by sexual orientation needs also to be acknowledged and accepted. This in particular will require honesty from the majority of male transsexuals, those who are autogynephilic, and will require major cultural change and support from the professionals who help these people, so that the process is centred on destigmatising the truth about the subject’s paraphilic sexual orientation and facilitating their coming to terms with this, rather than skirting round the issue. Such change can only happen if this is reflected in culture exogenous to the trans community, and be compassionate to these transsexuals while also addressing the myths that exist in popular culture around transsexualism. The best people to lead and motivate such a dramatic yet sensitive change would, of course, be transsexuals themselves and they should be supported by a system that allows them to live the lives they wish with access to treatments, particularly psychiatric care and therapy that is based not upon validation of cross-sex identity but to helping the patient become comfortable within their own body; any treatment that permanently alters the body should be a last resort.

Finally, we should be accepting our children for who and what they are. Biological sex should not be a barrier to children enjoying the things that they do; if our boys love pink or our girls love trucks, the response should not be to suggest their personality is incongruent with their bodies, rather that the rules we have for boys and girls need to accommodate children who do not conform to gender-based stereotypes. As gender itself is based upon stereotypes, instead of protecting concepts of “gender identity” we should protect gender non-conformity, this would have the benefit of protecting homosexuality and our homosexual children, in particular not subjecting them to a culture that threatens gender non-confirming children and adults with homophobic abuse. Finally, more and better research needs to be conducted into avenues of desistence and non-interventional options exhausted before committing any young adult to any form of medical intervention.

Works Cited

Albert, Angelina. 2015. Transgender children: ‘I first realised Jackie was different when she was 18 months old’. 29 October. Accessed February 13, 2017. https://www.daynurseries.co.uk/news/article.cfm/id/1571947/Transgender-children-How-nurseries-can-support-those-with-gender-identity-issues accessed 13 February 2017.

Bailey, J Michael. 2003. The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism. Joseph Henry Press.

Bailey, J Michael, and Kiira Triea. 2007. “What many transgender activists don’t want you to know: and why you should know it anyway.” Perspectives in Biology and Medicine 521-534.

Blanchard, R. 1991. “Clinical observations and systematic studies of autogynephilia.” Journal of Sex and Marital Therapy 17: 235-251.

Blanchard, R. 2008. “Deconstructing the feminine essence narrative.” Archives of Sexual Behavior 505-10. Accessed February 14, 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180619/.

Blanchard, R. 2005. “Early history of the concept of autogynephilia.” Archives of Sexual Behaviour 439-446.

Blanchard, R. 1993. “Partial versus complete autogynephilia and gender dysphoria.” Journal of Sex and Marital Therapy 19: 301-307.

Blanchard, R. 1989. “The classification and labeling of nonhomosexual gender dysphorias.” Archives of Sexual Behaviour 18, 315–334.

—. 2003. “Theoretical and clinical parallels between body integrity identity disorder and gender identity disorder.” Third Annual International BIID Meeting. Columbia.

Blanchard, R. 1985. “Typology of male-to-female transsexualism.” Archives of Sexual Behaviour Jun;14(3): 247-61. Accessed February 14, 2017. https://www.ncbi.nlm.nih.gov/pubmed/4004548.

Buhrich, N & McConaghy, N. 1978. “Two clinically discrete syndromes of transsexualism.” British Journal of Psychiatry Jul;133 p73-6.

Butler, J. 1986. “Sex and Gender in Simone de Beauvoire’s Second Sex.” Yale French Studies 72 (Yale French Studies) 35-49.

Cantor, J. 2016. Do trans- kids stay trans- when they grow up? 11 January. Accessed February 15, 2017. http://www.sexologytoday.org/2016/01/do-trans-kids-stay-trans-when-they-grow_99.html.

Cantor, J. 2011. “New MRI Studies Support the Blanchard Typology of Male-to-Female Transsexualism.” Archives of Sexual Behaviour 863-864. Accessed February 14, 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180619/.

de Beauvoir, S. 1949. Le Deuxième Sexe [The Second Sex]. Paris: Gallimard.

Dreger, A D. 2008. “”The Controversy Surrounding The Man Who Would Be Queen: A Case History of the Politics of Science, Identity, and Sex in the Internet Age”.” Archives of Sexual Behaviour 37(3): 366–421. Accessed February 14, 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170124/.

—. 2015. Answers to Some Questions about Autogynephilia. 15 June. Accessed February 14, 2017. http://alicedreger.com/autogyn.

Egan, N. 2016. “17 Signs I Was Transgender But Didn’t Know It.” Trans Cafe. 27 June. Accessed February 14, 2017. http://www.trans.cafe/posts/2016/6/27/17-signs-i-was-transgender-but-didnt-know-it.

Fine, C. 2010. Delusions of Gender: How Our Minds, Society, and Neurosexism Create Difference. W W Norton & Company.

GallusMag. 2012. Transgender Children: “The Transgender Taboo is a Threat to Academic Freedom’. 26 January. Accessed February 9, 2017. https://gendertrender.wordpress.com/2012/01/26/transgender-children-the-transgender-taboo-is-a-threat-to-academic-freedom/ .

Gender Spectrum. 2016. Understanding Gender. Accessed February 14, 2017. https://www.genderspectrum.org/quick-links/understanding-gender/.

Gerlich, R. 2017. How do you know if you’re “transphobic”, and what is to be done about it? 27 February. Accessed March 1, 2017. https://reneejg.net/2017/02/27/how-do-you-know-if-youre-transphobic-and-what-is-to-be-done-about-it/.

Hirshfeld, M. 1918. Sexualpathologie Teil II 1918. Bonn: Marcus & Weber.

Kohut, R. 1972. “Thoughts on narcissism and narcissistic rage.” Psychoanalytic Study of the Child 27, 360–400.

Lawrence, A A. 2017. “Autogynephilia and the Typology of Male-to-Female Transsexualism.” European Psychologist 22(1) 39-54.

Lawrence, A A. 2004. “Autogynephilia: A Paraphilic Model of Gender Identity Disorder.” Journal of Gay & Lesbian Psychotherapy 8(1/2), 69-87.

Lawrence, A A. 2003. “Becoming What We Love.” Perspectives in Biology and Medicine Vol50 No4; 506–20.

—. 2013. Men Trapped in Men’s Bodies: Narratives of Autogynephilic Transsexualism. Springer Science & Business Media.

Lawrence, A A. 2008. “Shame and Narcissistic Rage in Autogynephilic Transsexualism.” Arcives of Sexual Behaviour 37:457–461. Accessed Ferbuary 14, 2017. http://pfox.org/Shame-Rage.pdf.

Lees, P. 2015. “Caitlyn Jenner: a life-affirming, provocative and downright fabulous Vanity Fair cover.” The Guardian. 1 June. Accessed February 14, 2017. https://www.theguardian.com/tv-and-radio/2015/jun/01/caitlyn-jenner-vanity-fair-cover-life-affirming.

—. 2014. “Kellie Maloney has always been female.” Independent. 11 August. Accessed February 14, 2017. http://www.independent.co.uk/voices/comment/gender-can-t-be-bent-kellie-maloney-always-was-female-9662916.html.

Maglaty, J. 2011. “When Did Girls Start Wearing Pink?” Smithsonian Magazine. 7 April. Accessed February 14, 2017. http://www.smithsonianmag.com/arts-culture/when-did-girls-start-wearing-pink-1370097/.

Moser, C. 2009. “Autogynephilia in Women.” Journal of Homosexuality 539-547.

N, Buhrich N & McConaghy. 1979. “Three clinically discrete categories of fetishistic transvestism.” Archives of Sexual Behaviour Volume 8, Number 2.

NHS Choices. 2009. “My Trans Daughter.” NHS Choices. 27 May. Accessed February 14, 2017. http://www.nhs.uk/Livewell/Transhealth/Pages/Transrealstorymother.aspx.

Price, Megan. 2013. Convenience Samples: What they are, and what they should (and should not) be used for. 5 April. Accessed February 14, 2017. https://hrdag.org/2013/04/05/convenience-samples-what-they-are/.

Rametti, G, B Carrillo, E Gómez-Gil, C Junque, L Zubiarre-Elorza, S Segovia, and A Guillamon. 2010. “The microstructure of white matter in male to female transsexuals before cross-sex hormonal treatment: A DTI study.” Journal of Psychiatric Research.

Reddit.com. 2016. /r/asktransgender. 24 March. Accessed February 14, 2017. https://www.reddit.com/r/asktransgender/comments/303ymf/question_about_porn/.

Reilly-Cooper, R. 2015. Sex and Gender: A Beginner’s Guide. Accessed February 14, 2017. https://sexandgenderintro.com/trans-issues-and-gender-identity/.

Roche, J. 2016. “Other Lands.” The Queerness. 1 August. Accessed February 14, 2017. https://thequeerness.com/2016/08/01/other-lands/.

Sandeen, A, and K Pearson. 2010. CTLS: Interview With TransYouth Family Allies Executive Director Kim Pearson. 18 May. Accessed February 14, 2017. https://youtu.be/_b_xQzP_jHk?t=414.

Savic, I, and S Arver. 2010. “Sex dimorphism of the brain in male-to-female transsexuals.” Cerebral Cortex.

Serano, J. 2015. “Reconceptualizing “Autogynephilia” as Female/Feminine Embodiment Fantasies (FEFs).” Whipping Girl. 26 May. Accessed February 14, 2017. http://juliaserano.blogspot.co.uk/2015/05/reconceptualizing-autogynephilia-as_26.html.

—. 2007. Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Feminity. Seal Press.

Singal, J. 2017. You Should Watch the BBC’s Controversial Documentary on the Gender-Dysphoria Researcher Kenneth Zucker. 13 January. Accessed February 14, 2017. http://nymag.com/scienceofus/2017/01/you-should-watch-the-bbcs-kenneth-zucker-documentary.html.

Stoller, R J. 1964. “A Contribution to the Study of Gender Identity.” Journal of Psychoanalysis 220-226.

—. 1968. Sex and gender: On the development of masculinity and femininity. New York: Science House.

The Tavistock and Portman NHS Foundation Trust. 2016(4). Gender Identity and Sexuality. Accessed February 14, 2017. http://gids.nhs.uk/gender-identity-and-sexuality.

—. 2016(2). Gender identity development service (GIDS). Accessed February 14, 2017. https://tavistockandportman.nhs.uk/care-and-treatment/our-clinical-services/gender-identity-development-service-gids/.

—. 2016. Gender Identity Development Service Statistics. 12 May. Accessed February 14, 2017. https://tavistockandportman.nhs.uk/documents/408/gids-service-statistics.pdf.

—. 2016(3). Why Do I Feel This Way? Accessed February 14, 2017. http://gids.nhs.uk/young-people#why-do-I-feel-this-way?#why-do-i-feel-this-way.

Williams, R. 2016. “Autogynephilia – A Critique and Personal Narrative.” Philosophical Percolations. 8 February. Accessed February 14, 2017. http://www.philpercs.com/2016/02/autogynephilia-a-critique-and-personal-narrative.html.

World Health Organisation. Undated. ‘What do we mean by “sex” and “gender”? Accessed February 14, 2017. http://apps.who.int/gender/whatisgender/en/.

Yardley, M. 2017. Common Threads And Narratives of Transgender Children And What This Means For Our Lesbian And Gay Populations. 5 May. Accessed May 5, 2017. http://mirandayardley.com/en/common-threads-and-narratives-of-transgender-children-and-what-this-means-for-our-lesbian-and-gay-populations/.

—. 2014. Kellie Maloney, Newsnight and the debate the transgender community refused to have. 18 August. Accessed February 14, 2017. http://www.newstatesman.com/politics/2014/08/kellie-maloney-newsnight-and-debate-transgender-community-refused-have.

—. 2015. “What Does It Mean to be Caitlyn?” The Morning Star. 4 June. Accessed February 14, 2017. https://www.morningstaronline.co.uk/a-d78a-What-does-it-mean-to-be-Caitlyn#.WKWT6_nyjIU.