RESPONSE TO ANNE LAWRENCE AND REBECCA ALLISON ON AUTOGYNEPHILIA
Virginia Erhardt, Ph.D.
(Transgender Tapestry Journal # 94, Summer 2001)

(Part 1)

I’ve been struggling to understand my increasingly strong reactions to Anne Lawrence’s discussion of “Autogynephilia,” and Rebecca Allison’s response. My difficulties seem to stem from four factors: first, what I see as an erroneous use of the term paraphilia; second, my disagreement with some of the basic, value-laden assumptions undergirding the systematic categorization of Sexual and Gender Identity Disorders in the fourth edition of the DSM (Diagnostic and Statistical Manual) of the American Psychiatric Association; third, what I see as a genderpathophilic perspective I would prefer to believe only exists in nontranssexual people; and fourth, my irritation with the enduring tyranny of the binary imperative.

I was impressed by the quality of Anne Lawrence’s talk on “Autogynephilia” at Southern Comfort ’99. I have since read the corresponding piece on her web site. I do not argue against the existence of autogynephilia. Nor do I disagree that for some autogynephilic individuals, biological sex already matches gender identity. What strikes me as odd, however, is that Dr. Lawrence would choose to advance the piece of Ray Blanchard’s theory claiming that transsexuals who experience this phenomenon suffer from a paraphilia.

While Lawrence assures us that she does not mean to use the term paraphilia in a pejorative sense, this term is, at the very least, pathologizing. After all, it IS a psychiatric term used to label people as having a mental disorder. So how is the term paraphilia used by mental health professionals?

DSM IV (the fourth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association) defines paraphilia as a mental disorder characterized by two criteria: “recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving 1) nonhuman objects, 2) the suffering or humiliation of oneself or one’s partner, or 3) children or other nonconsenting persons, that occur over a period of at least 6 months (criterion A). The behavior, sexual urges, or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (criterion B).”

I assume that the rationale for inclusion of Transvestic Fetishism in the DSM is that the clothing/makeup/wigs, etc. are “nonhuman objects.” Yet, characterizing crossdressing as a paraphilia is simply incorrect unless the crossdresser a) experiences arousal, and b) this arousal causes clinically significant distress or impairment.

More to the point, I do not see how paraphilia criterion A accommodates arousal to ones own transformed body, whether one is in solitude or engaged in erotic activity with another. Perhaps Dr. Lawrence would like to expand criteria A to embrace autogynephilia, but for what purpose? As I see it, characterizing this experience as a paraphilic mental disorder does a disservice to an already maligned, marginalized, oppressed group.

My next point involves my objection to a great deal of the Sexual and Gender Identity Disorder section of the DSM. Here, I’ll simply mention one of my criticisms. “Transvestic Fetishism” (which is the only possible category justifying categorization of autogynephilia as a paraphilia) does not belong in a category composed mostly of criminal acts.

Public Exhibitionism; Voyeurism (observing unsuspecting [and thus nonconsenting] naked, undressing, or sexually engaged people); Frotteurism (touching and rubbing against a nonconsenting person); and Pedophilia are all nonconsensual, illegal acts. That leaves Sexual Masochism and Sadism, which are beyond the scope of this discussion; Fetishism (a general, catch-all diagnosis defined as sexual arousal involving the fantasy or actual use of nonliving objects, e.g., shoes); and Transvestic Fetishism (for some reason special enough to warrant its own individual diagnostic category).

Not too very long ago, homosexuality was a DSM mental disorder. Now it’s not supposed to be involved in a diagnosis unless it is ego dystonic (i.e., distressing due to being contrary to ones values or self-image). Thus, “persistent and marked distress about sexual orientation” is a diagnosable condition that fits in the category Sexual Disorder Not Otherwise Specified.. If any form of “fetishistic” behavior is to remain in DSM, this is where it belongs. It should not be seen as inherently a sexual mental disorder, nor should it be lumped in with illegal acts. If mentioned in DSM at all, the emphasis should be on intensely experienced distress about it. Considering crossdressing in and of itself a mental disorder is ridiculous. Placing crossdressers of any kind in the same category with criminals is reactionary, ludicrous, and harmful.

Continue to part two of this article

Return to the article index