TransRational is a diverse, international group dedicated to bringing rational perspectives to the trans debate.

Beyond Blanchard: Alternative Notions of Trans Etiologies for the Age of Information

by Kinesis

Hey everyone! I’ve been thinking a lot about the Blanchard typology and I’ve come to a place with it that I feel will generally get me automatically assigned the title of “lying AGP in denial” from staunch Blanchardists, but which I strongly feel has a solid logical and psychological basis in reason and potentially fact: the landscape has changed, and Blanchard’s two types are no longer the only two gangs in our West Side Story.


I’ve often heard it said that Blanchard’s theory is outdated by people who want to invalidate it. “It’s not even relevant any longer”, they say, “Autogynephilia (AGP) just doesn’t exist. It’s a myth.”

AGP is most certainly *not* a myth. It’s quite real, and I interact with many people who suffer from AGP (and some who just enjoy it) nearly every day. It’s quite real, and quite current.

Moreover, I have also interacted with enough HSTS types to know that the majority of them fit quite neatly into Blanchard’s typology. They too are quite real. Many people consider them to be the more “true” transsexuals, though from my personal standpoint this comes from shallow thinking: by looks and personality, yes, but transsexualism isn’t just about personality. It’s quite a bit more complex than that, as we’ll soon explore.

I’ve spent quite a while studying Blanchard’s ideas and discussing them with others, and as I said at the beginning, I have come to the conclusion that Blanchard’s research is, indeed, outdated.

However, I don’t believe he was wrong.

In the late 1980’s, when Blanchard’s work was published, the world was quite different from the world we see today. Let’s take a walk down memory lane, shall we?

I was born in 1986, and if I recall correctly was around 10 or 11 years old before I first learned the internet existed. It was Oregon Trail dial-up and by today’s standards it was so excruciatingly slow that if we had to go back to that era, we’d have given up trying to connect on the assumption that the internet was impossibly dead five minutes before the connection opened. Back then we’d start up the connection and be so excited for the junk emails that we could access ten minutes later. It felt so modern and cool. Things rapidly improved though: by sophomore year of high school, my secret school library Neopets addiction had already been realized.

Contrast this with nowadays, in which information flits around so rapidly that we can literally live-stream a video game to hundreds of people all over the world while we simultaneously capture ourselves and video record it while we stream it live. Obviously, this is not the same world Dr. B was living in when he wrote his typology.

In the world he was living in, transsexualism had to spring up from essentially nowhere. It wasn’t well understood, and for someone to even consider the idea of transition they had to have gender dysphoria so powerful that the desire would not only spring up on it’s own, but continue on it’s own in world that had little to no context for it, and where any information that existed was contained in a few easy-to-miss tv shows, a couple of obscure library tomes, or a few old newspaper articles on people like Christine Jörgenson. In other words, most people had to already want to seek out information on it before they found it. It wasn’t exactly something one ran into on a daily basis. And if one did, the concept was either treated as a scientific anomaly, a subset of the homosexual community, or a tabloid freakshow.

Because of this, there were really only two forces strong enough to drive someone to not only consider transition in the first place, but to seek out medical assistance and community support. Firstly, there were the HSTS, gay males so feminine in both psychology and biology that they were unable to function in society as men, and the rest of them: a heterogeneous group of men with various sexual orientations who, while not usually particularly feminine in psychology or biology, had a desperate and driving need to make themselves into women.

Blanchard’s great contribution was to discover the link between these sexual orientations: a typical history of paraphilic behavior involving oneself enacting or embodying one aspect of being female or another. Some fetishized becoming pregnant or having periods, while others were aroused by the idea of having breasts and a vagina. Some just wanted to be humiliated, emasculated, and treated as they believed women were or how they secretly desired to be; others became aroused by wearing women’s clothing. Even more complex: some became aroused at the idea of having sex in the way a heterosexual woman does, and developed a kind of pseudo-bisexuality in which they sought out men primarily for the way sexual contact with these men made them feel, rather than any genuine attraction. He grouped all of these together and called it “autogynephilia” (AGP).

Personally, I don’t think he was quite right to do so. Each of these variations is actually quite unique, but for a catch-all medical term it serves well enough. Too bad it got out- it’s not a very nice word to apply to oneself unless it’s a strong reality for you, and moreover, it’s deeper implications are difficult for people to want to understand when the word itself seems so openly offensive. It doesn’t help that some of the HSTS I’ve met, who tend to have been blessed with far more naturally feminine bodies, have a latched onto Blanchard’s typology and used it to bludgeon the more masculine AGPs. It’s led to a level of grade school level cliquishness that has only been harmful to the non-HSTS community.

Also frustrating is that radical feminists tend to take the same tack. Some AGP males who have “drank the kool-aid” as it is called when they choose to identify completely with the paraphilic self-image have occasionally act in incredibly obscene ways, and the nature of media is that these are the stories that travel around. Thus, AGPs have the misfortune as being often mistaken for the worst of their lot. And it doesn’t help that they are mostly attracted to female or transfeminine partners because it makes them, if mostly in the social imagination, potential predators. Thus, a passing AGP would be seen as more of a threat than a non-passing HSTS, because gay coded mannerisms tend to make women much more comfortable around a male. (I’ve used this hundreds of times and it’s extremely helpful for social interactions where I wish to instantly express to all the female people around me that I’ve got zero sexual interest in them.)

This is all anathema to Blanchard’s original purpose, which was, as he has said over and over, to provide a more accurate method of diagnosing transsexuals that would still give doctors a platform on which to reccommend them for surgery. AGP, he said, was an innate sexual orientation, nothing that could be changed, and therefore some level of transition would be necessary to help ease the patient’s suffering.

And make no mistake- AGPs usually suffer from their condition. If they don’t, it’s because they’ve done some tough internal work and have genuinely come to terms with themselves and who they are. Often as not, transition was a part of that journey.

In any case, both of these types were considered valid medical pathways for transition. Back before the age of the internet, when this information was initially compiled, these two motivations were the only two major psychological/ physiological states in which a person might wish to undergo such an intense process.

However, the world has changed.


The new environment

No longer a fringe concept, trans awareness has spread through culture like a fart in a crowded elevator. It’s everywhere you go and there’s no getting away from it. We’re still a fringe group, but a fringe group with a lot of social power. We can openly call people transphobic, but non-trans people have to suck it up and use our pronouns. We call it respect, but the vast majority of the outside world finds it awkward communication at best or infuriating at worst. A few people are very open to it and find it easy, but the majority of people cannot empathize and find it difficult when the trans person isn’t at least mostly passing for their target sex.

Meanwhile, there has always been a segment of the population that needs to be the victim. Chances are you’ve got at least one in your family- they’re quite common. It’s that person who’s always sick, whose problems are always worse than everyone else’s. And every other month it’s something new. In a society in which transsexuals are the number-one victim card, gender hypochondria becomes a new and sparkling option. Of course, it’s not as if they just pick it out of a basket and go for it- it’s a complex psychological process that begins with anxious rumination on the question “do I have this?”

This is one potential etiology for what Blanchard has coined as Rapid Onset Gender Dysphoria, or ROGD, but I feel the name is wrong- it’s so much more complex than just “oh look, I saw this on the internet and now two months later I’m a trans”.

Technically, Blanchard coined this term to offer an explanation for why there’s been a sudden 4000% uptick in FtM transitioners, especially those who are on the autism spectrum and who have been spending a lot of time with trans friend groups and on trans websites. While the existence of the Incels seems to me to be quite enough proof that online communities can influence people into extreme mental states and even violence, I can’t help but feel that prolific trans author Zinnia Jones has a valid counterpoint: how do we know that the person isn’t actually trans, and that their friend group isn’t just a group of people who need each other’s support?

Sometimes, it really *is* the case that the person is one form of trans or another. How often that’s true isn’t a data set we have right now, but by utilizing our observations of greater social patterns and wise application of psychology, it should eventually be possible to observe and predict. In any case, “Gender Hypochondria” (GH) might be a more accurate term than “ROGD” for many cases, though I rather doubt that this will be any more popular within the trans community, who have been so constantly inundated with naysayers and emotionally violent invalidation that they can’t see past their own empathy for people undergoing the same struggles they’ve been through. I’ve heard people describe this as “grooming”, but that’s so ignorant of the trans experience as to be nearly a slur. They are trying to prevent another person from having to walk through the same hell they have. They want to build a bridge over the lake of fire. It only looks like “grooming” if you’ve never had to walk through it yourself.

There is a story about a vedic god called Asha Vahishta, the god of truth. According to Hindu mythology, during the last days, he is responsible for the creation of a river of molten rock. All souls must pass through this river on their way to whatever comes next. Those who have lived a lie will be burnt until there is nothing left, while those who have lived with integrity will pass through easily, “as if it’s a river of warm milk”.

This story is an apt metaphor for the transition process itself: the experience is much easier for those of us for whom the process is natural or necessary. For those of us who are not being honest with themselves about their reasons, or for those whose reasons aren’t really in alignment with what’s good for them, it can be hell. A good example of this is a recent piece published by the New York Times in which the author describes her experience of transition as making her less happy than she’s ever been. And yet, like the souls of the damned she is compelled to continue deeper and deeper into the river of fire. Later, on Twitter, she tweets: “Yeah, I totally transitioned because ot turned me on”. We all must walk our own paths.

But I digress.

Medical Conditions

Aside from AGP, ROGD/GH, and HSTS, there are a number of other potential motivations for transition that would not have been powerful enough to motivate someone to seek medical or psychological help back in Blanchard’s day, but whose existence and emergence are made possible through access to technology.

Among them would be cases like my own: I was diagnosed with a chronic, severely debilitating autoimmune/nervous disorder called ME/CFS. While I’ve never been comfortable being male, I would never have transitioned merely because of emotional pain. I did not believe that hormones would really solve anything, I did not believe I had a particularly good body for it, I did not feel that a more feminine body could possibly be worth the pain of severed family ties, and ultimately gender issues seemed a problem that one should be able to simply meditate one’s way out of. Becoming a life long medical patient wasn’t a particularly attractive prospect either.

When I became sick, I had very little energy to do much, but when I did, I researched. Spending the next fifteen years of my life mostly confined to my bed, draining the resources of friends and family did not seem to me to be an attractive prognosis. The doctors gave up on trying to actually help me quickly and instead just told me to lie around and cope. After three long years of increasingly disabling and painful illness, I tried cross-sex hormone therapy on a well-researched hunch that most people felt was either nothing more than a wild theory or simply the proof I was secretly a woman.

I was too disabled to attend a gender clinic of any sort, and had it not been possible to simply obtain the medications on informed consent, and had those medications not been covered by state insurance, I’m not sure I would currently still be alive. If I were, I would almost certainly be living in the upstairs bedroom of my mother’s place, wishing I were dead from the constant onslaught of debilitating sound sensitivity and crippling fatigue. In Blanchard’s day, my case would never have appeared at all. And if it had, I most certainly would never have been allowed anywhere near the medications that have been my rebirth. WPATH standards of care, which were the result of technology allowing the trans community to come together and fight for medical privileges, literally saved my life. Or my ability to heal enough to write essays like this one, at least. I’m not cured, but I am a moderately functional member of society instead of a largely non-functional human-shaped pile of pain.

Moreover, I would not have had access to the information I did. I would not have been able to read article after article on nervous system and endocrine function. I’d never have reached that moment where I had failed to discover a meaningful connection between my symptom clusters, test results, and the three principal hormones: dopamine, adrenaline, and serotonin. I’d never have wondered whether or not there could be a connection between nerve health and sex hormones. And I’d never have learned that estrogen is vital for the rejuvenation and maintenance of the myelin sheath and of the sensory gating. In fact, I wouldn’t have even heard of sensory gating in the first place. This is my story, but I’m not alone. I’ve spoken with other transwomen, especially some of the old guard who have told me that many of us are quite susceptible to these kinds of physical ailments.

Taking anecdotes like mine into account, it becomes easy to see that the current informational and socio-political climate creates a world in which it’s much easier and more acceptable for people to transition today than it was in Blanchard’s time. And it is therefore possible that some people who appear to transition for reasons we might label AGP, GH, HSTS, or ROGD, may be nothing of the sort. It’s just possible that they are actually people who are experiencing an internal intuition that their body isn’t quite functioning correctly. Just putting that out there.

Anyway, in an informationless society, I and others like me would just be tragedies. Researchers like Blanchard would never have heard of us. We’d have simply wasted away.

Abuse and mental illness

Another type: sometimes trans people of both sexes are victims of sexual, psychological, or physical abuse, such as in the case of Walter Hyatt, whose story is quite interesting, even if I reserve my opinion on his character. There are also people who experience powerful cross-sex sensations during schizophrenic episodes.

It doesn’t stop there. The advent of the internet has created all kinds of diverse eddies in the cultural pond.

I strongly believe in the existence of something I’ve been calling Autoandrophobia, in which a male has a severe enough phobia of his own male anatomy that the discovery of an option like gential reassignment would seem like a gift from heaven. (As a side note, I’ve discussed this with several Female to Male transsexuals who feel that autogynephobia may be the best explanation for their experiences they’ve yet heard)

I strongly suspect that many Autoandrophobics are frequently mis-diagnosed as Autogynephiles by both experts and more commonly, packs of roving internet Blanchardists. However, despite autoandrophobia being my original experience with gender dysphoria, I have so far recieved no funding to study the phenomenon, and therefore have no real data with which to prove my assertions. The universe functions in dualities: one cannot separate fear from desire, and I think it’s quite obvious that the existence of one implies the existence of the other. If Blanchard had settled on autoandrophobia, I’d be writing about the existence of AGP.

In any case, it would seem quite clear why Blanchard could have missed many of this type as well: unlike AGPs, auto*phobics are not motivated by the desire to become the opposite sex so much as the desire to be rid of their sexed characteristics. Thus, prior to the age of information it’s less likely that they would have come up with the idea of wanting to become women, and if they did, how that desire played out is currently a function of guesswork. They might have seen psychologists with the desire to remove their genitals or breasts but not necessarily to become men or women and fallen into a totally different diagnostic category, such as body dysmorphia.

As an aside, auto*phobias may be the only cohesive theory for genuine non-binary dysphoria I know of.

Cultural siesmology and feminism

Another thing that could potentially make a person wish to identify as trans, especially in early life, is the allure of being part of a cultural rebellion. Trans is the frustrating-but-fashionable conversational subject of our time, and being a part of it means being a part of, and fighting on, the frontlines of history as it unfolds. We could be focusing on more important things, like climate change, but we’re too busy whining about bathrooms.

The information age has also been exceptionally helpful for women’s rights movements. Historically, due to being physically weaker than men on the whole, women have saught safety in numbers. Now, the access to global communications has made obtaining these numbers much easier than before. Women’s rights movements have made exponential progress over the past two decades. However, as with any rapid social movement, there is a backlash, and I strongly suspect that some fraction of the upswing of transgenderism is partly related.

The extreme fringes of feminism sometimes devolve into the explicit hatred of males, the glorification of political lesbianism, and the ominous sense in areas of male culture that women have taken up, or are trying to take up, all the roles. Now, not only does a man have to compete with other men, he also has to compete with women for the same positions. Positions that were already difficult for him to obtain in the first place.

Many men, especially those at the very bottom of the masculine totem pole, have erroneously found a shred of self-worth in the misogynistic notion that *at least they were born male*. Meanwhile, the traditional women’s roles have not been opened to them. Idealistically, yes- no one is going to say that men can’t aspire to be stay-at-home fathers because that would be unfashionable, but the reality is that men who want that life are seen as deadbeats, lazy, emasculate, or worse. Women tend to judge a heterosexual man who wants to be a house-husband somewhat harshly, and men who want life are rarely the sort of confident macho-types that attract women powerful enough to take on the role of breadwinner. Moreover, male society is still both emotionally regressive and suppressive. Men police masculinity, and if they don’t, one’s early years as a feminine or even mildly non-masculine male will have driven the point home. Thus, if a person feels the absence of any reason to be a man, but is trapped as one with no recourse, the foundations for a smoldering envy have been laid.


And finally, there’s always the chance that some trans people are genuinely intersex. I realize that this is currently a touchy point in the intersex community, but I have met one transwoman who I would bet everything I own is XXY because she has literally every symptom, and another I’ve known for years who was karyotyped and confirmed XXY but unable to transition because they’re also a type 1 diabetic and going on increased estrogen would kill them. You might argue that their experiences don’t count because they’re different, they’re actually intersex, but when I’ve engaged in discussions with them our internal experiences have been quite similar: in getting to know my real life friend, the conversation was a lot of “omg you too?” Perhaps, considering the influence of my medical condition, the application of Occam’s razor would simply say that I am intersex rather than trans, but in reality I have almost none of the symptoms of any of the intersex varieties. While I haven’t yet been karyotyped, I don’t particularly feel I need to be.

So then why would my experiences be so similar to those of an intersex person?

Honestly? I don’t know. Maybe I never will. Maybe it doesn’t matter. I’m not going around saying I’m intersex or that I have any clue what many intersex people go through. At most, I know that my experiences are quite similar to those of one XXY I know in real life and one I had a discussion with on Reddit. That’s just one type of intersex condition, and there are many. And it wouldn’t be just silly of me to co-opt their narrative: it would be insulting.

One thing I do know for sure: karyotyping is not part of the diagnostic process for transsexualism and I strongly believe it ought to be. It’s a data point that’s so absolutely obvious to me that I can’t see why it’s not one of the first things people considered. Just check and see. The data could be really useful. If intersex conditions occur in higher rates among the trans community, that certainly implies there may be things we haven’t yet discovered about the human body. If not, it’s another potential nail in the coffin for people who like to say that trans is a form of intersex.

One Final thought

Right now, as near as I can tell what matters most is keeping our heads and adjusting our perception to the changing cultural landscape. We’re not living in the same world as we were in the 1980’s. It’s high time we re-assess. We need to conduct new research from scratch, and we need a new star to arise: if Ray Blanchard is the Sigmund Freud of transsexualism, then it’s high time for it’s Carl Jung to appear and shed some light on the psychological nuance of its dreams.

The Seeds of Rationality

Autoandrophobia: A Pet Theory