A Review of “Is Transsexualism Really Independent of Sexual
Orientation?”, a Public Lecture From the CAMH Gender Identity Clinic

Presenter: James M. Cantor, Ph.D., Postdoctoral Fellow, Clinical Sexology Services, Law & Mental Health Program

Presented on: July 9, 2003 11:00am - 12:15pm


The people and the place being discussed in this article are particularly controversial. Partly it is due to their reputation when it comes to the treatment of transsexuals. The Clarke is the street slang for what was once called The Clarke Institute of Psychiatry’s Gender Identity Clinic. The Clarke is a teaching hospital focusing on metal health. It’s new name is The Center for Addiction and Mental Health, or CAMH. Some of the individuals that work in the Gender Identity Clinic have reputations too. Depending on who you ask they are either hell spawn or heaven sent.

Still even some people who have gone through the GIC at the Clarke and come away with positive feelings about it, still have a lot of problems with the Androphile/Autogynophile classifications of transsexuals. I’ve asked and they have told me quite clearly that they dissagree with this theory.

The lecture itself was about a theory supported by Dr. Ray Blanchard. It involves the idea that transsexuals can be split into two indivisible groups. The Androphiles, and the Autogynophiles

As for me, well let me introduce myself. My name is JT. Yes just that. Being stealth (hiding my trans identity and just living in the world as my chosen gender) does involve a little bit of concealment. I’m a currently 30 something TS with a little too much experience growing up trans. My interests involve the sciences including an interest in psychology hence my interest in this lecture. Although some of my interest in this theory is purely in the name of self defense.

The Attendees
Surprisingly there were many people at this lecture. Of the CAMH people there was of course Dr. Cantor, but also some other big names of the gender research field. Namely the main supporter of the theory being discussed, Dr. Ray Blanchard. Also in attendance was Dr. Kenneth Zucker, and Maxine E. Petersen (someone pointed her out to me.).

There was a sizable trans presence at this lecture. I knew several of the trans people from the local trans scene, or from one of the two online mailing lists that I’m a member of.

Others in attendance seemed to be people who worked for the CAMH. They had name tags, that’s how I knew. I suspect some were students since some of their conversations revolved around courses they were taking.

The Ideas Presented
The core concept of the lecture was that sexual orientation and gender identity had strong links to each other. Both MtF’s and FtM’s can be classified in such a way. The Androphile/Autogynophile MtF however is not quite as clean and easy a description of the way things are for Mtf transsexuals.

What I am presenting here is a summary of the ideas, not a word for word retelling of all that went on. If I wanted that I would have brought a video camera.

To start Dr. Cantor went over some of the popular ideas of what transsexualism is. The idea (or more like cliché) that there could be such a thing as a woman trapped in a man's body was seen as not realistic. Nor was the idea that sex and gender had nothing to do with each other. This was called the plumb pudding model of gender dysphoria. Basically a big confusing mixture of different ideas of transsexual origins and motivations.

He also mentioned how both extreme left and right wing groups were against transsexuals. The right mostly for religious reasons, and the left mostly as feminists who are very sure that men who become women are not women and degrade (The word rape was used) real women.

Finally he came to the idea of the two types of transsexuals, and how they can be classified by their sexual orientation.

The Androphile is noted for being a young person when they begin to object to their gender. They are seen as being a homosexual (attracted to males), being of lesser weight and height. They are supposed to cross dress without getting sexually aroused by the act of cross dressing (as a transvestite might). They have a gender a-typical childhood, meaning that they don’t just be one of the guys, playing team sports, rough housing, etc. They were also shown in the charts that were displayed to have toy and playmate preferences that were of the gender they desired to be (ie female). Lastly it was mentioned that there was a unequivocal desire for SRS by these individuals.

The Autogynophile is another matter since they are seen to crop up later in life. They are also called the Non-Androphilic transsexuals.

The autogynophile is supposed to get aroused by cross dressing therefore are more like transvestites in that their more like confused hetro males in need of the ultimate gender fix to make them feel at ease. This group is also more likely to present themselves to the Gender Clinic when they are age 30 to 40. Their childhoods are also more gender typical. This group is also seen as having a broad range of desires for SRS. Some 'really' want it, while others may not really know if it's for them. And of course the non-androphilic transsexual is most likely to exhibit autogynophilia. Autogynophilia is seen as a group of behaviours in a gender dysphoric person. These behaviours can include...

The other categories discussed were the female to male (FtM) transsexual, and the partial autogynophile. Brief mention of transvestites and cross dressers was mentioned but mostly on the topic of how society fails to distinguish between different trans groups.

The FtM part of the presentation mentioned that they FtM’s are almost all interested in women. This made at least one FtM in the audience put their hand up to challenge that idea.

Also it was said that the FtM’s were more likely to express their gender dysphoria at a young age and to be extreme tomboys. Cantor said that they found that the FtM’s were more likely to show up at the Gender Identity Clinic in their early 20’s rather than later in life.

To summarize what was said a diagram with 3 triangles were displayed on the over head power point presentation. It went something like this (start at top of column and read down)...

Gay (masculine) Simple Fetishist Feminine Lesbian
Gay (feminine) Transvestite Fetishist Masculine Lesbian
Drag Queen Partial Autogynophile Bull Dykes
Androphilic MtF Autogynophilic MtF FtM Transsexual

Next up in the presentation, Dr. Cantor spoke on the issue of SRS actually being beneficial to all groups of transsexuals. His conclusion was that in most cases it was beneficial. His numbers looked like this...

87% 97%
13% 3%

These numbers were gathered in follow up studies of patients.

Finally Dr. Cantor spoke on the roles of various individuals who work in the field of gender research and treatment, and also the role of politicians in all this.

The role of clinicians was seen to be able to recognize and normalize (make the person comfortable with) their feelings of autogynophilia if they are in that category. This is in response to an earlier system which classified the autogynophilic as unsuitable for SRS. Basically it used to be if one wasn't a hetrosexual in sexual orientation (ie liked men exclusively) then that patient was likely going to be denied SRS.

He also felt that clinicians should use care when assessing autogynophilic transsexuals for their suitability for surgery due to the uncertainty that is present in that group, while also realizing that surgery wasn't always the answer for every gender dysphoric person.

For researchers in the area of gender, he felt it was their role to “Carve nature at its joints”. What I take this to mean is to look at what is really going on. That studies of trans youth are irrelevant since youth are only androphiles (yeah right sure). There was mention of the studies of the wives of MtF's but my notes don't show if this is a good thing or considered a waste of time. Could be either but really anyone with a wife is likely to be pined as an autogynophile since most would be over 30 and would have lead a gender typical life until that time. Well it's a guess really so don't take this as exactly what was said.

For gender theorists he questions the idea that transsexuals are men trapped in womens bodies. That gender dysphoria neither supports nor denies the social construct of gender, and that an MtF is not the opposite of an FtM

Finally he mentioned that politicians needed to understand that all of these types of transsexuals deserved SRS. I imagine that this would be in relation to government funded health care (OHIP) covering the cost of the surgery, which was discontinued back in 1998. Again my notes fall short on details.


Unfortunately I didn’t take notes during the Q&A so I can only really recount my own question, plus I asked a someone who was there if she could remember her question and the answer she got. Fortunately she did.

The mysterious other someone who was there had the question about how bisexuals fit into Blanchard's theory of transsexuals. The response was pretty standard though. Bisexuals don't really exist. They are simply lying in order to fit into profiles that cast them in a favorable light..

My question was why the research for the theory was limited to the Clarke? This brought a response from Dr. Zucker who mentioned that a study done in a tribal culture, I can't remember which one, but one that hasn't been heavily affected by modern civilization was showing that the androphile is a very real phenomenon.

Dr. Ray Blanchard seemed to take my question somewhat personally. His face turned red as he went on about how everyone who wanted SRS in the province of Ontario went through the Clarke irregardless of socio-economic background since the surgery was being paid for by the province. He said that only a few well off persons opted to go it alone and pay their own ticket.

Small Talk and Coffee Talk

Immediately after the lecture was over people broke off into their own little groups. One or two people immediately went to speak with Dr. Cantor. They had voiced some opinions during the Q&A session.

Dr. Zucker came over to speak with me. He wondered if I had any ideas how communicating with the trans community for research purposes could be achieved. Unfortunately I didn’t do a lot of planning ahead for this kind of thing so I was without suggestions.

The room started to clear out after about 15 minutes. Some of the ladies decided to get together for the lunch hour. I was invited so I went along and wound up getting myself a soda with lime since I had to go to work soon. But others decided on the soup of the day to satisfy themselves. That gave us the time to discuss what had been said.

In short we were all very much not in support of the views that had been presented. We felt pretty equally that the theory didn’t describe us at all and that we were pretty universally offended by it too.

The age range in the group was from 30 to somewhere past 65 I think. I may be wrong but it would be rude to ask so we’ll go with that. Some were activist in their interests others were purely there for academic reasons. Two of us, myself and another lady really started our transitioning paths at very early ages (ie early twenties) compared with the rest of the group. And yet all of us felt Blanchard’s theory was bogus.

The Final Word

Okay this is the part where I get to put the final spin on things. Really I can’t agree fully with Blanchard’s idea about the two groups. I’ve seen too much variation that didn’t look like self-delusion, denial, or lying.

Having hung out on a youth based internet mailing list and met some of these people I’d say that a Lesbian or Bisexual trans youth definitely messes with Blanchard’s idea that androphiles are homosexual males who identify as women. From where I’m standing it really just doesn't work. I mean only people over a certain age are supposed to be autogyophile so how does a teenage trans lesbian fit the mold. Technically she can’t. She would have to be labeled an partial androphilic autogynophile or some strange combination, which Blanchard’s theory doesn’t allow for.

The two category system of this theory breeds an inflexibility no matter who it tries to describe. As much as I believe in simplicity in ideas. I also treasure flexibility in those ideas to deal with the real world as it presents itself. Something I think Blanchard has failed to take into account. The real world that is.

For further reading on the topic here is a list of books worth checking out.

The Man Who Would be Queen
J. Michael Bailey
A very controversial book that uses Blanchard’s ideas about transsexuals to support his own findings.

Brown, M., & Rounsely, C. A. (1996). True selves: Understanding
transsexualism--For families, friends, co-workers, and helping
professionals. San Francisco: Jossey-Bass