Review

This review was originally written for the Astral Codex Ten Book Review Contest. Unfortunately it didn’t make it as one of the finalists. but since I made use of the LessWrong  proofreading/feedback service, I am reposting it here. It can also be found on my gender blog.

If I ask ChatGPT to explain transgender people to me, then it often retreats into vague discussions of gender identity. It is very hard to get it to explain what these things mean, in terms of actual experiences people might have. And that might not be a coincidence - the concepts used to understand transness seem to be the result of a complicated political negotiation, at least as much as they are optimized to communicate people’s experiences.

Some people claim to do better, using elaborate words like autogynephilia and gynandromorphophilia and so on. They speak of typologies, science and history. Of developmental pathways and genetics. This ideology is sometimes called Blanchardianism, named after Ray Blanchard, a sex researcher who contributed many influential ideas within the sphere.

Phil Illy’s book, Autoheterosexual: Attracted to Being the Other Sex is the latest book pushing Blanchardianism. But is it any good?

Summary of the book on autogynephilia

Both Phil and I are probably most familiar with the concept of autogynephilia, so let’s start there. A substantial part of the book is about the feelings and experiences of autogynephiles.

Some individuals, born male, feel a deep happiness when imagining themselves as a woman and a deep sadness being a man, and this is often due to autogynephilia. Phil Illy explains that autogynephilia can be seen as an inverted form of sexual attraction to women, where the individual's attraction to women is applied to themselves. Autogynephilia is ultimately about sexuality, but Phil emphasizes that many of the feelings and experiences he describes are not driven by lust, but instead by strong emotional attachments. In some cases it can cause them to have medical treatment and make social changes to live as women.

Phil suggests that this accounts for most trans women in the US. Some people with strong autogynephilia might feel as if they have female body parts, like breasts or a vagina, even if they haven't undergone any medical procedures to obtain these features. The book also looks at how autogynephiles might act more like women in the way they talk and move, and how they might want to prefer spending their time around women rather than men.

Phil Illy talks about how autogynephiles enjoy the feeling and look of women's clothes. Wearing these clothes can sometimes replace friendships and socializing for them. Autogynephilia can also make someone feel like they have a period, even though they don't (because they want to have a female body). The book also talks about autogynephiles stealing clothes from female family members.

The author looks at many different parts of autogynephilia to help readers understand it better, including the sexual side. He explains that autogynephiles have sexual fantasies about becoming a woman through magic or science fiction, or about being embarrassed by wearing women's clothes and being sexually submissive to men. They might also have fantasies about having sex with dominant women who make them submit. During sex, they may wear women's clothes or special devices called chastity cages. These sexual parts of autogynephilia help us understand the whole experience and desires of people with this orientation.

As mentioned before, Phil claims autogynephilia accounts for most trans women in the US. But most trans women, and the trans community in general, disagree with this assessment, and claim that trans women don’t transition because of autogynephilia. So why does he believe that? He bases this on multiple different sources.

First, he draws heavily on some of the very earliest collections of case studies we have on transfeminine identity. He says that the transvestites in these studies are unlikely to face the political pressures that most modern trans women face, and therefore more likely to be honest about their autogynephilia. These include texts from the books Richard von Krafft-Ebing’s Psychopathia Sexualis, Havelock Ellis’ Studies In The Psychology Of Sex (Eonism), and Hirchsfeld’s Transvestites. One case he draws a lot on is the case he calls the Hungarian physician (case 129), which I would summarize as follows:

He was born into a family with a history of mental illnesses and, as a child, was small, pretty, introverted, and intelligent. He shared a close bond with his mother and was treated like a girl by her sisters.

As he grew older, the Hungarian physician started to feel ashamed of and resistant to being treated like a girl. He developed an obsession with soldiers and was often bullied for his feminine appearance. Secretly, he harbored a strong fascination with women's gloves, often trying them on in private. His skin became very sensitive as he matured, causing irritation from his pants.

In adulthood, the physician grew a beard, which gave him a more masculine appearance and lessened his concerns about bullying. Although he was sexually attracted to women, he also desired to wear women's clothes. Women enjoyed his company, but he tried to avoid them to prevent appearing feminine. Once, he confided in a friend about his wish to be a woman but couldn't explain why. As was common during that time, he felt ashamed about masturbating.

During his first sexual encounter with a woman, he wished he could be a woman too. He eventually engaged in heavy drinking, dueling, and attempted suicide twice. He suffered from insomnia, which led to hallucinations, and went on to study and become a doctor. He married an extroverted woman and had five children, all of whom had mental illnesses.

The physician developed gout and sought treatment through medical baths. One of these baths involved a particularly large dose of extract from Indian hemp. This treatment led to intense hallucinations, including the sensation of having a female body. He also experienced anemia, chest pain, cramps, and bizarre feelings as though he was giving birth. Afterward, he continued to have hallucinations and felt as if he had become a woman.

He experienced muscular weakness and heightened sensitivity to intense stimuli, such as loud noises. He believed that he could only consume what he called "a female diet" and felt that he regularly experienced period symptoms.

Another key source of evidence is Ray Blanchard’s studies. Based on their clinical experience, researchers had previously speculated about types of trans women, with various patterns. Often these proposals have included a fetishistic type and a feminine/homosexual type.

One of Blanchard’s contributions was studying this on an unprecedentedly large scale. He found that among trans women who were exclusively sexually attracted to men, autogynephilia was rare, but among trans women who reported being attracted to women, being bisexual, or being asexual, the majority had reported some autogynephilic tendencies, such as having become sexually aroused while wearing women’s clothes. This research has since been replicated by others, though some of the details have not yet 100% converged.

Blanchard also performed studies which found that the autogynephilic/nonandrophilic trans women were more similar to each other than to androphilic trans women in characteristics such as age of transition. He also studied trans women who seemed to contradict his theories more closely, and found that upon further inspection they might actually fit; for instance sometimes the trans women turned out to be lying, which he found out by asking their wives about things.

One key thing that might be interesting to know about autogynephilia is how common it is. Phil looks at various studies that investigate the prevalence of autogynephilia, such as a single question about whether participants have a preference of “imagining being of the opposite sex to obtain sexual arousal”. By looking at various statistics from various studies, Phil estimates that the prevalence of strong autogynephilia is around 2%, comparable to the prevalence of male homosexuality, which he also estimates to be around 2%.

Pseudo autogynephilia vs true autogynephilia

The biggest problem with the book is that many of its core points are wrong. One way to think of this* is by looking at how the studies in the book tried to find out how common autogynephilia is. They asked people a few questions about whether they felt sexually excited by the idea of having a female body or wearing women's clothes.

In order for this to work, the main reason people would answer "yes" to those questions should be because they have the true form of autogynephilia described in the book. However, based on questions I’ve asked of men who say they have this sexuality, they often have a different condition, which I'll call "pseudo autogynephilia." This condition differs from true autogynephilia in several ways, some of which can be seen here:

(You shouldn’t think of the above as necessarily following a specific pattern. The “true autogynephilia” column just contains the characteristics that Phil has collected which are descriptive of autogynephilia. “Pseudo autogynephilia” are just the characteristics (e.g. sexual fantasies) I have collected which are descriptive of men who score high on measures intended to get at true autogynephilia. Maybe there is a pattern, but it’s not the point.)

This error makes me question the core claims of the book. For instance, how do we know that the trans women Blanchard studied had true autogynephilia, rather than pseudo autogynephilia (or some third thing)? We don’t, really.

I also don’t think I buy into the book’s characterization of true autogynephilia, even beyond the distinction from pseudo autogynephilia. For instance, while there no doubt are males who are into being forcibly feminized and having their penises locked in chastity cages, is that really best thought of as a self-directed form of attraction to women? That is deeply counterintuitive to me, because it doesn’t seem similar to typical attraction to women.

An alternate theory of the origins of forced feminization would be the following: Maybe some find it shameful to be feminized (... perhaps because of societal stigma against male femininity?), and for some people shame becomes erotic. This would explain not just their eroticization of forced feminization, but also their eroticization of things like chastity cages, which don’t seem particularly feminizing.

I think what happened is that there were some trans women who just happened to be masochistic (lots of people are masochistic!), and people jumped on lumping this into the category of autogynephilia, without thinking about whether it was really better explained by other factors. There are many examples of this, where the book picks up a thing from an old story, suggests it originates from an inversion of heterosexuality, but where the thing really seems better explained by other factors, e.g.:

  • Does inverted heterosexuality supplant the need for friendship, or is it just that someone had some introverted tendencies or social difficulties which may or may not independently correlate with transness?
  • Was the Hungarian physician’s perceptions of having a female body really due to autogynephilia, or did it have something to do with their drug use and mental illnesses?

Anyway, pseudo autogynephilia vs true autogynephilia is one thing, but perhaps more important is the direction of causality between autogynephilia and transness. This is a highly controversial question, because it determines whether autogynephilia can be seen as the cause of transness or just a byproduct of it.

I’m not really satisfied with Phil’s treatment of the question of causality. It seems to me that there are good arguments to be made, but instead he makes bad ones. Specifically, Phil has a chapter of the question, where he makes six arguments:

  1. Some critics argue that autogynephilia cannot be causal for transness because cis women are autogynephilic too. But actually those people are wrong because cis women aren’t all that autogynephilic, and even if they were, that has nothing to do with what is going on in trans women.
  2. Some critics argue that trans women might have autogynephilia-like sexuality because they want to be female and dislike being male. But if that is true, then how does one explain the following facts:
    1. Autogynephilia-like sexuality is less common among trans women exclusively attracted to men,
    2. There are men with autogynephilia-like sexuality who don’t transition,
    3. Sexual orientation labels like “gay” are usually causally downstream from sexual attractions like getting boners when seeing hunks, so by analogy gender identity labels like “trans” should be causally downstream of sexual autogynephilic attraction.
  3. Trans women often have experiences in their childhood where they wanted to be girls, before their autogynephilic sexual arousal in puberty. This is analogous to how people of other sexual orientations often have childhood crushes, so this supports autogynephilia being causal. 

I’ll address these in reverse order; 3-2c-2b-2a. I’ll skip responding to 1 because the whole debate on it is a giant mess that would take a long and convoluted text to sort out while mainly concluding that I am too confused about the matter to know anything about it**.

3: I was really confused when reading argument 3. You might think I’ve made a mistake when explaining it - usually when you see a correlation between A and B, you’d think the one that comes first is the cause. But instead the author is arguing the opposite, that this shows autogynephilia to be the cause.

Phil’s argument seems to be in response to people arguing the opposite, obvious thing: that cross-gender ideation coming before autogynephilia means that autogynephilia is a side-effect and not a cause. I am sympathetic to Phil’s argument that childhood crushes that develop before one has unambiguous sexual arousal seem common, and that therefore the argument from timing isn’t as strong as one would think.

However, I think Phil goes too far when he concludes that the ordering is therefore evidence for autogynephilia being causal. This seems to be an error that I often see him making: he often jumps from the fact that one can shoehorn a phenomenon into his model, to the assumption that this phenomenon is therefore evidence for his model. 

2c: I think the argument about the causality of labels misses the point. Yes, it is true that labels like “homosexual” are causally downstream of experiences of sexual attraction to men. But what people are suggesting is not that an arbitrary gender label causes trans women to have sexual fantasies involving themselves as women, but rather that trans women’s dysphoria about being male and desire to be female causes this sexuality.

In the section where he makes the argument, Phil is very focused on the idea that gender identity labels change but sexual orientations do not change. He argues that since the change in self-identity happens much later than the autogynephilic arousal, identity cannot be taken to cause autogynephilia.

But in my experience, even way prior to transition, if you go out and ask autogynephiles how they feel about being male, they will give very different answers from what you get if you ask ordinary men. For instance one study found effect sizes of d=1.86 to d=2.85 (depending on how you count).

2b: It is true that there are autogynephiles who don’t transition. Some of them really want to transition and dislike being male; for instance I’ve seen one of them say the following:

I have always felt deep down that I would prefer to be female. I prefer the way they dress and act and it always made me a bit jealous of girls. I feel I would be more comfortable in my own skin as a female. I have come to terms with the way that I feel and accept that I wouldn’t want to go through a transition. I am okay with the way that I feel now and have learned to accept those feelings.

I don’t feel that I am traditionally very manly and feel more comfortable around girls

I think people who advocate the theory that gender dysphoria causes autogynephilia would be perfectly happy to bite the bullet that this guy’s gender feelings caused him to eroticize feminization, even though he doesn’t literally label himself as a woman.

On the other hand, there seems to be some autogynephiles who this doesn’t apply to; whose autogynephilia seems to exceed what could be explained by their desire to be a woman. But that just means that autogynephilia and gender identity are not deterministically correlated. As nondeterminism is a symmetric relationship, it doesn’t disprove that gender identity influences autogynephilia any more than it disproves that autogynephilia influences gender identity. It just means that there are other factors in play.

You can make up stories about what those factors are - ideology, sexual success, experience, etc. - but the opposing side can also make up stories about what the alternate factors that could cause autogynephilia are (e.g. I am pretty sure I’ve seen someone suggest that curiosity may play a role in causing autogynephilia without feminine gender identity).

2a: The argument goes that if autogynephilia was influenced by gender identity, then it should be as common among trans women who are attracted to women as it is among trans women who are attracted to men.

I don’t understand this argument. Elsewhere in the book, Phil says that attraction to women is a contributor to autogynephilia because this attraction gets “inverted” onto oneself in some sense. This seems intuitively sufficient to explain sexual orientation differences in autogynephilia among trans women by sexual orientation.

✱ Another way to think of this problem is to say that the author’s method for diagnosing autogynephilia is correct, but that the author is wrong about what autogynephilia is like. I would usually use this latter frame, of thinking of the problem as people being wrong about what autogynephilia is like. But Phil’s description of autogynephilia is common elsewhere, and it’s such a struggle to enforce an alternate description of autogynephilia that I am giving up.

If I’m willing to think of pseudo autogynephilia as being the real form of autogynephilia, with Phil just getting some facts about the characteristics of autogynephilia wrong, then I would not be surprised if my point sounds nitpicky to some of the readers. Who cares if it got a few details of autogynephilia wrong? But think of it from this perspective: throughout the book, Phil often has a narrative that trans women are in denial about autogynephilia, but that science will eventually prove him right. However if he gets most of the characteristics of autogynephilia wrong, then 1) it’s no surprise that trans women fail to relate to his descriptions, and 2) science will presumably prove him wrong.

When I asked Phil, he also said he preferred the pseudo autogynephilia vs true autogynephilia characterization to a characterization of him just being totally wrong about autogynephilia.

✱✱ If you want to see the most recent serious entry into the debate about autogynephilia in cis women, then it is the paper It Helps If You Stop Confusing Gender Dysphoria and Transvestism. It is somewhat biased against autogynephilia theory, though. See also my post, Transvestism vs Gender Dysphoria vs … for more.

The good and the bad

There is so much more that could be said about the flaws of this book. I’ve put a list of what I consider to be the most egregious flaws at the second-last part of this review. Perhaps the biggest flaw is that it often uses the same voice for ultra-speculative things as it does for well-established things, rather than properly acknowledging uncertainty. And it regularly makes strange assertions that seem to be strongly picking political sides, while neither acknowledging the political element nor rationally justifying the statements.

However, the book is not all bad.

Most importantly, the book talks about autoandrophilia, which is the female equivalent of autogynephilia. While autogynephiles are males who feel attracted to being female, autoandrophiles are females who feel attracted to being male. In my experience, people often don't think this kind of sexuality is important when talking about transgender issues. Some say they think that only men can have unusual sexual desires. But autoandrophilia is real! And it's likely an important factor for trans men (as well as for women who privately wish they were men but don't transition)!

As part of this, it gives examples of various aspects of autoandrophilia. These examples are sorely needed, as there are currently very few places that talk about what autoandrophilia is like. It includes discussion of how transvestism is more of a thing among autogynephiles than autoandrophiles, as well as discussion of how some autoandrophiles enjoy taking on the male role and picking up women.

That said, I think the book can end up treating things in an overly symmetric way. Unlike men, women seem to face very strong gender norms about looking good and being warm to others, and women who have male-typical interests often face problems as a result. I think this can lead to gender dissatisfaction driven not by sexuality, but by avoidance of gender norms.

While I complained earlier about aspects of its portrayal of autogynephiles, there are also aspects of its portrayal that are great. Its description of autogynephilic transvestism is detailed and informative. It gives lots of examples, and it is clearly a topic the author is passionate about.

It is also very informative about an adjacent topic, namely ‘traps’ - which it defines as feminized males with an intact penis*. Did you know that men who are attracted to traps are usually more attracted to cis women than to cis men? Did you know that men who are attracted to traps are also often autogynephilic? I knew that ahead of time, but many people might not. By reading the book, you can learn much more about this sort of attraction.

One concept he brings up is erotic target location errors. Basically, consider the controversy of Rachel Dolezal, a woman who became the center of a controversy for identifying as black when she was born white. Phil suggests that she may be “autophylophilic”, sexually attracted to being black, a sort of racial analogue of autogynephilia. Phil suggests that for any trait one can be sexually attracted to in others, there can be a corresponding self-directed sexual attraction, and he gives examples of this, including furries and body integrity identity disorder.

I am not sure I buy Phil’s story about autophylophilia and erotic target location errors. However, the chapter on transracialism is interesting, as it gives more details about Rachel Dolezal’s background. Did you know that she had a strong, lifelong attraction to black culture? Unfortunately, due to the many errors elsewhere in the book, I am not sure whether I can trust Phil to accurately represent Rachel Dolezal’s background, but it certainly is fascinating if true.

Finally, the book has some chapters on politics. Its chapter addressing general trans politics seems balanced and compassionate. It addresses questions such as how we should accept transition for autoheterosexuals, or what to make of transrace people. It also emphasizes the need for trans people to respect if cis people aren’t sexually attracted to them. It is not perfect, as some of its positions are dubious and there are a lot of unanswered questions, but it strikes a nice balance.

✱ Often these would be trans women rather than cis men. However figuring out the right categorization is tricky for all sorts of reasons. I’m using the term ‘traps’ because it is the most convenient term I know of which encompasses everyone in the group in question regardless of gender identity, and because this is the term the book uses for this section. However you should be aware that the term is usually considered offensive within the trans community.

Evaluation

Even if the book gets some things wrong, might it still be getting the big picture right? Should you read it? Let’s start with whether it gets the big picture right.

I am sympathetic to the idea that sexuality often plays a big role in transition. However, as you can see by the pseudo autogynephilia vs true autogynephilia distinction I came up with, I think Phil gets many of the details wrong. But it doesn’t seem that those specifics are what most people object to.

From asking around, I’ve found that most people believe in a theory that if people repress their desires, then those desires may come out sexually. I call this theory “masochistic CEO theory” because the archetypal example is an overworked CEO who goes to a dominatrix to release control after being overstressed at work.

If you believe in masochistic CEO theory, then the idea that something like autogynephilia plays a causal role in transitioning is probably very questionable, because people have done almost nothing to rule out the reverse causality, that repressed transgender identity causes autogynephilia-like sexuality. I personally don’t believe in masochistic CEO theory because I have never seen evidence for it and it doesn’t align with my theory of why sexuality exists or how sexuality works.

Other than autoheterosexuality, there are basically two alternative positions in the debate of how transness works. One is the feminine essence narrative (for MtFs; I suppose the corresponding FtM version could be called the masculine essence narrative). In this narrative, trans people transition because they are in some mental sense really like the opposite sex, and this inevitably leads to gender dissatisfaction. This is the narrative the book is in response to:

If someone’s deepest, most heartfelt wish was to be the other sex, which of the following explanations for their gender feelings would feel more emotionally satisfying?

They want to be the other sex because:

  1. In truth, they are actually more like the other sex in mind and spirit, but a mistake in development led them to have the wrong anatomy.
  2. They have an autosexual version of heterosexuality that makes them happier when they feel similar to the other sex or embody traits they associate with it.

It’s a no-brainer, right? The first one is obviously more emotionally satisfying.

This is why hearing about autoheterosexuality is so upsetting to many trans people. It suggests to them that their desire to be the other sex is ultimately because they are not that sex. Furthermore, their drive to be the other sex comes from a type of heterosexuality—the least queer kind of sexuality.

The autoheterosexual explanation can undermine the hard-earned sense of identity they’ve painstakingly constructed over years. Many loathe the concepts of autoandrophilia and autogynephilia, as well as the two-type typology that categorizes them as autoheterosexual if they aren’t solely same-sex attracted.

However, only a minority of autoheterosexuals transition to live as the other sex.

What about the rest of us? Don’t we deserve a fair shot at making sense of our experiences?

If either theory is true, it may eventually be provable using neuroscience to identify autogynephilia or brain feminization and show the direction of causality. This means that we can use prediction markets about future neuroscience findings to establish a consensus. I have made a market about this on Manifold Markets, which at the time of writing gives the theory 21%-23% probability, much more than the 12% probability of the feminine essence narrative:

(This is a thinly traded market. If you know anything about the topic, please trade to improve the probabilities!)

However, it appears that the most popular answer (at least for now) is that neither feminine essence nor autogynephilia theory is correct. I don’t think I’ve seen any satisfying alternate theories despite thinking about this subject a lot, so it is basically the “we don’t know yet” option.

And that makes it hard to evaluate, because it would require us to come up with fundamentally new ideas about gender identity, and I don’t know how those ideas would change my mind on existing issues.

But should you read the book? Phil suggests that instead of phrasing it as a yes/no question, I should think of it in a more open-ended way: If a person is autogynephilic or autoandrophilic, then what could they be asked to read to develop a better understanding of themselves?

The fact is, I don’t know of any great alternative writings on the topic. From that perspective, it is possible that Phil’s book is the “least bad” option, giving an overview of things from a sympathetic point of view. My fear is that the many flaws create confusion, and that the often strange or misleading arguments will lead critics to (rightly) conclude that this book is in bad faith. But I can’t deny his point that there is a lack of good alternative resources.

(If you know of any alternative resources, then please post them in the comments.)

So, if the topic seems relevant to you, then yes, it may be a good idea to read the book. Just beware of taking it too seriously, or you will probably end up caught on one of its many mistakes. Make sure to read widely (the book contains some references to get you started), and also make sure to be aware that the science in this area is overall very questionable.

Phil has this idea that his book will lead to a revolution, where many people come out as autogynephilic or autoandrophilic, and people discover the many applications of autoheterosexuality theory. I am skeptical of this.

Most of the direct applications of the autoheterosexuality concept “cut across” the category of autoheterosexuality, separating it in two. For example, autoheterosexuals who don’t transition need some name for their situation, and at times I’ve seen them identify as having “just a fetish”, which seems to me like a natural idea that they would spontaneously come up with, even without any activism.

But the notion of “I am not trans, I just have a fetish” is memetically similar to the concept of “I do not have a feminine essence, I am autogynephilic”, to the point where in my experience people have a hard time distinguishing between the two. And the distinction is critically important if we want to treat autoheterosexuality as the primary explanation of transness, because in that case we cannot treat the notion of autoheterosexuality as the opposite of being trans.

Phil tries hard to work against this in his book. However I think he will fail because he is working against natural memetic evolution. For example, it doesn’t seem to me that it is useful for people’s primary identity label to be one that lumps together private transvestites with public transsexuals, because it doesn’t relate to people’s lives. Instead I expect people to end up categorizing based on lifestyle.

Years ago, I was challenged to come up with practical applications of autoheterosexuality theory. I never succeeded. I am reminded of the post Extreme Rationality: It’s Not That Great. Aspects of autoheterosexuality theory may if you are lucky bring some clarity-of-mind benefits, but nobody has been able to come up with convincing applications that help you in practice. Still, you may appreciate the clarity-of-mind benefits anyway.

I also think fans of autogynephilia theory make their own research mistakes because they try hard to avoid distinguishing between autogynephilic cis men and gynephilic trans women. They generalize things inappropriately back and forth between trans women and autogynephilic cis men, without checking whether the generalizations are valid.

For instance, many autoheterosexuals seem to end up with an intuition that their feelings can be repressed through romantic relationships, Phil claims it has been found to not work. He may be right about the conclusion of it not working, however the primary evidence is based on trans women’s experiences, and since trans women by definition didn’t end up repressing, it would seem that if it sometimes works, you wouldn’t have heard about it through the methods he used.

Some of the most egregious flaws

This is a list of some very basic facts which I think affect how you interpret lots of other facts and which I think the book either gets wrong or does not sufficiently inform people about.

Meta-attraction: There is a phenomenon called meta-attraction, where autoheterosexuals develop a sort of desire to have homosexual sex, which is distinct from standard homosexuality. That is, an autogynephilic male might be interested in crossdressing and then having sex with males. I basically buy that it exists and is distinct from ordinary androphilia.

However, the concept of meta-attraction can end up being a form of gaslighting; on the one hand, the book emphasizes that meta-attracted autogynephiles are not truly attracted to men’s bodies, but instead fantasize about them as ‘faceless men’ who might as well be disembodied penises.

But on the other hand, the book emphasizes that it can be difficult to tell the difference between meta-attraction and classical attraction. These seem hard to square to me, and in my impression when communities apply the concept of meta-attraction, it is often done in a gaslighty manner, where they tell people that they are deluded about their sexual experiences.

Homosexuality and gender identity: The book vaguely implies that there is a connection between homosexuality and gender dissatisfaction, while neglecting to mention that typical gay men are as happy about being male as straight men are.

This problem feels especially noticeable in the chapter on juvenile transition. The book argues that when minors transition, they are usually homosexual rather than autoheterosexual.

However, if homosexual males typically end up perfectly happy with being male*, why is transition a good idea for them? Do the ones who end up transitioning have a fundamentally different condition than ordinary homosexuality? Do they transition because of factors like bullying, which might be better addressed by other means?

I don’t know, and these are the questions that make me most ambivalent about transition for minors, but they aren’t addressed.

Heritability: The book discusses heritability in a way that is basically invalid, due to the phenotypic null hypothesis. It treats heritability as a proof that things are biological, when really basically everything is heritable in a tautological way.

Apophenia: The book often makes very questionable inferences, involving linking things that are barely even related.

For instance, you may have heard that there is a very large sex difference on the people-things dimension of work interests, which means that men are more interested in jobs such as carpentry which involve working with things, while women are more interested in being social workers or similar, which involves working with people.

Phil makes the leap that this also makes men more sexually attracted to objects such as clothing, potentially explaining the sex difference in transvestic fetishism.

I would be extremely surprised if Phil turns out even remotely close to right in this prediction. And this is not the only case of similar apophenia.

Motte-Bailey in the romance hypothesis: One controversial concept within autogynephilia theory is called the “romance hypothesis”.

The motte version of this theory is a response to people arguing that autogynephilia theory must be wrong, because you would predict that as trans women start antiandrogen therapy, their reduction in libido should make them stop wanting to transition. Here, the romance hypothesis asserts that autogynephiles develop an emotional attachment to being female, analogous to romantic love, which causes them to want to stay women, even without lust.

I think many trans women’s experiences can be shoehorned into the motte theory, and so it is hard to argue against. Though because it states things so weakly, it can also be hard to argue in favor of it.

To defend the romance hypothesis, Phil argues that it has been observed for decades, citing researchers such as H. T. Buckner, who finds that transvestites treat their crossdressed selves as a sort of girlfriend. This includes buying gifts for themselves, talking about themselves in a dissociated/dualized way, etc.. Phil also cites the example of Lou Sullivan, a trans man who would speak of his union between his male and female self, and sing about his self-love:

Seven years prior to his gender transition, Lou Sullivan touched on this theme of internal union in his diary. Just before he got his first leather jacket and began to commit more deeply to transvestism, he wrote: I love to blend female and male—I think of myself as two people finally coming together in peace with each other. Of my other half, I sing, ‘Nobody loves me but me adores you!’”

This is the bailey version of the romance hypothesis: that autogynephiles create a female identity and in a very literal sense treat this female identity as a girlfriend that they are dating. The issue I have with this bailey version is that it doesn’t seem like the way the supposedly-autogynephilic trans women I know relate to themselves, so rather than being evidence for autogynephilia theory, it more seems like evidence against it.

✱ Unlike autogynephiles, who are usually at least somewhat skewed towards wanting to be women, even if they don’t transition.

Philosophy of science

My review has been quite critical of the book. I am concerned that this might make people falsely think that Phil doesn’t know anything about what he is writing about, so I want to address that here, as well as getting into some more general questions of science.

Phil is very enthusiastic about this research area, and is very well-read in a lot of old-school gender research. He’s somewhat biased in his selection of research, but much less so than the proponents of feminine essence theory that I have seen.

While writing this review, I had the thought that the real problem is that Phil believes in science. And the problem with science is that it is often a fractal of wrongness.

Let’s take an issue where Phil agrees with me: autoandrophilia is real. But if autoandrophilia is real, then why didn’t the scientists he cites emphasize it as much as they do with autogynephilia?

I think the answer to this question is messy, but likely involves many of the following concepts:

  • Because autoheterosexuality was for a long time named “transvestic fetishism”, researchers thought it was about the clothes,* and autoandrophilia is somewhat less transvestically focused than autogynephilia is, so they would be less likely to notice it.**
  • Autoandrophilia is somewhat rarer than autogynephilia, so they would have been less likely to notice it.
  • Researchers have long had a preconception that unusual sexual motivations are a male-only thing, so they would have been less likely to notice it.
  • Many studies have been performed on autogynephiles, but few studies have been performed on autoandrophiles, so they would have been less likely to notice it.
  • Women face stronger gender norms than men, so the autoandrophiles who transition will likely also have masculinity as a secondary motivator, making it less unclear whether autoandrophilia is even needed as an explanation, and therefore making them less likely to notice it.

Basically, the way I see it is, researchers were not paying enough attention to notice autoandrophilia. But in my opinion, autoandrophilia is sort of obviously a thing. If researchers are not paying attention to really notice it, then there are lots of other things that they also fail to realize. (In this perspective, it’s almost no wonder the prediction market participants expect the true answer to be a theory that hasn’t been put forth yet.)

There’s a lot of places in reading the book where I’ve been ambivalent. For example, consider furries. Furries are a community of adults who are enthusiastic for anthropomorphic animals. They often make artwork (especially, at least according to stereotypes, porn) of anthropomorphic animals, and one of their main hobbies is “fursuiting”, where they dress up as animals.

In the book, Phil suggests that furries have an erotic target location error, analogous to autoheterosexuality, where they have a sexual attraction to anthropomorphic animals, and then this attraction in some sense becomes self-directed.

To support this, Phil draws on some surveys (e.g. The “Furry” Phenomenon) which find that a lot of furries report sexual attraction to anthropomorphic animals, sexual attraction to being an anthropomorphic animal, and that the kind of anthropomorphic animal they are attracted to being is commonly the same as the kind they are attracted to as partners.

However, when I look at the furry surveys, I notice a lot of oddities that makes it questionable whether it is analogous to autoheterosexuality. For instance, in the case of autogynephilia, most men are gynephilic (attracted to women) but only a few are autogynephilic. But with furries, most furries are both attracted to anthros as partners and most furries are attracted to being anthros. If the mechanisms were the same, shouldn’t the pattern for furries be the same as the pattern for gynephiles? (With most furries being attracted to anthros as partners, but not to being anthros themselves.) And this is not the only example of internal contradictions in the theories about furries.

Does it seem plausible that there’s something going on with furries that is analogous to transness? Yes. But also, maybe it’s not analogous, maybe the similarities are superficial. I think it’s worth collecting more information on it, but also I can’t blame people for not engaging with his theories about furries, when those theories contain so many weak arguments and internal contradictions, and so little data.

And speaking of data, it is my impression that a lot of the characterization of what autogynephilia is like was created by stitching together anecdotes from trans women. But I worry that people are more likely to share unusual or extreme anecdotes, which would skew the characterization of autogynephilia towards the unusual or extreme end. And as mentioned earlier in the review, I worry that trans women may have other characteristics (either systematically or by coincidence) which get misattributed as inverted attraction to women.

I don’t think these problems are unsolvable. You’d go a long way by just taking all the autogynephilia stereotypes you’ve come up with, collecting data on them in a large general population sample, and performing factor analysis of this data. This would automatically disentangle coincidence from correlation, and it would be able to tell whether the stereotypes are getting at a single unified thing, or a mishmash of independent characteristics. This is fairly standard methodology, but researchers who work on autogynephilia seem strangely averse to doing it.

But I don’t think the negativity of this review can be entirely blamed on the research in these areas being weak, rather than on Phil. As you saw earlier in the review (such as with the arguments about direction of causality), I thought some of his own arguments were very bad. This can’t just be a data error.

I find this to be a deeply anti-rational approach, and I think is not viable if we want to do incremental science. Local Validity is a Key to Sanity and Civilization. If we accept poor and invalid arguments as long as they lead to the “right” conclusion, we will end up immersing ourselves into a thick mist of invalid and misleading arguments. This will be confusing, and when new surprising evidence comes along, I think the habit of making incorrect arguments will lead to making incorrect arguments about that evidence too. I have tried talking to some of the people doing research in this area, and I find this to be a serious problem in practice, which prevents them from doing course-corrections when needed.

✱ This also suggests another critique: since autoheterosexuality is not about the clothes, the fact that scientists thought so is indicative of a pretty serious problem with science.

✱✱ This argument is also made by Phil in the book.

Thank you to Justis Mills, Phil Illy, Zack Davis and Pasha for proofreading and feedback.

New Comment
9 comments, sorted by Click to highlight new comments since:
[-]Orual2914

One of the most frustrating things about the Blanchardian system for me is how it flattens a ton of variation into the "auto____philia" category, asserting the same "erotic target location error" cause for all of it, and the people pushing the theory tend to brush that off by asserting that trans people are lying (or grossly mistaken) about their own experiences and sexualities. That category in the original study was extremely heterogenous (and subsequent studies have been almost exclusively run on members of crossdressing fetish forums and similar, as you point out), but the sample size was too small in that initial study for any variation to rise to statistical significance. It's not simply that auto____philia is a less satisfying narrative, it simply doesn't track with many trans people's actual experiences at all, and I think analyzing a larger dataset (especially if the analysis were done by a researcher less prone to motivated reasoning and questionable statistical practices) would demonstrate that.

Blanchard would likely call me an autogynephile simply by virtue of my being bisexual, not being very stereotypically feminine, and transitioning late (though as soon as I had the knowledge and ability), despite having essentially zero erotic feelings around being feminine and never really even cross-dressing, much less getting off on it. In fact, he would likely suggest that I was mistaken or lying about the latter.

I think Phil understands the trans position (or should I say positions, because in actuality trans people have a ton of different and conflicting ideas about gender, sexuality, sex, and so on) very poorly, or at least represents it very poorly in the quote you provided. What he's presenting there is what I tend to call the "lies to cis children" version, intended to try and get the basic idea across to people who know nothing about transness and have no framework for understanding our experiences. It's also to some degree a narrative which was imposed upon trans people by doctors like Harry Benjamin and (as the concept of "gender identity") John Money (and made a prerequisite for accessing care, a strict template which for trans women included being stereotypically feminine, having zero interest in using one's natal genitals, and being exclusively attracted to men, i.e. the HSTS category) more than one trans people created. In fact, the HSTS subset of the initial Blanchard study sample likely consists almost entirely of patients who were seeing him in order to access medical transition and had to either have or pretend to have experiences and motivations which fit the Harry Benjamin template in order to do so. Most other trans people I've talked to would call that quote from Phil a dramatic oversimplification of their beliefs at best.

One of the reasons why there isn't a coherent position about gender, etc. among trans people, however, is because we're mostly just trying to get by, we're not nearly as concerned with theorizing. We're working from our own experiences, we're more concerned with practical things like access to the medical care which pretty demonstrably helps us even if we don't understand exactly what's going on under the hood, and we all have different experiences which inform how we think about this stuff. For some trans people that gender identity framework works pretty well, even if it's oversimplified. For others, it couldn't be more off-base. We're all blind people touching an elephant and trying to explain it to blind people who've barely even heard of elephants and aren't touching this one. Blind people who often prefer to ignore what we say and make up their own explanations, despite us being the ones touching the elephant. It's not easy.

I do want to pick out one thing from that explanation though, the idea of transness as broadly a developmental error to be ameliorated rather than a psychological/psychosexual condition. I actually think that, based on how we are successfully able to alleviate gender dysphoria in actual people, that categorization makes a certain amount of sense. Gender dysphoria isn't like almost anything else in the DSM in terms of how you treat it, and that treatment is dramatically more effective than the treatments available for pretty much anything else in the DSM. You basically treat it like an endocrine disorder and a birth defect, rather than a psychological condition, and that works. Treating it like the latter, or like a fetish (both of which tend toward pushing the person away from transition), doesn't result in good outcomes. 

I don't think that necessarily implies a whole lot about the underlying causes, whatever they are (I have an autoimmune disorder, celiac disease, that I treat like it's a severe allergy, these things exist), but in the absence of any real knowledge of the underlying causes, I think a "duck typing" sort of approach is a sensible one, and regardless of what the actual cause might be, it's fairly clear what works and what doesn't. You don't put someone with celiac on standard immunosuppressants or immunoglobulin and have them keep eating wheat just because it's an autoimmune disease and not an allergy. That would be a great way to harm them, not heal them. You have them cut out wheat completely and stay vigilant about cross-contamination, and they pretty much always get better. Likewise with gender dysphoria.

One of the most frustrating things about the Blanchardian system for me is how it flattens a ton of variation into the "auto____philia" category, asserting the same "erotic target location error" cause for all of it

In my opinion, this is not necessarily a problem. Not all variation is equal; if the goal is to describe the etiology of trans women, then it is not necessary to capture variation that happens for other reasons than etiology, such as personality.

the people pushing the theory tend to brush that off by asserting that trans people are lying (or grossly mistaken) about their own experiences and sexualities

I am ambivalent about this; clearly Blanchardians push this assertion too much, but also anti-Blanchardians don't acknowledge it enough.

the original study

What study do you have in mind?

It's not simply that auto____philia is a less satisfying narrative, it simply doesn't track with many trans people's actual experiences at all, and I think analyzing a larger dataset (especially if the analysis were done by a researcher less prone to motivated reasoning and questionable statistical practices) would demonstrate that.

Counterpoint: Towards a comprehensive study of potential psychological causes of the ordinary range of variation of affective gender identity in males

I think Phil understands the trans position (or should I say positions, because in actuality trans people have a ton of different and conflicting ideas about gender, sexuality, sex, and so on) very poorly, or at least represents it very poorly in the quote you provided. What he's presenting there is what I tend to call the "lies to cis children" version, intended to try and get the basic idea across to people who know nothing about transness and have no framework for understanding our experiences.

Phil is well-aware that trans activists are lying about trans etiology, that is sort of which schtick. It seems strange for you to acknowledge widespread deception while also dismissing accusations of deception earlier in your comment. Sure, Blanchardians probably don't hit 100% correctly with their guesses as to when trans people are lying, but hitting 100% correctly in identifying lies is hard.

In fact, the HSTS subset of the initial Blanchard study sample likely consists almost entirely of patients who were seeing him in order to access medical transition and had to either have or pretend to have experiences and motivations which fit the Harry Benjamin template in order to do so.

I kind of struggle with buying this theory, at least without more explication. How am I supposed to square this with people I've seen who seem to fit the HSTS archetype?

One of the reasons why there isn't a coherent position about gender, etc. among trans people, however, is because we're mostly just trying to get by, we're not nearly as concerned with theorizing. We're working from our own experiences, we're more concerned with practical things like access to the medical care which pretty demonstrably helps us even if we don't understand exactly what's going on under the hood, and we all have different experiences which inform how we think about this stuff.

I mean I can be sympathetic to this point. The standard response by Phil and other Blanchardians when trans women doubt the typology is "Well then why did you transition??" / "What model is better than Blanchardianism??", and in practice this seems to play out pretty abusively. You can't really expect someone to solve a tricky causal inference problem for you for no reason.

But on the other hand, most methods of evaluating evidence (e.g. Bayesianism) work best when there are multiple theories to contrast. If e.g. you could list some factors where you differ from cis men, which plausibly caused you to transition, then I could add them to a survey sent to the sample from my comprehensive study, and we could see whether there is any statistical patterns of interest. But otherwise it is really hard to figure out any objectively informative tests.

I have a somewhat meta-level question to people who sympathize with Blanchardian writing: what is the interest of this research? What questions could we answer by knowing to what extent sexuality plays a causal role in transition? Are there decisions we make as a result of this? Is it for the benefit of trans people themselves that they think of themselves in this way?

I come across a disproportionate interest in noting the (generally) taboo sexual fetishes that are (perhaps) more common among trans people. I would search for quantitative evidence by going to Google Trends and looking at autogynephilia as compared to some similar term for a different social group, but I'm not even sure what other term I'd plug in just because I've never come across something applicable. Correct me if my perception is wrong, though.

From my perspective, this discussion feels akin to questions like "is (x group) socially bad in (y abstract way that is very difficult to answer without splitting hairs over definition)?". You don't really learn much that is actually concrete or useful, but you solidify an ontology that associates a socially disadvantaged group with undeserved toxicity.

To be clear, I don't mean to attack the character of OP with this post, in particular because I think I trust lesswrong more than other places to have discussions that are (and should be) generally taboo. Also, to the extent that I am familiar with Blanchard's research, I +1 Orual's reply.

I feel fairly convinced that the legitimization of this line of questioning is bad for societal opinion of trans people in an unearned way. Blanchard's research is frequently cited by pundits with the strongest anti-trans political opinions. However, I only feel weakly that it is a basically useless line of questioning.

Some groups of people I have noticed being into Blanchardianism and things superficially resembling Blanchardianism:

  1. "Human biodiversity" people, that is intellectually inclined racists/sexists. They are usually conservatives trying to build models of society which acknowledge human differences as causes of group outcomes and ignore the relevance of ideology. A major reason they do this is to have explanations to counter antiracists/feminists and progressives who are trying to achieve group equality through affirmative action. Blanchardianism is important to them partly because gynephilic trans women's traits in many ways resemble those of biological males and gender ideology explains that through socialization forces, so Blanchardianism becomes a counternarrative they can appeal to in order to dismiss these socialization forces, which they want to do because they are sexist. And Blanchardianism is also important to them because they are ordinarily conservative so they kind of want to say that trans women are socially bad in an abstract way.
  2. Miscellaneous people who have conflict with trans women in various contexts, e.g. people who read too much Mumsnet and JK Rowling and now hate trans women, transwidows, female athletes who have to compete against trans women, non-GAMP lesbians whose dating sites have been overrun by trans women, feminists or HSTSs or transmeds playing respectability politics against conservatives who make fun of them for trans stuff. I think these are the main ones you are thinking of in your comment.
  3. ?Some unknown subset? (perhaps disproportionately masochistic?) of trans women who don't really feel like the standard trans narratives accurately match them, and feel that autogynephilia models are more accurate.
  4. Autogynephilic men who either don't want to transition and are using the term "autogynephilia" to explain how they differ from trans women, or autogynephilic men who want to transition but are repressing and are using the term "autogynephilia" to explain why they are repressing.

Blanchard and Bailey, the O.G. Blanchardians, are in group 1 (though they differ in that they are more classically liberal than conservative). I am also somewhat in group 1, though not really because I am not really politically opposed to trans stuff but instead just picked it up through other contexts. As mentioned, I think you have group 2 in mind, and they seem to be the biggest group. Phil Illy seems to be some mixture of group 3 and 4, with perhaps some degree of group 2. Zack Davis, who also comments on autogynephilia around these parts, seems to be some mixture of 1, 2, and 4. I could also be said to be of group 3, though really I would do special pleading and say that my main background is fairly unique.

Before I got into autogynephilia theory, I was still doing various sorts of trans research, but in different ways. E.g. I was looking into Zinnia Jones' depersonalization theory, looking into why nerdiness was correlated with transness, and looking into whether genderfluidity might be due to some sort of brain hemisphere switching thing. However I also occasionally added autogynephilia to my research, and I eventually found very large effects that didn't seem well explained by the non-Blanchardian theories I was working with at the time.

But to answer your question, one controversy that has recently come up is "rapid-onset gender dysphoria", a phenomenon where teens come out as trans to their parents and want to transition, without having exhibited unambiguous signs of transness early on. Some parents think that this is due to social contagion and that their children should be forced to go through puberty as their natal sex and should leave the ideology that caused the transness. The O.G. Blanchardians say that this is probably what happens among AFABs, but that among AMABs it is instead probably due to autogynephilia, and that it is plausible they could benefit from transition. Because my research has found evidence of the existence of autoandrophilia, I have long argued that autoandrophilia likely plays a role too, and so the AFABs could also benefit from transition. Phil sort of takes an intermediate position, saying that both AAP and ROGD plays a role.

Actually upon further thought, the heritability section of Autoheterosexuality shows that Phil also has some elements of group 1.

Thanks for the detailed reply! Indeed, 2 is the main group I was thinking of and which seems most affected by the whole...just using Blanchardianism as a way to legitimize their disdain for (perhaps not all) trans women, although that's probably an oversimplification. I'm happy for groups 3 and 4 having a way to reason about their personal experience as well. Group 1 is the one I'm most interested in -- it does seem reasonable to not just assume that all people are equal and that differences between groups could impact how we should structure society. I follow as far as:

They are usually conservatives trying to build models of society which acknowledge human differences as causes of group outcomes and ignore the relevance of ideology.

Although I don't have very much faith that these questions can be well answered with much confidence. I totally disagree by:

And Blanchardianism is also important to them because they are ordinarily conservative so they kind of want to say that trans women are socially bad in an abstract way.

A while back, I had a conversation with ChatGPT to try to understand the conservative perspective on trans people and it finally managed to stump me when it justified its claims on the basis of religious morality. I imagine this is a similar situation -- I don't quite understand how trans women transitioning in part because of autogynephilia is actually relevant for how we should structure society or how one ought to interact with a trans person. After all, cis/het people can make big life decisions like marrying a specific person (partly) on the basis of their sexual desire, and everyone seems okay with that. Does the argument go deeper than "autogynephilia bad and standard cishet sexual behavior okay because [gestures vaguely at religion or tradition]"?

...one controversy that has recently come up is "rapid-onset gender dysphoria", a phenomenon where teens come out as trans to their parents and want to transition, without having exhibited unambiguous signs of transness early on. Some parents think that this is due to social contagion and that their children should be forced to go through puberty as their natal sex and should leave the ideology that caused the transness. The O.G. Blanchardians say that this is probably what happens among AFABs, but that among AMABs it is instead probably due to autogynephilia, and that it is plausible they could benefit from transition.

It seems pretty legit that questions about sexuality and previous gender dysphoria could help determine whether someone should transition (i.e. if they will be happier and not want to detransition with high probability). It also seems like the decision rule could be informed by whether Blanchardianism is correct or not. Thanks!

A while back, I had a conversation with ChatGPT to try to understand the conservative perspective on trans people and it finally managed to stump me when it justified its claims on the basis of religious morality.

I don't think ChatGPT is good at conservatism. 😅 AI ethics STRONK.

I imagine this is a similar situation -- I don't quite understand how trans women transitioning in part because of autogynephilia is actually relevant for how we should structure society or how one ought to interact with a trans person. After all, cis/het people can make big life decisions like marrying a specific person (partly) on the basis of their sexual desire, and everyone seems okay with that. Does the argument go deeper than "autogynephilia bad and standard cishet sexual behavior okay because [gestures vaguely at religion or tradition]"?

After paying closer attention to some conservatives (especially Richard Hanania) for a while, I came up with this model. More recently, I've also gotten into intergenerational trauma as a further model of these things. (Roughly: Conservatives see how progressives fight them to introduce a bunch of progressive stuff, they decide that this means progressive stuff is their enemy, so they oppose it.)

So I have a friend I've known for two decades come out as trans, and began reading tons of material from trans people to learn about it.  Phil's book nails him to a T.  Phil doesn't say that all transgender women are atg, just that most are.  What was useful for me was that I could easily identify my friend as one.  I say this as someone who supports him fully and has no political or ideological agenda.

This book might be a life saver for him.  Instead of going through expensive and life altering surgery, he can learn to channel this sexual/romantic aspect of himself into a healthy outlet.  Your nitpicks on his section on atg are superficial as you noted.  My friend has wondered at what he is, and hears this gender stuff and thinks it makes it something non-sexual.  This is a fantastic book.  I believe all trans should read it just to make sure they are or are not atg's themselves.  

I think your argument about your friend is incomplete without a description of what your friend thinks of the book/concept.

Your nitpicks on his section on atg are superficial as you noted.

I'm not sure what you mean by this; can you expand?