"One day, around 1987 or 1988, I spent the afternoon in a reference room of the Robarts
Library of the University of Toronto. I was trying to find a word—or failing that, to
invent one—to denote a phenomenon I had gradually apprehended during clinical
interviews with many biologically male patients interested in sex reassignment surgery.
That phenomenon was the tendency of certain males to become erotically aroused by
the thought or image of themselves as females. The word I finally invented, after fruitless
searching through various kinds of dictionaries, was autogynephilia . I could
scarcely have imagined, on that long-ago day in that quiet room, that I would be writing
the Foreword to a complete book on the subject 25 years later.
My early writings on autogynephilia were published in specialty journals with
limited circulations. They were intended for a small readership of clinicians who
specialized in the assessment and management of gender dysphoric patients. The
general availability of the Internet in the home and workplace was still several years
away, and access to print journals for people unconnected to major universities was
difficult. I therefore had no expectation that the readership of my autogynephilia
papers would ever extend beyond the small group I had originally envisioned.
One person who did manage to fi nd and read them was the author of the present
volume, Dr. Anne A. Lawrence.
She was open to my ideas, which—although actually rooted in eight decades of prior clinical thinking—were bitterly opposed as heretical
innovations by the increasingly politicized transgender community and the clinicians
who served it. My ideas included the notions that gender identity and sexuality are not
separate and unrelated phenomena but rather two sides of the same coin; that there are
two major, etiologically and phenomenologically different types of male-to-female
transsexualism; and that neither of these types is sui generis —rather, one is related to
ordinary homosexuality and the other is related to autogynephilia.
The contemporary dogma in the transgender and allied health communities was that male-to-female
transsexualism is caused by a feminine gender identity—a proposition that is obviously
and utterly circular without some auxiliary hypothesis such as neuroanatomic
intersexuality. On this orthodox view, gender identity is about one’s sex but not about
sexuality, and to connect it with an erotic preference like homosexuality or autogynephilia
is conceptually (and politically) incorrect. Dr. Lawrence did not merely accept my ideas; she pushed them towards their logical conclusion and, in a 1998 essay published on her Web site, startled even me with the audacious title of her essay, “Men Trapped in Men’s Bodies: An Introduction to the Concept of Autogynephilia.” And so it was that the word autogynephilia began its slow escape from the library.
Challenging the emotionally invested beliefs of any group often has its price, and
Dr. Lawrence began receiving hate mail shortly after her views became known.
Worse consequences than hate mail awaited J. Michael Bailey, who published a
book dealing in large part with autogynephilia in 2003. This book, The Man Who
Would Be Queen , so enraged some male-to-female transsexuals that a small group
of them made a coordinated and sustained effort to get Dr. Bailey fired from his
university faculty and ruined professionally. The events of this extraordinary campaign
have been documented in a long and meticulously documented essay by medical
historian and bioethicist Alice Domurat Dreger.
In light of this history, it is remarkable that Dr. Lawrence has written a book that
describes autogynephilic transsexuals in a way that differs in important regards
from the way many in this group wish to see themselves or wish to be seen by others.
Her motives for completing this project are twofold. First, she is convinced that
psychologists, psychiatrists, and other helping professionals can provide better care
to autogynephilic gender dysphoric men if they understand the nature and
significance of autogynephilia. Second, she believes that there exist many isolated
and confused autogynephiles who would be comforted and reassured by the knowledge
that there are others in the world like them and that, in the long term, autogynephilic
transsexuals would lead mentally healthier lives if they had a
self-understanding based on objective reality.
The book with which Dr. Lawrence’s volume is most readily compared is Magnus
Hirschfeld’s 1910 classic work, Die Transvestiten . Both books include multiple
autobiographies written by persons who might nowadays be grouped under the
umbrella term “transgendered,” both also include direct clinical observations of
transgendered persons by the authors, and both contain substantial sections of theoretical
interpretation and conjecture. If I were forced to recommend to someone that
he or she read only one of these two books, I would—despite my deep admiration
for the great Magnus Hirschfeld—recommend Dr. Lawrence’s volume. Men
Trapped in Men’s Bodies is more focused, organized, and clear. It is simply a more
efficient and accessible introduction, for modern readers, to the phenomenon of
autogynephilic transsexualism. It does not, and does not attempt to, provide an
account of homosexual transsexualism in natal males or females—a topic that
would properly require a volume of its own.
Some days of one’s work life one remembers with a shudder of horror, others
with pleasurable memories of satisfaction at a job finally completed. Today, as I sign
the Foreword to this excellent book by my friend and colleague Anne Lawrence, is
like the long-ago day when I shut the last of the dictionaries and decided simply to
invent the word I needed— autogynephilia" .