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gender dysphoria and sexual orientation

I was surfing through Netflix the other night and happened upon the 2008 documentary film called “Pagent” which chronicles the battle for the Gay Miss America crown and which takes place somewhere in the United States every year. These are gay men who dress as women and compete for the title.

At one point in the film one of contestants looks at the camera and says very seriously: "You know this is not sexual for us at all".

And then it struck me. Of course they don't find it sexual; they are not drawn sexually to women. A bit of leg in high heels wouldn’t be the least bit arousing to a homosexual male. They are not aroused by seeing it and they are not aroused by wearing it.

Now let's put this into the context of gender dysphoria. Prior to puberty and sexualisation the only difference you might see in dysphoric children is the level of effeminacy. Typically you might find that those who may tend to become homosexual at a later stage could exhibit early signs of this behavior whereas the heterosexual probably would be like any other boy or at least appear to be. Both boys might be drawn to the idea of being female but there is no eroticism present for either.

As both enter puberty, the heterosexual boy begins to have fantasies about girls, wakes up with erections and begins to see a conflict between his burgeoning sexual attraction to women and his own desire for femaleness. This is the period where the clothing becomes arousing and the confusion between identity and sexual orientation happens. This boy wants to repair himself desperately and be normal for girls and he will do his best to suppress his gender issues for decades to come.

The homosexual dysphoric realizes there is a gender issue but is now also drawn to males so as agonizing as the decision process is there is no disconnect between the sexual orientation and the gender identity. This individual will likely transition much sooner, and hopefully make a normal life for herself as a woman in society. She has never experienced erotic imprinting because she is not sexually aroused by women. Dressing in female clothes seems normal and is not in the least way exciting.

The heterosexual will go through periods of confusion and may even believe that he is a fetishist because the arousal patterns continue to confuse him. But even as the arousal wanes, the inner female remains intact. It was always intact and always will be; we just don’t know why.

A fetishist will not seek out a life as a female in the world but will be happy sitting at home dressing privately in front of a mirror and masturbate; as his potency declines so will his desire to dress.

Harry Benjamin, unlike Ray Blanchard, did not segregate his patients according to sexual orientation but instead used a gender disorientation scale to measure the degree of disconnect with their birth gender. The more alienated to his body the higher the rating; his types V and VI had to transition or face insurmountable pressure and incapacitated function in life.

For Benjamin there was no homosexual transsexual (androphilic) or autogynephilic transsexual; there were only transsexuals.

Thankfully we still have people today who continue his good work in this direction. Anne Vitale is one of them.

Back in 2005 before the next update in the DSM, she did a presentation in Italy in which see said:

"As the DSM prepares the next update, I urge the authors to consider that the cross-gender behavior typical of gender variant people is neither a sexual disorder nor a gender identity disorder. Rather it is an anxiety disorder secondary to physical and sociological gender expression deprivation. Rather than referring to the cluster of behaviors as “Transsexualism” or “Gender Identity Disorder” I propose as I have elsewhere (25), that the condition be referred to as Gender Expression Deprivation Anxiety Disorder (GEDAD)"

They didn't listen to her but they should have.


  1. Joanna, Gender Expression Deprivation is exactly what we experience. That is so accurate.

    Great information here. Good post! Thanks


  2. The preceding post contains capital letters and repetitions for emphasis, insulting disparagement, plus non-sequiturs and unsubstantiated claims, both of which Senrub criticizes in Joanna Santos. These features combine to produce a tone of vituperation. The “open discussion” which Senrub calls for is rendered impossible by this tone. Its effect is to harass the reader and belittle the blog writer while insisting that the sole acceptable opinion is Senrub’s own.
    Freedom of speech entails certain responsibilities, one of which is to show respect and consideration for the person one addresses, even in disagreement. That is not happening here. The post speaks volumes about Senrub. It succeeds in alienating the reader, not in convincing or even raising doubt, apart from doubt about Senrub’s own opinions. My personal preference is for greater human dignity.
    Carole Fraser

  3. thanks for your support Carole and I have learned from experience not to allow her to turn my blog into a bully pulpit. I now just delete the comments. Jack Molay over at crossdreamers has had to unfortunately do the same.....

  4. Dear Joanna, I have read some of your descriptions of this 'condition' and strongly recognise myself there. However I have some questions around the distinction between fetishism and gender dysphoria. I am wondering about the relationship between the arousal response to dressing, the associated shame (over years) and the decrease in that arousal. My own experience, as a mature age cross dresser, is of increasing desire for the happiness that expressing my femme self provides, and decreasing arousal. However, after some decades of feeling shame and anxiety at my arousal response, I do not like thinking of myself as a fetishist, and for some reason feel more comfortable with the idea of being gender variant. Could it be that this idea contributes to the suppression of arousal response? I am looking forward to delving into Anne Vitale, I hadn't come across her before, so thank you for the reference. Barbara

  5. Barbara its very difficult for gender dysphorics to make the distinction between fetishism and their condition especially when we are younger. One of the signs that you are dysphoric is that as the eroticism wanes, you are connecting very strongly to your female inner self and are happier than ever. Unfortunately the shame and guilt are an obstacle in connecting with that inner self. Being gender variant is part of nature and accepting that you are this way you can find a balance between your male and female without transitioning but the first step is to fully accept the female without reservation. If you were truly a fetishist you would know it by now as that is simply driven by sexual addiction and nothing more. The fetishist has no inner female.

  6. I think a good place to start would be to read Harry Benjamin's book "The Transsexual Phenomenon" which is available free online as a pdf file. It is not a long book but it contains much that would be of use for a gender dysphoric


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