What is Autohomoerotic Gender Dysphoria?

Lou Sullivan

According to Michael Bailey and Ray Blanchard, Autohomoerotic Gender Dysphoria is described as:

This rare type of gender dysphoria is limited to females. Published cases have consisted of women whose gender dysphoria began in late adolescence or adulthood. (It is conceivable that it might begin earlier in some cases.) It occurs in (heterosexual) females who are sexually attracted to men, but who wish to undergo sex reassignment so that they can have “homosexual” relations with other men. These females appear to be sexually aroused by the thought or image of themselves as gay men. We have created the label autohomoerotic gender dysphoria to denote this sexual orientation. There are little systematic data on this type of gender dysphoria, although clinical mentions of heterosexual women with strong masculine traits, who say that they feel as if they were homosexual men, and who feel strongly attracted to effeminate men go back over 100 years...

...The few available case reports suggest that autohomoerotic gender dysphoria may have ideational or behavioral antecedents in childhood. However, these females are not as conspicuously masculine as girls with (pre-homosexual) Childhood Onset Gender Dysphoria. For this reason, and because it is rare to start with, it is unlikely that many parents will detect this syndrome in daughters. It is conceivable, however, that when they occur, cases of autohomoerotic gender dysphoria may be perceived by others as Rapid Onset Gender Dysphoria. This is not because their gender dysphoria arose suddenly, but rather because their early, atypical erotic fantasies were invisible to their parents. 

There is an on-going debate as to whether Autohomoerotic Gender Dysphoria is a counterpart to Autogynephilic Gender Dysphoria, or if it is a different phenomenon entirely. In The End of Gender, Debra Soh outlines the arguments against the former position:

[Autogynephilic gender dysphoria] isn't, however, the female version of autogynephilia, for several reasons. Those who are autogynephilic are turned on by picturing themselves as having the body of a woman, while individuals with autohomoerotic gender dysphoria are turned on by the thought of having gay male sex. With autogynephilia, becoming a lesbian woman is not the focus of transitioning, but a secondary outcome, whereas with autohomoerotic gender dysphoria, becoming a gay man is the focus. Sexual cross-dressing is also not present in autohomoerotic females.

Bailey & Blanchard agree with Soh, stating that:

This type of gender dysphoria does not appear to be the female counterpart of autogynephilic gender dysphoria, although the differences might appear subtle. Autogynephilic (male) gender dysphorics are attracted to the idea of having a woman’s body; autohomoerotic (female) gender dysphorics are attracted to the idea of participating in gay male sex. For autogynephiles, becoming a lesbian woman is a secondary goal—the logical consequence of being attracted to women and wanting to become a woman. For autohomoerotics, becoming a gay man appears to be the primary goal or very close to it. 

On the other hand, Phil Illy argues, rather persuasively, that it is a female version of Autogynephilia. In Autoheterosexual, Phil describes the different manifestations of Autogynephilia, including anatomic, sartorial, behavioral, physiologic, and interpersonal autogynephilia. In some cases of interpersonal autogynephilia, becoming a lesbian is the focus of transitioning: 

"When seen as a manifestation of autoandrophilia, however, this “autohomoerotic” dysphoria is simply the interpersonal aspect of autoandrophilic gender dysphoria."

To this point, Phil describes an early case study of autohomoeroticism, where Hirschfeld draws a comparison to autogynephilia: 

"...all the way back in 1910, Hirschfeld wrote about masculine females who were extremely attracted to feminine men and felt themselves to be gay men. He compared them to male transvestites who loved masculine women and felt themselves to be lesbians."

Secondly, the notion that sexual cross-dressing is not present in autohomoerotic females is not true. The most obvious example of this is the trans leatherman scene. Where autogynephilic transsexuals eroticize women's lingerie, autohomoerotic transsexuals eroticize leather. In Autoheterosexual, Phil Illy touches on this when he reviews Lou Sullivan's diaries. Autohomoerotic transsexuals are also known to eroticize men's underwear, jockstraps, and packers, as a manifestation of sartorial autoandrophilia: 

"For autohet females, wearing a jockstrap evokes the idea of having male genitals, and wearing a binder evokes the idea of having a flat, male-typical chest. For autohet males, wearing a bra evokes the idea of having female breasts, and wearing women’s underwear evokes the idea of having female genitals."

Between the two positions, I find Phil's line of reasoning more persuasive. Still, the notion that autohomoerotic ideation is related to autogynephilia remains controversial. If Autohomoerotic Gender Dysphoria is not a female version of Autogynephilic Gender Dysphoria, then what is it?

Two things can be noted of autohomoerotic gender dysphorics. First is the desire to mount (“top”) during sex. Often what makes them feel as though they are “gay men trapped in women’s bodies” is not just the desire to have sex with men, but the desire to penetrate (“top”) their partner. There is an equivalent to this in primate models, where it is called “mounting”.

Secondly, there is some evidence that autohomoerotics might be more category-specific in their sexual preferences. In "Sexual Arousal and Masculinity-Femininity of Women", Rieger et al. (2015) explain why category-specificity is a "male-typical" trait: 

Studies with volunteers in sexual arousal experiments indicate that women’s sexual orientation is weakly reflected in their relative level of physiological sexual arousal to male and female sexual stimuli. Specifically, women in these experiments show, on average, substantial sexual arousal to sexual stimuli depicting both males and females. Lesbians constitute an exception to this general finding because they tend to be more aroused to their preferred sex (females) than their less preferred sex (males). This pattern is male-typical in the sense that stronger arousal to the preferred sex is more commonly found in men than women.

One study found that autohomoerotic gender dysphorics were also more category-specific in their sexual preferences. The finding is crippled by its small sample size, and it is unclear whether the effect was caused by testosterone use. Still, if the finding is valid, it might be that autohomoerotics are somewhat "male-typical" in their sexuality.

In primate models, prenatal androgen exposure irreversibly masculinizes an array of traits, and the "timing of sensitivity to prenatal androgens varies for different behavioral endpoints". If a female monkey was found obsessively mounting her male peers, one might assume it was due to elevated androgen exposure. What if the same is true in humans? Gynephilia and category-specificity are both “male-typical” traits of sexuality, but they might masculinize at different stages of development. A female masculinized during one stage could become homosexual, while a female masculinized during the other becomes autohomoerotic. 

This hypothesis is supported by the findings of "Sexual Arousal and Masculinity-Femininity of Women", where Rieger et al. (2015) found that lesbians were more "male-typical" in sexual and nonsexual behaviors, but "on average, there were no indications that these 2 patterns were in any way connected." They concluded that "women’s sexual responses and nonsexual traits might be masculinized by independent factors", hypothesizing that "it is possible that androgen influences at different timeframes explain why some women show male-typical sexual arousal and others show male-typical behaviors, but that these are apparently not linked". Alternatively, they propose that "social environment" might explain variations in nonsexual behaviors, rather than the timeframe of androgen exposure.

Much like the different phenotypes of female nonheterosexuality, it is important to recognize autohomoerotics as a distinct category of person. This requires carefully delineating the traits that define autohomoeroticism, so not to conflate it with Rapid Onset Gender Dysphoria. At the present, autohomoerotic gender dysphorics are critically understudied: "studies have not yet reported on androphilic FtM." Research into autohomoerotic gender dysphoria could reveal something important about female masculinity in general, and could validate or disprove the Theory of Autoandrophilic Gender Dysphoria. 

Related Blog Posts

References

Bailey, J. M., & Blanchard, R. (2017). Gender dysphoria is not one thing. 4thWaveNow. December, 7. https://4thwavenow.com/2017/12/07/gender-dysphoria-is-not-one-thing/

Kreukels, B. P., & Guillamon, A. (2016). Neuroimaging studies in people with gender incongruence. International Review of Psychiatry, 28(1), 120-128. https://doi.org/10.3109/09540261.2015.1113163

Luoto, S., Krams, I., & Rantala, M. J. (2019). A life history approach to the female sexual orientation spectrum: Evolution, development, causal mechanisms, and health. Archives of sexual behavior, 48(5), 1273-1308. https://doi.org/10.1007/s10508-018-1261-0

Raines, J., Holmes, L., Watts-Overall, T. M., Slettevold, E., Gruia, D. C., Orbell, S., & Rieger, G. (2021). Patterns of genital sexual arousal in transgender men. Psychological Science, 32(4), 485-495. https://doi.org/10.1177/0956797620971654 

Rieger, G., Savin-Williams, R. C., Chivers, M. L., & Bailey, J. M. (2016). Sexual arousal and masculinity-femininity of women. Journal of Personality and Social Psychology, 111(2), 265–283. https://doi.org/10.1037/pspp0000077

Thornton, J., Zehr, J. L., & Loose, M. D. (2009). Effects of prenatal androgens on rhesus monkeys: a model system to explore the organizational hypothesis in primates. Hormones and behavior, 55(5), 633-644. https://doi.org/10.1016/j.yhbeh.2009.03.015

Wallen, K. (2022). Prenatal Steroid Hormones and Sex Differences in Juvenile Rhesus Macaque Behavior. In: VanderLaan, D.P., Wong, W.I. (eds) Gender and Sexuality Development. Focus on Sexuality Research. Springer, Cham. https://doi.org/10.1007/978-3-030-84273-4_2


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