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J. Michael Bailey's 2003 book The Man Who Would be Queen outraged many transsexuals through its linguistic insensitivity. And that is a shame, because it seems that its ideas are not essentially offensive, and may help us to better understand sexuality. Bailey's book is a attempt to popularize the current science of sexuality, and in particular the work of Ray Blanchard, of the Clarke Institute of Psychiatry in Toronto.

Blanchard's work recognizes that transsexuals fall into several categories. Some male-to-female (MTF) transsexuals are interested in sex with men, some are interested in sex with women, some are bisexual, and some are largely asexual. Blanchard claimed that the group interested in men was quite different in origin and psychology from the asexual, bisexual, or 'heterosexual' group.

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But the words homosexual and heterosexual are not very helpful when talking about transsexuals. They refer to sexual attraction to a member of the same or opposite gender, but transsexuals have one gender before sex-reassignment surgery and another after the surgery. So if MTF transsexuals prefer sex with women, is that heterosexual (because they started off as male) or homosexual (because they are now female)?

Blanchard and Bailey get a bad linguistic start with transsexuals by using the terms homosexual and heterosexual in reference to birth gender, and by referring to MTF transsexuals as men. That seems insensitive, and nearly guaranteed to cause offense.

Maybe it would be better to invent some neutral terms for talking about these different groups of transsexuals. If the those born male have XY chromosomes and those born female have XX chromosomes, then maybe we could say that MTF transsexuals who are attracted to men are the YY subtype, and MTF transsexuals who are attracted to women are the YX subtype. (There might also be two subtypes of FTM transsexuals-- XX and XY-- but Blanchard didn't propose that hypothesis.)

Blanchard's research suggests that YY and YX transsexuality have rather different origins and psychological properties. Of course, by definition both groups want to transition to having a female body. But there are important differences. YY transsexuals are typically very feminine as boys and are uncomfortable in behaving as males. They are far less likely to 'pass' as ordinary men. YX transsexuals are often typically masculine boys who develop a fascination with the thought of themselves with entirely or fully female anatomy. Many marry and have children before later coming out as transsexual.

Blanchard called the condition of this second group autogynephilia, which he defined as an erotic attraction to the idea of oneself as female. In Blanchard's view, the basic sexual impulse in autogynephilia is originally heterosexual. Autogynephiles begin as males who are aroused by the thought of the female anatomy-- but the twist is that they are aroused by the thought of themselves having a female body. Blanchard's research showed that the asexual and bisexual types of transsexuality were very similar in psychology and history to autogynephilia. And thinking of autogynephilia as a type of erotic attraction highlights the similarity to cross-dressing, which is also generally based in erotic attraction to women and their clothing. YY transsexuals, in contrast, are rather different and part of a continuum with feminine gay men and drag queens.

These ideas ignited a shitstorm of controversy among transsexuals. Many transsexuals waged a very public campaign against Bailey and Blanchard, labelling the research trans-phobic. However, a number of other transsexuals have found the idea of autogynephilia to be helpful and explanatory (see www.autogynephilia.org for examples).

What are the potential consequences of these theories for transsexuals? There have always been strict psychological requirements for sex-reassignment surgery. These requirements have been geared toward YY transsexuals, and excluded anyone who showed masculine behavior as a child or who showed an erotic interest in cross-dressing-- both histories typical of YX transsexuals. This made it necessary for autogynephiles to lie about their histories in order to get the surgery. And it also set up a harmful idea that only YY transsexuals were 'true' transsexuals, while YX transsexuals were derided and grouped with cross-dressers, fetishists, and the mentally ill.

Blanchard and Bailey have been explicit about the fact that both groups of transsexuals may benefit from surgery, and that YX transsexuals are no less 'true' members of the group than others. It's a pity that the valuable ideas suffer from the insensitive language, for recognizing the diversity of transsexuals could be an important step in advancing better treatment and understanding.