Transvestic fetishism, autogynephilia, and late onset gender dysphoria

What makes transvestic fetishism a “disorder”? Distress, or harm to others. The paraphilia subworkgroup producing DSM V explain: A paraphilia by itself would not automatically justify or require psychiatric intervention. A paraphilic disorder is a paraphilia that causes distress or impairment to the individual or harm to others…This approach leaves intact the distinction between normative and non-normative sexual behavior, which could be important to researchers, but without automatically labeling non-normative sexual behavior as psychopathological.

According to the DSM, in late onset gender dysphoria the progression is: transvestic fetishism, that is, the subject is aroused by cross-dressing; autogynephilia, arousal by fantasies of self as a woman; gender dysphoria, the desire to live continually as a woman and physically alter the body.

DSM V on transvestic disorder: The presence of autogynephilia increases the likelihood of gender dysphoria in men with transvestic disorder…Some cases of transvestic disorder progress to gender dysphoria. The males in these cases, who may be indistinguishable from others with transvestic disorder in adolescence or early childhood, gradually develop desires to remain in the female role for longer periods and to feminize their anatomy. The development of gender dysphoria is usually accompanied by a (self-reported) reduction or elimination of sexual arousal in association with cross-dressing.

DSM V on gender dysphoria: Adolescents and adults with late-onset gender dysphoria frequently engage in transvestic behavior with sexual excitement. The majority of these individuals are gynephilic or sexually attracted to other posttransition natal males with late-onset gender dysphoria. A substantial percentage of adult males with late-onset gender dysphoria cohabit with or are married to natal females. After gender transition, many self-identify as lesbian…Additional predisposing factors under consideration, [that is, theories without empirical justification] especially in individuals with late-onset gender dysphoria (adolescence, adulthood), include habitual fetishistic transvestism developing into autogynephilia (i.e., sexual arousal associated with the thought or image of oneself as a woman) and other forms of more general social, psychological, or developmental problems.

This is not on line, and I got the quotes from a comment from a trans-exclusionist, here. The DSM V definition of gender dysphoria is here.

It is a pity Ray Blanchard was involved in this part of DSM V. He claims transvestism develops into autogynephilia, then gender dysphoria, though not in all cases: there are cross-dressers who are quite happy with their gender and their hobby.

He overlooks distress and denial as a causal factor. Gender dysphoria plus denial manifests first as transvestism, then fantasising about being women, and finally gender dysphoria. We try to make men of ourselves. We cannot admit to ourselves that we are not men. But we cannot deny it completely, so first we compulsively cross-dress, with that extreme distress, repeatedly getting rid of the clothes; then we admit the desire to express female; and finally we cannot resist that desire any more, resisting is just too painful. I retain that distress. I want to be normal, and cannot be.

Which of these subjects may be observed? Only the ones who have developed gender dysphoria, generally: which of the fetishistic transvestites would you examine, as most of them will not develop GD. So my own evidence is of disproportionate value here. I self-identified as fetishistic transvestite, in 1992, when I sought aversion therapy. My psychiatrist Dr Yellowlees thought I showed transsexual tendencies, though I would have denied it, my distress (and so “disorder”) being so great. I am the example of the person who might give a history of developing female embodiment fantasies, which Blanchard calls “autogynephilia”,  after gender dysphoria was established.

Now read on: if fetishism develops into gender dysphoria, that is beautiful.

George Elgar Hicks, seated woman in white dress

15 thoughts on “Transvestic fetishism, autogynephilia, and late onset gender dysphoria

  1. I do not remember my childhood. I have just a handful of flashes from that period. It was awful but I have only two specific memories of being beaten badly. My family broke up, for a host of what were very good reasons. I was told that we had to leave, this was related to me long after leaving, because of fears my dad was going to kill me. I did not know why he would want to kill me until recently, in my sixties. I like women, I do not enjoy time with men unless they are family. I have always know something was not quite right in my comfort with sexual issues. It was clear to others, I was asked a number of times by people I knew, whether I was gay. I knew I was not.
    The snip of memory I can recall related to this situation is, that I was watching my grandmother brush her very long hair. She had native american heritage and her hair was long and beautiful. I know I wanted that, and perhaps other things. I do not recall anything thing after that.
    It was a profound relief to understand what may have occurred. I smile more, I am old, so I behave the way I choose. I am clearly feminine in many ways related to reasoning and thinking. It is amazing to me the level of suppression and repression that were part of my life. I suppose fear was a big driver. I do not cross dress, I certainly want to keep my original equipment. No one knows why I am so happy now, why I smile so much. I know myself so much better, and it feels so good. I do not share this personal information. It is not relevant to my life, as I do not find it disturbing, and there is no need to disturb others with it. It feels so good to understand and to walk without that weight.


  2. I gain a great deal of sexual excitement when I dress in certain women’s dresses and my particular desire is to wear a veil similar to that of a nun with it. It brings me peace and relaxation to do this, and I do NOT consider it a “disorder.” It is a perfectly valid and beautiful method of self-expression.


  3. Thank you for sharing your story, I’ve been wondering about the link between fetishism and dysphoria. Wondering whether I could be experiencing it subconsciously.
    I guess I’d be classified as a transvestic fetishist? I dressed in feminine clothing on occasions in my childhood, then began associating it with sexual pleasure in my teens and 20s. It was never compulsive, distressful or necessary for arousal. It wasn’t strongly arousing either when compared to other stimuli, but I did enjoy it.
    At 31 it became a desire to appear completely feminine, a desire that remained with me outside of occasions of sexual arousal. I began having intimate fantasies of men (who I have no physical attraction to) where the pleasure came from the sensation of being in a female role. I didn’t really visualize much, least of all the man. These were not just sexual fantasies, they were also romantic/affectionate. Focusing on expressing / receiving affection or comfort as a female, enjoying the emotion and expression in those moments. However, I didn’t feel that I was any different physically so therefore aren’t FEF?
    When I began acting on that desire (privately) and confessing this for the first time to a close friend, showing them my appearance, it felt as if a wall crumbled within my mind. Where before I’d been going through life feeling flat – largely emotionless – I now felt sadness, loneliness. But this also felt good, like I’m finally alive. I’ve gained the desire to connect more with friends and an ability to comfort them rather than avoid their feelings. A mental block of my own, thus an inability to empathize/respond easily to theirs? A small recognition of a female self that I’ve been unknowingly rejecting?
    I have no idea what this means, whether there’s some hidden dysphoria at play, but would love to understand it. I’m not conscious of any pain or distress regarding my body (although it’s already on the feminine side of male). However it’s unpleasant when I catch the reflection of my face in a mirror without first mentally preparing for it. I noticed this mental preparation is subconscious – mirrors in familiar places don’t have the same effect. I’m otherwise ok with it. It doesn’t really feel like my face but it’s fine, it fits with me being male, it’s not an ugly face to have. But this all changes when I dress in feminine clothing. Right now I look down and see my feminine shorts & tshirt – black with splashes of muted pink – long painted nails, slender hairless arms. It all works, I love it. There’s no arousal, it just feels nice. Then i look in a mirror and see that face – the illusion shatters and I hate it, a jarring clash between my face and body. I’m not sure I’d describe it as painful but I immediately feel stupid, silly, disappointed. Is this what dysphoria can feel like? It doesn’t seem to fit with what I’ve read about it. I wouldn’t describe it as strong, persistent, truly painful or distressing.


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