Dr. Anne Lawrence tells us that "autogynephiliacs" must be considered mentally for evolutionary reasons. I argue that this make no sense.
Some how you have wondered why I keep writing on "gay" and "transgender" animals, arguing that these pheonomena are of little relevance to a discussion of crossdreaming or "autogynephilia" (sexual arousal from the idea of having the body of the opposite physical sex).
I have argued that the presentation of "autogynephilia" (AGP) as a mental illness in the autogynephilia theory of Ray Blanchard, J. Michaels Bailey and Anne Lawrence is at least partially based on evolutionary biology and evolutionary psychology.
This means that the categorization of crossdreaming as a paraphilia (perversion) is ultimately based on the idea that it represents a trait that hinders procreation.
The sanctity of sexual selection
According to this type of thinking sexual selection provides organisms with adaptations related to mating. For male mammals, this theory holds, sexual selection leads to adaptations that help them compete for females. A behavioral adaptation that does not lead to them breeding with females is therefore harmful, and an illness.
They argue that "heterosexual transsexual men" (which is an impolite reference to people I would call lesbian or gynephilic -- woman loving -- transsexual women), are mentally ill. The underlying argument is that "autogynephilia" represent a maladaptation. The natural heterosexual longing for a woman out there has been internalized as a "erotic target location error".
I believe this explanation for crossdreaming is the end result of reductionistic evolutionary thinking. Their basic model cannot encompass the idea of gynephilic male bodied person wanting to be women, for the simple reason that in this theory sexual orientation equals sex identity. It cannot be otherwise in a theory that argues that sexual selection, and sexual selection only, explains the survival of the genes of the individual and -- ultimately -- of a species.
I have presented alternative research on the sexuality and gendered behavior of animals to show you that this basic understanding is wrong. A lot of the sexual behavior found among animals (and humans) does not have procreation as a goal. It is, for instance, used as a tool for socialization or for comfort.
None of these alternative theories dismisses the concept of evolution -- far from it -- but they argue that the survival of a genetic line relies on much more than mere sexual selection.
This research also shows that the social and sexual dynamics of animals does not necessarily adhere to the simplistic strong, aggressive, male conquers coy and passive female paradigm. And if the basis for the paradigm is wrong, the conclusions based on this basis are also most likely to be wrong.
Anne Lawrence presents the evolutionary argument
The reason some of you have questioned my interpretation of the basis of the "autogynephilia" theory is that Blanchard, Bailey and Lawrence rarely make such evolutionary arguments. The most important exception has been Blanchard's sibling theory on homosexuality, and that one is not about "autogynephilia" at all, but adaptive advantages to homosexuality.
Well, Anne Lawrence has let the cat out of the bag. She has written a paper, "Do Some Men Who Desire Sex Reassignment Have a Mental Disorder? Comment on Meyer-Bahlburg (2010)," where the argument is solely based on an evolutionary argument. "Autogynephiliacs" are mentally ill, because their condition does not lead to procreation:
"In autogynephilic MtF transsexuals, it is reasonable to infer that the mental mechanism responsible for accurately 'locating erotic targets in the environment' (Freund & Blanchard, 1993, p. 558) has failed to perform its natural function: Specifically, there has been a partial or complete failure of the evolutionarily selected mechanism that keeps heterosexual erotic interest (i.e., gynephilia) directed toward erotic targets external to the self. Autogynephilic MtF transsexuals experience a powerful erotic interest in turning their own bodies into facsimiles of their preferred erotic targets (females), an interest that competes with and sometimes completely overshadows erotic interest directed toward external female partners (Blanchard, 1992). It is easy to understand why evolutionary selection might favor the development of a mental mechanism that would keep gynephilic men's erotic interest focused on external female partners. When a gynephilic man's erotic interest is instead directed primarily toward his own feminized body, one can reasonably infer that this putative mental mechanism has wholly or partly failed. If the foregoing analysis is correct, then the desire for sex reassignment in autogynephilic MtF transsexuals -- that is, in many or most nonhomosexual MtF transsexuals -- represents a genuine mental dysfunction."
A way to define crossdreamers as perverts -- regardless
Anne Lawrence truly believes she has found the golden egg with this one, as she no longer has to define ambiguous terms like "gender identity". By basing the classification of crossdreamers as perverts on firm evolutionary ground, there is no need for other arguments. Case closed:
"Do some men who desire hormonal and surgical sex reassignment have a mental disorder? By framing the issue this way, one can avoid having to formulate a comprehensive definition of gender identity or address competing theories of normal gender identity development."
The trangender person's experience of having the body of the wrong sex is therefore of no interest, as it is the person's ability to procreate that is important, not his or her sense of self.
No core identity
In fact, Lawrence has the audacity of dismissing this sense of self altogether:
"Nonhomosexual [i.e. gynephilic] MtF transsexuals do not have a female or cross-gender core gender identity: In childhood, during pre-transition adulthood, and after sex reassignment, they know that they are, always have been, and always will be biologically male."
If she, with this, means that gynephilic male to femalecrossdreamers know that they have a male body during childhood, the sentence becomes either self evident or meaningless. It is not as if androphilic male to female transsexuals do not know that they have grown up in a male body!
If she by this means that they have a male sex identity, she will have to make the same argument as regards the androphilic transsexuals. They are also most likely to see the penis they have between their legs.
Lawrence tries, admittedly, to make a point out of the allegedly late onset of gender dysphoria among gynephilic male to female transsexuals:
"The development of a cross-gender identity in these men, however, typically occurs decades after the onset of erotic cross-dressing and is usually preceded by experiences of complete cross-dressing, public self-presentation while cross-dressed, and adopting a feminine name."
This is often used as an argument for gynephilic transwomen being different from the androphilic ones.
However, Lawrence herself has documented that many male to female transsexuals often experience gender dysphoria at a very early age, and who knows what the rest of them has managed to repress. There is in fact no difference between androphilic and gynephilic transsexuals as regards onset, which means that the androphilic and gynephilic transwomen must be equally "paraphilic".
Elsewhere she writes:
"It is useful to focus on the desire for sex reassignment, as opposed to variant or disordered gender identity; by doing so, one can address the actual presenting concerns of patients, rather than abstract concepts....Although the desire for sex reassignment historically has been conceptualized as reflecting a disorder of gender identity, disordered gender identity in nonhomosexual [i.e. gynephiloic] MtF transsexuals is an epiphenomenon, not the underlying mental disorder itself. It would be helpful for the text discussion in the DSM-5 to emphasize this point."
Note how she dismisses the experience of a misalignment between body and mind as an abstract concept, even if many "autogynephiliacs" experience this as a very concrete trauma indeed.
Although crossdreaming is an observable fact, the theory of "autogynephilia" has in no way been proven, even Ray Blanchard admits as much.
In spite of this both Blanchard and Lawrence behave as if it has, to the point of insisting of having "autogynephilia" included in the American psychiatric manual (DSM-5).
In other words: They feel no qualms about stigmatizing a whole group of people as mentally ill without any proof whatsoever.
In fact, all the observations made by Blanchard, Bailey and Lawrence may be explained as an effect of some kind of inborn alternative sex identity or as an effect of a complex variation of personality traits and sexual inclinations.
It is not that Lawrence denies that autogynephilia may be inborn, though:
"The sexed body dysphoria of autogynephilic MtF transsexuals is clearly 'in the individual'; although it may coexist with distress caused by prejudice, discrimination, or unwanted gender role expectations, it is not reducible to any of these and is not merely a result of social deviance, disapproval by others, or conflict with society."
That may perfectly well be the case. In fact, I am inclined to believe so, but there is absolutely no legitimate reason to prefer an explanation along the lines of the "erotic target location error" theory to an explanation based on an inborn sex identity or an explanation that says that it is the end effect of a complex interplay between a wide variety of biological, psychological and cultural factors.
I have tried really hard to read her text with an open mind, and see if there is a good argument for preferring the target error theory to the others, and the turns out there is no such argument. The text presupposes that the target error theory is the only correct one, as do all the offered proofs for this being so.
Wakefield and First
Lawrence takes the evolutionary definition of mental illness from Wakefield and First (2003):
"According to Wakefield and First, a mental disorder is "a 'harmful mental dysfunction,' with harm being determined by social values and the word dysfunction referring to the failure of a mental mechanism to perform its natural (i.e., evolutionarily selected) function" (p. 28). Wakefield and First recognized that an evolutionary analysis created potential epistemological challenges but argued that often 'one can judge with some plausibility the functions and dysfunctions of a [mental] mechanism (or at least that a function or dysfunction likely exists), with no need for detailed direct knowledge of the evolution of the mechanism.' (p. 39). They added that, in many cases, 'one can make such inferences without knowing anything about the actual mechanisms. . . . "
Please note that Lawrence is covering her back here. Even if the target location error turns out to be wrong, this still amounts to an evolutionary maladaptation and therefore a mental illness.
As Lawrence points out, Wakefield and First also emphasize that the dysfunction must be "in the individual" and "cannot be due only to social deviance, disapproval by others, or conflict with society or others".
This means that if it is possible for a crossdreamer to establish a good love relationship with another human being, the basic theory of a target location error must be wrong. The introversion and psychological suffering will be caused by the social stigma attached to being a "pervert", a condition that can be easily cured by acceptance. Since Lawrrence has already made up her mind about this, that option is not seriously considered, which leaves us with "autogynephilia" as an evolutionary maladaptation and a mental illness.
So what is wrong with Lawrence's evolutionary approach?
1. Using evolutionary arguments for the definition of mental illnesses is extremely controversial, as is evolutionary psychology in itself.
There is no consensus among experts on making sexual fitness the basis for defining a condition as a mental illness in the DSM-5. Actually, the proposed definition of a mental disorder in the DSM-5 contains no reference to evolution.
2. Mental illness and "paraphilias" are not only objective diagnoses made by disinterested scientists.
As history has shown again and again, they are also social constructs based on the cultural prejudices of the day. This is why, for instance, hysteria, nymphomania and homosexuality are no longer are considered mental diseases.
The gender and sex stereoypes presented by Blanchard, Bailey and Lawrence tell me, that we are facing yet another attempt at forcing natural diversity into another straight jacket of an allegedly biologically based normalcy.
Blanchard has defined a paraphilia as "any powerful and persistent sexual interest other than sexual interest in copulatory or precopulatory behavior with phenotypically normal, consenting adult human partners" (Cantor, Blanchard, & Barbaree, 2009). That is a cultural definition, and a very restrictive one at that.
I do not think it wise to give people like these the power to define what's normal in a public manual of mental health, no more than it was a good idea to let psychiatrist label homosexuals as perverts.
3. Lawrence shows little interest in the main objective of any psychiatric manual, which should be to increase the life quality of people.
People who are mentally balanced and well adapted are normally not considered mentally ill, even if they should engage in sexual behavior beyond the missionary position.
The reason some crossdreamers are depressed or confused could simply be caused by shame and embarrassment, and if that is the case, Doctor Lawrence becomes part of the problem and not the solution.
Lawrence denies this, of course:
The sexed body dysphoria of autogynephilic MtF transsexuals is clearly "in the individual"; although it may coexist with distress caused by prejudice, discrimination, or unwanted gender role expectations, it is not reducible to any of these and is not merely a result of social deviance, disapproval by others, or conflict with society.
But in her academic work Lawrence is not really interested in the development of an harmonic mind or healing. She is -- like her mentor Ray Blanchard -- mostly interested in putting human behavior into neat little boxes with Latin names. If a person does not fit into the blue box called "normalcy", off he goes into one of the small yellow ones labelled "paraphilia". And when he is put in one of those boxes, any mental anguish he might feel is caused by him being such a pervert, not the fact that Lawrence has put him there.
4. Even if it turns out that crossdreaming leads to less offspring, human psychological health is not based on the tooth and claw laws of evolution.
Psychological well being is, in fact, very much based on the fact that we do not let nature run its course.
Rape may, for instance, lead to the dissemination of the rapist's genes. That does not make him mentally sound. Cheating is definitely a good way of spreading one's seed, but that does not necessarily make cheating healthy.
In short: there is much more to life and human culture than the unions of sperm and egg cells. The fact that new research shows that this is the case among many animals, as well, tells us that sexual selection cannot be used as a basis for definitions of health.
Among our closest relative, the bonobo, all types of sex are permitted: male on male, female on female, adults on juveniles, and only a small fraction of all this hoopla leads to kids. They use sex to build social bonds and to defuse aggression, which -- of course -- help their survival in the long run. That doesn't mean that they are "paraphiliacs".
5. Using reproductive fitness as a basis for defining mental illnesses leads to a lot of absurdities.
Grown men and women who decide not to have children must be defined as mentally ill.
The fact that the DSM-5 forces perfectly healthy asexual people into the mental illness category shows us how bad such a philosophy is.
Within more tolerant societies homosexual men and women are less likely to have offspring than heterosexual ones. They must therefore also be included as paraphiliacs in the DSM-5, if we are to follow the logic of Lawrence.
Please note that homosexual men and women were removed from the manual in 1973. The reason for Lawrence not drawing the logical conclusion from her own argument, and demanding their re-inclusion, may therefore be a political one.
Still, I suspect that she actually believes that homosexual men are naturally feminine and lesbians masculine, and that this makes their behavior more "natural". This type of argument is another example of unfounded stereotypes (as the lesbian femme and the masculine gay man amply demonstrates), but it makes no difference when it comes to evolution. If offspring is the sign of mental health, the homosexuals must be mentally ill. The fact that they are not, is alone enough proof to sink the whole idea of using evolutionary fitness as a basis for defining mental health.
The fact that both Blanchard and Bailey try so hard to find an evolutionary advantage to homosexuality, seems at least partly to be an attempt to get homosexuality out of the paraphilia category. That is: They see the problem. It is amazing that Lawrence does not.
6. Evolutionary theory is not based on adherence to a particular ideal heterosexual relationship. It is based on the principle of having your genes transferred to the next generation.
There is nothing in the research that shows that male to female or female to male crossdreamers are less likely to have kids than other people. They do definitely get more children than homosexual men.
Crossdreamers try hard to live up to the stereotypes of their birth sex, and since they most often fall in love with the opposite biological sex they often get married and have kids. Besides: a more tolerant society would open up the possibility of male to female crossdreamers joining their female to male counterparts, leaving ample room for pleasurable sex as well as babies.
See also Inside the Battle to Define Mental Illness
APPENDIX: Heino F. L. Meyer-Bahlburg on Gender Identity Disorder as a mental illness
Below I have included some extracts from the paper that triggered Lawrence's response. It is interesting to compare Lawrence's bombastic and reductionist approach to Myer-Bahlburg's more nuanced arguments.
"In the developments leading up to the removal of homosexuality from the DSM, the demonstration that there were homosexuals who led productive and satisfied lives without demonstrable psychopathology constituted an important argument against the notion of homosexuality as a pervasive mental disorder. Although significant associated psychopathology has been seen in both DSD [disorders of sex development] (...) and non-DSD gender-dysphoric persons (...), this is by no means universal. It is often not seen in young children with GID (...), and not in all adolescents and adults with GID before they undergo hormonal and surgical measures associated with gender reassignment (...), and the rates of psychiatric problems after assignment to the desired gender diminish (...).
Moreover, much of psychiatric distress and suicidality seen in transgender persons can be statistically accounted for by the effects of stigmatization itself (...) and is therefore not necessarily inherent in persons with GID. On the other hand, other psychiatric diagnoses, such as PTSD [post traumatic stress disorder], are validly made as attributes of individuals, although their origin has been an external event or chronic stressful situation. One has to realize, of course, that even if GID is associated with increased risk of other psychopathology, its definition as a mental disorder should stand on its own feet and not rely on ‘'co-morbidity’ (...)."
"GVs [gender variants] fall onto a spectrum or continuum ranging from mild presentations such as gender-atypical behavior (e.g., '‘tomboyish' behavior of girls) without effect on core gender identity through presentations of clinical relevance such as, in males, the repudiation of certain anatomic and physiological features of manhood without the desire for changing into a female (...), to the desire for full gender transition including the acquisition of the somatic characteristics of the other gender. Characteristic of the entire spectrum is behavioral or psychological gender atypicality relative to the statistical norm, which can be readily quantified as a behavioral dimension. The more extreme cases are GIVs, [gender identity variants] that is, they show incongruence between their assigned gender with its associated societal role expectations on the one hand and their subjective experience of gender identity and the associated desire for gender expression on the other.
In the absence of an empirically grounded detailed theory of the mechanisms and processes of gender identity development, the available empirical evidence does not permit a categorical, universally valid statement that GIVs are or are not mental disorders.
With GIV-accepting parents, both young children of preschool age and early adolescents do not necessarily show significant distress or impairment, especially if they are shielded from stigmatization by others in their social environment. The same is true of many post-SRS trans men and trans women. Even expressions of distress in adult pre-SRS [sex reassignment surgery] individuals with GIV who are approaching or are in the process of somatic and legal gender change are highly variable and do not necessarily reach a clinically relevant degree of emotional distress. Therefore, a universal term involving a reference to emotional stress such as ‘'Gender Dysphoria’' also does not seem appropriate. Instead, a term such as ‘'Gender Incongruence’' as defined above appears to be more widely applicable to the various presentations of GIVs.
In addition, DSM-V needs to address, and possibly categorically distinguish between, GIV persons '‘in remission’' (in the sense of vanished cross-gender desire [...]), '‘post-transition’' with good adjustment, and '‘post-transition’' with regret (...).
Moreover, as clinical evidence indicates that there are individuals with great uncertainties about their gender, individuals who waver back and forth between their desired and their natal gender, individuals for whom the pursuit of gender change appears to be a way out of other (non-gender based) problems, and individuals where GIV is just secondary to a psychotic process, specific subthreshold or ‘NOS’ terms should be defined.
It is clear that the decision on the DSM- or ICD-categorization of GIVs cannot be achieved on a purely scientific basis. Instead, scientific issues need to be considered in combination with the service needs of persons with GIVs and the psychosocial implications of DSM formulations for such persons, when one works towards a consensus among stakeholders regarding a pragmatic compromise."
Heino F. L. Meyer-Bahlburg, "From Mental Disorder to Iatrogenic Hypogonadism: Dilemmas in Conceptualizing Gender Identity Variants as Psychiatric Conditions" Arch Sex Behav (2010) 39:461–476