April 5, 2010

The Cuckoo's Nest

I am doing a lot of searches for academic papers on autogynephilia, transsexualism, transvestitism and the like, in order to see if there is anything that can be of help.

Sometimes I come over the most amazing research.

I think the following abstracts could speak for themselves.

Still, just to make sure: The original papers were published in the seventies, at a time when the experts continued to believe that crossdressers could be treated with aversion therapy.

At the time these papers were written behaviorism was big in the US. One highly influential psychologist Burrhus Frederic Skinner held that since you could not (and should not) read the minds of people, you should only do research on displayed behavior.

He believed that all behavior was the result of reinforcement processes, stimuli and responses. Throughout your life your behavior was punished (negative reinforcement) or rewarded (positive reinforcement) by the environment, which led to specific behavioral patterns. The doctors used conditioning to encourage behavior they deemed good and productive.

Much of the theory was based on research on rats and pigeons. Behaviorism is an extreme example of how useful observations of some aspects of animal life, can be turned into a complete theory of life, love, art, and human values, killing our very humanity in the process.

Skinner followed the scientific methods of the day, and a majority of American psychiatrists and psychologist considered this kind of research as objective and sound as it could get. Based on that world view they went on to torturing their patients with various forms of aversion therapy, including the use of induced vomiting and electroshocks.

At the time nearly all of them were convinced that it could also be used to cure what they considered "sexual perversions", including homosexuality. For a while it seemed they were right. It turned out most of the "cured" gay patients were bisexual, however. Gay men were never "cured", as there was no disease to cure.

Crossdressers were asked to dress up and stand barefooted on a wire mat. A series of electric shocks were delivered to his/her feet, until the "patient" had removed all of the offensive clothing. Again, there therapy did not work, simply because the "transvestitism" was not the result of conditioning.

Anyone who believes that science always gives you the truth and nothing but the truth, should say 25 Ave Marias and go back to Start. There is no reason to believe that modern scientists are less caught up in their theories and prejudices than the scientists of the 1960s and 70s.

Penile plethysmography and biofeedback in the treatment of a transvestite-exhibitionist

Describes an innovative application of penile plethysmography and analog biofeedback procedures for the successful direct modification of chronic deviant sexual arousal.

The target of treatment was the compulsive transvestite-exhibitionistic sexual behavior of a 45-yr-old married male. Preliminary clinical interviews and laboratory assessment (baseline) sessions were followed by 12 treatment sessions while the patient was hospitalized in a psychiatric inpatient facility.

Sexual arousal was monitored during treatment by a mercury-in-rubber strain gauge. The patient's response to a videotape of the target behavior (transvestite-exhibitionist videotape) was gradually eliminated through the use of analog biofeedback procedures.

The posttreatment and 4 follow-up laboratory assessments provided direct evidence of lasting treatment effects. Assessment of appropriate heterosexual arousal revealed a consistent specific treatment effect not attributable to habituation or generalized suppression of sexual arousal.

After 2 yrs of apparently successful follow-up, the client's wife disclosed that he had resumed cross-dressing and exposure and had deliberately deceived the therapists during the greater part of the follow-up period. This is a dramatic example of the unreliability of self-report as a treatment-outcome measure.

Raymond C. Rosena and Steven A. Kopela
Rutgers Medical School, Coll of Medicine & Dentistry of New Jersey, Piscataway
Journal of Consulting and Clinical Psychology
Volume 45, Issue 5, October 1977, Pages 908-916

The experiment was a total failure. There is no reason to believe that crossdressing can be cured with aversion therapy.

And here is one from 1970:

Case conference: A transvestite fantasy treated by thought-stopping, covert sensitization and aversive shock

Abstract: The subject of this case conference is a 22-year-old college senior with a transvestite fantasy whose origin dated back to preschool days. It was successfully treated in six sessions using the behavioral techniques of thought-stopping, covert sensitization and aversive shock. Questions concerning goals, procedures, timing of approaches, and practical issues are discussed.

Louis GershmanVillanova University and Eastern Pennsylvania Psychiatric Institute, USAReceived 21 January 1970.
Journal of Behavior Therapy and Experimental Psychiatry
Volume 1, Issue 2, June 1970, Pages 153-161

Another one from 1973 shows us how they regarded homosexuals.

Aversion therapy for sexual deviation: Contingent shock and covert sensitization

Studied 2 different aversion therapy approaches to the treatment of sexual deviation (e.g., homosexuality) in 6 clinical referrals.

Covert sensitization, which provides an imagined aversive event following imagined sexual behavior, was compared with contingent shock, which provides a physical aversive event following erection to slides depicting sexually deviant material. Replicated, counterbalanced within-S presentations of each technique were used.

Treatment effects were monitored by measurement of penile circumference changes during slides presented prior to treatment sessions, and by daily subjective recording of sexual urges and fantasies as well as masturbation and sexual acts. No clear difference was found between the treatments on the penile circumference measure.

On suppression of subjective measures of sexual arousal, however, covert sensitization appeared to be more effective than contingent shock. Follow-up of 4-18 mo. is reported for the individual cases. (37 ref.)

Edward J. Callahana and Harold LeitenbergaaCarmarillo State Hosp., Calif
Journal of Abnormal Psychology
Volume 81, Issue 1, February 1973, Pages 60-73

So who were the real perverts here: the crossdressers and the homosexuals or the doctors treating them?

The image is from the movie A Clockwork Orange, which came out in 1971.


  1. I am somewhat surprised you haven't done this type of research earlier. Psych research more than any other branch has been the source template for the evil mad scientist. There is a reason no one wants to be labeled 'crazy' as what is legally done to crazy folks we would not allow to be done to our worst enemy.

  2. and scientists also deemed weed as an evil demon drug in the 50's. at one time, doctors bled patients with diseases in hopes of getting rid of evil spirits. One day we'll all laugh at how naive we view transgenderism.

  3. I found this little piece on the net. Sorry it's not related to this blogg entry. I'm personally very interested if hormonal treatment/srs options do actually work out for AGP people. In the text below it would seem that hormones helped to keep the AGP feminization desires going up until SRS, when everything stopped. It would be most interesting to do a piece on AGP people post transition and or SRS. Here is the piece:

    My story in brief is that I experienced autogynephilia, and it was my primary reason for taking hormones and undergoing SRS.

    After first experimenting with hormones to see what the feeling was like, I began therapy and down the track to SRS. I lied to my therapist in many ways so that he would let me continue on the path of so-called "womanhood." After a year in therapy and on hormones, with the changes that had taken place both physically and emotionally, I felt no choice but to continue. The feeling that I had to become more feminized grew, the further I went down the road. In spite of my therapist's suggestion that I slow down, or stop treatment for a while to rethink the matter, I continued on to the point of having SRS, which I thought would the height of my femaleness.

    After six months I concluded I was wrong! I really have no feelings or desires to be a woman now -- they just vanished over night it seems. What I thought was such a strong desire to be a woman, and to express my femininity for all to see, has dissipated. Now I'm in counseling with a new body that has been chemically and surgically altered, which I'm not pleased with. It's not that the hormones and surgery weren't a success, because they were. It's just my feeling are gone -- very ironic

  4. From Reading the entries in this blogg series I'm very surprised to learn that there is a whole group of AGP males that I never knew existed. That is the group of men who keep the fantasy in their heads alone. They don't cross dress and enact their fantasy in the physical world. I would have thought that the desires of AGP would be too strong to keep in 'the head' only. My agp insists that I enact out the role. How do such people manage such control over themselves?

  5. Is it felt that AGP is a result of repressed transsexualism? The sexual side is the only quick fix available for those who can't express feminity in their social role ?

  6. Cheryl, because people have differing abilities to imagine/disassociate from the “reality” perceived by their senses, I suspect that some are able to find satisfaction (at some level) by playing out the fantasy in their minds. That’s not to say that physically enacting the role would not enhance the experience, but if the cost (in terms of impact on other aspects of one’s life) exceeds the added benefit, an AGP may be able to control the urge to enact their fantasy in the physical world. Different strokes for different folks – as they say.

  7. @cheryl

    " I'm personally very interested if hormonal treatment/srs options do actually work out for AGP people."

    Unfortunately the research done on APG transsexuals is on pre-op, not post-op transwomen. There are, however, quite a few life stories online, and it seems there are three categories:

    1. The sex drive is diminished and the candidate is disappointed when the fantasies disappear. They do not adapt well to their new life as a woman.

    2. The sex drive is diminished and the candidate is happy to get rid of the constant focus on the AGP fantasies. She is happy with her new life as a woman.

    3. The candidate's main motive is to become a woman, and not to indulge in AGP fantasies. There will always be a price to pay for such a radical step, but many report that they are very happy with their choice.

    As regards the group of men who keep the fantasy in their heads alone, I am one of the non-crossdressing crossdreamers. There are other ways of living out your inner woman. Some write TG captions, illustrated erotic fantasies of becoming a woman, or TG short stories. Some live out their fantasies in Second Life.

    "Is it felt that AGP is a result of repressed transsexualism?"

    I believe there is a biological basis for crossdreaming/autogynephilia, and I have discussed why elsewhere on this blog. There is some disagreement whether Ray Blanchard, the architect behind the term "autogynephilia" believes it has a biological foundation or not. He calls it a paraphilia and a erotic target location error, which sounds like a psychological explanation to me.

    Andrea James argues that feminization fantasies of this kind represent the only way some biological men's repressed femininity can find an expression, and I believe she is right. The jury is still out on this one, though.

  8. Jack,
    I as a feminine gay man fully support your views on crossdreaming. I also think that feminine men and AGPs have many things in common. I am just like you- I am a non-crossdressing crossdreamer who has sissifying fantasies. I wouldnt say I dont get excited on feminizing myself-just that, it directly does not lead to a sexual arousal unless the fantasy also involves a guy making love to me.
    The way I see it is somply that we all have somewhat bigender/androgynous mixed traits but with our sexual orienattions different. Also, our femininity is not that large to make us the true transsexuals. Despite having the strongest sissy fantasies and exhibitionism desires, the only reason I have avoided transition is that I am feeling internally as male- a thing which could lead to far greater dysphoria and shame when I start having female body.

    But that does not mean I don't have a degree of repressed femininity wanting expression. I have just adjusted it in my life by dragging myself into the metrosexuality lifestyle.

  9. Cheryl,
    "My agp insists that I enact out the role. How do such people manage such control over themselves?"

    I will tell you how many people can avoid enacting the real role.Its not that they are avoiding, but its that they dont find it appealing.
    I have often been having feminine fantasies but that degree is just not enough for me to crossdress. The moment I begin crossdressing, the male inside me makes it look weird. There is a perfect mismatch between my male gender and the female presentation,which makes me just feel weird, as any other guy would do.
    However, my brain does not see the same mismatch when it engages in fantasies!! Because it can then forget the male inside me completely including my own body and imagine the scene with no physical reality hampering its vision. My femininity hence gets its full expression only when fantasizing is there but during crossdressing in reality, its expression is interrupted by the male inside me.
    I only try to integrate my feminine persona within me in reality by adopting the metro lifestyle- where you don't have to appear female by CD but can let your full feminine expression out. There simply is no other way out.

  10. I really dont support the "fetish pervert" concept. It seems like whenever some person has unconventional or socially unacceptable fantasy,it has become a trend to label the person as a freak.
    But,basically a sexual fantasy of any type is simply it-a sexual fantasy. No fantasy is more freakish than the other in true sense. My own therapist once told me that inner fantasies of a person reflect something about the person, and in case of sexual/transgender fantasy, it definitely gives a hint of the person's mental gender even though the person might not have the full inner force to enact them in reality.
    In my view hence, a person having crossdreaming fantasies is no less pervert than a man having fantasy of molesting a woman. They differ in their roles only because their inner gender identity differs.

  11. @Cheryl- with respect to keeping things bottled up in my head instead of outwardly expressing them, my fantasy is of me as an attractive, feminine woman. It is not of me, my male self, wearing women's clothes, or trying to appear womanlike, either through fashion or surgery. I am of particularly masculine build and appearance and the best I could hope to achieve through clothing and/or surgery/hormones would be a poor facsimile of a woman. Even if by some miracle I could pass as a woman, I would still know I wasn't one. Until the day comes where some sort of advanced technology can actually change me into a genuine XX female, my fantasies will have to stay hidden in my head, much to my frustration.

  12. These are all helpful comments. AC, in particular, made a point that resonates with me. My male self –very tall and hairy makes passing impossible – and I’m very far from the female form that I fantasize about. For me hypnosis is interesting because it allows one to visualize vividly outside “reality”

  13. I'm a few days late to this conversation, so take what I say with a grain or two of salt.

    I find myself very concerned with Cheryl's comment:

    After first experimenting with hormones to see what the feeling was like, I began therapy and down the track to SRS. I lied to my therapist in many ways so that he would let me continue on the path of so-called "womanhood."

    These sentences sent up all kinds of red flags for me. The WPATH Standards of Care are designed to help the treatment community identify those who need GRS from those who do not. However, if you lie to your therapist (and manage to keep the lie consistent enough that they don't detect it), you have not only undermined your therapist, but have placed yourself at enormous risk for an inappropriate outcome. (which, I'm sorry to hear seems to have been at least partially the case)

    One of the most important aspects of the therapy process is self-honesty. You have to be honest with both yourself and those you are working with to sort things out. Sometimes, that can mean facing some very unpleasant truths about ourselves and the images we have constructed over the years. (I know I had to look in the mirror more than a few times, and I didn't always like what I saw ... so I would undertake to address the issue - not always easy)

    I notice that a lot of the studies Jack cites are quite old (circa 1970) I know that researchers have done a lot of work since then, and there are some working groups within WPATH that are examining more closely non-transsexual gender variant populations. (e.g. non-transitioning transfolk and more recently the emergent Eunuch subgroup which is not trans per se, but demands similar medical treatments such as gonad removal)

    You might want to see if you can access the 'International Journal of Transgenderism' as well as the 'Archives of Sexual Behaviour' for more current research. (I suspect that some of the early 70s work is flawed either methodologically or with assumptions and terminology that does not correctly describe the study participants.)

  14. @MgS

    These are all very helpful observations.

    The International Journal of Transgenderism can be found here: http://bit.ly/bpJg02

    The Archives of Sexual Behavior are accessible through Springer: http://bit.ly/cFtKK0

    The problem is that both of them requires registration and payments.

    The issue of lying to your therapist has become a toxic topic in the TG/TS arena.

    There are clearly crossdreamers who long so much for transitioning that they try to make their story fit the classical transsexual narrative. That narrative has no room for feminization fantasies and sexual arousal.

    So, in order to be true to their inner woman they suppress some information to their therapist.

    It seems to me that many therapists are aware of this, but they go along with it as they believe autogynephilia can be a legitimate reason for SRS. Blanchard clearly thinks so. Their intention is good.

    The problem is that this regime undermines the safety precautions embedded in the system. Cheryl should clearly have had more time to think through her actions before committing to a life as a woman.

    Much of this could have been avoided if erotic fantasies were understood as a natural expression of an innate femininity. Then transition candidates could have been open about their fantasies when talking to their therapist.

    One final note. You say that that a lot of the studies I cite are quite old (circa 1970). Actually, most of the studies I refer to in this blog are from the 90's and 00's. The only studies from the 70's I have referred to so far are the ones I used as examples of how behavioral psychiatry went astray with aversion therapy.


Click here for this blog's Code of Conduct!

Discuss crossdreamer and transgender issues!