February 13, 2023

From homosexuality to "autogynephilia": The American Psychiatric Association hasn't learned.

In an obituary about Charles Silverstein, Neil Genzlinger gives some interesting insight into how Silverstein helped remove homosexuality from the American psychiatric manual, the DSM,  back in 1973. 

Silverstein had pointed out how the  American Psychiatric Association had fallen into the trap of creating pseudo-scientific sounding terms for sexualities the psychiatrists did not understand. Yes, this is unfortunately relevant to the trans community community today.

I looked up the original interview from 2019

Silverstein was part of a delegation from the Gay Activists Alliance, and he said this about their meeting with the people behind the DSM:

Syphilophobia and other silly diagnoses

 "I wrote [my speech to the  Nomenclature Committee of the American Psychiatric Association]  the night before, after having studied diagnostic systems, other diagnostic systems. 

What I did was write a parody, a satire, of all the absurd things that the American Psychiatric Association had diagnosed, and some of them were embarrassing. There were silly things. [He mentioned illnesses like “syphilophobia” (irrational fear of syphilis).]

At the end, I said, "These are the mistakes that you made before. You're making the mistake. Now, correct it." It seemed to have impressed them, and this came back to us in a number of publications. That was in February. In December of that year, homosexuality, per se, was eliminated from the Diagnostic and Statistical Manual. 

[Editor's Note: On February 8, 1973, Charles Silverstein made his presentation to the Nomenclature Committee of the American Psychiatric Association (APA). In December 1973, the APA decided to change the diagnosis of homosexuality in the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II). It was later in DSM-III-R in 1987 that homosexuality was completely removed as a mental disorder.]

A lot of people misunderstand what happened in '73. They think that homosexuality was removed as a diagnostic category. It wasn't. They decided there were two kinds of homosexuals, those that were ego-syntonic and those who were ego-dystonic. This is all jargon. The ego-dystonic are people who are very unhappy with their homosexuality, and if you got such a person, it was okay to treat them and try to cure them. If a person was ego-syntonic, that means that he was happy about his homosexuality, and it was not a disorder. 

What I was trying to say in that presentation that you quoted was, "This was absurd. You teach people to suffer so that the distinction between ego-syntonic and ego-dystonic is artificial." They're virtually all going to be ego-dystonic because you make people suffer. Homosexuality completely disappeared in, I think, DSM IV, I think, III or IV."

Did the  American Psychiatric Association learn from their mistakes?


From homosexuality to autogynephilia

In 2013 they decided to include the transphobic term "autogynephilia" in the "paraphilia" section of the DSM-5. The man behind this pseudo-science used the exact same trick as others had used to keep homosexuality in the DSM after 1973, arguing that there were benign and dysfunctional variants of "autogynephilia".  

To quote Silverstein:  "This was absurd. You teach people to suffer so that the distinction between ego-syntonic and ego-dystonic is artificial." 

It was the homophobia that made gay men and lesbian women suffer mentally. A trans woman who fantasizes about having sex as a woman is not a pervert. She is exploring a woman's sexuality.

By including "autogynephilia" in the chapter for sexual perversions ("paraphilias") Blanchard contributed to the continuing stigmatization of transgender women. The term is now actively used by TERFs and other transphobes in order to harass trans people.

Ironically, the DSM-5 chapter on gender dysphoria clearly stated that gender dysphoria or being trans was not a mental illness, and that also applied to transgender women who had reported instances of erotic crossdreaming og cross-gender fantasies. But that chapter was written by a different committee, one with more enlightened scientists on board.

The international health manual, the ICD, deliberately removed related terms in their eleventh edition.

So,  dear American Psychiatric Association, maybe it is time to honor Charles Silverstein by removing the remaining "autogynephilia" nonsense from your manual.

Photo: Charles Silverstein (left) and his partner William Bory in the 1970s. Rutgers Oral History Archives.

See also:


  1. I continue to see confusion regarding AGP and the conflation of arousal patterns as being the cause for a trans identity instead of an effect of one. AGP is a theory (a malintended one to boot) and giving it a fancy name does nothing to give it merit. Right wingers of course have a reason to promote this confusion but even some trans people themselves cannot seem to make the distinction which is disappointing since some critical thinking is all it takes.

  2. Blanchard got it into the DSM-5 at a time where he formally saw it as an hypothesis. Since then he has not presented research that has documented that the theory has any scientific validity, but by now Blanchard & Co treats it as a scientific fact.

    1. Wishful thinking only gets you so far but now that the right wing fringe and TEEFS have their hands on it no need for science especially when sold to an ignorant audience

    2. One of the issues I've had for a long time is the lack of attention many trans people have for what is being said and written about them at the clinical level. They whistle in the dark oblivious to what is going on which is unfortunate because to make matters worse are now ignorant lawmakers basing legislation in part on the Blanchard pseudoscience as well as crackpot ideas like rapid onset dysphoria.

    3. Joanna, how do you know this to be a fact? I've never heard of this.

    4. Of what Emma? Of the anti trans legislation by the GOP, the fact that many trans people aren't educated on the topic or about the promotion of rapid onset dysphoria?

    5. For ROGD look up Lisa Littman who is yet another crackpot :)

    6. How do you know this: "One of the issues I've had for a long time is the lack of attention many trans people have for what is being said and written about them at the clinical level."

      I'd love it if you would provide sources that publish such things that are not the GOP, Fox, or other such places.

    7. This is based on my own experience when I brought up the literature with many of them over the years. Invariably I would get the equivalence of blank stares. That applies to political and social justice issues as well; not with all but with many. Information is power


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