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30 July 2021

Did Magnus Hirschfeld coin the term Geschlechtsverkleidung?

Magnus Hirschfeld used two words somewhat interchangeably: Geschlechtsverkleidung and Transvestiten.   The former is a pure German word while Transvestismus is a Latin-based loan word from French and Italian.   


While Hirschfeld titled his 1910 book Die Transvestiten, in the contents to the book he mainly uses Geschlechtsverkleidung, and in the text itself, he often shortened it to Verkleidung.


Let us break down the word.

Geschlecht=sex, Kleidung=clothing, and the prefix ver in this context modifies the meaning of dressing to be other than normal.  Verkleidung can also mean in disguise.  Geschlechtsverkleidung means gender dressing, or Gendervesting. 


Geschlechtsverkleidungstrieb is also used.  Strieb means drive, so Geschlechtsverkleidungstrieb means the urge or drive to cross dress.   


Compare the English ‘Cross-Dressing’ which also means the same as Transvestism but uses only English roots rather than loan words from French and Italian, in turn based on the Latin.



What do people mean when they claim that Hirschfeld coined ‘Transvestitismus’?

Actually Hirschfeld never uses the word Transvestismus on his 1910 book.   He uses Transvestiten several times.  He mainly uses Verkleidung, sometimes Geschlechtsverkleidung.


  • Presumably they mean that he we was well-educated enough that he took from Latin trans + vestit-, a form of vestiō (“I clothe, I dress”), and created what he mistakenly assumed to be a new word that he could use in alternation with Geschlechtsverkleidung.   Perhaps he also considered Latin derived words to be more classy.
  • They also implicitly imply that he was so badly read that he was unaware that the various forms of transvest* and travest* had been in use in most west European languages since the 17thcentury.


Here is the Oxford English Dictionary entry for the verb form, to transvest, which it records for 1652.



What about Transvestitenschein?

Transvestitenscheinen were permits for Geschlechtsverkleidung issued by the Berlin police and arranged by Hirschfeld.   


Was Hirschfeld totally unaware that the Paris Préfecture de Police had been issuing Permissions de Travestissement since 1800?   Note that the Paris Préfecture de Police went ahead and used a transvest* word without waiting another 110 years for Hirschfeld to coin it.   After all, such words were in common use.


In 1929 when Violet Morris sued the  Fédération française de sports féminins (FFSF), they cited the  1800 Ordonnance and criticised Morris for never having applied for a Permission de Travestissement.  However Morris’ lawyer produced a letter from the Commissioner of Police giving assurance that they no longer pursued women in trousers.


So why is it that Hirschfeld is frequently - but incorrectly - credited with coining Transvestitismus, but is never credited with coining Geschlechtsverkleidung?





The earliest claim that I have found re Hirschfeld supposedly coining Transvestiten  (not Transvestitismus) is in Charlotte Wolff’s 1986 biography where she simply says on p107 that he coined it, but gives no support to the claim.


Wiktionary is very confused.   They claim that the English word ‘transvestite’ is “From transvestitism, from German Transvestitismus, coined in 1910 by Magnus Hirschfeld”.    Thus one is really impressed that J Wright in 1652 was able to use the verb form without waiting another 258 years for Hirschfeld to coin the term.





26 July 2021

Paul Walker psychologist - Part II: San Francisco

Continued from Part I.

In 1980 Paul Walker resigned from the UTMB and moved to San Francisco. He lived on Castro Street, and had an office at 1952 Union Street. He was now openly gay, and specialized in helping trans patients. His official diagnosis for trans patients was usually "anxiety" to keep it private and confidential until the patient began the real life test.

The Janus Information Facility (JIF) moved with him. One of the volunteers at JIF was Lou Sullivan - JIF’s first and only FTM member who did peer counselling and answered correspondence. There were very few out androphilic trans men at that time, and to Walker Sullivan could talk about his sexuality. They would also flirt with each other. Sullivan’s 1980 guidebook, Information for the female to male cross dresser and transsexual, and its later editions were distributed by JIF. Walker was added to the Board of Directors for the Stanford Gender Dysphoria Program, where he learned that Norman Fisk had once made a public announcement that he would never approve a gay FTM for surgery.

The sex offender treatment program in Galveston had been privatized after Walker left. The University of Texas Medical Branch continued its gender program - 121 trans women were operated on 1972-1992, and it is still in operation. The clinic embraced the HBIGDA Standards of Care when they were published in 1979, although they rejected candidates whom they regarded as ‘homosexual’ despite the SoC saying such are not to be excluded. It published a summary of its work in 1995.

In 1981 Walt Heyer, 40, a married transvestite on the down low and a regular at the Roadrunner Bar in San Francisco’s Tenderloin, gained Walker's name from the grapevine and came as a patient. Walker recognized Heyer, having seen his female persona in the Roadrunner.  According to Heyer’s account, at the end of the first session Walker diagnosed gender dysphoria, and in the third session gave Heyer a letter recommending trans surgery. This despite the Walker co-authored Standards of Care which required two such letters and at least one year of cross-living before surgery. Heyer actually went to Trinidad, Colorado and saw Dr Biber, but chickened out. In 1983 Heyer again gained approval from Walker, and again went to Trinidad. This time she went through with it and became Laura Jensen.

Walker was interviewed for the 1985 HBO documentary What Sex Am I?. He mentioned that for some, “It is better to have a medical problem than a moral or psychological problem”.

Dr Walker was recommended by the syndicated newspaper agony aunts, Anne Landers and Abigail Van Buren, and that is how airline pilot Sarah came to him for counselling in the mid 1980s. She commented: 

“I unfolded the grimy column, and he ruefully said that whenever she did that he was flooded with two or three thousand phone calls. Glad I had my dime handy early. Dr. Walker was indeed a recognized expert in the field of gender, but it still took three or four years for him to dismantle the straw man the military had done so much to create. When I first dragged myself across his threshold, I had never met anyone who had so much as contemplated gender reassignment, much less undergone it, and I was about as inclined to embrace the idea as nuclear waste. What I had imagined was some secret shrink voodoo that would excise this strange zit on my psyche, and restore me with a spasm of relief to the self I imagined myself to be. Instead, most of that lengthy therapy was spent slowly hammering down walls of guilt and shame. It’s remarkable how little attention was required to resolving the question of gender once that was done. I’m sure it’s always like that, and how I hope that some young teen reads these stories and has the sense to sidestep those twin distractions.”

In 1985 Sullivan asked Walker to help get him approved at Stanford, but he was rejected anyway. There were intimations that Walker would give a paper on gay FTMs at an HBIGDA convention but it never happened. Sullivan was disappointed in Walker’s reluctance to advocate on the issue. 

“Walker still felt that the homophobia of his fellow gender professionals needed to be challenged, but claimed that what they needed was a “squeaky clean” test case—and that Lou would not do because of his sexual history. Lou argued that he had “felt and acted consistently as a gay man,” regardless of those with whom he had had relations. But Walker wanted a gold star fag, or an FTM who had only ever had sex with cisgender men, and preferably no vaginal sex.” (Brice: 144)

Surgeon Michael Brownstein had been operating on trans men since 1978. He knew nothing of any Standards of Care - he simply provided plastic surgery as requested by his patients. Sullivan contacted Brownstein in 1986 and was arranging for a metoidioplasty. Walker contacted Brownstein and “scared the hell out of him for not following protocol”. After that he required referrals for his trans patients. Walker finally came through for Sullivan by providing a referral.

In 1987 Walker returned from the 10th HBIGDA convention which was held in Amsterdam with the news that Louis Gooren had reported gay FTMs at Amsterdam support groups. This opened a door and other sexologists finally admitted that they too had met such mythical creatures.

Shortly after, Sullivan was diagnosed as HIV+. Walker responded compassionately and their friendship was renewed. Walker’s husband was likewise diagnosed the following year, and Walker himself shortly afterwards.

Laura Jensen, now five years after her transition, having accepted Jesus Christ and become involved with Alcoholics Anonymous (AA), increasingly felt that she had made a mistake. Jensen made an appointment with Walker. Walker responded to her claim of four years of sobriety, by admitting that he too was in a 12-step program, that he had been addicted to drugs and alcohol after a ski accident, and that he was HIV+. He later wrote to Jensen (who was returning to being Walt Heyer) that therapists should address alcohol and drug issues before moving on to gender issues. He assured Jensen/Heyer “that I share, as best I can, some of the pain that this mistake has caused you”. Heyer seized onto the word “mistake”, and has since built a career as a campaigner against transgender surgery.

Christopher Barrett was a patient at the Stanford Gender Identity Clinic in the late 1980s, and the co-ordinator, Judy van Maasdam, arranged an appointment with Walker 

“who I found to be a very sincere, likable man. As it turned out, he was winding down his consultative services with that program, yet I was lucky enough to meet with him before he left.”

Both Paul Walker and Lou Sullivan died in 1991 of AIDS complications. The work of the Janus Information Facility was picked up by J2CP Information Services run by Jude Patton and Joanna Clark/Sister Mary Elizabeth.  1991 was also the year that Walt Heyer completed detransition. 

*Not the actor nor any of the footballers, nor the judge.


In the 1950s and 1960sh, there was a much repeated typology of homosexual, transvestite, transsexual.  It seems to have been implicit that the three types were mutually exclusive.   In particular several GICs and surgeons rejected 'homosexuals'.    Stanley Biber as late as the 1970s was quoted: 

"First, patients must pass at least two psychiatric evaluations ensuring that they're not homosexuals or transvestites or simply people seeking fame and fortune on the talk-show circuit. True transsexuals, Biber says, are not attracted to members of the same sex and do not become aroused by wearing clothes of the opposite sex. True transsexuals consciously and subconsciously believe they are members of the opposite sex, trapped in the wrong body. "

 Above we mentioned that the  The University of Texas Medical Branch also rejected 'homosexuals'.

Against this, Benjamin's Scale, 1966, had specified that a High Intensity Transsexual, Type VI was a Kinsey 6 which means Androphilic, which means 'homosexual' while still pre-op.  Now in his actual chapter, "The Male Transssexual', Benjamin did not stick to his scale said, and allowed Kinsey 4 persons to be a Benjamin VI.  

Robert Stoller declared Primary Transsexuals to be 'homosexual'.

More definitive was the HBIGDA SOC, 1979, clause 4,3,1:

"This definition of transsexualism is herein interpreted not to exclude persons who meet the above criteria but who other­wise may, on the basis of their past behavioral histories, be conceptualized and classified as transvestites and/or effeminate male homosexuals or masculine female homosexuals."

GICs and surgeons continued to reject androphilic trans women. 

The general practice among psychiatrists and sexologists was to use the expression 'homosexual transsexual' for a heterosexual trans woman.   Presumably a heterosexual trans man should also have been so designated, but in practice was not.

I presume that the UTMB GIC  and Biber meant pre-op-androphilic trans women when it said that it rejected candidates whom they regarded as ‘homosexual’.     

Lou Sullivan, contrarywise, was an androphilic trans man.   He had not been a lesbian.  There is a confused logic operating here.  In the sense that Sullivan was gay, so was Laura Jensen/Walt Heyer - who was gynephilic.  So - in this post-op sense - why were gay trans men rejected and gay trans women accepted?   I suggest it was the same reason that female couples but not male couples are found in heterosexual pornography.  And why most law codes in decades past criminalised gay men but not gay women.   Trans women who have a male lover before transition are 'homosexual', and trans men who have a male lover after transition are both considered 'homosexual', and both are rejected.   Trans women who have a wife before and a girlfriend after are somehow not regarded as 'homosexual'.   Trans men who transition and get a girlfriend are also not 'homosexual' - but doing what the doctors expect them to do.


No explanation has been offered for why Walker abandoned his own SoC for Heyer, other than that he had seen Heyer in a queer bar.  It was a standard complaint of trans women who had been living as female for - in some cases - multiple years, that the clock on the "Real Life Test" did not start until they were registered at a GIC.   In such cases it was reasonable to not require a further "Real Life Test".   But that did not apply at all to Heyer.   Oscillation, especially if done on the down low does not apply.  

None of the sources that I read tells whether Heyer arrived for the appointment with Walker in female clothing.   I suspect not.  In which case Walker's diagnosis is all the more strange. 

  • “Can the Army Tolerate a Soldier Married to a Transsexual?”. The Dispatch, Jun 18, 1977. Online
  • “Uncommon Marriage”. Pensacola News Journal, 26 June 1977: 18. Online.
  • Nicholas Ghosh. “Tribute to Paul A. Walker”. Gender Review, December 1978. Online.
  • Jane Brody, J. “Benefits of transsexual surgery disputed as leading hospital halts the procedure”. New York Times. October 2,1979. Online.
  • Kathy Thomas. “Psychologist says no cure exists for habitual rapist”. Galveston Daily News,April 20 1981.
  • Lee Grant (dir). What Sex Am I?. With Christine Jorgensen, Paul Walker. US HBO 60 mins 1985. Review.
  • Lou Sullivan, “Dr. Paul Walker Returns to Address the TV/TS Community,” FTM 12 (June 1990).
  • Dallas Denny. “Paul A. Walker”. Chrysalis. Online.
  • Lawrence Wright, “The Case for castration”. Texas Monthly, May 1992.
  • Gordene Olga MacKenzie. Transgender Nation. Bowling Green State University Popular Press, 1994: 20, 68, 78.
  • Susan Stryker. “Portrait of a Transfag Drag Hag” in Stephen Whittle & Kate More (eds). Reclaiming Genders: Transsexual Grammers at the Fin de Siecle. Cassell, 1999: 72, 76.
  • Joanne Meyerowitz. How Sex Changed: A History of Transsexuality in the United States. Harvard University Press, 2002: 257-8.
  • Deborah Rudacille. The Riddle of Gender: Science, Activism, and Transgender Rights. Anchor Books, 2005: 176.
  • Christopher Barrett. “A Committed Journey” in J Ari Kane-Demaios & Vern L Bullough (ed). Crossing Sexual Boundaries. Prometheus Books, 2006: 108
  • Walt Heyer. Trading My Sorrows.Xulin, 2006: x, xi, 56, 62, 86, 117 .
  • Walt Heyer. Perfected With Love. Xulon, 2009: 28, 75.
  • Brice D Smith. Lou Sullivan: Daring to be a Man Among Men.Transgress Press, 2017: 68, 97, 111, 124, 138, 140, 144-7, 150, 157, 159, 164, 185, 197-8, 216.
  • Ryan T Anderson. When Harry Became Sally: Responding to the Transgender Moment.Encounter Books, 2018: 87-91.
  • Martin J Smith. Going to Trinidad: A Doctor, a Colorado Town, and Syories from an Unlikely Gender Crossroads.BowerHouse, 2021: Passim.
  • Oakleigh Marshall Reed. Evaluating the effectiveness of a transgender-affirmative care training on healthcare workers’ and trainees’ attitudes toward and knowledge of routine care and transition support for transgenderindividuals. PhD Thesis, University of Montana, 2021: 23, 24, 28.

PipiWiki               EN.Wikipedia

24 July 2021

Paul Walker (1946 – 1991) psychologist - Part I: Baltimore and Galveston

 (Original version April 2012.)

Walker was raised in Baltimore, did research in behavioural endocrinology with John Money at Johns Hopkins Psychohormonal Research Instititute from 1966, and graduated 1976 from the University of Rochester with a PhD in Social Psychology with a thesis on attitudes toward drug use and sexual behavior. 

He then gained a teaching position at the University of Texas Medical Branch (UTMB) at Galveston where he started a sex offender treatment program using a combination of medication and psychotherapy. He also ran the Gender Clinic there which had been serving transsexuals since 1972, and was becoming one of the major Gender Identity Clinics in the US.

Reed Erickson closed the Erickson Educational Foundation (EEF) in 1977. Walker and Zelda Suplee, who had been Director of the EEF, then formed Janus Information Facility which carried on some of the work of EEF, and Zelda also moved to Galveston.

Most of the trans patients at UTMB were self-referred after they learned of the Gender Clinic by word of mouth or, from 1977, through information available from the Janus Information Service. The patients' physical and hormonal measurements were taken, and hormones were prescribed. The program ran 1976-80, and an account was published in 1986. The program evaluated and treated 60 male-to-female transsexuals (age 15 to 53 years, median 28 years) and 30 female-to-male transsexuals (20 to 55 years, median 34 years). Results were published in 1981 and 1986.

In 1977 Walker was the defense psychologist at Fort Rucker. Alabama, where a young female soldier was accused of homosexuality for marrying a transman, Kristian von Hoffburg. Walker testified that the wife was not at all homosexual, and described the marriage as ‘cognitive heterosexuality’.

When the Johns Hopkins Gender Identity Clinic was closed in 1979 based on the contentious study by Jon Meyer, Walker was quoted in the New York Times: 

“If the study shows anything at all, it’s that careful screening before surgery is critical to the outcome. You have to be very careful about whom you operate on. Many applicants, certain that they want an operation, give a very convincing biography of a transsexual. They know exactly what to say. But if you put up any barriers to the surgery, they change their minds”. He pointed out that Meyer’s study examined patients just before their surgery but after they had completed the real‐life test. He added that “most of the changes had already taken place, so it's no surprise that he found no further improvement afterward”. (Brody)

In response to to Dr David Barlow of Brown University who claimed to have ‘cured’ three transsexuals through conditioning techniques to act and think more like others of their biological sex, and earlier had reported a transsexual “well on his way to surgery” who was changed by a faith healer through exorcism, Walker countered that “if you can change them, they weren't transsexuals in the first place. I cure people every week, sometimes just by telling them what the preoperative workup and surgery will involve.” (Brody)

Millionaire trans man Reed Erickson had sponsored and financed three symposia (London 1969, Elsinore 1971, Dubrovnik 1973) that brought together the professionals in transsexual treatment. There was a fourth - not sponsored by EEF - at Stanford University in 1975 (The Harry Benjamin 4th International Conference on Gender Identity) and a fifth in Norfolk, Virginia in 1977 - the year that EEF closed down. Some organization was required. At the sixth Symposium at San Diego in February 1979 the Harry Benjamin International Gender Dysphoria Association (HBIGDA) was formally approved with Walker to be the first president. HBIGDA was officially incorporated as a non-profit corporation in the State of Texas, by Walker and his colleagues Walter J Meyer III and Alice Webb.

It was realized that a Standards of Care was needed. Apparently Walker wrote most of the first draft himself, but then struck a committee which he chaired. The first edition of the Standards of Care for transgender clients was published in 1979.

Continued in Part II. 

Writing by others about Paul Walker will be listed in Part II.

By Paul Walker:

  • With John Money. “Prenatal androgenization of females. A review.” Hormones. 1972;3(2):119-28.
  • "Transexualism". Medical Journal of Australia,2,790, 1973.
  • "Transexualism". in Wilbur W Oaks (ed) . Sex and the Life Cycle, Grune & Sratton, 1976: 141-6.
  • Attitudes toward drug use and sexual behavior. Ph.D. dissertation, University of Rochester, 1976.
  • With John Money. "Counseling the Transexual” in John Money and Herman Musaph (eds). Handbook of Sexology V: Selected syndrimes and therapy. Elsevier, 1977: 1289-130.
  • With John Money, Walter J Meyer III, C Wiedeking, AA Kowarski, CJ Migeon, DS Borgaonkar . “Pituitary function in adult males receiving medroxyprogesterone acetate”. Fertility and Sterility. 28(10) Oct 1977:1072-6.
  • With AF Payer, Walter J Meyer III. “The ultrastructural response of human Leydig cells to exogenous estrogens”. Andrologia,11(6), 1979:423-36.
  • With Jack C. Berger, Richard Green, Donald R. Laub, Charles L. Reynolds, Jr., & Leo Wollman. Standards of Care: The hormonal and surgical sex reassignment of gender dysphoric persons. The Harry Benjamin International Gender Dysphoria Association, Inc. & Janus Information Facility, Online.
  • With Walter J Mayer III & Zelda R Suplee. “A Survey of Transsexual Hormonal Treatment in Twenty Gender-Treatment Centers”. The Journal of Sex Research, 17,1, Nov 1981: 344-9.
  • With Walter J Meyer III, RW Furlanetto. “The effect of sex steroids on radioimmunoassayable plasma somatomedin C concentrations”. Journal of Clinical Endocrinology and Metabolism, 55(6) Dec 1982:1184-7.
  • With Walter J Meyer III, LE Emory, ER Smith. “Physical, metabolic, and hormonal effects on men of long-term therapy with medroxyprogesterone acetate”.Fertility and Sterility. 43(1) Jan 1985:102-9.

The University of Texas Medical Branch, Galveston Gender Center:

  • Walter J Meyer III, Jordan W Finkelstein, Charles A Stuart, Alice Webb, Edward R Smith, Andrew F Payer & Paul Walker. “Physical and hormonal evaluation of transsexual patients during hormonal therapy”. Archives of Sexual Behavior, 10(4) Aug 1981:347-56.
  • Walter J Meyer III, Alice Webb, Charles A Stuart, Jordan W Finkelstein, Barbara Lawrence & Paul Walker. “Physical and hormonal evaluation of transsexual patients: a longitudinal study”. Archives of Sexual Behavior;15(2) Apr 1986:121-38.
  • C M Cole, L E Emory, Ted Huang & Walter J Meyer III. “Treatment of gender dysphoria (transsexualism)”. Texas Medicine, 90, 5, May 1994.
  • Ted T Huang. “Twenty years of experience in managing gender dysphoric patients: I. Surgical management of male transsexuals”. Plastic and Reconstructive Surgery, 96, 4, Sep 1995: 921-30.

13 July 2021

A Miscellany of Typologies

 Of the making of typologies there is no end.

To some extent they are needed in that trans persons are and can be very different. Those who attempt to abolish our variation by banning the obvious words like Traassexual and Tranvestite deform us by making everybody a vanilla Transgender.

Howver none of the Typologies work comprehensively. Whichever one you prefer, there are many trans persons who do not fit in any of the boxes.

Unfortunately, for the last couple of decades one particular typology that of HSTS/Autogynephilia as propouned by Kurt Freund/Ray Blanchard/Michael Bailey/Anne Lawrence/Kay Brown/Rod Fleming has dominated the discussion. There was a basic insight there in that early transitioners are indeed different from those who are first husband and fathers before transition - but their confaltion of other variables with the basic dichotomy increases the number of those of us who do not fit into the schema.

The typologies give us words to describe ourselves, and even to organise. However they should not be taken dogmatically.

You will immediately notice that almost all of these typologies apply to trans women, and extremely few to trans men.

Magnus Hirschfeld

1 Heterosexual

2 Bisexual

3 Homosexual

4 Narcissistic

5 Asexual

Albert Moll

1 Impulsive States. The individual compelled by strong inner force.

2 Homosexual. Part of the perversion.

3 Heterosexual. Constitutes a part of a contrary sexual state.

4 Pronounced heterosexual desire to imitate and enter into the feelings of the opposite sex.

5 Pseudo-transvestism for reasons of employment.

Virginia Prince 1957

 three types of ‘males’ who may share ‘the desire to wear feminine attire’:

  1. homosexuals,
  2. transvestites
  3. transsexuals
  • “Homosexuality, Transvestism and Transsexuality: Reflections on Their Etiology and Differentiations”. The American Journal of Psychotherapy, 11, 1957: 80-5.

Georgina Turtle, 1962

A: The Immature type

Mr A, 25 and in catering, subject all his life to over-doting parents, no associates of his own age and sheltered from the outside world. No sexual experience and no opportunities to cross dress.

B: The Aesthetic type

A sensitivity of feeling, a desire of everything that is fine and clean, a love of music and the arts. A disassociation of all fine things from masculinity. A feeling that one cannot express finer emotions and remain masculine. A man's life is shallow and superficial while femininity represents purity, cleanliness, finesse, charm and gracefulness, gentleness and beauty. These transsexualists are intelligent and well-educated, and are successful in passing as male. They can be talked out of transition if the illogicality of associating aesthetic characteristics with womanhood is forcefully brought home. Mr B, 34, engineer, an only child raised by his father to avoid aesthetic and beautiful things. He spent good money so that his female clothes were just right. After a period on female hormones, he reverted to male after realizing that his female state would be less than perfect.

C: The Oedipus type

Identify with their mother, and are antagonistic to their father. Mr C, 44, chemical processing executive. His desire to cross-dress is repressed by his fear of ridicule, and when he does, he quickly burns the items afterwards.

D: The Homosexual type

Unlike the above, this type has friends, and does not feel guilty about cross-dressing, and often will reach a stage of being a man only for work. Many work as female impersonators, and transition earlier. Mr D, 42, engineer, served in the forces, taken for a girl as a child and overcompensated by being good at rugby and cricket. Attracted to men but rejects homosexuality. Has been to many doctors, and has started living as female, though unable to obtain surgery.

E: The Anti-Social type

Turtle sees this as a variation on the Homosexual type. They are selfish and cowardly, and desire to be female in that things must be easier for females. They want to be pampered and looked after without having to work hard. They enjoy the pleasure of fooling people by their appearance, and are exhibitionists. Often they will abandon wife and children to live full-time as female, and have fantasies about becoming prostitutes. Mr E, 56, married with several children, has lived on and off as a woman for much of his life, and has obtained a female National Insurance card. Has made no effort to seek treatment. Has been arrested for theft.

no letter The Glandular type

Glandular, that is endocrinal imbalances, result in a man in his twenties who does not shave, or a woman with a muscular physique and hirsutism. Of those so affected, only few become transsexualists. However for those few, the adoption of a cross-sex role comes easily. Those born boys often take up work as a female impersonator, but move on to a sex change, and afterwards desire marriage. Those who manage to obtain female hormones early avoid the male secondary sexual characteristics, and have less past to leave behind them. Turtle, however, cautions: "Nevertheless, it must be remembered that however much justification these individuals might appear to have they are no less biologically of the sex they were born, and can still only be called transsexualists. We are not therefore speaking here of someone who is intersexual."

F: The Basic Female transsexualist

Turtle admits that there should be a corresponding typology for female-born transsexualists, "Nevertheless, all cases known to the writer had intimate female partners, suggesting that most were probably homosexually oriented." There was no significant loneliness or need for secrecy. Miss F, 25, an only child, wanted to be a boy from childhood. Since the age of 18 has sought help from doctors, but with no success. Has had a female companion for many years.

G: The Intersexual group

In true intersexuality "sexual ambiguity is caused by a conflict of the biological factors affecting development, and, in contrast to transsexualists who often prove the normality of their sexual function, intersexes are often both physically and sexually immature and may indeed be sterile". However "intersexes may continue through life quite happy in their sex of rearing, regardless of their 'true' sex". Miss G, 37, realised from early years that her interests and feelings were those of a girl. "In spite of her inner feelings there was never any question of wanting to dress up or resort to transvestism, and it was only when she was eventually obliged to see a sexologist that her physical intersexual state was revealed."

British Medical Journal, 1966

3 kinds of transvestism:

  • as a masturbatory ritual associated with erotic excitement
  • a symptom associated with other anomalies such as homosexuality
  • a means of gratification without genital excitation or interest in homosexual behaviour.

It followed Kinsey in that a transvestite may or may not be homosexual, and rejected the common attitude in psychoanalysis that (1) was the main form.

Early Harry Benjamin

Divided all transvestites into three groups:

  • those who merely want to ‘dress’ and be accepted as women.
  • those who waver, who want breast development but shy away from surgery.
  • ‘fully developed’ transsexuals.

Benjamin had arrived at this typology after observing over 200 patients, of whom more than half he diagnosed as transsexuals.

Harry Benjamin 1966

  • Pseudo Transvestite
  • Fetishistic Transvestite
  • True Transvestite
  • Non-op Transsexual
  • True or Core Transsexual (moderate intensity)
  • True or Core Transsexual (high intensity)

Virginia Prince 1966

In reaction to Benjamin.

  • Fetishist
  • Low intensity TV
  • True femmiphile TV
  • Asexual type
  • Gender type TS
  • Intensive sexual type TS
  • Operated TS

Robert Stoller

  • Primary (androphilic)
  • Secondary (other)

Ethel Person

Types of transsexuals:

1 Primary - functionally asexual and who progresses resolutely toward a surgical resolution without significant deviation toward either homosexuality or heterosexuality, no evidence of effeminacy in childhood.

2a Secondary, homosexual - effeminate from earliest childhood, preferred girls as playmates, avoided boyish pursuits and were "mother's helpers." Crossdressing began in childhood, initially for narcissistic satisfaction, but later at puberty to attract male sexual partners. Cross-gender fantasies were frequently tied to identification with movie actresses and drag queens. The authors note that the homosexual cross-dresser wants to be noticed and to this end often wears flamboyant and colorful clothing and engages in theatrical endeavors.

2b Secondary, transvestic - appropriately masculine, and occasionally exceedingly hyper-aggressive and hyper-competitive. They neither played with girls nor engaged in female pursuits. They fantasized about being girls when cross-dressed, but valued their assertiveness and maleness.

This typology was in contradistinction to Stoller’s writings where the androphilic early transitioner was regarded as primary.

Charlotte Bach 1978

Central to Bach’s theory is an eight-box typology that is based on the old trapped soul concept. You may be a male soul in a male body, a female soul in male body, a female soul in female body or a male soul in a female body. Which gives four options. However the soul strives to become the other sex, and this striving can be denied or asseverated. Now we have eight options:

The stable options:
  • Male positive denialist. The heterosexual male, physically and psychologically male, denying the pull to become female.
  • Female positive denialist. The heterosexual female, physically and psychologically female, denying the pull to become male.
  • Male negative denialist. A female soul in male body who denies the pull to the other psychological sex, i.e. male. This is a transvestite or drag queen.
  • Female negative denialist. A male soul in female body who denies the pull to the other psychological sex, i.e. female. This is a butch lesbian.
The changeable/creative options:
  • Male positive asseverationist. The male, physically and psychologically male, accepting the pull to become female. (This is not properly explained. Would this be a metrosexual or a psychologically androgynous male who is accepting of his female side?)
  • Female positive asseverationist. The heterosexual female, physically and psychologically female, accepting the pull to become male. (This is not properly explained. Would this be a psychologically androgynous female who is accepting of her male side? Would one type of this be a career woman?)
  • Male negative asseverationist. A female soul in male body who accepts the pull to the other psychological sex, i.e. male. He will be masculine, and dress definitely so, and might be quite aggressive. (This is what others have called a homovestite. Would homophobia fit here?)
  • Female negative asseverationist. A male soul in female body who accepts the pull to the other psychological sex, i.e. female. This is a femme lesbian who dresses extra femme. (Although surely a heterosexual femme or homovestite would fit here also.)

  • Colin Wilson. Mysteries: An Investigation into the Occult, the Paranormal and the Supernatural. Putnam, 1978 : Grafton Books 1979: 514-523.

Ray Blanchard 1989

Adapted from Kurt Freud, and endorsed by Michael Bailey, Anne Lawrence, Kay Brown and Rod Fleming.

Two types of transsexualism:

  • Homosexual Transsexual (that is Androphilic) but also early transition and living on the margins of society without a regular job. Many are assumed to be prostitutes, performers or to work in gay bars
  • Autogynephile, usually a husband and father, also a late transition and usually well-employed.

Four types of Autogynephilia:

  • Transvestic – being aroused by the act or the fantasy of wearing women’s clothes
  • Behavioural - being aroused by the act or the fantasy of doing stereotypical female things, e.g. knitting, or having one’s hair’s done
  • Physiological - being aroused by the fantasy of menstruating or being pregnant
  • Anatomical - being aroused by the act or the fantasy of actually having breasts and a vagina.

    • “The concept of autogynephilia and the typology of male gender dysphoria”. The Journal of Nervous and Mental Disease, 177, 616-623. 1989

Alice Novic

A rewrite of Blanchard’s typology to be more polite

  • Love to be Femme (Cross-dressers and late transitioners. a) enjoy being women b) not spontaneously effeminate c) basically gynephilic d) business or technical careers)
  • Act-Femme (Drag queens and early transitioners. a) act like women naturally b) don’t automatically love being women, but if it works they go with it c) androphilic d) people-oriented or creative careers),

After Anne Vitale

The gender neutral version

G1. A high degree of cross-sexed gender identity. The cross-gender expression of identity of these individuals appears very difficult or impossible for them to conceal. They transition naturally, without anxiety and with relatively little difficulty

G2. A lifelong history of rejecting the dress conventions of their assigned gender along with conventional toys and activities. … these individuals typically take full advantage of the social permissiveness since the late 1960s and the gay and lesbian movements to wear gender-neutral clothing. They transition without anxiety.

G3. Individuals who look and act unambiguously as society expects them to but privately identity as the opposite gender. For these female-identified males and male-identified female the result is a more complicated and insidious sex/gender discontinuity. From earliest childhood these individuals typically suffer increasingly painful and chronic gender dysphoria. They tend to live secretive lives, often making incrementally stronger attempts to convince themselves and others that they are the gender they were assigned at birth.

Kris Kirk 1984

"If there is any one lesson to be learned from studying this field it is that the individual is individual. People define themselves and the self-definition must always takes priority over the received wisdom. I have met self-defined draq queens whom others would describe as TV either because they enjoy 'passing'; or because they 'dress' so often that it could be seen as a compulsion; or because they wear lingerie, either to turn men on or to make themselves feel sensuous. I have met drag performers who have grown to dislike drag, and men who insist on being called 'cross-dressers' because they dislike what the word 'drag' stands for, and men who wear part-drag in order to create confusion and doubt amongst others, but who would never wear full drag because that would defeat their object. I know self-defined TVs who are gay or bisexual or oscillating, some of them having learned to cross this sexuality barrier through their cross-dressing. I have met TVs who dress like drag queens and drag queens who dress like TVs, and TVs whose cross-dressing has encouraged them to question their 'male role', which in turn has made them examine their idea of 'femininity'. And perhaps most important of all, I have learned how marshy a terrain is the middle ground between our earlier clear-cut distinction between transvestites and transexuals."

Richard F Docter, 1988

a 5-part typology for heterosexual transvestites:

  1. fetishism,
  2. fetishistic transvestism,
  3. marginal transvestism,
  4. transgenderism
  5. secondary transsexualism.

a 4-part typology for homosexual transvestites:

  1. primary transsexualism,
  2. secondary transsexualism,
  3. "so-called drag queens"
  4. female impersonators.
  • Transvestites and Transsexuals: Toward a Theory of Cross-Gender Behavior.Plenum Press, 1968

Anne Bolin 1996

  1. hermaphroditic genders
  2. two-spirit traditions
  3. cross-gendered roles in the manly heart tradition
  4. woman-marriage
  5. cross-gendered rituals

  • “Traversing Gender”, in Sabrina Ramet. Gender Reversals and Gender Culture,1996

Richard Ekins 1996

3 modes:

  • body (as in transsexual changes)
  • gender (emphasis on doing and passing)
  • erotic (self explanatory).

5 phases:

  • Beginning (often in childhood, the first time)
  • Fantasying (sic) (he spends a lot of time on telephone sex-lines, but also pornography and the individual imagination)
  • Doing (solitary, solo, dyadic or group)
  • Constituting (the search for an explanation and maybe the adoption of a label)
  • Consolidating (a way of fitting femaling into one's life, e.g. by completing the transsexual change, by deciding not to change sex, but fitting into the transvestite subculture, or by finding an androgynous mix).

    • Male Femaling: A Grounded Approach to Cross-Dressing and Sex-Changin Routledge, 1996.

Richard Ekins & Dave King 1999

four major modes or styles of body transgendering:

  1. Migrating - crossing the gender divide permanently
  2. Oscillating - crossing back and forth
  3. Erasing - seeking to eliminate the divide (renamed Negating in 2006)
  4. Transcending - seeking to ‘go beyond it’.
    • "Towards a sociology of transgendered bodies". The Sociological Review, 47:580–602, 1999.
    • The Transgender Phenomenon. Thousand Oaks; 2006.

Myra J Hird 2002

(1) authenticity – transsexualism and ‘real’ sex and gender;

(2) performativity – transsexualism and fictive sex and gender;

(3) transgression – transsexualism and the disruption of sex and gender.

  • “For a Sociology of Transsexualism”. Sociology, 36, 3, 2002.

Charlotte Goiar 2005

  • HBS
  • Autogynephile

Ariadne Kane 2005

 The Transgender Phenomenon Flowchardt

Group A:

  • Bigenderist
  • Transgenderist
  • Androgyne
  • Gender Bender

Group B:

  • Masculine or Femme Impressionist
  • Cross-Dresser
  • Transvestite
  • Drag King or Queen

Group C:

  • Transsexual
  • Intersexual
    • Crossing Sexual Boundaries: Transgender Journeys, Uncharted Paths. Edited by J. Ari Kane-Demaios and Vern L. Bullough. Prometheus Books, 2005.

Mercedes Allen 2008

1.Zucker-Blanchard Model

2.HBS Model

3.Transgender Model

Koloa 2020

 I: Trans Individuals with higher risk tolerance, yet low adaptability manifest dysphoria at a younger age, fail to adapt to their assigned gender, yet feel more free to transition before mid-life if not in their teens and early 20’s because they are socially risk tolerant.

II: Trans individuals with high social risk tolerance and high adaptability are the most visible and carefree in their gender variance. Examples are Drag performers or gender rebels like Eddie Izzard and Conchita Wurst.

III: Trans individuals with high adaptability yet low social risk tolerance find they can live long successful lives as their assigned gender and often never transition at all. They avoid expressing variance due to a low social risk intolerance. And if they do transition it is usually mid-life or later after a process that enhances their social risk tolerance. Many MtF in quadrant III are gynophillic which might contribute to adaptability to their assigned gender.

IV: Trans individuals with both low social risk tolerance and low adaptability experience the worst situation because they cannot find any comfort in their assigned gender. The inability to adapt and the fear of the social and material consequences gives them a life bereft of expression putting their mental health and very lives at risk. Individuals in this quadrant simply endure until they experience a mental collapse that leads to treatment, or loss of life. This crisis can come at any age.


05 July 2021

Tammy (195? - ) electronics engineer

Tammy was born with ambiguous genitals, and her parents went with female. This went well until Tammy’s puberty when as Youngson & Schott put it, her “ equipment soon grew to respectable dimensions”. The embarrassed parents quickly switched the child to male clothing. The father, who was a doctor, was especially disconcerted and embarrassed; Tammy hated the change and knew it was all wrong. The father refused to talk to Tammy on the subject and considered his child’s objections to be unreasonable. 

Making the best of the situation, Tammy got a good degree in electronics and moved to London with a job in computer mainframe maintenance. She was still Tammy; Tammy was still female inside, and dressed appropriately at evenings and weekends. This led to homophobic abuse from her landlord, and after a co-worker recognised her, a warning at work from the boss. 

Tammy’s doctor was skeptical and unsympathetic. However she persevered and was taken on at a gender identity clinic, probably that at Charing Cross Hospital. She was subjected to the usual evaluations and delay tactics, but was finally approved and put on female hormones. 

As she dressed female full-time, she lost her job, moved to cheaper lodgings and lived on the dole. After completion surgery she still had problems finding work, but did find work developing CD-ROM disc drives, where she was obviously competent and was promoted. 

Her mother embraced her new daughter, but her doctor father continued to be disgusted by her development.

  • Robert Youngson & Ian Schott. Medical Blunders: Amazing True Stories of Mad, Bad, and Dangerous Doctor Robinson, 1996: 106-111.
  • Ian Schott & Robert Youngston. A Brief History of Bad Medicine: True stories of weird mediicne and dangerous doctors. Robinson, 1999:101-3.


Medical Blunders and Bad Medicine are the same book issued under different titles. Robert Youngson gained an extra ‘t’ in his surname for the latter. Both authors were doctors. That said, their research into transsexuality is amazingly deficient. The books jump from topic to topic giving an example of inadequate or bad doctoring. For most of the episodes I can only accept what they say.

However the section labelled ‘Sex Change’ contains only this one example. Tammy (presumably a pseudonym) is obviously intersex, and is not best described as a transsexual although she had to go through the usual transsexual conversion. It is most likely that she had the condition popularly referred to as ‘Penis-at-Twelve’, what doctors properly call 5-alpha Reductase Deficiency (5-ARD). 5-Alpha Reductase is an enzyme that converts testosterone to dihydrotestosterone. A baby deficient in this enzyme develops as a girl until puberty, and indeed may have a pseudovaginal perineoscrotal hypospadias which would be taken as a vagina. At puberty different and stronger forms of testosterone kick in and cause virilization. This condition is due to a defect on an autosome (not a sex chromosome) and requires two mutated genes, one from each parent. I have no idea why Youngson and Schott do not explain this. Nor why they do not name the Charing Cross GIC.

The authors open with: “Tammy ... was undoubtedly a man. A test had shown that every cell in his body contained an X chromosome and a Y chromosome”. So they have presumably not read the first chapter of Benjamin’s The Transsexual Phenomenon. 

Later they write: “As a result of his parents’ mistake, Tammy was a transsexual”. They do not tell us when Tammy was born. Assuming that she completed transition in her middle to late 20s, and we know that CD-ROMs came out in the early 1990s, she would have been born in the early 1960s, possibly the late 1950s. Knowledge of 5-alpha Reductase Deficiency was very rare around 1960, and thus it is totally unfair to accuse the parents of making a mistake at that time. However if we assume that Tammy arrived at puberty in the early 1970s, that is the same time as endocrinologist Julianne Imperato-McGinley was investigating the high frequency of 5-alpha Reductase Deficiency children in a village in the Dominican Republic and awareness of the condition was expanding. A particularly well-informed local doctor might have heard of it at that time.

“As a result of his parents’ mistake, Tammy was a transsexual”. Many books have been written on nature vs nurture, it is congenital or caused by rearing? In the 1960s it was fashionable to blame the parents, especially the mother, for all sorts of things. Two doctors writing in the mid-1990s should know better than to blame the parents like this.

The authors do not say what would have constituted good doctoring in this case. We now know that some 5-alpha Reductase Deficiency children choose to grow up as men and some as women. Tammy should have been listened to and counselled at puberty. Given that she felt that she was female, she should then have been offered female hormones to maintain her original sex - such therapy is offered in the village in the Dominican Republic.

Tammy was not transsexual, not in the sense of an apparent boy who grows up to be a woman. She was a girl whose girlhood was disrupted and only regained at great effort.