Psychology, Sexualization, and Trans-Invalidations

“Psychology, Sexualization, and Trans-Invalidations” by Julia Serano this is Chapter 30 from Julia’s third book: OUTSPOKEN a decade of transgender activism & trans feminism citation for this essay: Julia Serano, Outspoken: A Decade of Transgender Activism and Trans Feminism (Oakland, CA: Switch Hitter Press, 2016), pp. 126-144. 30 Psychology, Sexualization, and Trans-Invalidations This chapter was originally presented as a keynote talk for the Eighth Annual Philadelphia Trans-Health Conference in 2009. I was inspired to write it after, on multiple occasions, I had read or heard sexologists and mental health professionals play down or outright dismiss trans people’s concerns regarding psychological depictions, diagnoses, terminology, and theories about trans people.1 With this speech, I set out to explain, in very basic, easy to grasp language, precisely why trans people’s concerns regarding these matters are valid and should be taken seriously within the ields of psychology, psychiatry, and sexology. I would later expand upon the concept of “invalidations” in Excluded (speciically, Chapter 20, “Recognizing Invalidations”). Thanks, it’s an honor to be here. It’s rare that one gets to simultaneously speak to trans activists, allies, and trans health providers, so I am truly grateful for this opportunity. Being here is also somewhat surreal for me, as I grew up just outside of Philadelphia, less than ten miles from here. And I was thinking last night that if you would have told my younger, closeted, isolated self that one day, I’d be here in the Pennsylvania Convention Center giving a keynote talk at a trans-health conference . . . well, let’s just say that I would have been really, really mortiied. I want to share with you some of my thoughts regarding how gender variance, transgenderism,2 and transsexuality are depicted and discussed within mainstream psychology,3 and the impact that this has on trans people’s lives. While this has always been an important topic, it has become especially relevant in the last few years, as a result of the seemingly never-ending controversy surrounding J. Michael Bailey’s book The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism—a book which many trans activists, advocates, and sexologists found to be unapologetically stigmatizing, sexualizing, Psychology, Sexualization, and Trans-Invalidations 127 and a distortion of both trans people’s lives and the scientiic literature on the subject.4 Then there was last year’s news that Ken Zucker (who conducts reparative therapy on gender-non-conforming children) and Ray Blanchard (who coined the controversial term “autogynephilia”) were to play critical lead roles in determining the language of the Sexual and Gender Identity Disorders section for the next revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM).5 In certain sexology circles, the negative reactions expressed by trans activists in response to these incidents have been caricatured as expressions of “narcissistic rage”—a hysterical, irrational, mass overreaction to the supposedly logical, well-reasoned, empirically-based theories and diagnoses forwarded by psychologists.6 Reciprocally, in trans circles, psychologists are sometimes caricatured as heartless evil-doers who conspire behind the scenes in order to igure out how to further exploit and subjugate trans people via the DSM, WPATH Standards of Care,7 and so on, in order to achieve academic success and/or monetary gain for themselves. Personally, I am not a big fan of either of these narratives. First, there are some psychologists who do truly trans-positive work. Further, I believe that the majority of psychologists—even ones that I most fervently disagree with—forward the theories they favor because they sincerely believe that they are correct and will beneit trans people in the long run. I also believe that the concern, fear, and outrage expressed by trans people—even those who are the most vehemently deiant and angry at the psychological establishment—comes from a very real and legitimate place. It comes from our understanding that there is a direct connection between mainstream psychological discourses about gender-variant people and the societal marginalization we face in our day-to-day lives due to our gender variance. While some psychologists and trans health providers recognize this connection, too many others seem unconcerned by the problem. Perhaps they haven’t been exposed to, or don’t feel that it’s important for them to familiarize themselves with, trans perspectives. Or maybe they habitually view us as “other” and therefore have diiculties identifying with our plight. Or maybe they so fancy themselves as experts on transgenderism that they can’t comprehend that we (as trans people) have profound experiences and insights into gender that they are not privy to, and that frankly they could learn a thing or two by simply listening to us. Whatever the reason, I feel that a major obstacle that we as a trans community face is getting the greater psychological establishment, as well as the general public, to appreciate why our concern is legitimate, and to get them to understand in really concrete terms how 128 Outspoken certain psychological theories, therapies, terminologies, and diagnoses cause us very real harm and injury, and therefore should be done away with. To be honest, I think that we (i.e., trans activists) could do a better job articulating this than we have in the past. For instance, in the trans community, most of the complaints that I have heard about mainstream psychology or the DSM tend to center around two words. First, psychologists who forward theories and diagnoses that have a negative impact on trans people are often called out as “transphobic.” While this is often a valid critique, most lay people have a supericial understanding of the term, reading it literally as “fear of transgender people.” Thus, someone like Bailey can simply say “I have trans friends,” or “I support trans surgeries,” and this will sound like a reasonable response to most people outside of the trans community. The second word that trans activists regularly employ is “pathologize.” People will say that Bailey’s book is bad because it pathologizes people on the trans female/feminine spectrum. Or they will say that the trans-focused DSM diagnoses Gender Identity Disorder (GID) and Transvestic Fetishism pathologize gender-variant people. While I would agree with these statements, I do not believe that they convey the real problem. For one thing, the word pathologize is a very abstract and esoteric word. While many trans activists, psychologists, and academics understand its meaning, it is not likely to resonate with the general public. Second, we live in a society where all people must be willing to be pathologized (i.e., diagnosed as having a medical or psychiatric condition) in order to access the healthcare system. In recent years, I have been diagnosed for being hypothyroid and for having skin cancer, yet I never felt a sense of outrage over the fact that I had been pathologized in order to access care in these cases. Here is a more pertinent example: I am lucky enough to have therapy mostly covered by my health insurance plan. This isn’t transition-related therapy— it’s just your run of the mill therapy. My insurance company won’t cover my sessions, of course, unless I am diagnosed with something. So, for insurance purposes, my therapist uses Adjustment Disorder as my diagnosis—it refers to a “psychological response to an identiiable stressor,” which could include anything from stress at work or relationship issues, to more serious problems.8 Despite the fact that this is oicially a psychiatric diagnosis, it does not evoke strong outrage in me. In contrast, I was very disturbed about the fact that I needed to be diagnosed with GID in order to transition. This suggests that what bothers me about GID is not merely the fact that I have been “pathologized” (as being pathologized in other contexts does not bother me so much). Psychology, Sexualization, and Trans-Invalidations 129 Similarly, I don’t think that the word “pathologize” really captures why, when I read Bailey’s book, I was often illed with palpable anger. Or why I was moved to tears upon hearing a recent National Public Radio story that described a cross-gender-identiied child who was undergoing Ken Zucker’s reparative therapy.9 So if the issue is not pathologization per se, why is it that we, as trans people, often experience such an intense, visceral, negative reaction to these theories and therapies? I would argue that it is because they invalidate us. The deinition of the word invalidate is: to discredit; to deprive of legal force or eicacy; to destroy the authority of; to nullify.10 Whether deliberately or unconsciously, I believe that the theories and diagnoses forwarded by certain mainstream psychologists do just that to us. And with the rest of my talk today, I hope to draw a direct connection between these theories and diagnoses and the invalidations that we, as gender-variant people, experience in our day-to-day lives. We live in a world where trans people’s gender identities, gender expressions, and sex embodiments are deemed less natural and less legitimate than those of cisgender people.11 This double standard plays out at virtually every level of our lives. For example, I have the privilege of passing as a cisgender woman in my day-to-day life. In the eight years since my transition, I have never once had someone who presumed that I was a cisgender woman accidentally slip up my pronouns and call me “he.” It is simply a mistake that people never (or extremely rarely) make with people they believe to be cisgender. However, once I come out to people as trans, or after they discover that I am trans, it is not uncommon for them to accidentally slip up and call me “he.” I say accidentally here because, in most cases, people are apologetic after realizing their mistake. While it may not have been conscious or intentional, such incidents clearly indicate that my gender identity as a trans person is viewed as inherently suspect, and less legitimate, than it is when I am read as cis. I have had cisgender people say to me, “Why is that such a big deal? I wouldn’t get upset if someone slipped up my pronouns.” My reply to that is, well, of course you wouldn’t, because it never happens to you. And if it did happen to you, it would seem anomalous, and therefore harmless. But in my case, people do often slip up my pronouns, and when they do, it is a sign that on an unconscious level they see my gender identity as less authentic than the gender identities of cisgender people. In addition to these unintentional slip-ups, I occasionally come across people who purposefully call me “he,” who deliberately refuse to acknowledge 130 Outspoken my female gender identity. When this happens, it is generally done with an air of superiority, and the person makes no attempt to hide their indignation and contempt for me. And for every time that this happens to my face, there are hundreds of times when people direct similar trans-invalidations to the cisgender majority rather than me. For example, often I’ll be watching a TV show or movie, or I’ll be reading a newspaper or magazine, or a gender studies or psychology book, or maybe I’ll be in a restaurant or on the subway, minding my own business, and I’ll be blind-sided by an invalidating comment or rant about transsexuals: about how confused, or fake, or sick, or dangerous, or gross, or pathetic, or ridiculous we supposedly are. While these remarks may not have been intended for me, how could I possibly not take them personally, when they are so obviously about me? There is a straight line that connects inadvertent pronoun slips, the inability to legally change the gender markers on one’s driver’s license or passport, Focus on the Family’s anti-transgender fear-mongering ads about “men” entering women’s bathrooms, trans people who can’t ind employment because they don’t pass as cisgender, incarcerated trans women who get placed in all-male jail cells, and trans people who are beaten, even murdered, while their assailants claim that they are somehow victims of the trans person’s “deception.” These acts may difer greatly in their severity, but they all communicate the exact same message: that trans people’s gender identities, expressions, and sex embodiments are not deserving of the same rights or respect that are regularly extended to our cisgender counterparts. They all revolve around what Talia Bettcher in her writings calls the Basic Denial of Authenticity.12 There are myriad ways in which trans-invalidations may occur. Some people will claim that gender-variant identities, expressions, and bodies are unnatural or immoral, often citing some religious text or “Biology 101” soundbite in order to make their point. Or, they might go out of their way to portray trans people as imitators, impersonators, or even caricatures, of cisgender women and men. Others project ulterior motives upon us. Those who wish to invalidate same-sex attraction will claim that lesbian, gay, and bisexual people just haven’t met the right person yet, or are merely looking for an alternative lifestyle, or perhaps they’ve been duped by the homosexual agenda. Similarly, those who wish to invalidate trans people’s gender identities will claim that we must transition in order to gain certain gender privileges, or perhaps we’re merely trying to satisfy some sexual fetish, or maybe we’re really gay people who are trying to assimilate into straight society and/or to seduce unsuspecting straight people. Psychology, Sexualization, and Trans-Invalidations 131 All of these invalidating strategies are routinely used to delegitimize us. Perhaps the most widespread method of trans-invalidation occurs when people presume that trans people are mentally confused, incompetent, or ill, and therefore unable to speak with validity about our own experiences, identities, and personal histories.13 Of course, claiming or insinuating that somebody is mentally incompetent or inferior is one of the most common forms of invalidation more generally. If you and I disagree about something, I can gain the upper hand by suggesting that you are younger than me and therefore naive, or that you are a layperson, whereas I have an advanced degree. I could even insinuate that you are not as smart as me, or that perhaps that you are a little bit crazy. Because it is such an efective a strategy, invalidation based on mental inferiority has been invoked to perpetuate racism: There is a long history, stretching from phrenology to The Bell Curve, of dubious research that has attempted to give scientiic credence to the presumption that people of color are mentally inferior to the white majority.14 Invalidation by mental inferiority has also been used to justify sexism: The claim that women are biologically or hormonally predispositioned to be overly emotional (read: irrational or immature) has been invoked by those who feel that women should defer to men, or who feel that women are not capable of dealing with serious or important matters. For example, the sufragists who fought for women’s right to vote were regularly dismissed as sufering from “hysteria,” which was considered a legitimate mental disturbance at the time.15 Given this history, it is no surprise that those who wish to dismiss trans people often do so by claiming that we are delusional, or simply confused about, our genders. For example, back when I decided to transition, the people in my life who voiced the strongest objections invariably stressed that what I was experiencing was simply “all in my head.” Some saw my female gender identity as a faulty piece of misinformation that I simply needed to unlearn. Others presumed that what I experienced was akin to an addiction, and they argued that I just needed to be more disciplined in repressing my wayward urge. Their arguments relied on the presumption that my physical anatomy—my male sexed body—was the only relevant, unalterable reality, and that what was going on in my mind—my female gender identity—was unreal and illegitimate by virtue of its invisibility. Of course, this is the opposite of what I actually experienced: The feeling that I had had since childhood that there was something wrong with me being male, and that I should be female, was very real and very unalterable, whereas my physical body has proven to be quite malleable in 132 Outspoken comparison. But their belief that my external, anatomical sex is most relevant and immutable essentially rendered my inner experience, my mental state, as irrelevant and unstable. This dualism—that if one’s physical sex is “real” and “primary,” then the mind must automatically be “secondary” and “faulty”—implies that anything that a trans person says about their own experience, or about gender more generally, is inherently suspect. It efectively ensures that anything that any cisgender person says about gender or trans people automatically trumps what we have to say about ourselves. In efect, it positions cisgender people as de facto experts on gender variance by virtue of the fact that our minds are supposedly faulty while theirs are not. And in my experience, many cisgender people seem to relish in this supposed expert status. I cannot tell you how many times that I have interacted with people who know little to nothing about transgender people and experiences, yet who felt entitled to speak down to me or act intellectually superior to me with regards to the subject; people who repeatedly referred to my “gender confusion” in order to emphasize my presumed mental incompetence; people who have insinuated that I must be delusional because I don’t conform to their common sense; people who have dismissed my perspective and experiences on the basis that they are tainted by my supposed mental sickness. To such people, it doesn’t matter that I’ve had unique and enlightening gendered experiences that they have not shared. They don’t care that I have a PhD in biology, or that I’ve written a book and occasionally give keynote talks about gender and transgender people. To them, anything I say is viewed as a mere byproduct of my “mental aliction” and is immediately deemed invalid. To me, this is the heart of the problem. Words simply cannot convey how intensely frustrating and infuriating it is to be routinely invalidated in this way. Simply talking about it gives me an adrenaline rush. You could call me all sorts of names or profanities, make fun of virtually any other aspect of my body or personality, and it wouldn’t even come close to eliciting the anger and outrage that I feel when somebody dismisses my gender identity or insinuates that my gender-related knowledge and experiences are mere igments of my imagination. There is simply no more efective way of hurting me than trans-invalidating me. Trans-invalidations based on mental inferiority are especially triggering to me for three reasons: First, they happen to me repeatedly. Second, they play on the profound shame that I felt back when I was a child when I really did believe the cissexist premise that, since the rest of the world was supposedly “normal,” there must be something very wrong with me. Third, those Psychology, Sexualization, and Trans-Invalidations 133 who perpetrate trans-invalidations invariably refuse to acknowledge their own cisgender privilege and how it enables and exacerbates these incidents. After all, while I have had to ight my entire life to have my gender identity be taken seriously, my cisgender detractors simply take theirs for granted. This is the uneven playing ield upon which every debate about gender identity and transgender rights plays out. Cisgender people can pretend to have abstract, objective, and purely theoretical conversations about whether gender identity exists, or whether trans people should be allowed to transition, because their identities and life choices are never on the line. But for those of us who are trans, such discussions automatically call into question our identities, our autonomy, and our mental veracity. They literally put our entire personhood up for debate. Unfortunately, in this culture and at this point in time, dealing with and overcoming trans-invalidations is central to the trans experience. And I would argue that any person who does not understand or acknowledge how injurious these trans-invalidations are to us, simply does not understand transgender people. I’ll repeat that: Any person who does not understand or acknowledge how injurious these trans-invalidations are to us, simply does not understand transgender people. Period. I further contend that any medical or mental health provider who is sincerely concerned with the health, happiness and well-being of gender-variant people must make challenging and eliminating these trans-invalidations, both within their professional ields and in society at large, a top priority. Once we understand trans-invalidations, especially those based on mental inferiority or incompetence, it is relatively easy to see why most trans people have a beef with mainstream psychology. First, many mainstream psychologists continue to use what Kelley Winters calls “maligning language.”16 In the psychological literature, trans women are routinely called “male transsexuals” and trans men “female transsexuals.” Trans women who partner with men are called “homosexual,” while lesbian-identiied trans women are called “heterosexual.” And the cisgender majority are not called cisgender, or even nontransgender or nontranssexual women and men. Instead, they are generally called “normal” or “biological” women and men. Whenever I hear somebody use the term “biological” as a synonym for cisgender, I always make a point of assuring the person that while I may be trans, I am not inorganic or nonbiological in any way. The purpose of all this terminology is most certainly not clarity. After all, what could be more convoluted and confusing than using the term “heterosexual female transsexual” to describe someone who identiies and lives as a gay 134 Outspoken man? The only purpose that this terminology serves is to reinforce a hierarchy whereby trans people’s assigned sex and anatomies are viewed as primary and relevant, while our gender identities are deemed secondary and irrelevant. Trans-invalidations are also reinforced by the trans-speciic diagnoses in the DSM. Two of these—Transvestic Fetishism and GID in Children—were written in such a way that they primarily target people who are not cross-gender-identiied, but who simply crossdress or who are gender non-conforming in other ways.17 This is abominable. Such diagnoses serve no purpose other than to further stigmatize gender variance. The situation is admittedly more complicated for those who wish to socially, physically, and/or legally transition. As I alluded to earlier, a diagnosis is generally required any time one wants to access the healthcare system, and GID has provided that for quite some time. Having said that, having this diagnosis in the DSM reinforces the popular assumption that trans people are inherently delusional or confused, and thus, not surprisingly, it is regularly cited by those who wish to invalidate our gender identities. In one chapter of her recent book Gender Madness in American Psychiatry, Kelley Winters lists incident after incident in which people who were ighting against the civil rights of trans children and adults cited the GID diagnosis, and the fact that it is listed as a mental illness, in their attempts to invalidate us.18 This is why so many trans activists favor deleting this diagnosis entirely, or moving it from the psychiatric to the medical realm. Not only is the conceptualization of trans-as-mental-illness problematic in and of itself (as it plays into the stereotype of mental incompetence), but also the way GID is currently written is especially atrocious. As the name suggests, GID literally states that trans people’s gender identities are disordered. Furthermore, it was primarily designed to justify reparative therapy—as a result, trans people who repress their cross-gender identities do not meet the criteria of mental illness, whereas those of us who live happily as members of our identiied gender will continue to meet the criteria for GID for perpetuity.19 Some people have suggested that the diagnosis should be changed to Gender Dysphoria, which would focus solely on the gender dissonance we experience as a result of our bodies and identities not being aligned. Such a change would facilitate access to the means of transitioning while formally ensuring that those of us who are happy post-transition will no longer be deemed mentally disordered. While I agree that such a change would be a vast improvement over the current diagnosis, I do not think that it would be perfect. After all, so long as any form of gender variance is codiied in the pages of the DSM, it Psychology, Sexualization, and Trans-Invalidations 135 will continue to be cited by trans-invalidators as evidence that we are mentally inferior and incompetent. Perhaps the greatest example of trans-invalidation within mainstream psychology is the gatekeeper system.20 In order to legally transition in the U.S., one must undergo certain medical procedures, and to obtain those medical procedures, one must irst gain approval from one or two mental health professionals. Thus, mental health professionals are viewed as the ultimate “deciders” (as our recent ex-president would say21) of who should be allowed to transition and who should not. While some mental health providers are thoughtful, sympathetic, and have lots of experience with trans patients, others are clueless, unsympathetic, and rely primarily on trans-invalidating presumptions about trans folks that exist in the culture. Many also enforce blatant double standards. For example, I can’t tell you how many times that I’ve heard diferent trans women say that when they irst visited some psychiatrist or therapist about transitioning, they were told that they were obviously not a “real” transsexual because they didn’t come in wearing a dress and makeup.22 Because cisgender women always wear dresses and makeup, right? Now, I acknowledge that there are a small minority of people who do not appear to be trans at all, yet who seek out the means to transition. And there are many people who are gender variant who perhaps hastily rush into the decision to transition, or who have unrealistic expectations about the process, and so forth. So I can understand why many mental health professionals might feel that having this vetting process is important. But, from a trans perspective, this system is unbearably invalidating. It explicitly suggests that many trans-identiied people really are confused about our genders and should not transition, and that trans people more generally are not competent enough to make gender-related decisions for ourselves. In other words, it institutionalizes the cultural assumption that what we say about our own lives and our gendered experiences is inherently suspect. The gatekeeper system deems that any and all mental health professionals have more authority and expertise to speak for and about trans people and issues than trans people do. This is why documentaries and news programs about transsexuality almost invariably include interviews with psychological experts in order to validate (or invalidate) what the trans people in the program say about themselves. So when Paul McHugh describes sex reassignment as “barbaric” and compares it to mutilation, or when Dr. Phil airs a program entitled “Gender-Confused Kids,” their supposed expert status necessarily invalidates 136 Outspoken our experiences, identities, and voices.23 On that National Public Radio program about cross-gender-identiied children that I mentioned previously, Ken Zucker ofered the following quote to justify his reparative therapy: “Suppose you were a clinician and a 4-yearold black kid came into your oice and said he wanted to be white. Would you go with that? . . . I don’t think we would,”24 Of course, comparing cross-gender identity—which is a very real pan-cultural and trans-historical phenomenon25—to a ictionalized “racial identity disorder” (which does not in actuality exist) is false logic. And I, of course, am free to publicly claim that his argument is utter nonsense. But who’s going to believe me? In the marketplace of ideas, my critique will be dismissed as a biased, unobjective perspective from someone who is mentally disordered. Zucker, on the other hand, is a psychologist who has published countless research articles on transgenderism. In the eyes of the world, he is viewed as an expert of me. As long as the DSM and gatekeeper system position him as an authority on gender-variant people, what he has to say will always efectively silence me. And that, frankly, makes me very legitimately angry. Now that I have described what it feels like to be trans-invalidated, and how this phenomenon is reinforced and exacerbated by mainstream psychology, I want to turn our attention to what is perhaps the most insidious form of invalidation: sexualization. A recent American Psychological Association Task Force on the Sexualization of Girls deined sexualization as occurring when any one of the four following criteria are fulilled: “[A] person’s value comes only from his or her sexual appeal or behavior, to the exclusion of other characteristics; a person is held to a standard that equates physical attractiveness (narrowly deined) with being sexy; a person is sexually objectiied—that is, made into a thing for others’ sexual use, rather than seen as a person with the capacity for independent action and decision making; and/or sexuality is inappropriately imposed upon a person.”26 It is the nonconsensual nature of sexualization that distinguishes it from healthy sexuality. Trans people are often sexualized in our culture, and this sexualization constitutes a form of invalidation. For example, we live in a culture where it is considered rude, disrespectful, harassing, and even dehumanizing, to ask strangers or even acquaintances graphic questions about their sex lives or their genitals. Yet, those of us who are out as trans, or who are discovered to be trans, are often barraged by these sorts of questions. The very fact that people assume that it’s okay to ask a trans person (but not a cis person) such inappropriate Psychology, Sexualization, and Trans-Invalidations 137 questions indicates that we are not seen as fully human or deserving of the same rights and respect that cisgender people receive. While people may be sexualized in diferent ways and for diferent reasons, the fact that our culture is heterosexual-male-centric ensures that the sexualization of those who are female-bodied and feminine in gender expression is the most common and pervasive form of sexualization in our culture. And there is a large body of research demonstrating that sexualization has very serious, negative ramiications on the lives of girls and women. For example, it’s been shown that individuals who are sexualized are seen as less than human, are not treated with empathy, are not taken as seriously, and are seen as less competent and intelligent than individuals who are not sexualized.27 Research also indicates that the media plays an important role in reinforcing the sexualization of women. According to the APA Task Force: “Across several studies, women and men exposed to sexually objectifying images of women from mainstream media . . . were found to be signiicantly more accepting of rape myths (e.g., the belief that women invite rape by engaging in certain behaviors), sexual harassment, sex role stereotypes, interpersonal violence, and adversarial sexual beliefs about relationships.” They conclude that “. . . exposure to sexualized depictions of women may lead to global thoughts that ‘women are seductive and frivolous sex objects’ . . . and ‘foster an overall climate that does not value girls’ and women’s voices or contributions to society.’ ”28 Like our cisgender counterparts, trans women and others on the trans female/feminine spectrum are routinely sexualized in our culture.29 In her excellent book How Sex Changed: A History of Transsexuality in the United States, Joanne Meyerowitz chronicles the rise of (what she calls) the “eroticization” of trans women.”30 It began in the early 1960s (less than a decade after the mainstream public irst became aware of transsexuality), when “tabloid newspapers and pulp publishers produced a stream of articles and cheap paperback books on MTFs who had worked as female impersonators, strippers, or prostitutes,” which were often accompanied by “photos that revealed breasts, legs, and buttocks.”31 These stories focused predominantly on the subjects’ “unbridled sexual desires,” and Meyerowitz comments that they gave the impression that, “the truth of sex change lay in its sexual acts.”32 By the late 1960s, the sexualization of transsexual women had reached mainstream publishers and movie producers. Perhaps the most notable, early example of this is Gore Vidal’s Myra Breckinridge,33 which became a best selling novel in 1968. Myra, who is arguably the irst ictional transsexual woman 138 Outspoken character to garner mainstream attention, embodies several stereotypes projected onto transsexual women that have since recurred over and over again in the media. First, Myra does not identify as a woman, but rather as a homosexual man who has transitioned to female in order to seduce men. In addition to being purposefully sexually deceptive, Myra repeatedly boasts that no man can resist her and she discusses her own female attributes, not in terms of feeling comfortable or right being in her own body (as most transsexuals do), but rather in terms of their capability to entice men. Further, she has an insatiable sexual appetite and engages in sex acts that some would consider deviant or even predatory—for example, there is a thirty-page passage in the book that explicitly chronicles her raping a man with a dildo.34 These assumptions—that trans women are inherently sexually promiscuous, sexually deceptive, sexually deviant, and sexually motivated in our transitions—persist in what are perhaps the three most common trans woman archetypes seen in the media over the years: the gay man who transitions to female in order to seduce unsuspecting straight men, the male “pervert” who transitions to female in order to fulill some kind of bizarre sex fantasy, and the overrepresentation of trans women as sex workers.35 In sharp contrast, transsexual men are not typically portrayed in a hypersexual manner, nor are they depicted as being sexually motivated in their transitions. Instead, the most common ulterior motive projected onto trans men is that they transition in order to obtain male privilege. Because women are viewed as the “lesser sex” in our culture, people often cannot understand why anyone would give up being a man in order to become a relatively disempowered woman. So they assume that trans women transition in order to obtain the one type of power that women are perceived as having in our society: the ability to be sexualized and to be objects of heterosexual male desire. Thus, the hypersexualization of trans women and our motives for transitioning merely relects the implicit cultural assumption that women as a whole have no value beyond our ability to be sexualized.36 Before moving on, I should make two quick points. First, in her historical analysis of transsexuality, Meyerowitz makes the case that, as the media’s (and the public’s) interest in trans women became increasingly sexualizing and sexually explicit, their interest in trans men declined reciprocally.37 Thus, the relative invisibility of trans men in the media is a direct result of media’s inability to sexualize them—a diiculty that no doubt stems from the fact that maleness and masculinity are not typically sexualized or objectiied in our culture. Psychology, Sexualization, and Trans-Invalidations 139 Second, the societal sexualization of trans female/feminine identities has a very real negative impact on trans women’s lives. Many trans women ind that, when others are aware of our trans status, we are often bombarded by objectifying comments and sexually explicit propositions that are typically far more hardcore, debasing, and frequently occurring than what we normally experience when we are presumed to be cis women.38 Because nonconsensual sexualization is inherently disempowering and dehumanizing, such incidents are quite often linked to transphobic discrimination, harassment, and violence.39 The sexualization of trans women, and the reciprocal invisibility of trans men, occurs not only in mainstream culture and in the media, but also in the ield of psychology. Historically, psychologists and psychiatrists have regularly sexualized trans people on the trans female/feminine spectrum (while largely ignoring those on the trans male/masculine spectrum) with regards to taxonomy, theories of etiology, descriptions of case histories, and diagnoses.40 For instance, it is well documented that many gatekeepers have based their recommendations for sex reassignment on whether they considered the trans woman in question to be physically attractive and/or willing to dress and act in a hyperfeminine manner.41 And while trans people on both the trans female/feminine and trans male/masculine spectrums are currently pathologized under the diagnosis of Gender Identity Disorder (which notably focuses on gender identity and expression rather than sexuality), only trans female/feminine-spectrum individuals can have their gender identities and expressions additionally pathologized as “paraphilias,” a category of disorders that are characterized by “recurrent, intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, or situations.”42 One trans female/feminine-speciic paraphilia currently listed in the DSM-IV-TR is Transvestic Fetishism. Its main criteria is: “Over a period of at least 6 months, in a heterosexual male, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing.”43 As Kelley Winters has pointed out: “The very name equates crossdressing with sexual fetishism and social stereotypes of perversion. It serves to sexualize a diagnosis that does not clearly require a sexual context. Crossdressing by males very often represents a social expression of an inner sense of identity. In fact, the clinical literature cites many cases, considered diagnosable under transvestic fetishism, which present no sexual motivation for cross-dressing and by no means represent fetishism.”44 So in other words, crossdressing in the trans female/feminine direction is 140 Outspoken presumed to be of a sexual nature even when it is not. Reciprocally, if a woman was aroused by crossdressing in men’s clothing (as some are45), she could not be diagnosed with Transvestic Fetishism because the diagnosis is speciic for heterosexual males. In fact, psychologist Robert Stoller even argued that women who crossdress must really be transsexuals (read: driven by cross-gender identity) rather than transvestites (read: driven by cross-gender arousal). His reasoning was simple: “Men’s clothes have no erotic value whatsoever; these people have no clothing fetish.”46 While I know plenty of women and gay men who would argue with Stoller’s claim, I do believe that he was onto something. Because femaleness and femininity are so routinely sexualized in our culture, female clothing is imbued with a kind of sexual symbolism that male clothing does not have.47 This naturally leads people to presume that crossdressers on the trans female/feminine spectrum must be doing it for sexual reasons even when they are not. This sexual symbolism also explains why many crossdressers and transsexual women pass through stages where they experience some arousal associated with women’s clothing. Indeed, many trans female/feminine-spectrum individuals often refer to their “teenage girl” phase—a period early on when they are particularly interested in sexually revealing or provocative women’s clothing. This stage parallels what many young cis women go through as teenagers as they literally try on the sexual symbolism associated with femaleness and femininity in our culture. Many trans female/feminine-spectrum individuals eventually come to realize that there is simply more to their desire to be female than sexuality, just as cis women learn that there is more to being a woman than being sexually appealing to others. In the late 1980s and early 1990s, psychologist Ray Blanchard took the psychological sexualization of trans femininities to new heights with his theory of “autogynephilia.”48 This theory claims that transsexual women come in two (and only two) subtypes, each with a distinct etiology (or cause). Blanchard refers to the irst of these subtypes as “homosexual transsexuals,” who are conceptualized as being feminine from a very early age, attracted exclusively to men as adults, and who supposedly never experience cross-gender arousal. Proponents of the theory often depict transsexual women belonging to this group as a type of feminine gay man who ultimately transitions to female in order to attract heterosexual men.49 The second subtype according to Blanchard’s scheme are “autogynephilic transsexuals,” who are essentially viewed as a type of heterosexual man who, typically around puberty, begins to experience cross-gender Psychology, Sexualization, and Trans-Invalidations 141 arousal in response to imagining themselves as women. Blanchard argued that this cross-gender arousal is a paraphilia and that it eventually becomes the primary factor that drives these individuals to physically transition to female later in life. Thus, Blanchard’s model proposes that all transsexual women are sexually motivated in their transitions, and he forwards two subtypes that suspiciously resemble the sexualizing archetypes of trans women—i.e., the gay man who transitions to female to seduce unsuspecting straight men and the male deviant who transitions to fulill some kind of bizarre sex fantasy—that appear over and over again in the media. Furthermore, his theory does not even attempt to explain FTM transgenderism, mimicking media depictions that sexualize trans women while ignoring trans men. The fact that this theory so blatantly mimics sexualizing stereotypes of trans women that already exist in the culture explains why proponents of the theory cling to it so desperately despite the many lines of evidence demonstrating that trans women do not fall neatly into two distinct subtypes; that, for most trans women, gender dissonance and/or a desire to be female precedes sexual arousal or attraction by several years; and that fantasies and patterns of arousal that Blanchard labels “autogynephilic” also occur in many cisgender women.50 Critics of autogynephilia, including myself, have written extensively about the many methodological and theoretical laws of this theory. So, rather than rehash that evidence, I want to address what is perhaps an even more salient issue, but which has unfortunately received signiicantly less attention: Why is it exactly that the overwhelming majority of trans women feel that autogynephilia theory is not merely “wrong,” but oppressive and invalidating? First, it is extraordinarily nonconsensually sexualizing. It not only assigns sexual motivations to trans women, but it categorizes us as either “homosexual” or “autogynephilic” based upon those supposed sexual motivations. In other words, it reduces us to sexual motivation. As I alluded to earlier, there is an extensive body of psychological research that shows that when people are sexualized, they are not treated with empathy, are not taken as seriously, and are seen as less competent and less intelligent than those who are not sexualized.51 This is why historically in rape trials, defense lawyers who wanted to undermine the female victim’s testimony would ask her lurid questions about her past (or presumed) sexual history, or mention details about what she was wearing when the incident occurred, especially if her outit was provocative or revealing.52 Of course, most reasonable people would agree that, in and of themselves, these matters do not excuse rape. So why do lawyers bring them up? Because sexual- 142 Outspoken izing a person invalidates them! It undermines what they have to say. It enables others to see them as less than fully human and without empathy. This is precisely why feminists have worked so hard to eliminate sexual harassment in the workplace and in the public sphere. And this is exactly why most trans women feel that Blanchard’s theory and terminology should be eliminated from psychological discourses. Here is an analogy that I hope will further elucidate this point. What if Blanchard (or someone like him) claimed that all women fell into two distinct groups: those who have “forced” or “rape” fantasies and those who do not.53 And suppose he labeled women who have rape fantasies “autoraptophiles” and claimed that their female gender identities were merely a secondary efect of their paraphilic desire to be raped. And suppose he (and other proponents of his theory) argued that this terminology should be widely used in the psychological literature under the presumption that one cannot fully understand autoraptophilic women unless you recognize that they are primarily motivated by their desire to be raped. And what if the psychologist who coined this term was appointed to head the DSM-5 taskforce that would rewrite the section of adjustment disorders, and he proposed that there should be a modiier to Adjustment Disorder: “with Autoraptophilia.” What do you think the outcome of this scenario would be? First, many women—who are already highly sexualized in our culture— would now have to contend with yet another form of nonconsensual sexualization. This form of sexualization would be potentially more threatening than most though, as it would be legitimized by the psychiatric establishment. Those who sexually intimidate, harass, or assault women could cite autoraptophilia (and the fact that it’s in the DSM) to argue that the woman in question was literally “asking for it.” And, if the woman visited a psychotherapist to work through family or relationship issues, she might instead be barraged by annoying and demeaning questions about her sexual fantasies, as though that were the root cause of all of her problems. I think that most reasonable people will immediately recognize why this hypothetical scenario is so scary. And if it were real, I am sure that most of you—especially those of you who are female—would do whatever you could to stop it. Well, for trans women, this scenario has pretty much come true with regards to autogynephilia. Ray Blanchard has been named to chair the Paraphilia subworkgroup for the DSM-5, and he has proposed changing the Transvestic Fetishism diagnosis to Transvestic Disorder with one of two modiiers: with Psychology, Sexualization, and Trans-Invalidations 143 Fetishism, or with Autogynephilia.54 While the diagnosis supposedly targets “heterosexual males” who crossdress, the psychological literature regarding autogynephilia (the bulk of it written by Blanchard) repeatedly claims that lesbian, bisexual, and asexual trans women are really just heterosexual men with a fantasy problem. Therefore, according to Blanchard’s proposal, a queer-identiied trans woman (such as myself ) could theoretically be diagnosed as having “Transvestic Disorder” any time that I have any kind of sexual urge while wearing women’s clothing. Since I wear women’s clothing pretty much every day of my life these days, my sexuality would presumably be considered perpetually transvestically disordered according to this diagnosis. I should mention that Blanchard has also proposed signiicantly expanding the DSM’s deinition of “paraphilia” to include: “any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, consenting adult human partners.”55 Having read many of Blanchard’s writings, I can tell you that he does not consider transsexual bodies to be “phenotypically normal.” So, according to this deinition, anyone who has an “intense and persistent sexual interest” in me is automatically deemed to have a paraphilia. Thus, Blanchard intends not only to paraphilize56 all of my present and future sexual partners, but to reduce me to the status of a mere fetish object. To him, my identity, my body, my entire person is nothing more than an expression of aberrant sexuality. Because autogynephilia sexualizes trans women (thus invalidating us), it has been employed to erase trans women’s subjectivity. For example, there are many exceptions to Blanchard’s two-type classiication scheme: There are lesbian, bisexual, and asexual trans women who have never experienced cross-gender arousal, and there are heterosexual trans women who have. In his writings, Blanchard routinely mischaracterizes the irst group as autogynephiles who are lying about not having experienced cross-gender arousal, and the second group as autogynephiles who are lying about their sexual orientation.57 In addition to being bad science, such accusations essentially portray lesbian, bisexual, and asexual trans women as being both hypersexual and pathological liars. In fact, I would argue that it is Blanchard’s hypersexualization of trans women that enables him to portray us as liars (in a manner similar to how defense lawyers portray rape victims as hypersexual or promiscuous in order to invalidate their testimony). This strategy has been most efectively used by Bailey in his book The Man Who Would Be Queen. First, Bailey describes trans women’s bodies in sexually 144 Outspoken graphic terms, he repeatedly comments on how attractive (or not attractive) certain trans women are, he suggests that certain trans women might be “especially well-suited to prostitution,” and (of course) he repeatedly stresses that all trans women are sexually motivated in our transitions. While doing that, he also relentlessly accuses those trans women who deny being sexually motivated of lying, misreporting, deceiving, and misrepresenting themselves.58 The onetwo punch of the “hypersexual” and “pathological liar” stereotypes, of course, reinforce the idea that trans women are mentally unstable and unreliable, which (once again) reinforces Bailey’s authority as a psychologist to speak on our behalves, as we are presumably too riddled with psychopathology to speak for ourselves. Given the efectiveness of this strategy, it is not surprising that other sexologists have also tried to dismiss trans women’s legitimate critiques of autogynephilia theory, or our expressions of outrage over its invalidating terminology, as being mere manifestations of our supposed mental instability and sexual deviancy.59 So, in summary, according to mainstream psychology, I am a lying hypersexual deviant whose opinions are unobjective and irreparably tainted by my supposed mental disorder. And this view gives scientiic legitimacy to those who wish to invalidate me. This is why I am legitimately angry. And this is why I think that overturning mainstream psychological depictions of trans people is a crucial step if we ever hope to obtain social legitimacy and gender equity. For decades, trans people have raged against the machine, but the machine has not taken us very seriously. But, thankfully, this has slowly started to change, as we have begun to ind our collective voice and to speak on our own terms about our experiences, desires, and our perspectives on gender and transgenderism. And there are a growing number of allies and advocates in the medical and mental health ields who have shown a willingness to listen to what we have to say, who recognize how injurious the tropes of sexualization and mental inferiority are to gender-variant people, and who treat gender-variant people, not as mere research subjects or “natural experiments,” but as human beings who have autonomy and agency. And together, as activists, allies, and advocates, we can work to displace the current psychological establishment in favor of a system that places trans people’s needs irst and is free of trans-invalidations. Notes What follows is the Notes section for the entire “Part 3: Pathological Science Revisited” section of Outspoken: A Decade of Transgender Activism and Trans Feminism. Notes speciically for Chapter 30, “Psychology, Sexualization, and Trans-Invalidations,” begin on page 302. Notes speciically for Chapter 33, “Reconceptualizing ‘Autogynephilia’ as Female/Feminine Embodiment Fantasies,” begin on page 308. Notes speciically for Chapter 34, “Trans People Are Still ‘Disordered’ in the DSM-5,” begin on page 310. Full citations for some references may be found in the Notes for previous chapters (which is why I have included all the endnotes for Part 3). 302 Outspoken Part 3: Pathological Science Revisited 1. Serano, Whipping Girl, 115–160. 2. Serano, Whipping Girl, 253–271 and 283–306. 3. Julia Serano, “A Matter of Perspective: A Transsexual Woman-Centric Critique of Dreger’s ‘Scholarly History’ of the Bailey Controversy,” Archives of Sexual Behavior 37, no. 3 (2008), 491– 494. Dreger’s article and numerous peer commentaries are cited in Chapter 30, Notes 1, 4, and 6. 4. These critiques are compiled in Julia Serano, “Alice Dreger’s disingenuous campaign against transgender activism” (http://juliaserano.blogspot.com/2015/04/alice-dreger-and-makingevidence-it.html). 5. Julia Serano, “Debunking Psychological Diagnoses and Theories about Transsexual and Transgender People” (http://juliaserano.com/TSetiology.html). 6. Sheryl Ubelacker, “CAMH to ‘wind down’ controversial gender identity clinic services,” The Globe and Mail, December 15, 2015 (http://www.theglobeandmail.com/news/ toronto/camh-to-wind-down-controversial-gender-identity-clinic-services/article27766580/); “Support Airmative Care for Trans and Gender Diverse Kids!,” (http://www.ipetitions.com/ petition/support-airmative-care-for-trans-kids). The backlash is described (and critiqued) in Casey Plett, “Zucker’s ‘Therapy’ Mourned Almost Exclusively By Cis People,” Harlot, April 11, 2016 (http://harlot.media/articles/2582/zuckers-therapy-mourned-almost-exclusively-by-cispeople). 7. Julia Serano, “Placing Ken Zucker’s clinic in historical context,” February 9, 2016 (http:// juliaserano.blogspot.com/2016/02/placing-ken-zuckers-clinic-in.html). 30 – Psychology, Sexualization and Trans-Invalidations 1. For instance, Ray Blanchard—who has carried out research on trans people at Centre for Addiction and Mental Health (formerly the Clarke Institute of Psychiatry) for decades—when asked “Do you think that classifying transgender people as having a disorder does contribute to stigma against the trans community?” callously replied “No. I mean how many people who make a joke about trannies consult the DSM irst?”; see Laura Cameron, “How the Psychiatrist Who CoWrote the Manual on Sex Talks About Sex,” Motherboard, April 11, 2013 (http://motherboard. vice.com/blog/heres-how-the-guy-who-wrote-the-manual-on-sex-talks-about-sex). In J. Michael Bailey. The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism (Washington D.C.: Joseph Henry Press, 2003), 158, Bailey seemingly admires his colleague’s contemptuous attitude when he says, “Blanchard is irreverent, cynical, and politically incorrect . . . He has little patience for arguments about whether research is good for people (such as ‘Are homosexual people hurt or harmed by research on the genetics of sexual orientation?’).” But the example that was fresh in my mind when writing this speech was Alice Dreger, “The Controversy Surrounding The Man Who Would Be Queen: A Case History of the Politics of Science, Identity, and Sex in the Internet Age,” Archives of Sexual Behavior, 37, no. 3 (2008), 366–421, in which she repeatedly played down and dismissed trans people’s legitimate concerns about Bailey’s book and its potential ramiications (as noted in most of the peer commentaries cited in Note 4). 2. The word “transgenderism” has a long history of being used as a neutral term to describe the phenomenon of transgender people and experiences, much like “transsexuality” or “transsexualism” is the phenomenon of transsexual people and experiences. However, some contemporary Notes 303 trans activists have tried to claim that the term is derogatory, mostly due to how it has been misappropriated in recent years by trans-exclusive radical feminists (e.g., Sheila Jefreys in her book Gender Hurts; see Chapter 35) to give the impression that it refers to an aberrant political ideology rather than the phenomenon of gender variance. This is but one of many examples of the Activist Language Merry-Go-Round phenomenon that I describe in the second half of Chapter 45. I discuss the history of the word “transgenderism,” and why I feel that we should not abandon it, in Julia Serano, “Regarding Trans* and Transgenderism” (http://juliaserano.blogspot. com/2015/08/regarding-trans-and-transgenderism.html). 3. Throughout this piece, I use the term “mainstream psychology” as an umbrella term to refer to those psychological, psychiatric, and sexological discourses on gender variance, transgenderism, and transsexuality that have dominated the medical/mental health literature or have been institutionalized in our society (e.g., via the gatekeeper system and the DSM) over the last half century. I chose the word “psychology” (rather than “psychiatry”) primarily because most of the theories and diagnoses that I critique here have been invented and/or forwarded by psychologists. 4. A few examples include: Walter O. Bockting, “Biological reductionism meets gender diversity in human sexuality,” The Journal of Sex Research, 42 (2005), 267–270; Madeline H. Wyndzen, “The world according to J. Michael Bailey inside ‘The Man who would be Queen: The Science of Gender Bending and Transsexualism’,” All mixed up: A transgendered psychology professor’s perspective on life, the psychology of gender, & “gender identity disorder” (http://GenderPsychology. org/autogynpehilia/j_michael_bailey); and peer commentaries from John Bancroft (426–428), Ben A. Barres (429), Talia Mae Bettcher (430–433), John H. Gagnon (444–447), Riki Lane (453–456), Charles Moser (472–475), Margaret Nichols (476–480), Julia Serano (491–494), and Elroi J. Windsor (495–497) in Archives of Sexual Behavior 37, no. 3 (2008). 5. Zak Szymanski, “DSM controversy could overshadow opportunities,” Bay Area Reporter, May 29, 2008 (http://ebar.com/news/article.php?sec=news&article=3018). 6. The quote is a reference to Anne Lawrence, “Shame and Narcissistic Rage in Autogynephilic Transsexualism,” Archives of Sexual Behavior 37, no. 3 (2008), 457–461, which is her peer commentary on Dreger’s article (cited in Note 1). Both Lawrence and Dreger depict trans people as engaging in an irrational, mass overreaction to mainstream psychology, although Lawrence’s article is admittedly signiicantly more psychopathologizing than Dreger’s. 7. The World Professional Association for Transgender Health (WPATH) Standards of Care (SOC) is a set of guidelines for trans health providers. While early versions of the SOC were rather horriic (see Serano, Whipping Girl, 116–126), recent revisions have incorporated changes suggested by the trans community—see Eli Coleman et al., “Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7,” International Journal of Transgenderism 13 (2011), 165–232. 8. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) (Washington D.C.: American Psychiatric Association, 2000). 9. Alix Spiegel, “Two Families Grapple with Sons’ Gender Identity,” National Public Radio (NPR), May 7, 2008 (http://npr.org/2008/05/07/90247842/two-families-grapple-with-sonsgender-preferences). Throughout this chapter, I will use the phrase “cross-gender-identiied” in reference to people who identify as the gender other than the one they were assigned at birth. 304 Outspoken 10. Deinition according to Dictionary.com (http://dictionary.reference.com/browse/invalidate). 11. Reviewed in Viviane K. Namaste, Invisible lives: The erasure of transsexual and transgendered people (Chicago: University of Chicago Press, 2000); Currah, P., Juang, R. M. and Minter, S. P. (eds.) Transgender Rights (Minneapolis: University of Minnesota Press, 2006); Serano, Whipping Girl. 12. Talia May Bettcher, “Appearance, Reality, and Gender Deception: Relections on Transphobic Violence and the Politics of Pretence,” in Felix Ó. Murchadha (ed.), Violence, Victims, and Justiications (Oxford: Peter Lang Press, 2006); Talia May Bettcher, “Understanding Transphobia: Authenticity and Sexual Abuse,” in Krista Scott-Dixon (ed.), Trans/Forming Feminisms: Transfeminist Voices Speak Out (Toronto, Canada: Sumach Press, 2006); Talia May Bettcher, “Trans Identities and First Person Authority,” in Laurie J. Shrage (ed.), You’ve Changed: Sex Reassignment and Personal Identity (Oxford: Oxford University Press, 2009). 13. Further discussion of the depiction of trans people as mentally incompetent can be found in Kelley Winters, Gender Madness in American Psychiatry: Essays from the Struggle for Dignity (Dillon, CO: GID Reform Advocates, 2008). Bettcher, “Trans Identities and First Person Authority” (see previous Note) ofers an in depth philosophical analysis to explain why trans people are not typically viewed as having legitimate “irst person authority” regarding gender identity. Serano, Whipping Girl, 161–193, provides a framework to challenge many of the foundational assumptions that enable such trans-invalidations. 14. Elizabeth Ewen and Stuart Ewen, Typecasting: On the Arts and Sciences of Human Inequality (New York: Seven Stories Press, 2006); Stephan Jay Gould, The Mismeasure of Man (New York: W.W. Norton and Company, 1996). 15. Mara Mayor, “Fears and Fantasies of Anti-Sufragists,” The Connecticut Review 7 (1974), 64–74. 16. Winters, Gender Madness in American Psychiatry, 45–49. See also Madeline H. Wyndzen, “The banality of insensitivity: portrayals of transgenderism in psychopathology,” All mixed up: A transgendered psychology professor’s perspective on life, the psychology of gender, & “gender identity disorder” (http://GenderPsychology.org/psychology/mental_illness_model.html). 17. Winters, Gender Madness in American Psychiatry, 19–43. 18. Winters, Gender Madness in American Psychiatry, 71–78. 19. Winters, Gender Madness in American Psychiatry, 161–167. 20. Critiques of the gatekeeper system can be found in Anne Bolin, In Search of Eve: Transsexual Rites of Passage (South Hadley, MA: Bergin and Harvey, 1988), 48–68; Namaste, Invisible Lives, 157–234; Arlene Istar Lev, Transgender Emergence: Therapeutic Guidelines for Working With Gender-Variant People and Their Families (Binghamton: The Haworth Clinical Practice Press, 2004), 25–54; Jacob C. Hale, “Ethical Problems with the Mental Health Evaluation Standards of Care for Adult Gender Variant Prospective Patients,” Perspectives in Biology and Medicine 50 (2007), 491–505; Serano, Whipping Girl, 115–160. 21. This is a reference to George W. Bush, who while president, once said: “But I’m the decider, Notes 305 and I decide what is best.” 22. For other examples of trans women not being taken seriously by gatekeepers because they did not dress especially feminine, see Bolin, In Search of Eve, 107–108; Namaste, Invisible Lives, 163–164. 23. Paul McHugh is a psychiatrist who does not believe in sex-reassignment and who has become the “go to” authority and interviewee for those wishing to invalidate trans people—the speciic quotes cited here are from Bailey, The Man Who Would Be Queen, 206; FoxNews.com, “Critics Slam Boston Doctor Who Ofers Sex Change Treatment to Kids,” May 19, 2008 (http://foxnews.com/story/0,2933,356592,00.html). Dr. Phil is a psychologist and television host whose eponymous show ran an episode called “Gender-Confused Kids” on October 29, 2008 (http:// drphil.com/shows/show/1138). 24. Spiegel, “Two Families Grapple with Sons’ Gender Identity.” 25. For a comprehensive list of references supporting this fact, see Serano, Excluded, 308, Note 4. 26. American Psychological Association Task Force on the Sexualization of Girls, Report of the APA Task Force on the Sexualization of Girls (Washington, DC: American Psychological Association, 2007), 2 (www.apa.org/pi/wpo/sexualization.html). Note: the American Psychological Association is diferent from the American Psychiatric Association (who publishes the DSM). 27. American Psychological Association Task Force on the Sexualization of Girls, Report of the APA Task Force on the Sexualization of Girls, 27–35. 28. American Psychological Association Task Force on the Sexualization of Girls, Report of the APA Task Force on the Sexualization of Girls, 31–32. 29. Serano, Whipping Girl, 134–138 and 253–271. 30. Meyerowitz, How Sex Changed, 168–170 and 196–207. 31. Meyerowitz, How Sex Changed, 197–198. 32. Meyerowitz, How Sex Changed, 168, 202. 33. Gore Vidal, Myra Breckinridge (Boston: Little, Brown & Company, 1968). For a description of the impact that Myra Breckinridge had on popular culture (and thus, popular assumptions about trans female/feminine people) see Meyerowitz, How Sex Changed, 203–206. 34. Vidal, Myra Breckinridge, 166–197. 35. Serano, Whipping Girl, 16, 134, 261–262. 36. This case is made in more detail in Serano, Whipping Girl, 35–52 and 253–271. 37. Meyerowitz, How Sex Changed, 206. 38. I describe my own personal experiences of this in Serano, Whipping Girl, 255–259. While 306 Outspoken such experiences (which many other trans women have shared with me) are admittedly anecdotal, they are indirectly documented in the sexual harassment and abuse statistics cited in Note 39. 39. Recent reports have chronicled that up to 64 percent of transgender people have been the victims of sexual assault, and that 76 percent of transgender students had experienced sexual harassment, including unwanted sexual remarks or being touched inappropriately—see Grant et al., Injustice at Every Turn; Emily A. Greytak, Joseph G. Kosciw, and Elizabeth M. Diaz, Harsh Realities: The Experiences of Transgender Youth in Our Nation’s Schools (New York: GLSEN, 2009). The phenomenon of “walking while transgender” (discussed in Chapter 24, Note 2) is also an example of the sexualization of trans women being linked with discrimination and harassment. The interconnectedness of sexualization, discrimination, and violence is further explored in Bettcher, “Understanding Transphobia: Authenticity and Sexual Abuse”; Talia Mae Bettcher, “Evil Deceivers and Make-Believers: On Transphobic Violence and the Politics of Illusion,” Hypatia: A Journal of Feminist Philosophy 22, no.3 (2007), 43–65. 40. Serano, Whipping Girl, 126–139 and 253–271; Lev, Transgender Emergence, 132–143. 41. Reviewed in Serano, Whipping Girl, 126–139. See also Bolin, In Search of Eve, 106–120; Namaste, Invisible Lives, 163–164 and 202–205. 42. American Psychiatric Association, DSM-IV-TR, 535. As I describe in the more recently written Chapter 34, this statement is no longer accurate for the DSM-5. For critiques of the DSM’s Paraphilia section, see Charles Moser, “Paraphilia: A Critique of a Confused Concept,” in Peggy J. Kleinplatz (ed.), New Directions in Sex Therapy: Innovations and Alternatives (Philadelphia: Brunner-Routledge, 2001), 91–108; Charles Moser and Peggy J. Kleinplatz, “DSM-IVTR and the Paraphilias: An argument for removal,” Journal of Psychology and Human Sexuality 17, no. 3/4 (2005), 91–109. 43. American Psychiatric Association, DSM-IV-TR, 574–575. For critiques of the Transvestic Fetishism diagnosis, see Charles Moser and Peggy J. Kleinplatz, “Transvestic fetishism: Psychopathology or iatrogenic artifact?” New Jersey Psychologist 52, no. 2 (2002), 16–17; Serano, Whipping Girl, 127–129 and 263–265; Winters, Gender Madness in American Psychiatry, 33–43. 44. Kelley Winters, “Issues of Psychiatric Diagnosis of Cross-Dressers,” GID Reform Advocates (http://web.archive.org/web/20090510090634/http://www.gidreform.org/tf3023.html). 45. Gordene Olga MacKenzie, Transgender Nation (Bowling Green: Bowling Green State University Popular Press, 1994), 52–53, 88–89; Lev, Transgender Emergence, 141; Niklas Långström and Kenneth J. Zucker, “Transvestic fetishism in the general population: prevalence and correlates,” Journal of Sex and Marital Therapy 31 (2005), 87–95. See also Chapter 33, Note 11. 46. Robert J. Stoller, Sex and Gender: On the Development of Masculinity and Femininity (New York: Science House, 1968), 195. On the numerous occasions that I have shared this Stoller quote while giving talks on trans, queer, and/or feminist issues, it consistently evokes uproarious audience laughter. I point this out to show the huge disparity between what is taken for granted within mainstream psychology (e.g., that men’s clothing has no erotic value, or that female-assigned people cannot possibly experience any bona ide arousal via crossdressing) and what real people outside of the psychological establishment actually experience in real life. 47. Serano, Whipping Girl, 283–306. Notes 307 48. Ray Blanchard, “The Classiication and Labeling of Nonhomosexual Gender Dysphorias,” Archives of Sexual Behavior 18, no. 4 (1989), 315–334; Ray Blanchard, “The Concept of Autogynephilia and the Typology of Male Gender Dysphoria,” The Journal of Nervous and Mental Disease 177, no. 10 (1989), 616–623; 49. For example, Bailey, The Man Who Would Be Queen, 146. 50. These and many other facts and indings that together disprove Blanchard’s autogynephilia theory are reviewed in Julia Serano, “The Case Against Autogynephilia,” International Journal of Transgenderism 12, no. 3 (2010), 176–187; Charles Moser, “Blanchard’s Autogynephilia Theory: A Critique,” Journal of Homosexuality 57, no. 6 (2010), 790–809; Julia Serano, “The real ‘autogynephilia deniers’,” July 13, 2015 (http://juliaserano.blogspot.com/2015/07/the-realautogynephilia-deniers.html). 51. American Psychological Association Task Force on the Sexualization of Girls, Report of the APA Task Force on the Sexualization of Girls, 27–35. 52. Lynda Lytle Holmstrom and Ann Wolbert Burgess, The Victim of Rape: Institutional Reactions (New Brunswick: Transaction Books, 1983), 171–188. While somewhat tangential, it is worth noting that Bettcher (in “Trans Identities and First Person Authority”) points out that the denial of irst person authority plays a central role in both rape and in trans-invalidations. In the irst case, a rapist will dismiss the fact that the woman explicitly said “no” to his sexual advances, and instead privilege his own interpretation of her (e.g., arguing that she must have really meant “yes” because of what she was wearing, or supposedly communicating with her body language). Similarly, a trans-invalidator will ignore what a trans woman (or man) says about her own gender identity and experiences in favor of their own interpretation of her gender. 53. “Forced” or “rape” fantasies are fairly common in women. Anywhere between 31 to 57 percent of women report having them—reviewed in Joseph W. Critelli and Jenny M. Bivona, “Women’s erotic rape fantasies: an evaluation of theory and research,” The Journal of Sex Research 45 (2008), 57–70. The term “autoraptophilia” does not exist in the psychological or sexological literature—I invented it for the sole purpose of demonstrating how invalidating and potentially damaging it can be to deine people based upon their sexual fantasies, especially if the population in question is already routinely sexualized in the culture at large. 54. Ray Blanchard, “DSM-V Paraphilia Options: General Diagnostic Issues, Pedohebephilic Disorder, and Transvestic Disorder,” a paper presented at the Annual Meeting of the Society for Sex Therapy and Research on April 3, 2009, at Arlington, Virginia (http://individual.utoronto. ca/ray_blanchard/index_iles/SSTAR_2009_Talk_on_DSM.html). Unbeknownst to me at the time, this proposed diagnosis would undergo numerous subsequent revisions—see Chapter 34 for speciics. 55. Blanchard, “DSM-V Paraphilia Options.” I discuss this deinition (and the many problems with it) in more depth in Chapter 34. 56. Paraphilize (transitive verb): to deem a person’s autonomous or consensual sexual desires, urges, and/or orientations to be abnormal, unhealthy, or psychopathological. 57. For example, see Ray Blanchard, “Typology of male-to-female transsexualism,” Archives of Sexual Behavior 14 (1985), 247–261. 308 Outspoken 58. Bailey, The Man Who Would Be Queen. Bailey’s hypersexualization of trans women is mostly found on pp. 141–212. The “especially well-suited to prostitution” quote can be found on p. 185. Most of the trans-women-as-pathological-liars depictions can be found on pp. 157–176. 59. Discussed more in depth in Winters, Gender Madness in American Psychiatry, 107–116. 31 – Stop Sexualizing Us! 1. Jerry Springer and There’s Something About Miriam were television series that portrayed trans women in a sensationalistic and sexualizing manner (described in Serano, Whipping Girl, 37– 38), and Myra Breckinridge was discussed in the previous chapter. 2. This quote is found in Moser and Kleinplatz, “Transvestic fetishism: Psychopathology or iatrogenic artifact?” 3. He does this in Ray Blanchard and Peter I. Collins, “Men with sexual interest in transvestites, transsexuals, and she-males,” Journal of Nervous and Mental Disease 181 (1993), 570–575, wherein he coined the term “gynandromorphophilia” to describe the supposed paraphilia of being sexual attracted to trans female/feminine-spectrum people. It is also implied in Blanchard’s broadening of deinition for “paraphilia” for the DSM-5 (mentioned in the last chapter and discussed in more depth in Chapter 34), as it is clear that he does not consider trans people as “phenotypically normal.” 33 – Reconceptualizing “Autogynephilia” as Female/Feminine Embodiment Fantasies 1. Serano, Whipping Girl, 126–139 and 253–271; Winters, Gender Madness in American Psychiatry, 117–140. 2. Serano, “The Case Against Autogynephilia”—full citation in Chapter 30, Note 50; available for download at http://juliaserano.com/av/Serano-CaseAgainstAutogynephilia.pdf. 3. Moser, “Blanchard’s Autogynephilia Theory: A Critique”—full citation in Chapter 30, Note 50 (available for download at www.tandfonline.com/doi/pdf/10.1080/00918369.2010.486241). 4. American Psychiatric Association, DSM-IV-TR, 568. While the accuracy of this claim is debatable, the crucial point here is that this notion (that paraphilias are male-speciic) is what allowed Blanchard to portray “autogynephilia” as a paraphilia in the irst place: In his 1989 paper in which he irst introduces the concept (Blanchard, “The Classiication and Labeling of Nonhomosexual Gender Dysphorias”), Blanchard considers the presence of “autogynephilia” in many trans women, and the supposed lack of its counterpart in trans men, to be evidence that it must be a paraphilic impulse (under his presumption that trans women are “men” and trans men are “women”). In stark contrast, recent indings (see Note 5) indicate that what Blanchard calls “autogynephilia” is likely to be a more general sexual phenomenon associated with female/ feminine-identiied people (both cis and trans), rather than being a trans-speciic paraphilia. 5. Charles Moser, “Autogynephilia in Women,” Journal of Homosexuality 56, no. 5 (2009), 539– 547. See also Jaimie F. Veale, Dave E. Clarke, and Terri C. Lomax, “Sexuality of male-to-female transsexuals,” Archives of Sexual Behavior 37 (2008), 586–597; Noah Berlatsky, “Why Are Trans Women Penalized For Body Fantasies Everyone Has?,” The Establishment, May 16, 2016 (http:// www.theestablishment.co/2016/05/16/why-are-trans-women-penalized-for-body-fantasies- Notes 309 we-all-have). 6. Numerous examples of this are compiled in Julia Serano, “The real ‘autogynephilia deniers’.” 7. Serano, “The Case Against Autogynephilia.” 8. Harold Leitenberg and Kris Henning, “Sexual fantasy,” Psychological Bulletin 117 (1995), 469– 496; Emily Dubberley, Garden of Desires: The Evolution of Women’s Sexual Fantasies (London, UK: Black Lace, 2013). See also Berlatsky, “Why Are Trans Women Penalized For Body Fantasies Everyone Has?” 9. Blanchard’s taxonomic view of trans female/feminine people (centered on the presence or absence of “autogynephilia”) is reviewed and debunked in Serano, “The Case Against Autogynephilia”; Moser, “Blanchard’s Autogynephilia Theory: A Critique”; Jaimie F. Veale, “Evidence Against a Typology: A Taxometric Analysis of the Sexuality of Male-to-Female Transsexuals,” Archives of Sexual Behavior 43, no. 6 (2014), 1177–1186. 10. Serano, Whipping Girl, 268–269; Talia Bettcher, “When Selves Have Sex: What the Phenomenology of Trans Sexuality Can Teach About Sexual Orientation,” Journal of Homosexuality 61, no. 5 (2014), 605–620 (https://learningtrans.iles.wordpress.com/2013/12/whenselves.pdf ). 11. “Autoandrophilia” seems to have irst appeared in the sexological literature in a singular case study of a cisgender gay man; see Anne A. Lawrence, “Anatomic autoandrophilia in an adult male,” Archives of Sexual Behavior 38, no. 6 (2009), 1050–1056. For less pathologizing examples, see Tracie O’Keefe, “Autogynephilia and Autoandrophilia in Non-Sex and Gender Dysphoric Persons,” Paper presented at the World Association for Sexual Health conference, Sydney, April, 2007 (http://tracieokeefe.com/autogynephilia-and-autoandrophilia-in-non-sex-andgender-dysphoric-persons); Jack Molay, “Autoandrophilia, on women who fantasise about having a man’s body,” Crossdreamers, February 13, 2010 (http://crossdreamers.com/2010/02/ autoandrophilia-on-women-who-fantasise.html). 12. See Serano, “The Case Against Autogynephilia,” and references therein. 13. For evidence of MEFs in gay trans men, see the Discussion section of Matthias K. Auer, Johannes Fuss, Nina Höhne, Günter K. Stalla, Caroline Sievers, “Transgender Transitioning and Change of Self-Reported Sexual Orientation,” PLOS ONE 9, no. 10 (2014), e110016. “Girlfag” is a term (mostly used in online communities) to describe androphilic (i.e., attracted to men) female-assigned individuals who identify with gay men, gay male culture, and/or fantasize about being gay men having sex with other men—e.g., see Ili, “‘I am something that does not exist!’ (On queer schwulwomen, girlfags and guydykes),” Crossdreamers, September 1, 2014 (http:// crossdreamers.com/2014/09/i-am-something-that-does-not-exist-on.html), and other posts listed in Jack Molay, “A Reader’s Guide to the Crossdreaming and Autogynephilia Blog,” January 1, 2008 (http://crossdreamers.com/2008/01/readers-guide-to-confessions-of.html). 14. The “repression-mystiication” hypothesis I describe here was irst forwarded (in much greater detail) in Serano, Whipping Girl, 283-306. The “identity-defense” model is described in Jaimie F. Veale, Terri C. Lomax, and Dave E. Clarke, “Identity-defense model of gender-variant development,” International Journal of Transgenderism 12, no. 3 (2010), 125-138. While these models vary in certain respects, they both posit that the two “types” or “classes” of trans female/ feminine-spectrum people frequently cited in the psychiatric/sexological literature represent dif- 310 Outspoken ferent reactions or defense mechanisms in response to societal transphobia/trans-misogyny. The “current trend” I mention here is a personal observation based on informal conversations that I’ve shared with numerous young (typically college-aged) queer-identiied trans women. The claim (and supporting data) that FEFs (more speciically, in the form of transvestic fetishism) “may be a historically fading phenomenon” is from Larry Nuttbrock, Walter Bockting, Mona Mason, Sel Hwahng, Andrew Rosenblum, Monica Macri, and Jefrey Becker, “A further assessment of Blanchard’s typology of homosexual versus non-homosexual or autogynephilic gender dysphoria,” Archives of Sexual Behavior 40, no. 2 (2011), 247-257. 34 – Trans People Are Still “Disordered” in the DSM-5 1. The original 2012 blog posts are Julia Serano, “Trans people still ‘disordered’ according to latest DSM” (http://juliaserano.blogspot.com/2012/12/trans-people-still-disordered-according.html) and Julia Serano, “Follow up on DSM-still-considers-trans-folks-‘disordered’ post” (http://juliaserano.blogspot.com/2012/12/follow-up-on-dsm-still-considers-trans.html). This piece also draws from my 2009 piece: Julia Serano, “Why feminists should be concerned with the impending revision of the DSM,” (http://juliaserano.com/TSetiology.html#FeministingParaphilias). 2. Julia Serano, “Trans People Still Disordered in DSM,” Social Text, DSM-CRIP issue (http:// socialtextjournal.org/periscope_article/trans-people-still-disordered-in-dsm). 3. Twitter is a social media platform that allows people to share short messages (which are referred to as “tweets”). As I searched the Internet for such articles, I found that most of them were quite short, used similar language, ofered no critical analysis, nor included comments from any trans activists or advocates who had been critical of the DSM-5 revision process. It seems to me that the most likely scenario is that the American Psychiatric Association (who publishes the DSM) probably sent out some kind of press release touting their supposed “trans-friendliness,” and that several news outlets simply passed the misinformation along as “news” to their readers. 4. Kelley Winters, “Third Swing: My Comments to the APA for a Less Harmful Gender Dysphoria Category in the DSM-5” (http://gidreform.wordpress.com/2012/06/19/third-swingmy-comments-to-the-apa-for-a-less-harmful-gender-dysphoria-category-in-the-dsm-5). The diagnosis itself can be found in the “Gender Dysphoria” section of American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (Washington D.C.: American Psychiatric Association, 2013). 5. Serano, “Placing Ken Zucker’s clinic in historical context” (and references therein); Winters, Gender Madness in American Psychiatry. 6. The deinition that appears in the text is from the “Paraphilic Disorders” section of American Psychiatric Association, DSM-5. It is identical to the one Blanchard proposed in 2009 (see Blanchard, “DSM-V Paraphilia Options”; full citation in Chapter 30, Note 54) with the exception that the phrase “physically mature” has replaced the word “adult.” The vast array of problems with this deinition are dissected in Andrew C. Hinderliter, “Deining Paraphilia in DSM-5: Do Not Disregard Grammar,” Journal of Sex and Marital Therapy 37, no. 1 (2011), 17–31; see also Charles Moser, “Yet another paraphilia deinition fails,” Archives of Sexual Behavior 40 (2011), 483–485. 7. In Blanchard, “DSM-V Paraphilia Options,” he explicitly describes sexual attraction to “amputees, paralyzed persons, physical deformities” as paraphilic, and in Blanchard and Collins, “Men with sexual interest in transvestites, transsexuals, and she-males,” he described attraction to trans Notes 311 female/feminine individuals as a paraphilia that he named “gynandromorphophilia.” Blanchard is also a co-author on a paper that argues that people who have a sexual interest in individuals outside of the age range of seventeen to forty-ive are paraphilic (see Hinderliter, “Deining paraphilia in DSM-5: do not disregard grammar”). See Chapters 42 and 43 for my argument against conceptualizing such forms of attraction as “paraphilias.” 8. Blanchard, “DSM-V Paraphilia Options.” While this speciic language does not appear in the inal DSM-5, the sentiment clearly remains—see Note 9. 9. The DSM-5 explicitly lists “interests in spanking, whipping, cutting, binding,” and “telephone scatologia (obscene phone calls)” as examples of paraphilias, and the Fetishistic Disorder diagnosis additionally includes “recurrent and intense sexual arousal” in response to various articles of clothing or footwear, or “a highly speciic focus on nongenital body part(s)” (see “Paraphilic Disorders” section of American Psychiatric Association, DSM-5). Hinderliter, “Deining paraphilia in DSM-5: do not disregard grammar,” discusses how the DSM-5 paraphilia deinition could be interpreted to deem masturbation, orgasming without genital stimulation, watching pornography, reading erotica, and sexual role play as paraphilic as well. 10. Cameron, “How the Psychiatrist Who Co-Wrote the Manual on Sex Talks About Sex” (full citation in Chapter 30, Note 1). 11. “Paraphilic Disorders” section of American Psychiatric Association, DSM-5. 12. Charles Moser, “Problems with Ascertainment,” Archives of Sexual Behavior 39 (2010), 1225– 1227; Patrick Singy, “What’s Wrong With Sex?” Archives of Sexual Behavior 40 (2011), 483–485. Both these authors point out that this sort of false distinction is precisely why the diagnosis “Ego-dystonic Homosexuality” was removed from previous DSM revisions. Hinderliter, “Deining paraphilia in DSM-5: do not disregard grammar,” additionally points out that the term “paraphilia” has a several-decade-long history in the psychiatric literature (including previous DSM revisions) to refer to a set of diagnosable mental disorders, and thus is entirely unsuitable as a label to describe nonpathological behaviors. 13. Charles Moser and Peggy J. Kleinplatz, “DSM-IV-TR and the Paraphilias: An argument for removal,” Journal of Psychology and Human Sexuality 17, no. 3/4 (2005), 91–109. 14. Charles Moser and Peggy J. Kleinplatz, “Transvestic fetishism: Psychopathology or iatrogenic artifact?” New Jersey Psychologist 52, no. 2 (2002). “The immediate or ultimate result of the paraphilia” is language that appears in the “Paraphilic Disorders” section of American Psychiatric Association, DSM-5. 15. Marty Klein and Charles Moser, “SM (Sadomasochistic) Interests as an Issue in a Child Custody Proceeding,” Journal of Homosexuality 50 (2006), 233–242; Peggy J. Kleinplatz and Charles Moser, “Towards clinical guidelines for working with BDSM clients,” Contemporary Sexuality 38, no. 6 (2004), 1, 4; Keely Kolmes Wendy Stock, and Charles Moser, “Investigating Bias in Psychotherapy with BDSM Clients,” Journal of Homosexuality 50 (2006), 301–324; Charles Moser, “A Diferent Perspective,” Archives of Sexual Behavior 37 (2008), 366–421; Serano, “The real ‘autogynephilia deniers’.” 16. The Blanchard quote is from Cameron, “How the Psychiatrist Who Co-Wrote the Manual on Sex Talks About Sex,” and numerous examples of people citing DSM diagnoses (e.g., GID) 312 Outspoken as justiication for discriminating against trans people can be found in Winters, Gender Madness in American Psychiatry, 71–78. 17. Ray Blanchard, “The DSM Diagnostic Criteria for Transvestic Fetishism,” Archives of Sexual Behavior 39 (2010), 363–372. 18. Luk Gijs and Richard A. Carroll, “Should Transvestic Fetishism be classiied in DSM 5? Recommendations from the WPATH Consensus Process for Revision of the Diagnosis of Transvestic Fetishism,” International Journal of Transgenderism 12 (2010), 189–195. 19. Between April 2010 and June 2011, there were at least three diferent proposed versions of “Transvestic Disorder”—these are all listed in Gail Knudson, Griet De Cuypere, and Walter Bockting, “Second Response of the World Professional Association for Transgender Health to the Proposed Revision of the Diagnosis of Transvestic Disorder for DSM 5,” International Journal of Transgenderism 13, no. 1 (2011), 9–12. The inal diagnosis difers somewhat from all of these, and can be found in the “Paraphilic Disorders” section of American Psychiatric Association, DSM-5. 20. Many trans activists and advocates working to eliminate this diagnosis from the DSM (including myself—see Serano, Whipping Girl, 127–128) often pointed out that the diagnosis was sexist in that it singled out “heterosexual men” (whereas people of other genders and sexual orientations were presumably free to crossdress without the stigma of pathology). Our purpose in doing so was to point out the ludicrousness inherent in the diagnosis, in the hopes that it would ultimately be removed. Frankly, it never occurred to me (although perhaps it should have) that Blanchard might use these accusations of sexism as an excuse to expand it to include even more people (he essentially admits to this in the article cited in Note 22). 21. For more on “autoandrophilia,” see Chapter 33, Note 11. 22. Cameron, “How the Psychiatrist Who Co-Wrote the Manual on Sex Talks About Sex.” 23. WPATH also opposed both the speciiers “in remission” and “in a controlled environment” (not discussed here) on the grounds that they “exclude the possibility of an ‘exit clause.’”—see Knudson, De Cuypere, and Bockting, “Second Response of the World Professional Association for Transgender Health to the Proposed Revision of the Diagnosis of Transvestic Disorder for DSM 5.” In the inal DSM-5, the speciier is listed as “In full remission” and requires one to experience “no distress or impairment in social, occupational, or other areas of functioning for at least 5 years,” which seems to imply that someone who has not experienced those issues for four years still qualiies for the full diagnosis sans speciier. 24. See for example Luke Brinker and Carlos Maza, “15 Experts Debunk Right-Wing Transgender Bathroom Myth,” Media Matters for America, March 20, 2014 (http://mediamatters. org/research/2014/03/20/15-experts-debunk-right-wing-transgender-bathro/198533); Serano, “The real ‘autogynephilia deniers’.” 35 – An Open Letter to The New Yorker 1. Julia Serano, “Op-ed: An Open Letter to The New Yorker,” Advocate.com, August 5, 2014 (http://advocate.com/commentary/2014/08/05/op-ed-open-letter-new-yorker). 2. Michelle Goldberg, “What Is a Woman? The dispute between radical feminism and trans-