"Autogynephilia" and disability

This September 2004 correspondence with a reader who uses a wheelchair was in response to my essay A defining moment in our history: examining disease models of gender identity. My comments in response to an earlier letter are indented.

[AJ] I have observed that many of the people who identify with the term "autogynephilia" like it because it labels them as diseased or impaired. I have also noticed that many also seem to exaggerate the sick role in other ways, too. I have just written a long essay on the whole matter that will be available in the next few weeks.

I've read it and along with your appearance on Gendertalk last week, it's probably the first time I've actually found someone talking about things I've seen with both the disabled and trans communities, despite the huge differences between the two. No one will admit it, but within the disability community the "sick role" does seem to be a big thing, to the point that I think that's where at least some of the conflict over "credibility" comes from. For a long time I thought my problem was that I was seen as "cheating" because I was disabled but not dealing with some of the things that other disabled persons deal with, since my being in a wheelchair is due to an orthopedic condition rather than a neurological condition or spinal injury. More and more though, I've learned that it might just be the opposite: I do too many things that aren't about my disability and because I'm not totally immersed in the "sick role" I occasionally run into the unwarranted criticism. Much of the support-related services are actually better suited to assist people who are totally into the sick role as opposed to someone pursuing other things *not* dictated by their health problems.

I've also observed that the sick role isn't just something an individual adopts for themselves. I've seen many examples where a person has a particular disability or health issue and while they themselves take on the sick role, their family and close friends also take on that role- being close to a disabled person for the "bragging rights" as well as enabling the individual to use that sick role as a free license to make themselves the center of attention. Much of the hostility within the community seems to be the result of a handful of people totally in the sick role fighting to make sure they don't have to share that attention or identity with anyone else.

In my own experience, I've wondered if the situations I've been in where I've basically been read the riot act about trying to get special treatment or "attention seeking" stemmed from their attempts to keep that "sick role" a commodity that only a select few are "allowed" to have. It's funny in a strange way because I've actually been very uncomfortable being the center of attention for any length of time- and I've always made sure that I'm not accepting help at the expense of anyone else.

From a trans perspective, the concept of sick role really does explain why there's the reveling in the mental illness aspect, and both your essay and what you talked about on Gendertalk points to people feeling threatened by the reassessing of their situation because they've based so much of their existence on receiving public assistance and making their gender variance their sole identity. I totally agree: gender identity issues aren't an illness or disorder, and even if someone is dealing with a genuine mental condition that's still no excuse to wave it around as one's sole reason for being. Most people can be treated and would probably welcome the chance to get treated and to attempt at least to function enough that they wouldn't need to be on welfare.Don't get me wrong- I personally benefit from assistance programs but I also have been working towards a graphic arts degree to eventually make it possible to get a decent job and *not* need assistance at some point. My main frustration now is having to deal with the reality that many of the programs aren't about getting people to be independent but maintaining their clientele. Especially nowadays: in the past few weeks alone I've had to spend time dealing with the local housing authority and the social security office over assistance renewal, and was really upset at the huge inconvenience of it all because that was time I really needed to be doing more important business. Then it hit me- that's the whole point. The people who don't seem bothered at time spent waiting in line are the ones who don't have anything else going on, so the assumption is that everyone has unlimited free time to hang out waiting to see a caseworker (requiring one to make a real commitment to the role of being low income!).

Where mental condition is concerned, I myself have been dealing with depression and ADHD for years, albiet undiagnosed, and when I was finally diagnosed a few years ago, I put a lot of effort into getting treated and current I'm doing just fine. The one thing I have noticed though are people who seem to like their mental illness diagnosis a little too much- some seeming to feel threatened by the prospect of actually getting treated, and others who seem to have made a "career" of sorts playing the role of advocate but really just seem to be promoting the idea of mental illness as something one can embrace as a condition, almost like saying to make one's life more interesting by bragging about having depression or bipolar disorder. I personally never found anything "hip" or "cool" about it and never had any qualms about taking the meds so I can actually get out and *do* something that's not all about me being depressed or physically limited.I see a great psychiatrist, but I've seem that same sick role mindset going on when I've been in his waiting room for an appointment. There's one or two days during the week where he'll see all the low-income patients to get their med prescriptions updated, and it's usually crowded enough that me in my chair are in the way, and I've lost track of the times I've overheard someone making it seem like a big joke about the trouble they caused when they went off their meds that weekend, or one person is there to see the doctor but they've brought an entourage of family or friends. And overall, it's that same feeling that some of the people waiting seem to make that the high point of that week, while I'm sitting there *very* uncomfortable because a)I've usually got work to do and really need to get home to study or work on a project and b)the frustration that comes with feeling like I have to make the time because the assumption that low income persons with health problems have nothing better to do than hang around the doctor's office.

[AJ] I have a suspicion that many of these people are threatened by people like you who are differently abled, because there is readily visible evidence of your difference. It's similar to the way that some who embrace "autogynephilia" have negative things to say about intersexed people, where there is an observable manifestation of those sorts of traits. I believe it may stem from frustration that their own feelings cannot be pinpointed with available medical evidence for any definitive proof they are "sick" as claimed.

I've wondered about that myself. And it did seem like the "sick" aspect was pushed at the group I went to, and gets played up or exaggerated on the online chats I used to check out. No one ever jumped up and claimed autogynephilia directly, but there really was a fixation on feminization and SRS without any talk allowed of what one does *after* they've transitioned and had the surgery. Could that explain the cavalier attitude about hormones- promoting the idea of obtaining medical help and hormones through some back-channel source rather than actually go to a legit doctor and take the hormones under a doctor's supervision- because if they went that route they'd run the risk of a doctor discrediting their motives, if that makes sense. It's similar to what I've seen where someone makes a big deal about some vague "chronic illness" they might have, but get really angry when someone requires them to actually go to their doctor to get the condition documented if they're trying to claim assistance or access to resources based on that.

On the subject of chronic illness: have you encountered transpersons trying to connect other health problems to their trans situation? In line with people playing up the sick role, that's something I ran into in the group- basically talking about having something like high blood pressure or a panic disorder and pushing the idea that those conditions are directly connected with being trans. In fact at the meeting where I was told I was banned from the group, I got a huge lecture from the MtF in charge about how my mere presence was exacerbating her blood pressure problem and had caused some unknown problem with another member. Seemed like the idea was presented that "real" MtFs have all these other ailments to deal with.

[AJ]The reason these people dislike me is because I do not feel that being different from others is a disorder or disease. Disorder suggests an "order" that has gone wrong, and I do not consider gender variance or interest in feminization to be a disorder. Because this threatens the most fundamental thing they believe about themselves, they respond with tremendous hostility.

I wonder if it's also because you conduct yourself as someone who is well adjusted and conducts herself in a socially appropriate way. I say that because I've gotten the impression that the hostile MtFs are the ones who made such a big deal about being transsexuals and perhaps even came across as obnoxious about it that they've been rejected and are angry at other MtFs who *did* transition and go out into the world as real people and not crass charactitures of women. I recall my own encounter with the people in the group , the people I've chatted with online (long time ago!) and reading about the inappropriate actions of Anne Lawrence.

Which has me thinking: could at least some of that hostility actually be a way for them to get even with the bigger trans community for not accepting them? Reading some of Lawrence's writings, I get a certain amount of contempt and smugness that seems more personal than a doctor giving their medical take on things. Where you might disagree with Jennifer Reitz on a professional level over the validity of the tests on her site, Lawrence seems to personally hate the fact that Reitz is an MtF expressing femininity. If I'm out of line here, I apologize, but there's a serious and perplexing hatred of femininity by some MtFs- could that be the result of them not being accepted by other MtFs?I bring it up because it echoes something I've run into where disability is concerned: a small faction of disabled persons, or persons with that vague "chronic condition", who openly express contempt for other disabled persons *because* the rest of the world couldn't deal with their obnoxious actions. Take people playing the sick role and combine it with a twisted sense of entitlement. I recall several years ago the local transit authority's wheelchair van service was getting complaints- not about the service, but from a handfull of people very blatantly filing complaints against other disabled persons using the service. Anger because they tried to force everyone else to accept them and their conditions, or else. And it backfired, so they declare war on everyone.

[AJ] I have known several people in wheelchairs who have feminized to one degree or another and are happier for it. I hope you will find a safe, supportive, and healthy place to explore this for yourself, without the baggage of those who want to be looked at as mentally disabled or disordered.

Thanks for the encouragement! More and more I know that my experience with that group and the strange things I've encountered online are more of an aberration than the norm. Does any of the literature discuss the success of MtFs who are wheelchair users? Already I'm impressed with what you and Lynn Conway are doing to show MtFs as real people doing just fine post transition :)

Sorry about things running long- it's just that so much of what you've said resonates with me and it's the first time anyone has actually put together something definitive about what's going on. One aspect of disability and being trans that I don't think has ever been addressed is being trans and *having* to accept being around very conservative and possibly transphobic persons because of having to access healthcare or other services related to their disabilities. Since I'm "pre-everything" I'm not running into that directly but there have been *lots* of awkward situations and conflict over me not connecting with "required" gender roles exagerated by disability (in other words, guys in wheelchairs are supposed to be ultramacho, and I am far from it! ;) ). No one ever suspected anything was really different about me, but it's always been difficult not being truly allowed to access help or resources in ways that are truly ok for me, from a psychological point of view. I've even had to hide the small doll collection I have because of an incident a couple of years ago when a home health aide was at my apartment and really started pressing the issue- awkward questions, the way one would try to make someone admit they're doing something wrong.

One thing I wanted to add: on the subject of gatekeeping- there too are parallels between both the trans and disabled communities, at least from my experience. People who need certain services and resources finding themselves thwarted by people in support capacities or even by members of those respective communities. I recall the time I was in the process of getting a new wheelchair about 10 years ago (second of 3 chairs I've since I've been disabled) and that was a *huge* fight. Parent's insurance was going to cover a lot of the cost, and my doctors had given their approval, but I ran into four months of stupid "conflict" with rehab workers and wheelchair dealers over what later turned out to be "social rules" they were "enforcing": they felt I shouldn't have a much-needed new chair, and acted like I was some spoiled teen trying to get mom and dad to get me a fancy car. On the trans side of things, I've read all the horror stories about how MtFs get denied approval for SRS because they didn't adhere fanatically to the narrow guidelines and complicated rules about what "someone else" thinks makes an MtF truly "worthy" of being allowed to have the surgery. My biggest fear is that I might ultimately be denied because I'm not going along with the required stereotypes- like my total lack of interest in men and attraction to women regardless of what my gender identity is.

Follow-up comments y the same author

Despite being so busy, I've been going back and reading through more of your site, and in reading the entries about Lawrence and autogynephilia, I came across comparisons to the so-called "wannabes" who are obsessed with amputation, some of whom have actually managed to have a limb removed. Your other entries on the subject go into a lot of depth about the sexualization of medical treatment and procedures, and descriptions of Lawrence's obsessions with SRS procedures and the results (the account of your aborted book collaboration, with her trying to make it a picture book about SRS results sticks in my mind), has me thinking that there are more things in common with the disability and trans communities.

In the disabled community, "wannabe" is part of a larger phenomenon referred to as DPW, or "devotees","pretenders", and "wannabes", and it runs deeper than merely a few people who would choose to lose a limb or otherwise become disabled. Devotees are people who are attracted to persons with disabilities, although it's usually seen more as someone who has a thing for the disability rather than the whole person. Pretenders are people who "get off" on the attention from pretending to be disabled, and of course the wannabes are those who take it further.

The devotees can be compared with the "tranny chasers" in the TS world, and in many ways, their obsession with all the minutia of someone's disability came to mind when I was reading about the way certain people's interest in transpersons and SRS doesn't go much further than wanting to know all the graphic details of someone's experience, going as far as engaging in outright harassment of the person or persons they're "interested" in. The main difference I can see is that the disability "devotees" can operate more under the radar, and have a better chance of indulging their "interests" under the guise of something more socially acceptable, like being involved in support roles of some kind. Their real motives do ultimately surface though when the disabled persons they're trying to get close to either catch on or don't live up to "expectation" and the devotee's attitude sudden turns hostile. Although there are female devotees, primarily one hears about men harassing disabled women. As I think was mentioned in one of the articles, it's known that some wannabes are also devotees.

But the major similarity is in the obsessive interests on the part of devotees and tranny chasers, and I often wonder if I've encountered both situations in my experiences with both communities- while I have no proof I've actually met devotees, it would explain some experiences. Rather than recount a litany of incidents, I'll sum it up by saying that I've met people over the years who've seemed to act very "aggressive" in their interactions with disabled persons, including the weird fixations on certain aspects of one's situation, and more obviously, aides and helpers on one hand seeming to be into their jobs but on the other hand, seeming very dissatisfied with how things were going, and I can't help but think that what was really going on was that in those situations, it was a case of devotees frustrated that they didn't get to hang out with macho guys or pretty girls wheeling around. When some people in charge of support services or resources start acting harsh and arbitrary about including or excluding people, again I (and it's just my observation) suspect that it's a case of a devotee "getting even", so to speak, with disabled persons who "refused" to conform to stereotypes.

One are where I really compare it to the tranny chaser phenomenon is in the way both devotees and tranny chasers are so obsessed with the minutia of someone's situation that they're totally oblivious to negative reactions from the people they're bothering, even going as far sometimes as getting angry because they feel entitled to demand a chat about even the more personal aspects of one's trans or disability experiences. I've seen in disability forums online where *a lot* of the discussion threads seem to focus on very juvenile discussions about sexuality or incontinence management- think 3rd grade bathroom humor combined with medical jargon.

Reminds me of your accounts of Lawrence being very inappropriate but hiding it behind her credentials (I get the impression that she figures since she's a doctor, her antics are somehow ok).

Where wannabes are concerned, I don't think I've met any myself, but here again, some encounters could be explained. For me, it's not that I met someone in a wheelchair and suspected they were faking, it's more along the lines of meeting someone who has a relatively minor limitation or condition but has managed to use it to ingratiate themselves into the disabled community, putting themselves in the same class as people with more serious disabilities, and taking on the role of "expert" on all things disability.

From a trans standpoint, it seems very similar to what I described about that support group or what I've seen online where someone's apparent interest in trans issues didn't seem to match their actual situation- I don't mean someone deep in the closet asking MtFs for advice, I mean what looked like people who weren't interested in transition themselves but were pressing everyone else present for info- fixating on the crude aspects.

Something else I've been thinking about- knowing how devotees act in regards to disability, I wonder if it's farfetched to think that perhaps some resources "advertised" as trans support are actually organized by tranny chasers? I recall a Yahoo group where it looked like the moderator wasn't MtF themselves, and got really irked when the discussion drifted away from talk about SRS, hormones, and "women exist to serve men, MtFs even more so". That was the first time I think I encountered autogynephilia although I didn't actually know the term at the time. Most of the list members were really espousing attitudes very much in line with Lawrence's longing to be a "receptacle", as if the only thing an MtF should aspire to is being the best sex object to blindly serve the tranny chasers.

At the local support group I went to briefly, the MtFs present also seem to hold this concept as the only thing MtFs are "good" for, and at one meeting, one of the members brought her male partner, and I just felt creeped out. I didn't see a couple, a boyfriend and girlfriend together. I saw her going to great lengths to appear "submissive" to her partner, the whole meeting deferring to him as if he was in charge, and trying to illustrate that *that* was the only future one should expect if they pursue transition and SRS. Actually there's a twist there, because at one point she was talking about how for all intents and purposes, MtFs doing their own thing is betraying the tranny chasers, and since some of them want a pre-op, SRS is a form of betrayal. That was around the time I got lectured about how oh-so-wrong it is to want SRS but have no intent of having sex with men, never mind actually wanting to be out in the world as a woman. Basically fueling the idea that MtFs aren't real women. I got the idea that perhaps one reason I wasn't welcome there was that me being there in a pre-everything state would remind any tranny chasers coming around that the people they had a thing for used to be male. There was also an odd attitude from the MtF running the group- basically "sex with men is soooo disgusting, but what choice do I have?". Does this fit into the the "forced feminization" fantasy concept discussed in some of the autogynephila material? Lots of talk as if becoming female was some terrible fate they resigned themselves to.

Basically though I have to wonder if groups like that aren't trans support groups, but actually something set up by and for tranny chasers and people identifying their trans situation as driven by autogynephilia.

I say this because years ago, during the first year or so I was in the wheelchair, I found out about what was advertised as a group for disabled singles, but over the course of a year I attended some of their gatherings (social gatherings rather than group meetings), and every time got a weird vibe about the whole thing. One, it at times felt more like "let's all hang out and pretend we're not disabled", and other times it seemed like the group was for a lot of other things but excluding bona-fide disabilities. The most bizarre thing though was that at a couple of gatherings, I encountered what I later learned were probably devotees and wannabes. At one gathering in particular I saw more non-disabled men than anyone else with a disability, and prior to the start of the event people were meeting outside in the parking area. One guy was walking around talking to everyone- until the event started, when he calmly walked to his car, got out a wheelchair, and wheeled himself in. Didn't look like he had trouble walking, so *that* seemed bizarre. Later on as the gathering got under way, the large group of non-disabled men seemed to be standing around looking really perturbed about something, giving some people dirty looks, and later were seen following one woman in a wheelchair around the whole evening, and flocking around her table when she wasn't moving around. Looking back I personally think that basically I encountered wannabes and a room full of devotees. While I think the groups origins had to have been innocent, somehow it evolved into what I saw at those events.

I apologize if I'm rambling, just trying to "catch" the thoughts as they come :)

I hope I've articulated things as well as I have in the past. It just all started hitting me after reading through those entries on the site that there more similarities than I first thought. Behavior of both devotees and tranny chasers, and the way some disabled persons and trans persons tolerate or even encourage it.

The whole devotee/pretender/wannabe thing had made me paranoid for years because sometimes a person who's legit and doing nothing wrong can find themselves accused of having ulterior motives, as what seems to happen to some trans persons, credibility questioned for failing to be a stereotype, or paradoxically seen as less than honest because they seem "too knowledgeable" about trans issues. I'm working on not being so paranoid, but in both areas, I still fear what might happen if I really express myself from either perspective. Don't get me wrong- it feels good to finally be at a point where I can be creative, because the opportunities seem unlimited, but it's still a concern of mine that what I might create (art or writing) from a disability perspective would be totally misinterpreted as some crass and shallow scheme to get attention, and anything from a gender perspective would get me into similar trouble. I've had the bad luck of being accused of having ulterior motives at times when I couldn't have been more honest about what I was doing.