Bailey on Blanchard

In the defamatory book The Man Who Would Be Queen [1], pop psychologist J. Michael Bailey expresses profound admiration for his mentor:

Ray Blanchard, Head of the Clinical Sexology Program of the Clarke Institute of Psychiatry in Toronto, knows more about transsexuals than just about anyone else. Like so many sex researchers, Blanchard 's introduction to sex research was fortuitous rather than intentional… In 1980 Blanchard took a job at the Clarke, where he has remained, recently taking [Kurt] Freund's position after his death. (157)

Blanchard is irreverent, cynical, and politically incorrect. During the opening ceremony of the International Academy of Sex Research, during the eulogies for members who died during the previous year, he regularly engages in wickedly entertaining whispered commentary about the deceased, unsentimentally recalled. (158)

Bailey considers him a role model:

Academics remember each other by their "contributions," or ideas that make a mark, ideas that get the attention of other academics, motivating others to study the same thing. Blanchard has made two contributions so far. (158)

Blanchard’s observations about homosexuality and birth order have led him to the “gay germ” hypothesis:

Psychologist Ray Blanchard has found that gay men tend to be later born sons in a series of brothers… Blanchard has obtained this same result in more than 10 studies, so we can have confidence in it. He theorizes that the "older brother effect" is a biological one, caused by the mother's immune system, which reacts increasingly to a succession of male fetuses… This immune response affects brain development and, in particular, the sexual differentiation of the brain. Blanchard is in the early stages of testing the immune hypothesis, so we don't yet know if it's true. (111)

Blanchard has also put forward a disease model for gender variance which Bailey and Blanchard find intriguing:

But I think his more revolutionary contribution has been to the classification and explanation of transsexualism. In a series of articles beginning in 1985 and continuing for about a decade, Blanchard established that there are two very different types of men who change into women, who have very different presentations, motivations, and probably, causes. Blanchard 's observations transformed male-to-female transsexualism from a seemingly chaotic and bizarre collection of phenomena into two straightforward and clinically comprehensible patterns. (162)

Bailey believes the "pathology" of gender variance will be found by comparing symptoms, and that research of this supposed disease will proceed like AIDS research:

Eventually, they hypothesized that these were all consequences of the same infection, and when it was possible to test for HIV, its presence was confirmed in virtually all cases. Ray Blanchard 's contribution to transsexual science was of the lumping variety Distinguishing "homosexual," "heterosexual," "bisexual," and "asexual" transsexuals diagnostically makes sense only if the different types have fundamentally different causes. (162)

Bailey and Blanchard believe this “second type” of transsexual is in reality a subgroup of crossdressers with what Blanchard calls “autogynephilia”:

While cross-dressed, they typically pretend to be women: taking female names, trying to walk and sometimes talk like women. According to Blanchard , even crossdressers who do not want to change their sex have autogynephilia, which they share with nonhomosexual transsexuals. (164)

The difference between a crossdresser and a transsexual in this model is the severity of the disease:

Blanchard hypothesized that the type of autogynephilia that a man has should predict whether the man would become transsexual. A cross-dresser with only transvestitic or behavioral autogynephilia can probably satisfy his urges by periodically cross-dressing in private or in the company of other transvestites. (165)

Why would Blanchard appeal to someone like Lawrence?

Anne Lawrence is the primary promoter of "autogynephilia," which allows Dr. Lawrence's behavior and erotic interest to sound more socially acceptable. Blanchard advances the claim that crossdressers are born and not made:

Blanchard 's conceptualization of cross-dressing, as arousal by an image of oneself as a woman, is very different from the idea of a fetish. Conceptualized Blanchard 's way, it is difficult to see how cross-dressing could arise through conditioning. (169)

By taking crossdressing out of the category of “lifestyle choice” and into the category of sex-fueled mental illness one is born with, behavior that is considered socially unacceptable is now an innate medical condition one cannot help.

In the way that most crossdressers are not interested in therapy, this model bypasses the talking cure and skips to chemical or surgical interventions:

Blanchard 's ideas have not yet received the widespread attention they deserve, in large part because sex researchers are not as scholarly as they should be and so don't read the current scientific journals. And although Blanchard 's ideas are fundamental to an understanding of transsexualism, they might not matter that much for helping transsexuals, which most clinicians have as their first priority. With luck, the next revision of the DSM will distinguish "homosexual" from "autogynephilic" transsexualism. (176)

This explains Dr. Lawrence's interest in hormones and surgery and not in therapy and socialization. Dr. Lawrence believes in better living through chemistry, just like another transgender doctor who self-administered hormones:

... you better get on Thorazine or Zoloft or Prozac or get locked up or do whatever it takes to keep you from being allowed to do something like this.

-- Renée Richards (1999)

It is understandable that people with medical training would have faith that medical intervention will cure their "disease," but Richards' regrets and Lawrence's loss of career suggest that the disease model does not adequately explain this phenomenon, and that chemicals and surgery are only part of the therapeutic picture.

It is interesting to note that Anne Lawrence and Marci Bowers both transitioned within the same hospital group in Seattle. Dr. Lawrence resigned amid a scandal and lack of acceptance following transition. Dr. Bowers continued to run a thriving OB/GYN practice, even though her involvement with female patients was significantly more personal and intimate than Dr. Lawrence's anesthesiology job. Bailey and Blanchard would claim they are the same "type," so why such different reactions to their transitions? The answer to that question goes to the heart of the problem with Blanchard's taxonomy, and it will have to wait for another essay.

For now, suffice it to say that Anne Lawrence is heavily invested in being considered a "real transsexual," as she noted on annelawrence. com, even though my encounter with Dr. Lawrence was charged with "the unmistakable presence of a lust being satisfied," which Dr. Lawrence notes as a hallmark of crossdressing. [2]

Why would Blanchard appeal to someone like Bailey?

Bailey starts off his section on transsexuals asserting he is a "single, heterosexual man." (142) Later he returns to his mentor:

Ray Blanchard is the only researcher who has studied men who are sexually attracted to she-males. (Blanchard calls men with sexual interest in she-males "gynandromorphophiles." ... Blanchard thinks that a significant number of men who want she-males are "partial autogynephiles" they are primarily aroused to the image of themselves as shemale. Blanchard says that the men are not gay but are more like "scrambled up heterosexual men.” The transsexuals I know who worked as she-male prostitutes confirmed this. "There was nothing gay about those men," said one, who knows plenty about gay men. (187)

Suddenly, a "single heterosexual man" can maintain that self-identity while he's attracted to "a type of gay man" (178). Perhaps Bailey should rename his two classifications "Hot" and "Not":

If Blanchard and I saw the same 100 transsexuals, I would be surprised if we disagreed on more than 2. But most readers will not have met a single transsexual of either type, and even most clinicians who see gender patients are not used to thinking about them this way. (192)


Blanchard's appeal to his academically stunted progeny might be best looked at from a disease model as well. By lumping the types of sexologists who gravitate to his ideas, we can start to understand more about the origins of Blanchard's unfortunate mind virus, the meme of "autogynephilia."

In future essays, I will look at why Blanchard's meme about gender variance appeals to unsophisticated gay sexologists like James Cantor and Simon LeVay as well.

In the meantime, I will continue to look at ways to cure therapists who might have been exposed to this toxic recombination of science and ideology and prevent future infections from occuring by isolating the carriers.


Originally published 13 November 2003.

1. Bailey JM. The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism. Joseph Henry Press, 2003. Parenthetical numbers throughout this essay refer to page numbers in the book. Links within quotations were added by the reviewer.

2. Lawrence AA. Book Review: Normal. Archives of Sexual Behavior, Volume 32, Number 4, August 2003, p. 387.