J. Paul Fedoroff is a Canadian psychiatrist and “autogynephilia” proponent who has published on “paraphilia” and transgender topics. He worked at Canada’s notorious CAMH clinic at a time when the vast majority of trans people seeking healthcare were turned away.


Fedoroff has served as the Director of the Sexual Behaviors Clinic at the Royal Ottawa Mental Health Centre. He is also Associate Professor of Psychiatry at the University of Ottawa and Vice-Chair of the ROHCG Research Ethics Board (REB) He is both a Neuropsychiatrist and Forensic Psychiatrist. Fedoroff’s research interests include the assessment and treatment of paraphilic sexual disorders and prevention of sex crimes. He has a special interest in individuals with developmental delay or brain injury. He has published over 100 research articles and book chapters. He presents frequently at scientific meetings around the world and is frequently consulted by the media to comment on problematic sexual behaviours.

Debate with Ray Blanchard (2000)

While working at CAMH, Fedoroff published a debate with Ray Blanchard on public funding of transgender healthcare, focusing on genital surgery. This is often presented as evidence of Blanchard’s “progressive” views. Below is an excerpt from Fedoroff’s argument against public funding for trans health services.

Currently, TS [transsexual] is the only psychiatric disorder for which genital surgery is the mainstay of treatment. It is the only psychiatric disorder in which no attempt is made to alter the presenting core symptom. To date, there is no definitive evidence that surgery is more helpful than anything else.

Psychiatric advocacy of TS surgery has the following effects:

  • it legitimizes surgery as a solution for a (presumably) psychiatric condition
  • it simultaneously pathologizes TS as a psychiatric condition and as a surgically treatable disorder
  • it does not affect the core symptom (belief that one belongs to the opposite sex)
  • it confirms the TS person’s belief that they are abnormal, pathological, and untreatable
  • most importantly, it diverts resources from finding a true cure for this disorder toward a band-aid, unproven, and potentially misguided solution.

Finally, no one who has sat across from a man who is tearfully begging to be castrated can fail to appreciate the extreme anguish that TS patients endure.

However, we also sit across from patients with Munchausen’s syndrome who plaintively beg for the same procedure. Both would be “happier” if referred for surgery, but I maintain that our response should be the same: to humanely and respectfully save our patients from the consequences of their disorder, even if it means admitting we don’t have a cure…yet.


Blanchard R, Fedoroff JP (2000). The case for and against publicly funded transsexual surgery. Psychiatry Rounds 4:2 (April 2000). [PDF]


Fedoroff JP (2019). The Paraphilias: Changing Suits in the Evolution of Sexual Interest Paradigms. Oxford University Press ISBN 9780190466329


Wikipedia (en.wikipedia.org)