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“Autoandrophilia”: a disputed diagnosis

“Autoandrophilia” (AAP) is a sex-fueled mental illness created by disgraced anesthesiologist Anne Lawrence in 2009. It means “a woman’s paraphilic tendency to be sexually aroused by the thought or image of herself as a man.”

Support for this disease model of gender diversity is almost nonexistent, limited to a small group of conservative activists and supporters. The many critics of the diagnosis include professional organizations and the vast majority of trans and gender-diverse people.

Like “nymphomania” and other discredited sex diseases, the term “autoandrophilia” appeals to biased people who want to shame or punish people with sexual interests and behaviors outside social acceptability.

Background

Ray Blanchard created “autogynephilia” in 1989. Anne Lawrence soon took the term “autogynephilic transsexual” as a personal identity and began promoting it. Lawrence claims that “autogynephilic transsexuals” are “men trapped in men’s bodies” who transition because of a “sex problem.”

In order to make this identity sound more legitimate, Lawrence began promoting “autoandrophilic transsexual” as an identity. The idea was almost completely rejected by trans people, though some of Lawrence’s friends have used it.

The term was widely ignored until gender critical people and conservatives began using it, often in the context of another controversial concept: “detransition.”

These same conservative sexologists began claiming it is an “erotic target location error” (ETLE). They believe that the person’s attraction to men gets turned inward, sometimes making them want to transition into what they desire, or an “erotic raget identity inversion” (ETII): “If this ETII exists, it would involve sexual arousal by the thought or image of being another man, which has been called autoandrophilia (Dickey & Stephens, 1995; Lawrence, 2006, 2009b).”

Supporters

“Autoandrophilia” as a term appeals to a very specific type of person: neurodiverse, fixated on collecting and categorizing, socially isolated/eccentric, rigid thinking. That makes it very hard for them to let go of bad ideas, in the way it’s hard to convince believers that horoscopes or Myers-Briggs types are unscientific. It helps them make sense of the world, and they “see themselves” in the disease.

Canadian psychiatrist and anti-trans activist J. Paul Fedoroff wrote:

As a final comment on DSM-5 criteria for transvestic fetishism, the subcriteria for this condition imply that a person is either fetishistic or autogynephilic (or autoandrophilic). Clearly, a person could also be both and possibly neither. At a time when psychiatry is moving toward increased levels of diagnostic specificity, does it make sense to list autogynephilia and autoandrophilia within transvestic disorder rather than a sseparate paraphilias?

Fedoroff (2011)

Criticism

In 2001, Jamison Green wrote:

We must acknowledge all components of human behavior and work toward the full acceptance of humanity in all its complexity. If we isolate autogynephilia or autoandrophilia as occurring only in the trans world, we revictimize ourselves, perpetuating the invalidation most of us experienced for much of our lives. If we’re going to talk about the combustible mixture of gender and desire, we have to recognize that it is not the exclusive province of transsexuals. This will help put it in perspective, and help to reduce the pathologizing we so logically dread.

Green (2001)

As Stephanie Hsu writes:

As other sexologists took up [Blanchard’s] work, autoandrophilia or “the love of oneself as a man” was peremptorily coined to serve as autogynephilia’s exact counterpart in subjects assigned female at birth, but virtually no studies into autoandrophilia have been completed.

Hsu (2019)

Value-neutral terms

Erotic interest in masculinization and autoerotic interest in masculinization are phenomena that are discussed by ethical scientists via value-neutral terms. Good science is free from bias, which is why biased terminology like “nymphomania” has been replaced with less biased terms.

Many people have proposed value-neutral terms for transgender sexuality that do not frame gender diverse fantasies as a sex disease. These include:

  • genderplay or gender play (used since middle 20th century)
  • crossdreaming (proposed by Jack Molay)
  • interest in masculinization and interest in feminization (proposed by Andrea James)
  • female embodiment fantasies and male embodiment fantasies (proposed by Julia Serano)
  • erotic femaling and erotic maling (proposed by Richard Ekins and Dave King)
  • Tiresian fantasies (proposed by Will Powers)

Among people with these erotic interests, some use the terms fujoshi and fudanshi.

Having these surprisingly common interests is perfectly fine, and it can be fun to explore these interests as part of a healthy sex life!

Disease literature references

Dickey R, Stephens J (1995). Female-to-male transsexualism, heterosexual type: Two cases. Arch Sex Behav 24, 439–445 (1995). https://doi.org/10.1007/BF01541857

Lawrence AA (2009). Anatomic autoandrophilia in an adult male. Arch Sex Behav. 2009 Dec;38(6):1050-6. https://doi.org/10.1007/s10508-008-9446-6.

Fedoroff JP (2011). Forensic and diagnostic concerns arising from the proposed DSM-5 criteria for sexual paraphilic disorder. J Am Acad Psychiatry Law, 2011;39(2):238-41. https://jaapl.org/content/jaapl/39/2/238.full.pdf

Benestad EEP, AlmĂ„s E (2017). Autogynephilia and Autoandrophilia Revisited [conference presentation abstract]. The Journal of Sexual Medicine (Vol. 14, Issue Supplement_4b, pp. e281–e281). Oxford University Press (OUP). https://doi.org/10.1016/j.jsxm.2017.04.354

“Phil Illy” (June 8, 2023). Autoandrophilia (AAP): Love of Self as a Man. Understanding Trans https://phililly.substack.com/p/autoandrophilia-aap-love-of-self-as-man

Disease criticism references

Green, Jamison (2001). Autoandrophilia? Transgender Tapestry #93 Spring 2001, p. 20. https://archive.org/details/transgendertapes9320unse

Hsu S (2019). Fanon and the New Paraphilias: Towards a Trans of Color Critique of the DSM-V. J Med Humanit 40, 53–68 (2019). https://doi.org/10.1007/s10912-018-9531-3 Reprinted in Queer Interventions in Biomedicine and Public Health. ISBN 9783031296772 p. 56