The Autogyne Files Part IV
A conversation with a young sexologist
This is the final part of the series, the Autogyne Files. For context, it maybe helpful to catch up on the previous parts, which you can do so here:
The Autogyne Files Part I - Dirty Words: Exploring the narratives around Autogynephilia
The Autogyne Files Part II - A conversation with Anne Ominous, a young transitioner
The Autogyne Files Part III - A conversation with Jennifer, a Trans Widow
The Autogyne Files Part IV - A conversation with a young Sexologist, G
I hope you find this piece informative and helpful, please let me know in the comments.
The Autogyne Files Part IV
A conversation with a young sexologist, G
Ritchie: “You’re 24, right?”
G: “I'm not that old Ritchie, I just turned 23!!! Don't make me feel older than I am.”
Ritchie: “Grumble, grumble! 24 is not old!!!”
Ritchie: “You transitioned as a teenager, can you tell us how old you were when you started, and how that came about?”
G:”I was given a gonadotropin releasing hormone analogue at 15 years old, after being assessed at the age of 14 by a prominent American gender clinician (often cited in articles by people opposed to the practice of gender medicine!).”
“I had no/very little gender dysphoria prior to the onset of male puberty, however at the start of natal puberty my mental health and body dysphoria rapidly decreased as male puberty progressed. When puberty started I was unaware that trans people even existed, it wasn't until I discovered these medicines existed that I opted for them.”
“I was forced to do a little over a year of monotherapy (only pubertal suppression) before I was permitted estrogen by my endocrinologist, something I fought very hard for and was and still am glad to receive. I am aware of there being controversies over the (supposed) side effects of GNRHa and other similar drugs in trans people, however I personally have experienced literally zero adverse effects. I can still orgasm, have never broke a bone and am in great academic standing in college currently with a cumulative GPA of around 3.8. I had the 2nd highest GPA of my graduating class in high school whilst on GNRHA and estrogen. The idea that these drugs doom you or make you an incompetent moron are absolutely false in my case.”
Ritchie: “Sounds like you’re doing well in life, I’m glad you’re not experiencing any adverse affects. I met someone a similar age to you, who had the same pipeline but horrific osteoporosis. it was only found after a bone scan and it showed his hip especially was in a bad condition. I wonder how much of that is hormones. Yet, I have a feeling, even if that was the case, people would do it anyway. How were you functioning before you took hormones?”
G: “I would have to know more about that person's situation to comment on it, I will say just from my understanding of human anatomy and physiology that I would generally advise against GNRHA monotherapy for long periods of time. Taking gonadotropin releasing hormone analogues without exogenous estrogen or testosterone induces a sort of menopausal type situation in which bones do not continue to gain the benefits of sex hormones strengthening them.”
”This is why when many females enter menopause they opt for exogenous estrogen medications, as it strengthens the bone mineral density. Outside of the original treatment protocol which pioneered using GNRH analogues for dysphoric and/or trans adolescents, it has always puzzled me why the standards of care was monotherapy rather than simultaneously administering estrogen and GNRHa, as the patients overwhelmingly desire the effects of estrogen and there are plausible, mechanistic reasons to believe that prescribing estrogen simultaneously rather than forcing a waiting period of monotherapy GNRHA could be explored. Were I an endocrinologist I would favour simultaneous prescriptions rather than the historical monotherapy to watch period protocol that ensued. This would likely reduce the number of people who had bone issues.”
“Before HRT I was pretty poorly functioning mentally and at odds with my anatomy. HRT allowed me to see the closest thing to the puberty I had long desired and rid me of most of the secondary sex traits I disliked having.”
Ritchie: “Are your family supportive with your transition? How are things now?”
G: “My mother was sceptical at first due to my atypical symptom presentation and lack of prepubertal signs. However once she saw my gradual improvement on hormones she came to be happy with my outcomes and without my prompting said a year or so ago she thinks they saved my life. Were I not given hormonal medicine I think I would be in a much worse situation.“
“For reasons unrelated to gender, I am not on speaking terms with my father's side of the family but they were mostly agnostic to it/didn't care much when I was speaking with his family.”
Ritchie: “In what way do you feel the treatment improved your life?”
G: “Body image, depression, confidence to go outside, confidence to publicly speak, and ability to function professionally and academically. Allowing my body to align with how I always wanted it to gave me both internal mental improvement and allowed me to reach professional milestones I had dreamed of such as being dual enrolled in community college and high school at the same time.”
Ritchie: “For the audience, can you give us a brief run down on the different types proposed in sexology?”
G: “Among natal males, the only recognized types of gender dysphoria in the literature are autogynephilic gender dysphoria, homosexual gender dysphoria, and psychotic gender dysphoria (the rarest type, transcendent in nature and experienced when in a bipolar or psychotic episode).”
“Homosexual dysphoria is that of androphiliac trans women and begins very early in life, before the onset of puberty. Autogynephilic gender dysphoria is more heterogenous and is known to contain 4 or 5 subtypes, anatomic gender dysphoria where someone is aroused at having the opposite sex genitalia and sex traits (a vulva and/or breasts), transvestic where one is attracted to the other sexes clothes (such as skirts or a dress), behavioural where one is attracted to cultural behaviors of females/woman such as having their nails painted or living as a woman’s social role, interpersonal autogynephilia is where one is attracted or distressed at not living as a woman interpersonally, such as being invited to a woman's retreat or having sex as women do.”
“Either with men or women, the former is referred to as pseudoandrophilia, meta attraction or pseudohomosexuality insofar as an auto gynephile's attraction can at the surface seem most similar to the homosexual transsexual's symptoms; however the aetiology is very different insofar as it is not beginning in childhood (before puberty). Physiological autogynephilia is that of desiring female bodily functions such as pregnancy, menstruation, or lactation.”
“Ray Blanchard, the doctor who formally conceptualized autogynephilia found that anatomic Autogynephiles had the most dysphoria and the most desire to undergo vaginoplasty and subsequent transition. There are also autogynandromorphophiles (what a mouthful! this is often shortened to 'AGAMP' for brevity) who desire to keep their phallus but desire breasts and somatic feminization.”
“A "rapid-onset gender dysphoria" [often shorted to 'ROGD'] in natal males has been proposed by anti-LGBT activist organizations such as Genspect or the American College of Paediatricians and their umbrella organizations, however, specific clinical criteria for this diagnosis have yet to be formally described. "ROGD" in natal males is often said to originate from pornography, social media, or peer influence in natal males; however no compelling evidence outside parental reports has been produced suggesting that this aetiology is existent in males. The diagnostic criterion or patient symptomology of so-called rapid-onset gender dysphoria must be distinguished and described by advocates for its' clinical applicability to assigned males must be described and justified for this novel aetiology to be taken seriously by clinicians and scientists.”
“Natal males are very much less likely to historically experience sociogenically induced mental illness than natal females are, with known sociogenically induced disorders such as Multiple Personalities, Anorexia, and other social contagions nearly exclusively affecting natal females, with rare outlier cases affecting males. The case for assigned males experiencing ROGD is extremely weak, with much counterevidence to the claim that so-called "ROGD" cases are "ROGD" rather than simply autogynephilic dysphoria at a younger age than historically recorded.”
Ritchie: “Some would argue that is reductive of sexual orientation, and some gay men would even fit some of those categories. Can you see why some critics are weary of the theory? As for male ROGD, I agree the evidence is weak, but I think thats because it may manifest itself differently from girls. I think Autism has a huge factor in this, especially when you mix in isolation and the Internet.”
G: “I can understand why critics are weary, however, I would counter we have much more compelling reason to favour the AGP explanation as autogynephilia as an aetiology for gender dysphoria in natal males has unlike much of the social sciences been replicated in studies.”
“Littman's study which invented rapid-onset gender dysphoria had a supermajority female sample and could not even attempt to exclude males who were autogynephilic from the sample, as Lisa only interviewed parents who would be highly unlikely to understand their children's sexual desire.”
“It is possible that there is a non AGP/HSTS aetiology in males, however, I remain sceptical as proxy measures such as having transgender friends have been vastly overrepresented among ROGD females than the hypothesized "ROGD boy" according to lower-quality surveys attempting to support ROGD such as the relatively recent Diaz and Bailey study which found very few males had trans friends of the same sex, making it difficult to explain a supposed 'peer contagion'.”
“I am of the opinion that autism is over diagnosed at this time and that the vast majority of diagnoses do not have anything resembling the historical definition of autism. Autism diagnoses have increased astronomically as the diagnostic criteria widened and Asperger's ceased to be a clinical diagnosis, leading me to be sceptical of the true prevalence. Additionally, even if I were to concede that a large % of the gender dysphoric population had autism, this would not be enough to support a novel aetiology of gender dysphoria. Many mental disorders have patients with other psychological comorbidities, (eg, many people have both depression and anxiety) and we do not pretend this is a novel presentation.”
G: “With regards to the internet, I am not confident that the internet has a significant effect on psychological outcomes of the majority of young people, especially those who are not natal females. Many researchers have tried for the past 15 years to establish compelling evidence that phones/social media lead to psychological illnesses, however, they have overwhelmingly come up short. I recommend the work of Psychologist Dr. Christopher Ferguson who studies these topics and often criticizes the societal problems people blame on phones and social media. This podcast I link is a great overview of the problems with claiming phones/social media cause X, Y, Z personal or social problem.”
Ritchie: “Are there any you think shouldn’t transition? If so why?”
G: “I definitely don't think anyone with active psychosis or bipolar symptomology should be transitioned, however, I am agonistic to their transition if such symptoms are treated psychiatrically with antipsychotics or anti-bipolar drugs like Seroquel or lithium and the dysphoria perseveres longitudinally. I think the more severe the symptoms the more strong the case for hormonal interventions is. Generally, I am in favour of informing patients of the aetiology of their condition with appropriate verbal explanations.“
Ritchie: “In a few years, we could be reading your name on research papers, what are your hopes for future research, and what would you like to focus on especially?”
G: “hahaha, thank you. That's very kind and definitely what I aspire to do.”
“My hopes for future research are to enrol patients in cohort studies, target trials, or randomized control trials with waitlist control groups in multiple nations so we can finally calculate the effect size (for the statistically inclined I am referring to Cohen's *d* and establish higher-quality evidence in this field. Such an experiment would be very expensive and difficult to conduct but is necessary to advance clinical practice and better understand how to serve this population. For example, psychotherapy has often been prescribed to treat gender dysphoria however we have very little understanding (post the prepubescent cohort, which is a tiny and very irrelevant population at the moment) whether psychotherapy even helps gender dysphoria in of itself in this population rather than just serving comorbidities such as depression or anxiety.”
“A RCT where groups were assigned to either psychotherapy-only, hormonal interventions only (in this case, pubertal suppression and estrogen prescription), or psychotherapy and hormonal intervention would be a great way to answer important questions in this field and solve a lot of questions. I hypothesize that hormones and therapy would both have an effect on clinical outcomes, but that for body image and gender dysphoria that the effects of hormonal interventions would be much greater than that of psychotherapy alone.”
Ritchie: ”I do think hormones had a calming effect, but I’m not convinced they’re entirely without negatives, though the psychological benefits seem to be quite evident in self reports. Though I also suspect this could be due to finding a community and freeing yourself from isolation.”
Ritchie: “We’ve been chatting for quite a number of months now, and i was shocked to see that your partner had desisted, but remains on hormones. How did you feel when they brought that to you?”
G: “Well, I was shocked at first but they are pretty happy/content at this point living as a guy on estrogen.”
“My partner although a detransitioner doesn't really have regret or animosity to undergoing the transition process so I think that makes things a lot easier for them, at this point we are taking things day by day and I love them regardless of whether he chooses to go back to transitioning socially or whether he decides to just take estrogen and live as a man on estrogen.”
“I think for Autogynephiles this can be a "middle-ground" path to both mitigate gender dysphoria and not further masculinize whilst not having to take major changes in their social lives. These people often want to be androgynous or masculine but dislike body hair and not having breasts, which is why they desire Estrogen only but none of the other interventions like socially transitioning or getting vaginoplasty.”
Ritchie: “That’s sweet. I wish I had that insight myself several years ago. I hate body and facial hair, but I wonder how much of that is due to the sensory elements rather than the implicit meaning.”
Ritchie: “What was it that got you interested and kept you interested in sexology?”
G: “I saw a YouTube interview of a prominent sexologist (James Cantor) and discovered the field after looking into some of the topics he discussed. I found it a super fascinating field and relevant to things I cared about and had never even heard of sexology as an academic discipline prior to the interview.”
“Unlike most scientific fields sexology is extremely interdisciplinary and encompasses psychological, anthropological, psychiatric and endocrinological research so there isn't really a major called "sexology" at most institutions. At my current undergraduate there isn't a course frequently taught titled "sexology" so I have been limited to buying books, reading papers and watching interviews of experts to teach myself this field, but I have found it such an interesting topic as it encompasses such a major part of society and our personal lives that most people care a lot about but don't think about as a scientific discipline in the same way that they do as say, chemistry or cardiology. Sexology is a very understudied topic and I encourage people to think about entering endocrinology or psychology to better study it.”
Ritchie: “Sounds like it’s been a special interest for yourself. As for sexologists like Cantor and Bailey, they receive, what is in my opinion valid criticism for their stances on non-offending paraphilics, and I’m not sure its unwarranted. Whilst I agree it’s helpful to study for preventive measures, I do feel uncomfortable with the attempt to almost empathise with those individuals, which for those looking in is extremely distressing, more so for the victims who have not received such empathy themselves. What are your thoughts on that?”
G: “I understand the concern with paedophiles, it is a very uncomfortable topic for the vast majority of people to deal with.”
“There is some evidence that creating support groups for people with these desires and offering them counselling, psychiatry and medical sex drive reduction can help reduce their offending rates and improve their mental health.”
“I am not an expert in paedophilia and so I cannot say more, but I will say having those desires and not wanting to offend sounds like a hell on earth. Imagine being unable to ever love a man (or woman, if you so desired) because you knew by acting upon your urges you would be hurting someone; they are in a rough situation and I hope we as a society can fund and destigmatize researching treatments and rehabilitative resources for this population, as regardless of anything else, nobody chooses to have such desires. A German sexologist wants to export his controversial approach, but the idea faces legal and cultural hurdles.”
Ritchie: “You’ve previously mentioned in our group conversations, that you are meta attracted. Can you explain what that means?”
G: “Meta attraction is an Autogynephiles attraction to men although they are Autogynephiles (Autogynephiles are frequently portrayed as ONLY being into trans women or cis women sexually). I am attracted to men and trans women and my first sexual fantasies involved cisgender men, which seems to be atypical.”
Ritchie: “Me too, but again, many would argue this is normal homosexual/bisexual development, and the desire to be seen as a woman is something that makes that more acceptable in that persons mind. Did you ever experience internal homophobia? I’m asking because I certainly did, I hated the fact I was attracted to men.”
Ritchie: “Do you think there are any gaps in the typologies? And how can you distinguish between someone who just grew up in a homophobic environment, that was gay and someone who is meta attracted?”
G: ”I think you have to take a broader look at the individual, however I will say that there is a decent amount of evidence for "prehomosexuality" in children. Boys who turn out to grow up to become fabulous homosexuals oftentimes are much, much more effeminate prior to puberty. “
“The presence of this history is a good piece of evidence that they are not autogynephilic. There are other ways you can estimate it, however I would take the persons life history, their onset of dysphoria (HSTS have dysphoria prepubertally, AGPs usually don’t), and other proximal signs that could indicate one sign or the other.”
Ritchie: “You’ve passed comment on this previously, albeit in private, but you’ve noticed that many detrans men, fall into religion, specifically Catholicism. Do you have a theory why you think that might be?”
G: “I think they are oftentimes trying to substitute their autogynephilia with something that will both replace their feelings about gender and give them an easy "out" or excuse to leave the gender/sexuality world. Although I really think this is an understudied topic and I know we don't have easy scientific answers to it at this point, such a study could be an interesting topic for a sociologist to explore if they are into this field.”
Ritchie: “Should people who are aware of their AGP have children?”
G: “I would strongly discourage it, all psychological disorders are to varying degrees hereditary, and there is some suggestive evidence paraphilias run in families. There are at least two Autogynephiles in my maternal family and none on my paternal side as an anecdote. I believe that it is unfair to the child, or for that matter, their own potential children to bring them into this world and knowingly pass on unhygienic and undesirable traits they would likely benefit from not having. I feel similarly about persons with schizophrenia or drug addicts having children.”
Ritchie: “Final question. What are your hopes for the future of this discourse?”
G:”I hope that both sides are able to stop pushing for laws that will restrict and bind researchers from conducting important scientific research and that activists will respect individuals' wishes to transition or detransition without attacking their decisions and restricting the options available to them to one narrow path. Detransition, transition or neither can look like a lot of things and the more restrictions on either side in this field that are in place, the more suffocated people will feel to only choose one or two pathways.”
Ritchie: “G, thank you so much for your time.”
G: “My pleasure.”
Reflections from this series
Having been on both sides of this intense conversation, it’s clear to me that the human element has not only been overlooked, but has been discounted in exchange for sides and factions, each with their own nuances.
For the women involved, hearing the likes of Jennifer’s story goes to show how destructive Autogynephilia can be on a family, and how women are quickly demonised, and boundaries violated in the name progress. It feels insidious, yet lumping them in with the younger cohorts may not be correct.
Speaking of the young transitioners, it feels as though they are paying for the misdeeds of far older, unstable autogynaphilic married men, even though these groups are fundamentally different. When I first spoke out, I was accused of being an ex-offender, even though I’ve never been married, left a family behind or committed any crime. It was by virtue of transition that led to this judgement, and it felt as though that understanding was one dimensional, and fell onto me alone, and no one else.
What stands out from Anne and G versus radical trans activists, is their self awareness, perhaps that is the missing key here? That being said, Anne and G’s self-awareness may not be enough to discourage them from the path of transition and surgery, which many family members hope for.
There is also a very obvious personal challenge here, going out of my own comfort zone to understand reasonings that led me to transition. But again, as I reflected in the first part of this, I struggle to see the practical use of this understanding, outside of a clinical diagnostic tool. Even though both Anne and G are armed with this information, they still want to transition and want surgery.
People like Anne who continue to use male facilities should be at the very least commended, if not encouraged. Yet, my concern is that even though they are making concessions, it will never be enough. Some will claim that they are applying ‘woman face’ or wearing woman as a costume, and that in itself feels reductive, if not somewhat neurotic. No one has a monopoly on the expression of others, but neither do men have any rights to womanhood. I would never tell a woman with a masculine presentation, they are applying manface, so why is the inverse right? Where is the line? Is there one? I think when it comes to single sex spaces, that line is evidently clear, and the problem many Autogynephiles have, is that they lack critical self-awareness, and often breach boundaries because of that, and people like Anne, G and even myself will pay for that.
With regards to sexology, I can see why it makes many feel uncomfortable. The judgements can sometimes be reductive, and lack nuance themselves. For instance, if I’m in a same sex relationship, regardless of the origins of my desires, the outcome is the same, and unlikely to change, so again, how does it help to be classified as either Gay or Meta attracted? To me it seems to be creating friction within the factions that have these arguments. I often think of the line that, there are only ‘sexual acts’. Human nature dictates to understand something; it must be correctly labelled, and those labels appear to be emotionally charged, and lack critical thinking, especially in this field.
I wanted to also test the claim that people who understand sexology are less likely to transition, and I’ve come to realise this is far from the truth. Those who are neck deep in sexology, are just as obsessive as those who aren’t, and if anything, feel more validated in their transition. Therefore, I reject the notion that being educated on sexology, acts as a preventive measure for transition. In practice, it’s quite the opposite.
My concern is that suffering is being organised into a hierarchy, with some elevating themselves above others, and vice versa. And many hold righteous indignations for the proposed crimes of the other, yet neither Jennifer, G or Anne expressed that, the sentiment is rife on social media. This is perhaps a reflection of the overwhelming number of Autogynaphilic men who lack any self-awareness, who do impose their position on others, without any credence to the others.
For me, being honest and sincere is more important than being correct, and I’m not shy to change my opinion on these matters, but I do wonder what the future of this discourse will look like.
I’m concerned for our youth, for those who are in the fray of transition, and those who are being enabled to cross extraordinary boundaries in society and law. I wonder, if we had more Anne’s and G’s in the world, perhaps we’d have less Roxy Tickles, and more progression in treating the deliberating impacts of sex dysphoria.
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Your ongoing support, feedback, and well wishes keep me going! Thank you!
-Ritchie
Well that was fascinating. There truly are all different internalized understandings of transition. I appreciate hearing a different point of view. However, he seems to show his own bias in his discussion of ROGD. When people of my generation didn’t “fit in” we went to musical identities- heavy metal, rap, punk, goth- and we outfitted ourselves to match our affiliations. The idea that any young person “needs” to medically transition is very modern, very culturally specific, and very much in line with our Western culture’s obsession with the individual as opposed to the collective. I so enjoy reading your explorations and discussions with people on this topic! Thank you.
"I’ve never been married, left a family behind". But to be accused of this by women is very natural. It's not widely known that Miranda Yardley has an ex wife and a daughter. I wonder why so many women don't know that in the UK? I didn't know that until a younger woman showed me. It's really not surprising that the AGPs are so many and then they tell people they are gay.
To the female sex this sexual typologie doesn't matter. We don't protect ourselves from the sexual desires of men, we protect ourselves from the male sex, to which sexuality is a smaller and less important part. We don't care what you call yourselves or what you do. To impose males on women is Afganistan level of misogynist culture.