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Sex and Transsexuals

Are all male-to-female sex changes performed to correct a biological accident? A new book points to other reasons, and some transgendered people are furious at the implications.



"Sex, schmex," says Deirdre McCloskey. "I was a man for 53 years. I did not go through the trouble to become a woman, go through such a radical change, merely for sexual pleasure. If it were just about having sex with men, there are a lot more convenient ways to do that than to have gone through all this."

Tall and blond at 61, McCloskey is a professor of economics, history, literature, and communications at the University of Illinois at Chicago. In her 1999 book Crossing she says her decision to abandon her male life--during which she married and fathered children--let her find a much broader female identity, one with spiritual, emotional, physical, and, yeah, sexual dimensions. That's how she still explains it to anybody who asks.

J. Michael Bailey, chairman of Northwestern University's psychology department, doesn't think that's the whole story. In the most controversial section of his recently published book The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism he applies the theory of a Canadian sex-and-gender researcher to the cases of seven male-to-female transsexuals he met here in Chicago. The researcher, Ray Blanchard, is a professor of psychiatry at the University of Toronto and head of clinical sexology services at the Clarke Institute, and the theory in question boils down to this: all men who go through sex-reassignment surgery are motivated by one of two things. Either they're very, very homosexual and want to be penetrated by a man the way a woman is, or they're fixated on having a vagina of their own, maybe to be penetrated by a man, maybe by a woman, more likely by neither--it's arousing enough just to have a vagina.

No one seems to have good numbers on how many people worldwide have surgically crossed from male to female, but Blanchard says the vast majority of them are in the first category--homosexual transsexuals who usually transition in their 20s and 30s and emerge looking a lot like women. A small minority of transsexuals fall into the second category, and most of them transition later in life, sometimes in their late 50s. Many have lived fully male lives, including marrying women and fathering children, and they often retain more mannish physical features than homosexual transsexuals.

Bailey and Blanchard describe the transsexuals in the second group as having "autogynephilia," a term coined by Blanchard that means being attracted to one's own female sex organs. "Their primary sexual attraction is to themselves as straight women," Bailey says. "It's heterosexual attraction, but it's turned inward toward themselves, not outward toward a partner." Meaning they're turned on by a vagina, but they'd prefer it to be their own.

McCloskey and some other transsexuals say that transitioning from male to female is about wanting to have a fuller life by surgically repairing a biological accident, and they're incensed that Bailey and Blanchard are claiming that it's mostly about wanting to have sex in a particular way. They see Bailey's book as an all-out attack on them. "He's telling people like me, 'You're just a guy who wants a peculiar kind of sex,'" says McCloskey. "Can you see how that would be maddening to me?"

Bailey counters that even very intelligent people such as McCloskey can be so close to their own situation that they can't see it as clearly as an impartial social scientist looking at lots of similar cases. "This is not the way these people want to think of themselves--as having this narcissistic injury that made them men who were attracted to themselves as women," he says. "But also some of them have explicitly mentioned that the concept of autogynephilia is politically damaging, because it will make other people less sympathetic and maybe more frightened by transsexuals if [the general public knows that] some of them are motivated by this unusual sex thing."

According to Bailey, the particulars of individual cases don't say as much as the aggregate does about the phenomenon of men who feel so misplaced in male bodies that they have them surgically renovated. According to McCloskey, no one's more capable of understanding the phenomenon than the person who's been through it.

McCloskey and several other transsexuals have complained about Bailey to Northwestern officials who oversee faculty research, and in November they persuaded the university to investigate charges that Bailey didn't get informed consent from the Chicago transsexuals he interviewed for the book. Some transsexuals have roasted him on Web sites, even writing leering captions for pictures of his two children in an attempt to satirize his presentation of the case studies in his book. And they've called in eminent university scholars who are male-to-female transsexuals to denounce him.

Some transsexuals have said publicly that the autogynephilia concept actually does fit them. Willow Arune, a 57-year-old Canadian woman who identified most with lesbians when she was a man, crossed over at 49 and two years later learned about Blanchard's theory. Now an activist on transgender issues and in what she calls a partner relationship with another woman, she openly acknowledges that she's autogynephilic. She says that reading Blanchard's work, "I knew, this is on the right track. It explains what I was brought up to deny, and it lets me be free." She describes herself as "not 100 percent woman and not 100 percent male. I'm neither. I'm a transsexual woman." And she says that dovetails with Blanchard's description of an autogynephilic transsexual as a man who has successfully internalized a female love object--the person is still a man but with a female body of his own. (Bailey notes that to the extent that autogynephilics are attracted to others, they tend to be attracted to women.)

But plenty of people have been bashing Bailey, and not just transsexuals. Randi Ettner, an Evanston psychologist, counsels gender crossers before, during, and after the transition. She's written two books, the clinical Gender Loving Care: A Guide to Counseling Gender-Variant Clients and the more reader-friendly Confessions of a Gender Defender: A Psychologist's Reflections on Life Among the Transgendered, which got her a spot on Oprah. Ettner says Bailey's book has "had a crushing effect on the transgender community and the research on transgender issues. Transsexuals are so stigmatized and so misunderstood and so shamed. These are people who society has a lot of prejudice against to begin with, and this man from a major university is saying that they're basically just fetishists. That's very damaging."

McCloskey bashed Bailey probably harder than anyone in a 3,000-word article titled "Queer Science" in the November issue of the libertarian-leaning Reason. In the article she calls Bailey's methodology sloppy, his reporting lazy, his conclusions foregone and unscientific, his book a sop to right-wingers intent on keeping potential gender crossers in whatever gender they started life in. She calls him "homophobic" and "transphobic" and compares him to a guy in a lab coat selling laxatives on TV. She doesn't seem to like anything about Bailey's work except his writing style, which she calls "charming."

McCloskey has never met Bailey, and neither have most of the transsexuals who've allied against him publicly. But one of his fiercest critics, Anjelica Kieltyka, a 52-year-old transsexual who lives without a partner in Berwyn, has known Bailey for almost a decade. She's one of the key case studies in his book and was also the person who introduced him to most of his other subjects. "I was duped by Bailey," she says. "We worked together on very sensitive material, and the whole time he had a hidden agenda he didn't tell me about."

Kieltyka believes Bailey started with the assumption that for a subset of transsexuals the desire to cross genders is based on a sexual fetish, not a gender disconnect, then paid attention only to evidence that supported that assumption. "I thought we were working together, but he didn't see me as an associate," she says. "He was using me to get to my friends in the transgendered community."

Northwestern won't let Bailey talk much about Kieltyka, because it's interviewing her as part of its investigation into whether he got informed consent from his subjects and because she threatened to sue him and the university over the book. But he does say this: "Anjelica and I had a very friendly relationship, but we disagreed all along on some things, including whether she was motivated by autogynephilia."

In 1994, two years after her surgery, Kieltyka saw Bailey on a TV talk show discussing whether tomboys were destined to grow up to be lesbians. She says that in her life as a man she was a decidedly unfeminine roughhouser who was into baseball and cars and that much of that masculine side is still expressed in her life as a woman. "My masculinity as I became a woman could easily be understood as a lesbian tomboy," she says. "I called Bailey up and asked if he was interested in doing some research on transsexuals. 'Have me come down there and talk to you, do some educating.'"

Early in his career Bailey, who's now 46, did some research on IQ testing and on schizophrenia, but most of his time has been spent studying men who don't fit their gender's norms. When Kieltyka saw him on TV he was studying the links between male gender nonconformity and homosexuality. "It's not that all gay men are like women," he says. "But some gay men are kind of like women in certain ways, and I found this interesting. Particularly during childhood there's a strong link. Boys who want to be girls tend to grow up to be men who like men."

His research eventually led him to look at male-to-female transsexuals. By about 1996 he and his assistants were hanging out at nightspots like Crobar trying to recruit research subjects. "Farm boys from Iowa don't sign up to work in my lab," he says. "The people who worked with me all thought it was very cool to be doing this."

Kieltyka introduced him to several males she knew who were getting ready to change genders. She thought it would help both parties: Bailey would meet the kind of people he was looking for, and the men would get letters from a psychology professional supporting their decision to have sex-reassignment surgery, something they have to have before the surgery can be authorized. Kieltyka says that over the years she also spoke to several of Bailey's classes. She felt she was an integral part of his research team.

Kieltyka, McCloskey, and others are now trying to portray Bailey, Blanchard, and other writers, scholars, and clinicians as part of a broad conspiracy to keep potential gender crossers from making the transition. They say the Clarke Institute is peddling research that discourages clinicians from endorsing sex-reassignment surgery for autogynephilics. After the right-wing National Review published a positive essay on Bailey's book, McCloskey says, "the religious right picked Bailey up as their own." Lynn Conway, a transgendered retired professor of electrical engineering and computer science at the University of Michigan, lists on her Web site many of the links she's found between Bailey, Blanchard, and Clarke and right-wingers, religious groups, and others who might oppose the rights of transgendered people. McCloskey says, "It's not so much Bailey's book but his allies who are really scary."

"The idea that I am part of an antigay, antitranssexual conservative conspiracy is laughable," says Bailey. "If you have been following conservative attempts to block funding for sex research, especially research focusing on gay issues, you will see my name prominently featured as a target." He then mentions a Web link at that features his research--and not in a good way. Moreover, he says, "I explicitly say in the book that I favor treatment of transsexuals."

And that's another issue. Bailey wants to see autogynephilia included in the psychiatric industry's big book of disorders, the Diagnostic and Statistical Manual of Mental Disorders. McCloskey, Kieltyka, and others say a DSM listing would brand them as pervs. Kieltyka says she introduced herself to Bailey as part of her larger campaign to "find a psychological professional who would help me get transvestite fetishism out of the DSM, where it doesn't belong." She isn't a psychological professional, but she says her personal experience and advocacy work with other transsexuals have shown her that transvestite fetishism isn't a mental disorder. McCloskey, who's firm in her conviction that getting sex-reassignment surgery is a personal choice that shouldn't be restricted by any government or institution, insists that putting autogynephilia in the DSM will simply give people who oppose the surgery an excuse to deny it to candidates. In her Reason article she writes, "Bailey and his conservative friends hope to get autogynephilia into the next edition of the DSM, in order, I suppose, to prevent free people from doing what they harmlessly please. Great idea."

Blanchard, who happens to be an American citizen, says a DSM listing has different implications in Canada than in the U.S. "This question of whether autogynephilia should be listed as a disorder is strictly an American preoccupation," he says. "In the U.S. there is no universal health insurance plan, so people will pay for their SRS out of their own pocket. But in most of the Western world, where there is government-run health insurance, in order for their sex reassignment to be paid for, it has to be a disorder, it has to be in the DSM. Health plans don't pay for surgery that is elective. They pay for surgery that is medically necessary."

He points out that from 1970 to '99 the Ontario Health Insurance Plan covered sex-reassignment surgery for patients who'd been approved for it by the Clarke Institute. But the conservative government that came to power in 1999 stopped paying for it. "Now a group of transsexuals have brought a human rights complaint against removal of sex-reassignment surgery as a benefit," he says. "Their argument is that this is a recognized treatment for a psychiatric disorder. It's got to remain in the DSM. The DSM has no formal jurisdiction in Canada, but in fact it's taken as the standard."

Transsexuals who oppose listing autogynephilia in the DSM are troubled by its proximity to pedophilia in the classifications, something that troubles Bailey too. "Autogynephilia is a paraphilia--it's in the same class as some bad things like pedophilia," he says. "I hasten to add that I don't think there's anything immoral or harmful necessarily about autogynephilia. But there are scientific reasons--it's not arbitrary that autogynephilia and pedophilia are lumped together. There's something similar, not in the harmfulness of them but in the fact that they are both atypical sexual orientations and they are both phenomena that are found only in males as far as we can tell."

Some transsexuals are opposed to the listing of autogynephilia because they don't believe it was a motivation for them and don't want anyone assuming it was. McCloskey, who won't discuss her current sex life, says that nothing in her past or present fits the definition of autogynephilia. As Don McCloskey she was married for 30 years and had two children. She taught economics at the University of Chicago for 12 years, then at the University of Iowa for 19--the first 14 as a man and the last 5 as a woman--before coming to UIC in 1999. Don had feelings that he wanted to be a girl from age 11, but repressed them as much as possible. Deirdre says she had "a completely guy life. I was captain of my high school football team, and I was a rough, tough guy. And that was not overcompensating--I was a guy. I started to cross-dress, and it became a hobby, a sideline that my wife knew about. I was a cross-dresser, a heterosexual cross-dresser. I conceived two children and didn't ever when I was having sex with a woman think, 'Oh, I wish it was me! I wish it was me!'"

It was never about sex, always about gender identity, McCloskey says, though she acknowledges that "it was often sexualized. When I would masturbate I was often dressed [as a woman]. But big deal--guys masturbate about all kinds of things."

Bailey has read McCloskey's book and says he sees "all the hallmarks of autogynephilia."

That makes McCloskey livid. "He reduces it all to sex, sex, sex," she says. "Nothing about identity."

Arune, the Canadian transsexual who supports Bailey, says, "Oh, my big fat foot! They all want to say they became women for higher, noble reasons. They were born with this birth defect called a penis, and they are pure of heart and noble of purpose and not motivated by sexual matters. That's a mystique they invented, and their counselors helped them invent it to gain acceptance."

Ettner, the Evanston psychologist, argues that the autogynephilia diagnosis is "such an oversimplification." She says Bailey "wants to pigeonhole these people."

As a social scientist, Bailey says, he has the goal of finding the commonalities among groups of individuals--individual differences exist, but they're less important than the very similar underlying motives. To the people he's writing about, that can seem procrustean. He responds, "Nobody has the right to claim they know the objective truth about themselves."

Arune agrees. "Let's face it, honey," she says. "We're the patients in this exercise. We're not the experts."

Bailey suggests that some transsexuals who insist autogynephilia didn't motivate them are just covering up something they're embarrassed about. He says, "Blanchard has shown in a couple of clever studies that nonhomosexual transgender patients who deny autogynephilia still show evidence for it." Kieltyka, for example, wore a homemade artificial vagina before she got one surgically. She describes that as an identity issue. Bailey labels it a fetish.

"People kind of take whatever transsexuals say about themselves at face value," Bailey says, "even when it seems quite implausible." For instance? "Well, I gather Donald McCloskey was a very aggressive, masculine man, though Deirdre says he was really a woman inside. What does that mean really? What does it mean to say you were a man but you 'felt like a woman'?"

Arune gladly admits that she denied any trace of autogynephilia when she applied to have sex-reassignment surgery. "I had been a lawyer, so I did what lawyers do," she says. "I exposed things that would help my side, and I concealed things that would not help." While living as a woman before the surgery, she says, "I was a lesbian, but I didn't tell them that. I told them I was heterosexual, because, honey, they want Prince Charming. So I gave them Prince Charming--a macho, heterosexual guy who would rather be a woman. They set up gatekeepers, and the only way past is to give the gatekeepers what they want."

Arune says she understands why McCloskey, Kieltyka, and other gender crossers have attacked The Man Who Would Be Queen so vociferously. "These trannies are older when they transition," she says. "They're not the young, beautiful ones who were living as women from an early age. They had maybe 50 years of being males and being forceful and aggressive and shouting to get what they want as men. They're only a few years, relatively, into their lives as women when they have these strong feelings that Bailey is wrong, but they don't yet know how to control feelings the way a woman would, so they go about arguing against him in a very male way. I know that's the worst insult I can aim at a fellow tranny, but look, these people like McCloskey and Conway are used to being powerful in their respective occupations, and they demand to be listened to."

Art accompanying story in printed newspaper (not available in this archive): photos/Andre J. Jackson.

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