Gender Identity Disorder Information


The terms which follow on this page are NOT part of the clinical diagnostic classifications in neither the DSM-IV nor ICD-10. While GID likely does encompass many, if not all, of the classifications on this page, they are not widely accepted as clinical terminology, if at all. To see the exact clinical defintions read the "WHAT IS GID?" page.


This is a colloquial term that emerged relatively recently. The exact meaning of the word is a subject of debate. The coining of the term is usually attributed to Charles "Virginia" Prince, a "full time" male to female crossdresser (meaning he wished to present himself dressed as a woman but not become physically female). However, the specific reference to first usage remains elusive. If you read Issue 60 of The TV/TS Tapestry, you'll see a letter from Prince promoting the term "Bigendered". That was 1991, and the term "transgender" apparently hadn't yet been proposed.

Prince wrote:

... Now I think it is time and necessary to generate a new and acceptable term for us.

I say necessary because there is an aspect of this terminology problem that has not been given much consideration, but which is vitally important, and that is the public perception of whatever term is used. Whether we like it or not, the public needs to have a descriptive term which they can easily understand and use, which is also acceptable to members of our community. We are not like alcoholics, drug abusers, criminals, voyeurs, pederasts, schizophrenics, epileptics, or a million other types of people. Therefore, we need a handle by which others can comfortably refere to us, distinguish us from other types of people, and which is positive and not condemnatory.

"Bigendered," while still in use in some circles, never had the wide acceptance of "transgendered" but the belief is that Prince's intentions were the same - to coin a word that would distinguish full-time crossdressers like himself from transsexuals (and other groups). If true, it is rather ironic because the term "transgender" is now generally accepted as an "umbrella term" encompassing ALL contrasexual presentations, identifications, and behaviors. It is the common-usage equivelent of the medical classification "Gender Identity Disordered / Gender Dysphoric."

That being said, in some places it remains more associated with transvestiticism while in others it is now more associated with transsexualism. Some transsexuals prefer it as a means to "de-sexualize" their condition as the suffix "-gender" focuses attention on the subject of GENDER whereas the suffix "-sexual" concentrates on SEX - often perceived to mean sexual activity or orientation (in the same vein as "heterosexual," "bisexual," or "homosexual.").

If your intent is accuracy it may be wise to avoid applying the term to anyone altogether unless they've already applied it to themselves, and if you aren't sure what they mean by it, ask them before making any assumptions.


This is a contraversial THEORY about motivation for some contrasexual behavior. It is not part of the official medical diagnostic criteria and is mentioned here for informational purposes only. It is, however, used for diagnostic purposes at the University of Toronto and the affiliated Clarke Institute, where the theory was formulated. Other than the Clarke Institute and a scattered few private therapists, the theory has not been widely accepted by the Psychology Community.

The term autogynephilia was coined in 1989 by Ray Blanchard, a clinical psychologist at the Clarke Institute of Psychiatry in Toronto. Blanchard hypothesized that there are two fundamentally different types of gender dysphoric males: those who are exclusively or almost exclusively aroused by men, i.e., who are androphilic ; and all the rest, who, as it turns out, are primarily aroused by the idea of being women, i.e., who are autogynephilic. Note that it says IDEA - which means that a person could be unconflicted, never actually engaging in any contrasexual behaviors, but could be aroused by the fantasy of it.

Perhaps Blanchard explained this motivation best when he wrote: "Autogynephilia takes a variety of forms. Some men are most aroused sexually by the idea of wearing women's clothes, and they are primarily interested in wearing women's clothes. Some men are most aroused sexually by the idea of having a woman's body, and they are most interested in acquiring a woman's body. Viewed in this light, the desire for sex reassignment surgery of the latter group appears as logical as the desire of heterosexual men to marry wives, the desire of homosexual men to establish permanent relationships with male partners, and perhaps the desire of other paraphilic men to bond with their paraphilic objects in ways no one has thought to observe."

DSM-IV Sexual and Gender Identity Disorders: Paraphilias [defined as recurrent, sexually arousing fantasies, sexual urges or behaviors generally involving 1) non-human objects, 2) the suffering or humiliation of oneself or one's partner, or 3) children or other non-consenting persons.]

  • 302.4 Exhibitionism
  • 302.81 Fetishism
  • 302.89 Frotteurism
  • 302.2 Pedophilia
  • 302.83 Sexual Masochism
  • 302.84 Sexual Sadism
  • 302.3 Transvestic Fetishism
  • 302.82 Voyeurism

Strictly speaking, though, if it is recurrent, sexually motivated fantasy, urges, or behaviors regarding oneself it would be categorized as a "Paraphilia." Notice that "Transvestic Fetishism" is also lumped into this category. Please note that the Greek root "philia" means "love or fondness," NOT "perversion!"

Blanchard's general criteria to identify the presence of autogynephilia were something like this: If the person is NOT a homosexual, did NOT have gender conflicts early in life, and IS aroused by contrasexual fantasy, behavior, or activities; the condition is found to be present. There are also sub-classifications by type or arousal:

  • from crossdressing or from clothing of the opposite sex (transvestic)
  • from acting in a contrasexual manner or showing an interest in contrasexual activities (behavioral)
  • from fantasizing about having physical attributes of the opposite sex (physiologic)
  • and/or from actually altering physical appearance to be more like that of the opposite sex (anatomic)

Many transsexual people despise this theory or are even offended by the sexualization of their problem. Within the Transgender Community there are transsexual people who assert that anyone who identifies as an autogynephile is not really transsexual, but has some unrelated form of gender fetish in the same way that a crossdresser is not the same as a transsexual, many transsexuals argue an autogynephile is also distinct and different from a transsexual. Autogynephiles have been described as "Men trapped in men's bodies," a turn of phrase used to indicate they are/were never psychologically female, even after they may have undergone SRS to become phenotypically female. While this may be true for some autogynephiles, there also appears to be subset of psychologically female transsexuals (many lesbian in orientation) who, at some point, acknowledge experiencing sexual attraction to themselves or arousal from some "feminizing" process they've undergone. Some of them simply accept this as "normal," while others worry it somehow invalidates their identity as either a transsexual or a woman. It should be noted, however, there are natal women who also experience self-arousal or attraction so it isn't necessarily an experience exclusive to fetishistic transsexual narcissists, though no studies have been done to clinically identify the behavior in natal women (or anyone other than non-adrophilic transsexual women), so there is simply no way of knowing how "normal" or "unusual" this sort of auto-erotic reaction may be within the general population.

If you really want to know more about this theory, you might start by reading self-described transsexual autogynephile and clinical Sexologist Dr. Anne Lawrence's article HERE.

"Transgender" Types

In 1966 Dr. Harry Benjamin, an Endocrinologist who pioneered the standardized treatment of transsexuals, published a scale to "type" transgendered people. This was very similar to the scale developed by Dr. Alfred Kinsey for categorizing sexual orientations.

The Kinsey Scale of Sexual Orientations:

Type 0: Exclusively heterosexual with no homosexual experience
Type 1: Predominantly heterosexual, only incidentally homosexual
Type 2: Predominantly heterosexual, but more than incidentally homosexual
Type 3: Equally heterosexual and homosexual
Type 4: Predominantly homosexual, but more than incidentally heterosexual
Type 5: Predominantly homosexual, but incidentally heterosexual
Type 6: Exclusively homosexual, with no heterosexual experience

The Benjamin Sex Orientation Scale (S.O.S.) or Gender Identity Scale
Sex and Gender Role Disorientation and Indecision (Males):

Type 0 - "Normal"
Type 1 - Transvestite - (Pseudo)
Type 2 - Transvestite - (Fetishistic)
Type 3 - Transvestite - (True)
Type 4 - Transsexual - (Non-Surgical)
Type 5 - True Transsexual - (Moderate Intensity)
Type 6 - True Transsexual - (High Intensity)

Please note that this is Dr. Benjamin's ORIGINAL scale from 1966. The term "True Transsexual" has since been dropped from the nomenclature. The criteria for the "Modified Benjamin Scale" are as follows:

Normal sexual orientation and identification, heterosexual, bisexual or homosexual. The ideas of "dressing" or "sex change" are foreign and unpleasant. Includes the vast majority of all people.

TYPE I - Tranvestite (Pseudo)
Gender "feeling" : Masculine
Dressing Habits and Social Life : Normal male life. May get a "kick" from "dressing". Not truly TV.
Sex Object Choice and Sex Life : Usually heterosexual. Rare bisexual. Masturbation with fetish. Feels guilt. "Purges" and relapses.
Conversion Operation (SRS) : Not considered in reality.
Hormone Therapy/Estrogen Therapy : Not considered. / Not indicated.
Psychotherapy :Not wanted. Unnecessary.
Remarks : Only a sporadic interest in "dressing". Rarely has a female name when "dressed".

TYPE II - Transvestite (Fetishistic)

Gender "feeling" : Masculine
Dressing Habits and Social Life: Lives as a man. Dresses periodically or part time. Dresses under male clothes.
Sex Object Choice and Sex Life :Usually heterosexual. May be bisexual or homosexual. "Dressing" and "sex change" in masturbation fantasy mainly.
Conversion Operation (SRS) :May consider in fantasy. Rejected
Hormone Therapy/Estrogen Therapy : Rarely interested. / May help to reduce libido.
Psychotherapy : May be successful in favorable environment.
Remarks : May imitate male & female double personality with male and female names.

TYPE III - Transvestite - True
Gender "feeling" : Masculine (but with less conviction)
Dressing Habits and Social Life : "Dresses" constantly or as often as possible. May live and be accepted as a woman. May dress under male clothes.
Sex Object Choice and Sex Life : Heterosexual except when dressed. Dressing gives sexual satisfaction, relief of gender discomfort. Common to purge and relapse.
Conversion Operation (SRS) : Rejected but the idea is attractive.
Hormone Therapy/Estrogen Therapy : Attractive as an experiment. / Can be helpful as a diagnostic.
Psychotherapy : If attempted, almost never successful as to cure.
Remarks : May assume a double personality. Trend may be toward Transsexualism

TYPE IV - Transsexual - Non-Surgical
Gender "feeling" : Uncertain Wavering between TV and TS. May reject "gender".
Dressing Habits and Social Life : "Dresses" often as possible with insufficient relief of gender discomfort. May live as man or as a woman.
Sex Object Choice and Sex Life : Libido low. Genrally asexual or autoerotic.May be bisexual.
Conversion Operation (SRS) : Attractive but not required.
Hormone Therapy/Estrogen Therapy : Needed for comfort & emotioal balance.
Psychotherapy : Only as guidance, most often refused and unsuccessful.
Remarks : Social life dependant on circumstances. Often identifies as "transgenderist".

TYPE V - Transsexual - Moderate Intensity
Gender "feeling" : Feminine "Trapped" in a male body.
Dressing Habits and Social Life : Lives and works as a woman if possible. Insufficient relief from "dressing".
Sex Object Choice and Sex Life : Low libido. Asexual, autoerotic, or passive homosexual activity.May have been married and have children.
Conversion Operation (SRS) : Requested.
Hormone Therapy/Estrogen Therapy : Needed for a substitute for or preliminary to SRS operation.
Psychotherapy: Rejected. Unless as to cure. Permissive psychological guidance.
Remarks : Operation hoped for and worked for, often attained.

TYPE VI - Transsexual - High Intensity
Gender "feeling" : Feminine. Total "psycho-sexual" inversion.
Dressing Habits and Social Life : Usually lives & works as a woman. No relief from "dressing". Gender discomfort intense.
Sex Object Choice and Sex Life : Intensly desires relations with normal male as a "female" if young. Later libido low. Heterosexual, bisexual or lesbian identification. May have been married and have children.
Conversion Operation (SRS) : Urgently requested and usually attained.
Hormone Therapy/Estrogen Therapy : Required for partial relief.
Psychotherapy : Psychological guidance or psychotherapy for symptomatic relief only.
Remarks : Despises her male sex organs. Strong danger of genital self-mutilation or even suicide if too long frustrated before SRS is attained

[Original version: Harry Benjamin © 1966, Julian press, Modified version: Anne Curr © 1995, Basic Books]

In the past doctors believed a person HAD to meet the criteria for a "True Transsexual" to be diagnosed and treated as one. Surgical reassignment, in most cases, was only recommended for those who met the criteria for a Type VI True Transsexual. This meant that the person HAD to intensely desire surgical reassignment and HAD to homosexual (as determined by birthsex - in other words, if born male they had to be attracted to men). In many cases these people also had to be hyper-feminine, self-mutilating, and suicidal. Studies supported the observation by therapists that these strict criteria were rarely encountered in a clinical setting, and in many of the cases where they were it was later discovered the patients had lied to the doctors to obtain the Type IV diagnosis and a recommendation for immediate surgical reassignment. Those who still adhere to the original Benjamin Scale (many of them post-op transsexuals who were diagnosed under it) claim the studies and observations used to overturn the "true transsexual" criteria were "tainted" because therapist had simply misdiagnosed people who where not "truly transsexual" as being transsexual. The detractors sometimes cite the fact that - in the past - all post-op transsexuals met the strict criteria, which is of course circular logic, because if they did't they wouldn't have got the diagnosis to be cleared for surgery in the first place. Whether they like it or not, the Benjamin Scale has been modified by modern medicine to recognize that a person CAN have a female gender identity, be sexually attracted to women, and be something of a "Tomboy" while having a desire for sex reassignment surgery. In other words, a stereotypically feminine, heterosexual outcome is no more a requirement today than it is for natale females.

It should go without saying, but unfortunately doesn't, that these types and categories are not meant to classify one person as being "better" than another person. Nor do these two highly generalized categories describe the life experiences of EVERY transsexual person.

For more detailed information on the role these terms, types, and categories play in the "Transgender Community" please read the section on the TRANSGENDER COMMUNITY.

Primary & Secondary Transsexuals

These terms apply to both female-to-male (F2M) and male-to-female (M2F) transsexuals.

Primary Transsexuals: Usually behave like their target sex from childhood. They feel they are (or should be) members of the 'opposite' sex before puberty. They rarely doubt their convictions that they are/should be a member of their target sex. If they do and try to conform to their biological sex's gender role, they don't do very well at blending into the expected gender role. Primary transsexuals are often sexually attracted to their biological sex (i.e., classified as "homosexual" by most doctors). Primary transsexuals are either living as their target sex or requesting sex reassignment surgery (SRS) by the time they are 25 years old. With very supportive parents they sometimes even have SRS at 18 years old. Primary M2F transsexuals are usually obviously feminine and primary F2M transsexuals are quite masculine. Many primary transsexuals are ill received by secondary transsexuals for playing into gender stereotypes or because primary transsexuals tend to transition at a younger age with better physical results and socialization in their target gender role than secondaries usually achieve.

Secondary Transsexuals: Usually don't 'come out' until almost 40 years old or later, often in the midst of a mid-life crisis. The most striking feature of secondary transsexuals is how, despite a deep conviction of being their target sex, their gender behavior is still quite a lot like that of their biological sex. They say they went into deep, long-term denial and they often highly successful in the gender role of their biological sex. Even after transitioning their gender behavior still isn't all that much like their target sex. Especially in the case of M2F secondary transsexuals there are often charges that they simply aren't "trying hard enough" to fit into a female gender role, or that they want to "have thier cake and eat it too" by trying to maintain the patriarchal power they enjoyed while living as men.

Secondary transsexuals report higher rates of regret and less social adjustment than primary transsexuals do. Some researchers and transsexual people alike question if the distinction into these two categories is really appropriate. No matter how or if you categorize 'types' of transsexuals, almost all research on SRS shows very positive outcomes, with the exception of a major study saying SRS wasn't effective (Meyer and Reter, Arch. Sex. Behav. 9: 451-456) which ultimately proved so methodologically flawed the conclusions cannot be trusted. [reference: Fleming M, Steinman C, Bocknek G (1980), Methodological Problems in Assessing. Sex-Reassignment Surgery:]

"The Three Dysphorias"

Within some quarters of the Transgender Community you might hear terms like "The Three Dysphorias" or references to the individual "Physical Dysphoria" or "Social Dysphoria." These concepts seem absent and largely ignored by academic circles, but seem quite obvious to many transgender people. While everyone seems to have their own ideas about these, this is what I've gleaned from the Internet as a definition:

Physical Dysphoria - this refers to the amount of unhappiness an individual has with their physical form or appearance.

Social Dysphoria - refers to the amount of unhappiness an individual has concerning their social interaction (i.e., "gender role").

Identity Dysphoria - refers to the degree of a person's self-perception is that of the opposite gender, including emotionally and cognitively, as well as their beliefs concerning how others perceive them.

A person can have any combination or intensity of these factors, which will shape the nature and intensity of that person's overall Gender Dysphoria. It is believed that these three variables explain the diversity of gender dysphoria expressed within the Transgender Community - for example, why some people are comfortable with just crossdressing in private and have little or no unhappiness with their identity, while others have great unhappiness about identity and are driven to change their bodies and social role.


Please do not use this information to "diagnose" yourself. Although GID is a "condition" that is often described as "self-diagnosed" you should seek the help of a qualified therapist specializing in gender psychology. A good list of therapists is available at Dr. Becky Allison's web site.

For more information on the diagnosis and treatment of Gender Identity Disorders also see the Standards of Care section. A fairly comprehensive "patient information" article is available from eMedicine.