Earlier today I wrote this thread in response to a follower who asked me, “What is your actual position on transgender people?” It looks like my reply has not been delivered to a single person besides the original inquirer, so I am reposting it here.
My beliefs include the following 6 elements: (1) Transsexualism and milder forms of gender dysphoria are types of mental disorder, which may leave the individual with average or even above-average functioning in unrelated areas of life.
(2) Sex change surgery is still the best treatment for carefully screened, adult patients, whose gender dysphoria has proven resistant to other forms of treatment.
(3) Sex change surgery should not be considered for any patient until that patient has reached the age of 21 years and has lived for at least two years in the desired gender role.
(4) Gender dysphoria is not a sexual orientation, but it is virtually always preceded or accompanied by an atypical sexual orientation – in males, either homosexuality (sexual arousal by members of one’s own biological sex) . . .
or autogynephilia (sexual arousal at the thought or image of oneself as a female).
(5) There are two main types of gender dysphoria in males, one associated with homosexuality and one associated with autogynephilia. Traditionally, the great bulk of female-to-male transsexuals has been homosexual in erotic object choice.
(6) The sex of a postoperative transsexual should be analogous to a legal fiction. This legal fiction would apply to some things (e.g., sex designation on a driver’s license) but not to others (entering a sports competition as one’s adopted sex).

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More from @BlanchardPhD

Oct 3, 2020
<< Difference Between Old-Time (≈1970–1990) And Contemporary Transsexualism Specialists >>

1 of 4: Old-time clinicians did not adopt patients’ perceptions and viewpoints *as their own*.
2 of 4: Old-time clinicians understood that patients had some incommunicable sensation of “truly” belonging to the opposite sex, and they judged that certain severe, intractable cases would be happier approximating the appearance and social role of the opposite sex.
3 of 4: They did not, however, believe that patients actually *were* the opposite sex in their Platonic essence or in some other regard.
Read 4 tweets
Jul 28, 2020
The reason I emphasize postoperative transsexuals’ access to washrooms is because the ability to void outside of private homes is important for participation in normal life, including work. 1/5
Gender-critical folk who do not want male-to-female transsexuals using women’s washrooms could simply argue that the necessity of urinating or defecating while in public is transsexuals’ problem, not women’s problem, and that it is up to transsexuals to cope as best they can. 2/5
That viewpoint, however, is out of tune with modern sensibilities, which prohibit any expression of “That’s your problem, not mine” toward any minority group, even when such a stance might reasonably be justified. 3/5
Read 5 tweets
Jul 23, 2020
This is a thread about the recent study by Jabbour et al., Robust evidence for bisexual orientation among men. PNAS, pnas.org/content/early/….
Phallometric testing was invented as a penile lie detector, and it is still used for the clinical diagnosis of pedophilia in sexual offenders against children, especially when diagnosis from the patient’s history alone is uncertain. ImageImage
Many people, including many gay men, have asserted that self-described bisexual men are attempting to deceive themselves or to deceive others. Throughout much of the 20th century, many experienced and sophisticated clinical experts also believed this.
Read 4 tweets
Jan 3, 2020
I’m going to stop tweeting about “reasonable compromise” after this thread, because it’s been unproductive. Here are my final thoughts, which pertain to adults only. 1/5
Compromise for women: I think that male-to-female (MTF) trans should be allowed in women’s rest rooms after vaginoplasty. 2/5
Compromise for trans: There is no basic need (comparable to urination) to swim in a public pool or exercise in a public gymnasium, and MTF trans should stay out of women’s locker rooms and showers, even if they’ve undergone vaginoplasty. 3/5
Read 5 tweets
Nov 19, 2019
Here is my contribution to Autogynephilia Awareness Day. Shortly after I began assessing and researching men with paraphilias and gender identity disorders, I realized that empathy was not going to take me very far.
Either one feels sexual excitement at the thought of putting on women’s underwear, or touching a young child’s genitals, or showing one’s penis in public to strangers, or being bound and gagged - or one does not.
Empathy will not help you experience the same feelings. One comes to understand paraphilias and gender identity disorders the same way one comes to understand mathematics or history or geology - by studying and thinking.
Read 4 tweets
Sep 30, 2019
Something I read recently on Twitter prompted me to write this thread. It concerns the days when gender identity clinics were generally associated with university hospitals (roughly, 1970’s and 80’s), and when these clinics operated on the “gatekeeper” model. 1/7
One sometimes hears or reads transsexuals brag that they “told the clinicians what they wanted to hear” and so manipulated clinical staff into writing prescriptions for sex hormones or letters of approval for sex reassignment surgery. 2/7
In fact, clinical authorities had been writing since 1972 (at the latest) that some adult gender patients were “unreliable historians,” who retrospectively distorted their childhood histories to give the onset of their gender dysphoria an earlier date. 3/7
Read 7 tweets

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