Sex Differences in Sexuality: A Key to Understanding Autogynephilia

Understanding sexual arousal, sexuality, and the male propensity for paraphilias set the stage for understanding autogynephilia.

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About the Author

Dr. Michael Bailey is an American psychologist, behavioral geneticist, and professor at Northwestern University best known for his work on the etiology of sexual orientation and paraphilia. As professor for 35 years, and a researcher for over 40, Bailey has published over 100 academic articles.

Bailey is a leading expert on the topic of autogynephilia, the phenomenon of males being aroused by the thought or image of themselves as female. In 2003, Bailey wrote The Man Who Would Be Queen, a book that examines gender identity, sexual orientation, and the role of autogynephilia in male-to-female transgender experiences.

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Ray Blanchard, who originated both the term and theory, defined autogynephilia (AGP) as “a male’s propensity to be sexually aroused by the thought of himself as a female.” AGP is a form of sexuality present in some natal males.

Before delving into AGP—next essay, I promise—we will explore what we know about human male and female sexuality, with a special emphasis on sex differences in sexual orientation. This is important for two reasons: first, AGP occurs in males but not females, and aspects of AGP can be better understood by comparing it with normal male sexual orientation. Second, a significant proportion, possibly the majority, of gender-critical individuals are women. Their comprehension of AGP may be limited if they are not familiar with the typical sex differences in sexuality.

Sex differences in sexual orientation are particularly relevant. I have spent most of my career studying sexual orientation as it is usually understood: attraction to men, women, or both. In the mid 2010s, I was approached by the organization UNAIDS due to concerns about proposed legislation in Uganda that would increase criminal penalties for homosexuality. They asked me to rebut unscientific claims being used by Ugandan legislators to justify the legislation. I organized a panel of experts and, in 2016, we published a comprehensive review of the scientific knowledge on sexual orientation. This review covers the definition and assessment of sexual orientation, its development and causes, ethical considerations (“Are the causes of sexual orientation relevant to its moral standing?” No.), and crucially, sex differences in the distribution and expression of sexual orientation. I strongly recommend our article to anyone seeking an in-depth understanding of sexual orientation. (Sadly, Uganda has continues to pursue an anti-homosexual agenda despite our efforts.)

Some Sex Differences in Sexual Psychology Are Large

There has been a tendency to downplay sex differences in sexuality, perhaps for ideological reasons. It’s true that both men and women aim for sexual satisfaction. However, there are notable differences between the sexes, such as:

Sex Drive

Sex drive refers to the strength of the desire to engage in sexual behavior, particularly for orgasmic release. One of the best indicators of sex drive strength is the frequency of masturbation. Unlike partnered sex, masturbation reflects only the masturbator’s motivation. A recent review of sex differences in sex drive concluded that the difference was “medium-to-large”: “Men more often think and fantasize about sex, more often experience sexual affect like desire, and more often engage in masturbation than women.”

An important cause of this sex difference is the level of circulating testosterone, which is considerably higher in men than women, on average. Castration of sex offenders is highly, if imperfectly, effective in preventing recidivism. However, for men with normal levels of testosterone, increasing these levels does not boost their sex drive; the picture is similar for women.

I suspect few will be surprised by the fact that men’s sex drives, on average, are higher than women’s. But I sometimes feel that women underestimate the strength of this motivation in men.

Casual Sex Interest

Men are more interested than women in having emotionally uncommitted sex, sex with attractive strangers, and one-night stands. Although most men do not engage in casual sex, many more would if given the opportunity—provided they do not wish to remain faithful to their partners. This sex difference has been verified across cultures.

Interest in Visual Sexual Stimuli

Men are more interested than women in viewing attractive naked people of their preferred sex. Arousal is heightened when these attractive people are engaged in explicit sexual activity. Thus, men like and use pornography more often than women. The causes and consequences of pornography usage have been topics of longstanding controversy. I won’t get into that here.

For now, what’s important to note is that pornography use is common among men, regardless of their sexual orientation, and it is more prevalent than among women. Men’s primary motivation—at least their proximate motivation—is orgasmic release. Pornography facilitates men’s sexual arousal during masturbation, leading to a quicker and more intense orgasm. (That is a main reason why we got the Internet.) Men—and adolescent boys—seek out the kinds of pornography most sexually arousing to them. And men with different sexualities find different kinds of pornography arousing.

When I was a teenager in the early 1970s, there was no Internet and the only visual pornography available was pictures in magazines. The Playboy and Penthouse centerfolds I occasionally saw were much tamer than pornography readily accessible online today. However, viewing these images of attractive nude women was sexually arousing because I was/am a heterosexual male. These experiences didn’t make me heterosexual. These experiences did not determine my sexuality; my sexuality was there already. Similarly, many gay men had the experience of viewing the same centerfolds and wondering what the fuss was about. For gay males who recognized their sexuality after encountering gay pornography, these materials did not cause their homosexuality but rather illuminated it.

Interestingly, lesbians tend to be more aroused than heterosexual women by visual sexual stimuli. Though not as much as men.

Sexual Orientation

Several interesting sex differences in the expression of sexual orientation are probably caused by one that isn’t well known: the relationship between laboratory-measured sexual arousal patterns and preferred sex partners.

That’s not going to be widely understood without explanation, so here goes: We’ll start with men, who are relatively straightforward to study. In the laboratory, we can measure men’s patterns of sexual arousal in response to different kinds of erotic stimuli (typically, pornographic videos featuring different configurations of attractive actors) by showing them these videos while measuring their erections. Men who say they’re heterosexual tend to get much larger erections when viewing videos featuring only attractive women compared to videos featuring only attractive men. In these studies, videos that include both sexes are less informative because it’s unclear whether the arousal is triggered by the woman or the man. Therefore, we usually use videos of female-female and male-male couples engaged in sexual interactions. Why use videos of couples engaged in explicit sexual acts? Because measuring genital arousal patterns in the lab accurately requires intense sexual stimuli. Videos of couples having sex provoke stronger arousal than videos of individuals masturbating, which in turn are more arousing than still erotic images. Conversely, men who say they’re homosexual show the opposite pattern–a tendency to get far larger erections in response to videos featuring attractive men rather than those featuring attractive women.

The following hypothetical figure is representative of findings from my (and others’) research on male sexual arousal and orientation in the lab.

Figure 1: Male genital arousal and sexual orientation.

I use words like “tend” and “tendency” for two primary reasons. First, not all men get erections during a particular study (or in real life experiences). Those who don’t may be tired, uncomfortable with the procedure, or simply less arousable than other men. A lack of arousal in a one-time laboratory assessment doesn’t mean someone lacks a sexual orientation; it just means we couldn’t measure it. The vast majority of non-responders are heterosexual or homosexual (or bisexual) men. A small minority may be attracted to other types of persons or things, but let’s hold off on discussing that.

The second reason is that some men's arousal patterns do not align with their reported sexual identities. This discrepancy may stem from intentional deceit, self-deception, or, more charitably, an incomplete understanding of themselves. This is most likely to happen when a man who claims to be heterosexual shows a homosexual pattern in the lab. I’ve encountered cases where, upon further questioning, the man acknowledged a sexual attraction to men. Such men maintain heterosexual identities but have homosexual orientations.

Three more points before we get to women.

First, during these studies we ask men to rate how sexually aroused they felt after each video. Men’s self-reported sexual arousal patterns parallel those for genital arousal patterns mentioned above. Their self-reported arousal always matches their self-reported orientations. Rarely, the self-reported sexual arousal pattern and objectively measured genital arousal pattern diverge. This typically happens when men report heterosexuality despite a homosexual arousal pattern.

Second, I believe that a man’s sexual arousal pattern essentially is his sexual orientation. Gay men learn they’re gay by the fact that they experience much greater sexual arousal by men than by women. If a man identifies as heterosexual, has only had sex with his wife, yet gets much stronger erections to men than to women, he has a homosexual orientation.

Finally, men’s genital arousal patterns provide an objective way of measuring their sexual orientations. Indeed, that was the original purpose of the technique, which was originally developed by the renowned sexologist Kurt Freund in communist Czechoslovakia. The government tasked Freund with identifying men who falsely claimed to be gay to avoid military service. His method—showing men nude pictures of men or women and measuring penile response—was the result. Since then, the procedure has been adapted for other purposes, both clinical and scientific. For instance, it has been modified to evaluate sexual attraction to children. My lab has utilized genital arousal assessments in research on a range of topics, including AGP, and it has often been revealing. We will return to this in a future essay.

Okay, what about women? The first question is: How can we measure female genital arousal, since women don’t have penises whose erections we can measure? Measuring female genital arousal is considerably more indirect and complicated compared to that of males. An instrument called a vaginal photoplethysmograph, which is contained in an acrylic tube the size and shape of a tampon, is used for this purpose. Women insert it into their vaginas prior to watching our videos. The photoplethysmograph contains both a light source and a light sensor. The source emits light, and the sensor measures light reflecting off the vaginal walls. During women’s sexual arousal, blood flows into the vagina, changing its color. These changes provide the cue of arousal. See, I told you it was complicated! But it works. When women view erotic stimuli, their measured vaginal response increases. Regarding women’s genital arousal patterns, here’s what we (and others) find:

Figure 2: Female genital arousal and sexual orientation.

When comparing the patterns (the relative heights of the different bars) of women in Figure 2 to those of men in Figure 1, notice two main things: First, homosexual women get more genitally aroused by viewing videos of women than by videos of men; however, this difference isn’t as pronounced as it is for the analogous difference in men. Second, heterosexual women’s arousal pattern shows no preference for either sex. One could describe it as “bisexual,” although I prefer “indifferent.”

I have named the male pattern “category specific sexual arousal”—men’s sexual arousal is specific to the category of person they are most attracted to. Women’s pattern of sexual arousal is less category-specific than men’s. Indeed, heterosexual women entirely lack category specificity.

Let me make it clear: I am not suggesting that heterosexual women are actually bisexual. Rather, I am stating that while men’s sexual orientations are equivalent to their sexual arousal pattern, women’s sexual orientations are not. This is especially true for heterosexual women. Moreover, the mechanisms that guide women’s sexual preferences and choices remain uncertain. Women are quite picky, and the vast majority prefer male partners. But we don’t understand why.

Women’s patterns of self-reported subjective sexual arousal to the different videos differ from their genital arousal patterns, as shown in Figure 3 below.

Figure 3: Female subjective arousal and sexual orientation.

Neither homosexual nor heterosexual women feel sexually aroused by watching male couples have sex—indeed, even heterosexual women tend to dislike this. However, this does not undermine the conclusions regarding women’s low category specificity. Some studies using erotica featuring single individual actors have examined women’s genital arousal and they show the same patterns.

Other Sex Differences Related to Sexual Orientation

Women’s sexual behavior is less influenced by sexual arousal than men’s, because arousal is both less intense and less focused in women. Consequently, it wouldn’t be surprising if women’s sexuality were more culturally and socially malleable. For instance, there is a common belief that women who have experienced abuse by men may be more likely to adopt a lesbian identity. There is some evidence consistent with this idea, although it is difficult to test. Large recent shifts in LGBTQ identification have been more pronounced among girls and women than among boys and men, although these shifts have not been accompanied by equivalently large changes in sexual behavior.

Paraphilias, which are atypical sexual interests including autogynephilia (AGP), will be the subject of a future essay. Paraphilias are far more common in men than in women, and I have previously speculated that this may be linked to the sex difference in sexual arousal patterns:

It is unlikely to be coincidental that it is men who have both a category specific sexual arousal pattern and a propensity to have paraphilias. One way of thinking about category specificity is as a strongly motivating, rigidly fixed, bias to experience sexual arousal toward one kind of person (or perhaps also one type of activity). For evolutionarily sensible reasons, category specific arousal usually promotes men’s seeking sexual intercourse with sexually mature women. However, for reasons still largely unknown, the bias is sometimes rerouted to other types of persons, including men and children.

Summary of Sex Differences in Sexuality

Men generally have stronger sex drives compared to women and show more interest in casual sex and visual pornography. They also exhibit a more specific pattern of sexual arousal, which closely aligns with their sexual orientation, unlike in women. This difference likely contributes to greater sexual flexibility (or fluidity) in women than in men, as well as a higher tendency among men to develop paraphilias–intense sexual attractions to specific types of people, objects, or fantasies.

Understanding AGP will benefit from knowing some of these facts.

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