Sympathy for the Devil: Autogynephilia as Psychic Retreat

There’s no one-size-fits-all explanation for why some men become autogynephilic.

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For women gathering in groups to advocate for single sex spaces and female-only sports, nothing provokes more outraged disgust than the male trans-rights activists (TRAs) who show up wearing wigs and dresses to heckle them. Those vocal in the defense of women’s hard-won civil rights ridicule such TRAs as cocks in frocks, denounce them as misogynists, and sneer that they’re all perverts and fetishists. Autogynephile (or AGP) is a label of special opprobrium deployed by these women against those who harass them.

For those readers not immersed in the wars over gender ideology, a man who struggles with autogynephilia feels sexually aroused by the thought or image of himself as a woman. Back in the 1980s, the sexologist Ray Blanchard set forth a typology for men seeking sexual reassignment surgery: they were either (a) effeminate men with a homosexual orientation, or (b) heterosexual men who take themselves in the guise of a woman as the object of their own sexual desire. AGP is a controversial topic: some consider it a fetish or paraphilia, others see it as a variation on normal heterosexuality, and many TRAs deny that it even exists.

Men presumed to be autogynephiles have a special power to infuriate radical feminists and others who advocate for women’s sex-based rights. To say that these women loathe AGPs would be an understatement. Porn-addled fetishists, sexual deviants, and narcissistic creeps are but a few of the caustic epithets deployed to vilify them. AGPs are self-evidently evil and scarcely human. Men who derive sexual satisfaction from putting on women’s lingerie and masturbating in front of a mirror are the devil incarnate.

In my practice as a psychotherapist, I work with a half dozen such men, some once or twice per week and others for a cluster of sessions at irregular intervals. Unlike the typical TRA who denies struggling with autogynephilia, my clients acknowledge that they’re in the grips of a sexual compulsion that torments them. They know they are not and never can be women, even though they may be tortured by the siren call to “transition.” More than anything, they long to be free of the profound shame they feel.

I approach therapy with these men just as I would with any other client–that is, with an open mind but also with a set of assumptions about human nature and what drives us. Though autogynephilia may seem almost impossible for most of us to fathom, I believe these men struggle with the same challenges the rest of us do. In general terms, that means:

1. Coming to terms with the reality of human need and interdependency.

2. Learning to manage their emotions; and

3. Developing a sense of self-worth.

I discuss these challenges and the common psychological defense mechanisms all humans use to cope with them in my 2012 book, Why Do I Do That?

This essay sets forth the insights I’ve gleaned from working with these young men, aided by my exploration of the subreddit AskAGP and private conversations I’ve held with AGPs who aren’t my clients; I’ve also spoken with two “transwidows”–women whose marriages collapsed when their autogynephilic husbands decided to transition. I have deep compassion for all men who struggle with autogynephilia, though when they are most defended against their inner truth, most in denial about the ways they are damaged, it’s hard to hold onto that compassion. When confronted by their hostility and belligerent defensiveness, I understand why those who want to preserve single-sex spaces come to despise them.

I first read a description of autogynephilia forty years ago as a psychoanalyst-in-training, though that word wasn’t used in Freud’s essay from 1911 because it wouldn’t be coined for another 70 years. Unlike his other case histories, The Schreber Case¹ does not recount Freud’s work with one of his own patients but sets forth his psychoanalytic appraisal of a strange autobiography written by Dr. Jur. (doctor of jurisprudence, a legal title) Daniel Paul Schreber, published in 1903. Schreber believed himself to be a sort of Redeemer for the sins of mankind and that God was gradually transforming his body into the flesh of a woman for that purpose. Freud made use of Schreber’s autobiography to illustrate his theories about the role of projection in paranoia.

In passages quoted by Freud, Dr. Schreber’s description of autogynephilic arousal is unmistakable:

… I am sometimes to be found standing before the mirror or elsewhere, with the upper portion of my body bared, and wearing sundry feminine adornments, such as ribbons, false necklaces, and the like. This only occurs, I may add, when I am by myself, and never, at least so far as I am able to avoid it, in the presence of other people. (p. 21)

And when watching himself in the mirror, Schreber becomes sexually aroused:

By applying pressure to this tissue [where a woman’s breast might be], I am able to evoke a sensation of voluptuousness such as women experience, and especially if I think of something feminine at the same time. (p. 32)

Those voluptuous feelings (“as women experience” them) recur throughout Schreber’s description of his supernatural transformation.

As I recall, I’d been assigned to lead discussion during seminar that week, 40 years ago, as we dove into the case of Schreber; I opened by arguing that we could better understand this case through the lens of object relations theory, and in particular, Melanie Klein’s description of defenses against need and dependency.

“To evade unbearable desire and envy,” I opined, “Schreber transformed himself into the object of his own libido so he wouldn’t need anyone or anything outside himself to satisfy it.”

We discussed Klein’s theories about infants who, in preverbal fantasy, will imagine themselves to be in possession of the breast (symbol of the mother) because they can’t bear feeling dependent upon or envious of her for what they need. Simply put–I already have what I need within my own self. This approach represents a maladaptive response to issue #1 mentioned above–coming to terms with the reality of human need and interdependency. To believe you possess within yourself all that you desire is to deny that humans rely upon one another for what they need.

I was a young man and somewhat doctrinaire when it came to Kleinian theory, but I wasn’t entirely wrong. I’ll have more to say about Schreber in the pages ahead.

Many years later, when I began to work with autogynephilic men, I found most of the extant literature to be less than illuminating. Leading theorists such as J. Michael Bailey tend to dismiss psychodynamic explanations. Others attempt to destigmatize AGP by relabeling it autoheterosexuality–a variation on normal heterosexual attraction that just happens to boomerang back on itself. They tend to deploy scientific-sounding terms like “erotic target location error” that make AGP into a kind of computer glitch, a coding error without psychological meaning or content, and certainly without developmental/psychological roots in childhood.

In Men Trapped in Men’s Bodies, for example, Anne Lawrence’s encyclopedic account of men who struggle with AGP, she states that she intentionally redacted lengthy family histories submitted by her subjects because she considered them “peripheral” to her subject matter.² The book shuns all psychodynamic explanations, even when the evidence for them jumps off the page. Despite these frustrating omissions (I’d love to review what she deleted one day), I nonetheless returned for a second visit to MTiMB as I began writing this essay.

The book is full of first-person accounts that seemingly lend support to my 40-year-old hypothesis about AGP, at least from the object relations perspective. Lawrence quotes the men who responded to her survey in almost identical language, describing how they felt sexually excited by “myself as the object of my own desire.”³ The word envy appears many times, though oddly makes no appearance in the Subject Index; to give just one example: “I seethed with envy while at the same time becoming sexually aroused–I wanted to possess them even as I wanted to become them.”⁴ Even the hardcore Kleinian who thinks in very literal terms will find support for this theory: “I always have loved women with large breasts. However, I have discovered that my feeling for women involving their breasts is the wish that I had them.”⁵

Nowadays, we use the word narcissist as a putdown to describe people we don’t like and who think too well of themselves; we tend to over-focus on the grandiose sense of self inherent in the DSM-5 diagnostic criteria for Narcissistic Personality Disorder. But in object relations theory, the word narcissism denotes a defensive stance, a form of self-deception used to evade unbearable feelings of envy, neediness, and dependency. It embodies a rejection of authentic human relationships and one’s own neediness. I still view narcissism (and autogynephilia) as defensive in nature, as an attempt to escape from unbearable pain, though over the years, I’ve expanded my understanding of the nature of that pain.

In my 2015 book The Narcissist You Know, I identified the driving force behind narcissism as a type of shame–core shame as I call it throughout my work and which I define as a deeply painful sense of being damaged or defective at one’s core, usually unconscious and often experienced as feeling ugly or deformed. It takes root in childhood as a result of (in broad terms) failed attachment relationships or early trauma. So, narcissism, as I’ve now come to understand it, represents a maladaptive, defensive effort to cope with issue #3 identified above: developing a sense of self-worth. The person in flight from unbearable shame constructs an idealized false self to cover over the unconscious sense of defect, damage, and unworthiness; for the more extreme narcissist, life involves a non-stop effort to validate and defend that identity.

Individual chapters in The Narcissist You Know depict various, usually familiar types of narcissists (the Seductive Narcissist, the Know-It-All Narcissist, etc.) and describe defensive strategies they use to uphold and defend their idealized false self-image. The Vindictive Narcissist, for example, will attempt to destroy your character and sense of self-worth should you ever challenge him. The Bullying Narcissist tries to make you feel like a loser so he can feel like a triumphant winner in comparison.

As I’ve argued elsewhere, the apparent character structure and overt behavior of most public TRAs demonstrate features of the Cluster B personality disorders, particularly Borderline and Narcissistic Personality Disorders. I’m no fan of diagnostic labels and I’ve been arguing against the disease model of mental health since I began blogging in 2012, so in no way am I diagnosing TRAs with a personality disorder. What I mean is this: a profound sense of damage and defect (core shame) lies behind what we call the Cluster B personality disorders; trans-identified males in flight from shame rely on pervasive narcissistic defenses to inhabit their female identity–the embodiment of their idealized false self.

Many people who encounter a well-defended narcissist, a person whose lies and defects eventually become obvious, have a hard time understanding that they are not lying, dissembling, or doing it “on purpose.” Instead, extreme narcissists experience the defensive character structure they have evolved to ward off shame as the truth about who they are–that is, they believe in the reality of the false self they strive to inhabit and don’t recognize it as a form of self-deception.

When his idealized self-image is challenged–say, by someone who does not agree that transwomen are women–the TRA will attack and attempt to destroy her, just as a vindictive narcissist would do. Anyone who has seen video footage of TRAs attempting to disrupt one of Kellie-Jay Keen’s Let Women Speak events will understand what I mean. When Michael Bailey published his book about male-to-female transsexuals, The Man Who Would be Queen (2003), a coalition of trans-identified males who objected to the way Bailey had portrayed them launched an extended campaign to harass his family and destroy his career. If you’re interested in vivid depictions of this prolonged assault, may I recommend Alice Dreger’s beautifully written and engaging book, Galileo’s Middle Finger (2015). 

In a paper from 2008, Anne Lawrence discusses an earlier article by Dreger describing that same assault and identifies this persecutory behavior as narcissistic rage in response to shame: “many autogynephilic transsexuals are likely to be particularly vulnerable to feelings of shame and may be predisposed to exhibit narcissistic rage in response to perceived insult or injury.”⁶ This is an accurate description as far as it goes, but Lawrence fails to consider whether the shame might be more than “a consequence of the inevitable difficulties they face in having their cross-gender feelings and identities affirmed by others, both before and after gender transition.” She never considers whether that shame might be about something else, something deeper, with roots in early childhood experience.

For the same reason, and because Lawrence redacted the lengthy family histories that might have shed welcome light on this issue, Men Trapped in Men’s Bodies offers few clues as to the possible role of core shame as a force behind autogynephilia.* Yes, there are some references to feelings of failure and inadequacy during childhood, especially around insufficient masculinity, but stronger evidence for the role of shame can be found in Lawrence’s discussion of “sexual masochism which not uncommonly occurs in association with MtF transsexualism.”⁷

Masochism reflects an attempt to control and predict the painful experience of humiliation, a topic I discuss at length in my 2018 book Shame. And as I learned through my work with autogynephilic men, sexualization is an additional strategy for coping with unbearable shame. By deriving sexual pleasure from the experience of humiliation, the person transforms intolerable and unpredictable pain into a controlled source of gratification, even comfort. I discussed this idea and presented case material in a presentation I gave at Genspect’s Killarney conference in 2023, a transcript of which appeared on Wesley Yang’s Substack. My views have evolved since then, and I’ll have more to say about the role of sexualization in the final section of this essay.

Spend some time on the AskAGP subreddit and you’ll discover a pervasive sense of shame and low self-esteem–references to the shame these men feel about their condition, of course, but also descriptions of a kind of shame that predates it, beginning in childhood. I don’t believe there’s a one-size-fits-all explanation for why some men become autogynephilic, but the prevalence of profound feelings of early shame and low self-esteem is hard to miss. A random sample:†

My mom was always super critical of me so it made me feel worthless as a man. I always thought I was ugly. Then I started taking more feminine looking pictures and honestly agp helps my confidence in my looks, it made me realize I had nice features.

[IN RESPONSE] I had very low self-esteem, but it has nothing to do with being a boy. If I was a girl I almost certainly would have suffered the same low self-esteem, and if I was a heterosexual girl, I probably would have been AAP [autoandrophilic]. The lack of self-esteem was more around poor attachments early in life. Losing everyone I cared about, either through the breaking up of my family, moving to new towns, or abandonment.

I was dysphoric until I took mdma and mushrooms and realized it’s largely a result of low self esteem, and dropped the notion that there’s such a thing as being “born trans”. But yeah that’s just my experience.

[IN RESPONSE] Yes, trans is something you only become when transitioning. I haven’t tried either mdma or mushrooms and I’ve always had low self esteem, so maybe you’re right. Would be nice if it was that simple.

And finally, from a frequent and very observant commenter:

The root cause of AGP, seems to me, becoming trapped in deep overwhelming emotion of shame for being who and what we are, our (gender) identity and sexuality. … It explains the number of severe childhood abuse traumas and indicators I have seen here [in this subreddit]. … I think that most of us would never dare to start taking hormones, surgeries or even cross dressing in public if we would be able to feel this shame.

The men I see in my psychotherapy practice also present with early trauma and failed attachment relationships as described above, the type of childhood where core shame takes root. The mother of one client suffered severe post-partum depression followed by years of hatred for her husband so intense that it poisoned family life. He once showed me photos of supposedly joyful family occasions over the years; his mother looked unhappy, almost angry in every one of them. Another client was given up by his birth mother and adopted by a couple so psychologically ill it was remarkable he survived and remained sane. A third came from a less obviously dysfunctional home but whose parents were locked in perpetual discord, mostly abandoning him to the care of his depressive aunt who lived with them.

These latter two clients found special gratification in sissy porn and forced feminization videos. As I described in my Killarney paper, one of them would occasionally hire a dominatrix to humiliate him–treat him like a “bitch” or a “pussy” as he described it. Schreber’s belief in being transformed by God into a woman, against his will, also looks like a fantasy of forced feminization. In the earliest phases of his delusion, as Freud explains, Schreber clearly felt himself to be a victim who was humiliated by what was happening to him: “It may be added that the ‘voices’ which the patient heard never treated his transformation into a woman as anything but a sexual disgrace, which gave them as excuse for jeering at him.”⁸ In the beginning, then, he felt degraded by his transformation until he understood God’s higher purpose and his own role as Redeemer. What at first was felt as a kind of degradation (shame) eventually turns grandiose.

To repeat, the creation of an idealized false self, often grandiose, serves to ward off the core shame that drives narcissism. In MTiMB, Lawrence describes men not merely aroused by the image of themselves as women but besotted with it, infatuated by their false female identity in an idealizing sort of way:

the process by which a man’s erotic desire to turn his body into a facsimile of a female body eventually gives rise to a strongly held, highly valued cross-gender identity and the process by which that new identity–that image of himself as a female–becomes the focus of his desire, admiration, idealization, attachment, and love …⁹

Lawrence has an ingenious explanation for this phenomenon that likens it to the sort of love and idealization a heterosexual male might feel for his wife, construing AGP in parallel to a normal loving relationship between a man and woman.¹⁰ Many people writing on this topic, including several I know and respect, find this theory persuasive. I do not. As a psychodynamic psychotherapist, I instead see a tension between narcissistic self-sufficiency and object relatedness (that is, connecting to other people based on the inescapable truth that humans need one other). I find the Lawrence theory self-evidently wrong and, to be honest, a little preposterous.

My understanding of the relationship between shame and narcissistic self-idealization helped me to understand the abrasive behavior of the typical TRA and the role shame played in the psyche of my clients; but as my work with young autogynephiles went on, I found such an understanding insufficient to fully account for their condition. One crucial piece of the puzzle had yet to fall into place.

In a 2002 article from The Atlantic, “Conservative Men in Conservative Dresses,” Amy Bloom describes her encounters with men who view cross-dressing as a form of relaxation, a way to escape the demands of manhood. By turns funny, poignant, painful, and appalling, the Bloom article profiles cross-dressers and their long-suffering wives, women forced into the role of cheerleader/audience to their husbands’ sexual fetish. No doubt for political/ideological reasons, this article has since been removed from The Atlantic’s archive, though it has fortunately been preserved on a few Internet websites such as this one.

At one point in Bloom’s article, a cross-dressing male explains to her that “Men are always trying to become what women are content to be.” I’ll quote the remainder of this passage in full because it’s poetic, insightful, and funny.

“What is it that women are content to be?” I [Amy] asked.

“Oh, you know, they know when to give it a rest. They know when and how to quit. They can relax and be themselves.”

I did know. He meant that in his vision, idealized and old-fashioned, women are like oceans, or like fields, or like horses, and men are sailors, farmers, and cowboys, and that is their curse and that is women’s blessing, although women may not realize it. It is exhausting to be a man, and delightful to kick off those demands and slip into something more comfortable.

In March of last year, the Canadian writer Eva Kurilova wrote a commemorative essay about Bloom’s article for The Distance, quoting this very passage and observing: “Bloom’s is a natural reaction virtually all women would feel to a man telling us that we are ‘content’ to give it a rest and relax, to simply be ourselves, and that men don’t have such a luxury.” Both writers take understandable offense at this masculine view of their sex.

For some time now, gender critical women have been pointing out with growing impatience that the version of womanhood portrayed by TRAs (presumably autogynephiles) is one influenced by pornography–unsurprising if you understand cross-dressing for men as a fetish or paraphilia. The feminized version of themselves these men seek to embody is one that appeals to their own sexual tastes, so of course they would never dress up as an ordinary woman, a frumpy housewife, or a grandma. When a self-avowed autogynephile showed up at the Genspect conference in Denver last November, he wore a “tacky blue velvet dress with sheer blue sleeve-length fingerless gloves,” as my friend Lisa Selin Davis described it on her Substack. No professional woman I know would ever have come dressed that way to such a conference.

But Amy Bloom and Eva Kurilova have highlighted an additional, non-sexualized feature of (imaginary) womanhood which AGP males attempt to embody. To them, being a woman represents contentment, freedom from stress or anxiety, and utter relaxation. Such a vision has nothing to do with real women and their experience, of course, but instead represents an idealized retreat from the challenges of being a man in general as well as from the individual pains and stresses afflicting each particular man. In other words, attempts to impersonate a woman have both a sexual and a non-sexual component.

Person and Oversey made this very point in an essay from 1974 entitled The Transsexual Syndrome in Males: Secondary Transsexualism¹¹:

Cross-dressing begins in childhood or early adolescence in one of two ways. It can start nonsexually, to promote a sense of well-being, then secondarily be sexualized; or it can be sexual from the beginning, though accompanied by the same sense of well-being as before.

In my view, to achieve that sense of well-being is a primary goal of autogynephilia.

Many references to AGP as a mode of escape from stress into a state of relaxation can be found in the comments posted on AskAGP. Here are some examples:

Whenever I crossdress, there’s not just a sexual feeling, there’s an inner contentment, a relaxation, even a feeling of being peaceful.

When I crossdress the primary reason is AGP. However, like you, I also crossdress to self soothe. When something happens that hurts my feelings, I often want to put on women’s clothes, cook, clean, etc.

For me AGP seems to be related to severe emotional neglect when young and pop up when dealing with periods of severe stress. Something like finding a soothing mother in myself to calm my stress with love.

I remember when I saw a picture of a nude woman, it felt easier to become like her than approaching her for a relation and get even more rejected. It was this calming fantasy that created AGP instead of feeling calm to approach a woman for a heterosexual relationship.

Im certainly kind of a bimbo when transitioned, and surely its running away from my normal personality. The question is... why? Why the normal personality is felt exhausting? Why do i feel the need to do that? Why do I feel the push to change completly my life and just be a relaxed kinda bimbo “girl” who just goes about life and thats pretty much it and brings wholesomeness?

female mental shift gives me peace and 100% reduction in brain fog and very calming effect, where as when i remove female clothing and get back into male role that mental shift after few hours feel distressing and brain fog and difficulty in focusing on things.

In short, these men describe cross-dressing as a way to manage their emotions–issue #2 which I identified earlier in this essay as one of the primary challenges all humans face.

While I can understand how many women might take offense at the idea of “womanhood” as a form of relaxation for men, reading these passages stirs deep compassion. These participants in the AskAGP subreddit are so obviously suffering, so painfully confused about how to make themselves feel better. It seems obvious that taking flight into their female persona reduces stress and brings them comfort, even without the added sexual component. I see this behavior in my own clients, who often find the autogynephilic urge to be strongest when “real life” feels too difficult.

It’s tempting to build a theory around the comment above that describes finding a “soothing mother” inside, but that would be too simplistic, like Person and Oversey’s theory that explained autogynephilia as a method of overcoming early separation anxiety through symbiotic fusion with the mother. As Alex Byrne remarks in his recent book, Trouble with Gender (2024), this theory has been “consigned to the dustbin of history” and surely belongs there.¹² But we needn’t throw the baby out with the bath water, so to speak. For the men I’ve quoted above, autogynephilia involves a self-soothing mechanism that appears rather maternal in nature.

I also want to make a point rarely acknowledged but which every man knows to be true: sometimes we masturbate to relieve stress and soothe ourselves. While many women find the idea of men masturbating to pornography displayed on their computer screens to be repulsive or offensive, such men often do so because they’re lonely, sad, anxious, or depressed. Yes, sexual stimulation is exciting, but ejaculation can bring a sense of relief and calm. As Lawrence and others have noted, cross-sex identification often abates after ejaculation, at least temporarily, which may in part be due to the stress relief that comes with orgasm.

But ejaculation may also leave the AGP male with a sense of emptiness and depression. For this reason, some of them try to prolong the state of sexual excitement as long as they can, or even to forgo having a climax altogether. I’ve known clients who masturbate for hours, usually with the aid of pornography, and hold off ejaculating–a practice known as edging. They exist in a state of mind that takes them out of space and time, into a world where nothing exists but excitement and sexual imagery; this kind of sexualization resembles an altered state akin to drug intoxication, and I sometimes find it useful to think of AGP fantasies as an addictive drug, as a compulsive way to self-medicate for “pain” in all its forms.

In a collection of essays focused on the theories of Heinz Kohut, Charles Strozier and his co-authors describe sexualization as “a phenomenon whose functions attempt to soothe the self …”¹³ They link it to “weaknesses in the self” resulting from early childhood trauma or failures of attunement between mother and child; this coincides with a sense of shame and inferiority because the person feels incapable of coping with “life’s complex challenges.” Sexualization from the Kohutian perspective is understood as “a compensatory substitute for internal resources.”

Though the authors are discussing sexualization in general, I’ve read no better description of my psychotherapeutic encounters with autogynephilic men. Whenever they find the stresses of the external world too much to bear, they retreat into cross-dressing and masturbatory fantasy as a way to calm themselves. Feeling deficient and plagued by shame, often focused on their inability to take the initiative in a “masculine” way, they take flight into cross-sex identification where to be a woman means being protected from the exigencies of life. One of my clients masturbates to the vision of himself as a ditzy girl with no responsibility greater than dusting the living room. Facing a major life transition and serious career choices, another finds sexual gratification while imagining himself to be a beautiful young girl whom all men desire, complete unto herself and expected to do nothing more than be pretty.

In part, such fantasies enact femininity as something akin to privileged childhood, a withdrawal from the pressure to be a mature and responsible adult. They embody a psychic retreat, to use a term coined by the psychoanalyst John Steiner, which he defines as “a part of the personality where the patient can retreat when reality becomes unbearable.”¹⁴ Though offering a kind of sanctuary from intolerable stress and anxiety, such “[p]athological organizations stultify the personality, prevent contact with reality, and ensure that growth and development are interfered with.”¹⁵

For many people, trans-identification represents exactly this kind of stultifying psychic retreat. Teens in my practice often contemplate their future transition as if it will be a major achievement, the most important thing they’ll ever do, meanwhile neglecting other important questions about their future–like which career path to choose and how to earn a living. Behind this fantasy, I sense their dread of the demands and responsibilities that will come with adulthood. Transwidows whose husbands decided to transition later in life describe men in flight from their financial responsibilities and commitments–to their wives and to their children–into a fantasy world where their only ambition is to be perceived as a woman.

They often defend their false new identity in an all-out war against those who challenge it, including the women they married. These autogynephiles call to mind the Vindictive Narcissists I described in my 2015 book, men who exploit the legal system to persecute the ex-wives who divorced them: they file endless motions without merit as a form of punishment, both financial and emotional. In the near future, I’ll be writing an article that details the narcissistic abuse these men inflict upon their children and ex-wives, both to highlight the suffering of the victims and to further distinguish abusive autogynephiles from the brave men in my practice.

For them, growth and development means coming to terms with being a man and finding ways to feel masculine in a positive way. It’s what they want more than anything else to do. My own ideas about the meaning of masculinity continue to evolve, but in recent discussions with these men, we focus more and more on the idea of taking the initiative. One of my clients finds the prospect of initiating a sexual advance toward a woman to be paralyzing; he retreats into pseudo-bisexual encounters with older gay men where he behaves in a passive and “childlike” way, as he describes it, although his sex partners seem to perceive him as feminine. Another older male married late and has never slept with anyone but his wife; he feels he wouldn’t ever have married if she hadn’t pursued him.

Anne Lawrence herself alludes to this possibility in an essay from 2007:

when nonhomosexual MtF transsexuals describe themselves as having been unmasculine or ‘not like other boys,’ they often may be referring to an unwillingness or inability to seek out female sexual partners with an avidity comparable to their peers, rather than to the presence of female-typical interests or behaviors.¹⁶

In my own experience, doubts about one’s viability as a male often lie behind such “unwillingness or inability.” To take determined action in pursuit of a desired object and to persist until attaining it, whether the object be a sexual partner or a non-sexual goal, strikes me as a central feature of masculinity, perhaps its most defining trait.

I am not laying claim to initiative and perseverance as exclusively masculine traits. No doubt they also matter to women. I am saying they’re of particular importance to men in developing a sense of their own agency in the world, and for helping them to esteem themselves as effective males.

In the months and years ahead, I’ll continue helping my clients to feel better about themselves as men while encouraging them to emerge from their psychic retreat. That means (1) accepting their need for other people in general and a female partner in particular, rather than taking themselves as the object of their desires; (2) learning how to manage their emotions more effectively without constant recourse to masturbatory self-soothing, and (3) building authentic self-esteem through initiative and achievement.

We have a lot of work to do.

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Footnotes & References:

* Core shame driving autogynephilia should not be confused with the shame these men feel as a result of their sexuality, which is often profound and crippling.

† When quoting from AskAGP, I copy text as it appears online and don’t bother with the usual indications of spelling or grammatical errors.

[1] Freud, S. (1911) Psycho-Analytic Notes on an Autobiographical Account of a Case of Paranoia (Dementia Paranoides). Standard Edition of the Complete Psychological Works of Sigmund Freud (SE), Vol. 12, pp 9-82.

[2] Lawrence, A. (2014). Men Trapped in Men’s Bodies: Narratives of Autogynephilic Transsexualism. (New York City, NY: Springer), p. 43.

[3] Ibid., p. 90.

[4] Ibid., p 112, quoting Hunt, N. (1978). Mirror Image: The Odyssey of a Male-to-Female Transsexual (New York, NY: Holt, Rinehart, and Winston).

[5] Ibid, p. 190.

[6] Lawrence, A. (2008). Shame and Narcissistic Rage in Autogynephilic Transsexualism. Archives of sexual behavior. 37. 457-61; discussion 505. 10.1007/s10508-008-9325-1.

[7] Lawrence, MTiMB, p. 152.

[8] Freud, op. cit., p. 20.

[9] Ibid, p. 21.

[10] See Lawrence, A. (2007) Becoming What We Love: autogynephilic transsexualism conceptualized as an expression of romantic love, in Perspectives in Biology and Medicine, vol 50, 4 (autumn 2007): 506–20 (New York: The Johns Hopkins University Press).

[11] See Chapter 7 of Person, E.S. (1999). The Sexual Century. (New Haven: Yale University Press).

[12] Byrne, A. (2024) Trouble with Gender: Sex Facts, Gender Fictions. (Cambridge: Polity Press), p. 128.

[13] Strozier, C. et al. (2022). The New World of Self. Heinz Kohut’s Transformation of Psychoanalysis and Psychotherapy (Oxford University Press), p. 71.

[14] Steiner, J. (1993). Psychic Retreat: Pathological Organizations in Psychotic, Neurotic and Borderline Patients. (London: Routledge), p. 13.

[15] Ibid, p. 5.

[16] Lawrence, A., Becoming What We Love, p. 514.