The mainstream narrative suggests that most transgender individuals transition because of persistent gender dysphoria—a long-standing and deep-seated feeling of being born in the wrong body. This story is often framed to evoke empathy and support for gender transitions, especially in children. However, the reality of why people transition today is far more complex, and it differs significantly from this traditional view.
Three primary pathways explain why most people transition: autogynephilia (AGP), rapid-onset gender dysphoria (ROGD), and the homosexual type of gender dysphoria. The largest group is driven by autogynephilia, followed by ROGD, particularly in teenage girls, and the least common reason for transition is traditional gender dysphoria. This essay will break down these distinct paths and examine how misunderstanding them leads to misguided medical and social interventions.
1. The Homosexual Type of Gender Dysphoria: A Declining Group
For decades, the homosexual type of gender dysphoria was the most widely understood reason for transitioning. Individuals with this condition typically experience gender dysphoria from early childhood, and many grow up to be gay or lesbian. These individuals might express discomfort with their assigned sex from a young age, insisting that they are actually the opposite sex. Historically, this group was the face of transgenderism.
Famous figures such as Christine Jorgensen and Sylvia Rivera exemplify this type of gender dysphoria. They sought to align their bodies with their internal sense of self, often driven by same-sex attraction. However, this group, once seen as the standard model of transgender experience, has now become the smallest of the three primary pathways to transition. As society shifts, the motivations for transitioning have also changed, and this form of gender dysphoria is no longer the dominant reason behind most transitions.
2. Autogynephilia: The Largest and Most Controversial Group
Autogynephilia (AGP) refers to a sexual fetish in which a man is aroused by the thought of himself as a woman. First described by sexologist Ray Blanchard, AGP has been a controversial subject because it challenges the mainstream narrative that all transgender individuals transition due to gender dysphoria. Autogynephilia is about sexual arousal, not identity. TIMs with this condition often fantasize about embodying a female form and may engage in behaviors like cross-dressing or adopting female personas. Eventually, many pursue medical transitions to satisfy these fantasies.
Autogynephilia and Transition: TIMs with AGP tend to transition later in life, after having lived as men, often fathering children and maintaining heterosexual relationships. Their desire to transition is not about alleviating gender dysphoria but about fulfilling a fetishistic fantasy of becoming a woman.
Denial Within the Trans Community: Despite clear evidence from Blanchard’s research and others, many in the transgender community deny the existence of autogynephilia, instead promoting a unified narrative of gender dysphoria. However, studies have repeatedly shown that AGP is a significant motivator for many male-to-female transitions.
Grooming Behavior: There is a darker side to autogynephilia that often goes unmentioned. AGP TIMs, many of whom frequent online communities, are known to groom ROGD girls, encouraging them to explore transgender identities. Social media platforms like Reddit and Tumblr are breeding grounds for this behavior, where AGP TIM influencers act as role models, creating a space that pressures vulnerable girls to question their gender identities. These platforms can be dangerous, exposing teenagers to fetish-driven individuals looking to legitimize their own desires by grooming others.
Autogynephilia remains the largest driver of male-to-female transitions today. Ignoring this reality misleads both the public and medical professionals about the true motivations behind most transitions.
3. Rapid-Onset Gender Dysphoria (ROGD): The Influence of Social Media
Rapid-onset gender dysphoria (ROGD) describes a phenomenon where teenagers, particularly girls, suddenly identify as transgender, often after spending time on social media or in peer groups where being trans is popularized. ROGD is not about lifelong dysphoria; it emerges quickly, typically in adolescence. Dr. Lisa Littman’s pioneering research highlighted this phenomenon, showing that social contagion plays a significant role in shaping these identities .
Social Contagion and AGP TIM Influencers: ROGD is fueled by the echo chambers of social media. Platforms like TikTok, Instagram, and Tumblr feature trans influencers, often AGP TIMs, who glamorize transitioning and present it as an easy fix for adolescent anxieties, depression, and identity struggles. These TIM influencers often gain popularity by sharing their own experiences with transition, promoting an idealized version of transgender identity. Vulnerable ROGD girls, looking for a sense of belonging, are especially susceptible to these messages, leading them to question their gender in ways that may not have occurred without these online influences.
The Dangers of Rushing Medical Intervention: The medical community has been quick to affirm and facilitate transitions for these adolescents, often without thorough psychological assessments. This rush to medicalize can have devastating consequences. Many young adults are now detransitioning, expressing regret after undergoing irreversible surgeries and hormone treatments. These detransitioners often realize that their gender identity was influenced by social factors rather than genuine dysphoria.
Grooming and Exploitation: As mentioned earlier, AGP TIMs frequently target ROGD teens in online spaces. By positioning themselves as mentors or guides, they validate the teens' confusion, pushing them further into a trans identity. This is not a safe or supportive environment but a predatory one, where fetishistic desires are projected onto vulnerable teens.
The Critical Importance of Understanding These Distinctions
Failing to understand the distinctions between autogynephilia, ROGD, and the homosexual type of gender dysphoria leads to harmful medical and social practices. Treating all transgender individuals as if they are motivated by the same form of dysphoria creates one-size-fits-all solutions that harm more than they help.
Medical Consequences: For those with genuine gender dysphoria, transitioning may alleviate their distress and help them live fulfilling lives. But for TIMs with autogynephilia and ROGD teens, transitioning often does not address the root of their issues. In the case of autogynephilia, medical transition only serves to fulfill a sexual fetish, leaving the underlying psychological complexities unaddressed. For ROGD teens, transitioning may be a response to temporary identity confusion exacerbated by social influences.
Misleading the Public: The mainstream portrayal of transgenderism focuses heavily on the traditional gender dysphoria narrative, which is now the least common reason for transitioning. By failing to acknowledge the prevalence of autogynephilia and ROGD, both the public and policymakers are being misled about who transgender people are and why they seek medical interventions.
Medical and Social Implications
The implications of these distinctions are profound, particularly in terms of medical care and public policy.
For Autogynephilia: AGP TIMs should receive psychological support, not encouragement to pursue transition as a way to fulfill a sexual fetish. Medical professionals must recognize the fetishistic nature of AGP and respond appropriately with therapy rather than enabling medical transition.
For ROGD: Adolescents experiencing ROGD require careful psychological evaluation, not immediate affirmation and medicalization. Therapy should focus on the underlying causes of their dysphoria, such as anxiety, depression, or peer pressure, rather than pushing them toward irreversible treatments. The grooming behavior of AGP TIMs in these spaces must also be addressed and monitored more closely by both parents and professionals.
Conclusion: The Need for a Nuanced Approach
Transgender identities are not a monolith. The largest group, TIMs with autogynephilia, transition not because of gender dysphoria but due to a fetishistic desire. ROGD teens are influenced by social contagion and groomed by AGP TIMs online, creating dangerous and misleading environments that push them toward medical transition. Meanwhile, the homosexual type of gender dysphoria, often used to justify transgenderism, is now the least common reason for transition.
To ensure that transgender individuals receive the care they need—without causing harm to those who do not truly require medical intervention—we must recognize and understand these distinctions. Only then can we move beyond the oversimplified narratives and provide more effective, ethical treatment.
Citations:
Blanchard, Ray. "The Concept of Autogynephilia and the Typology of Male-to-Female Transsexualism." Archives of Sexual Behavior, 2005.
Bailey, J. Michael, and Blanchard, Ray. "Gender Dysphoria Is Not One Thing." Archives of Sexual Behavior, 2017.
Littman, Lisa. "Rapid-Onset Gender Dysphoria in Adolescents and Young Adults: A Study of Parental Reports." PLoS ONE, 2018.
Shrier, Abigail. Irreversible Damage: The Transgender Craze Seducing Our Daughters. Regnery Publishing, 2020.
Entwistle, Kate. "Detransition: The Voices Missing from the Trans Debate." The Times, 2022