Identifying HSTS

Perhaps the most important issue, for HSTS, is in identifying who is and who is not HSTS. We discuss the differences between HSTS and autogynephilic transvestites elsewhere, but here we are seeking to help people who think they might be HSTS, or who think their child might be, in identifying and understanding what is actually going on.

Homosexual transsexualism, according to Ray Blanchard and many others, sits on an ‘aetiology’; or scale of development with what are often called ‘feminine homosexual males’ or ‘masculine homosexual females’. To keep things concise, I call these ‘transgender homosexuals’ after Bailey et al. This term covers both sexes.

Homosexual transsexualism is the end of this scale. It can be regarded as its logical conclusion, but that does not mean that all transgender homosexuals are HSTS. In fact, many are not. But HSTS is the strongest outward expression of the inverted sexuality that gives rise to transgender homosexuality.

Homosexual Gender Dysphoria is a feeling of discomfort at being made to present in a gender that does not match the individual’s sexuality. We discuss this elsewhere but, briefly, gender is how we advertise our sexuality to others. It is how we communicate, to our desired partners, that we are sexually and romantically interested in them. It is also the primary interface through which we see and are seen by the society around us. Human society is naturally gendered and, despite the efforts of extremist feminists and others of their ilk in the West, this will not change. All that happens is that gender differentiation may be reduced; gender itself remains.

So, if the gender we are obliged to present in does not match our inner expectations of how we should be treated, then there is a problem. This causes the discomfort that we know as Homosexual Gender Dysphoria.

Gender is a function of sexuality, rather than sex. While sexuality is indeed informed by sex — it is how we achieve sexual pleasure, after all — it is much more influenced by desire, with whom we wish to have sex and, crucially, how.

MtF HSTS have a unique advantage since they can both penetrate and be penetrated. It might well be that using the anus as a receptive sex organ is not quite in line with social expectations, but it works very well nevertheless. Many transgender homosexual/HSTS males can achieve full sexual satisfaction through anal sex alone: that is to say, they orgasm. This means that they can imagine themselves being penetrated, without any surgery at all and, indeed, can realise this with a willing partner.

This means that, certainly in the case of HSTS MtF, the individual’s sexuality — to whom he or she is attracted — counts for far more than what his or her genitalia might be.

Sex and Sexuality

For most people, sexuality maps directly on to birth sex and gender naturally follows. So most of us never think about this. But in transgender homosexuals there is a mismatch between sex and sexuality such that they have the sexuality normally found in the opposite sex. So, male transgender homosexuals have female sexuality and female ones have male.

Essentially, that means that transgender homosexual males not only desire men, they desire to play the role of women, to men. In other words, they are receptive in sex. In addition, they tend to desire to be protected by their partners and to be submissive socially as well as sexually. They are looking, in a partner, for a strong, conventionally masculine personality, to whom they will submit in bed and defer in society. In females, the opposite holds true.

We know this is innate for a number of reasons and we have described the clustering of physical features typical of HSTS elsewhere, that support this. But note also that, at the time when heterosexual children begin to have opposite-sex romantic crushes, young transgender homosexuals begin to have same-sex ones. At the same time, they may begin to identify with the opposite sex more practically. Boys may like to wear make-up, prefer to wear girls’ clothes and shoes, often will wear a towel or a tee-shirt on their heads, hanging over their shoulders, to simulate long hair. They will usually prefer the company of girls to other boys, avoid rough-and-tumble games, have a toy preference that is typical of the opposite sex and, when they begin to read, prefer stories that feature heroines rather than heroes. This last, in those who read less, may be replicated in other entertainment figures. For example, Miriam Rivera, a well-known Latin American HSTS, states that, in play, she was ‘always Wonder Woman’. She is not alone.

Again, in females, the opposite is approximated.

These behaviours and preferences are called ‘Gender Non-Conforming’ or GNC.

Intermittent or passing GNC behaviours are common in childhood, especially under the age of 5 or so, because at this time the child’s sexuality is still developing and so his or her understanding of gender is somewhat fluid. It was once thought that this fluidity indicated that gender could be shaped in this period, but today there is much evidence to show that, as sexuality develops, so does gender. So if the sexuality is normative, the GNC behaviours will pass.

Parents whose children exhibit passing GNC behaviour should take it with a big pinch of salt. Usually, the child has become fascinated by a fictional character and is exploring his or her own self through role-play. This is completely normal and should be encouraged. Masculinity, in humans, is always offset by a particle of femininity and vice versa. In males it gives compassion, nurturing and creativity. In females it may give decisiveness, assertiveness and willingness to take moderate risks. These are good, positive traits.

Persistence, consistence and insistence

If, however, the GNC persists over a period of months or years (persistency) spreads into other areas of life (consistency) and/or the child becomes more strident in insisting that the GNC behaviour be accepted (insistency), then something else might be happening. Again, however, prior to puberty, little can be predicted with reliability and the parents should try to ensure that the child has a normal and supported life. That does not mean they should encourage the GNC, but rather they should do everything they can to ensure that the child is not harmed by it, or by others because of it.

As long as the situation is contained within the family home, this should be easy. If there are older children, they should be encouraged to play sympathetically. Parents should explain that it’s just a phase and be prepared to turn it into a family game. Do ‘dress-up’ parties. Have fun with it. Do not allow it to become an issue within the family.

If the GNC is manifesting at pre-school or school, then there may be complications. Schools like consistency, especially where they have uniform rules, so even if they accept what they might think of as ‘trans’ behaviour, they may tend to ‘lock in’ GNC or worse, call in ‘experts’ (who rarely are) who will do exactly the same. The child needs time and space to explore this and, while he or she should not be discouraged, GNC should never be rewarded, at this stage. Make sure the child knows that he or she can always turn back, that nothing is set in stone, and that whatever happens, your love will never fade.


If the child is insisting on being called by cross-sex names, wearing cross-sex clothes to school and so on, then the child is being insistent. It is one thing for a boy to want to be called by a girl name in the home, as part of a role-playing game, but once this goes out of the protective framework of the family, it gets much more serious. This still does not mean that it will not pass, but it does mean that it is more ‘cemented in’. Ensuring the child realises that it’s possible to backtrack, while supporting him or her in the GNC behaviour in front of others, may be tough for parents.

Essentially, the longer the behaviour goes on, and the more consistent and insistent it is, the greater the likelihood is that it will persist and evolve through puberty and beyond. But this is still not an absolute certainty. Many GNC-exhibiting children will settle into more normative behaviours as puberty sets on.

This is happening because, by puberty, sexuality is established. Instead of vague romantic crushes, the child begins to have real sexual desires and so everything moves to a new level. For a few, it’s ‘time to put away childhood things’ and they may revert to sex-normative behaviour. For most, however, this will not be the case.

If the consistent and insistent GNC persists through puberty then the chances are high that the child, now an adolescent, is transgender homosexual. If the behaviour persists in the years immediately after puberty, then this is almost certain.

This, however, still does not mean that the child will definitely be HSTS, although the chances are increasing in favour of it.

All transgender homosexuals experience some level of Gender Dysphoria (GD). In interview, reading narratives and in the literature, again and again we hear ‘I’m gay but I used to think maybe I was trans’. And again, even more consistently, we hear HSTS saying ‘I used to think I was a gay boy’.

So what makes some transgender homosexuals transition into HSTS and others not?

Think of it like this: transition will occur if the cross-sex identification exceeds the level of perceived social intolerance of transition. In common language, if the boy feels like a girl strongly enough and thinks she can make it as a girl, then she will transition.

This is one reason why so many HSTS have such strikingly good looks. They self-select. The purpose of an HSTS, in transitioning, is to find a straight male partner who will love and accept her, and these people are not fools. If they look in the mirror and think, ‘Hmm, I’m pretty cute,’ then we are half-way there. This is also one reason why we see so many more HSTS in cultures where intolerance is low; you don’t have to be so passable to get away with it.

As adolescence proceeds, then, the situation changes both for the subject and the parents and it is vital that no schism develops. The child must not be led to believe that ‘it’s all my fault’ or that she is a burden on the family. MtF HSTS especially, from a very early age, are extremely conscious of the feelings of those around them; they can be remarkably empathetic individuals who might well deny their own desires in order to please others.

Unfortunately, this propensity has often been used, by ‘therapists’ as a tool to persuade the child against accepting her natural sexuality. These individuals are often trained psychologists who fully understand what they are doing; we consider this behaviour reprehensible at best.

Remember, we are talking about someone who is transgender homosexual; nothing you do will change that. This person is not heterosexual, so parental desires for such an outcome are not viable. The individual must now decide which life-path would be most likely to result in happiness and long-term contentment; and his or her parents need to be supportive.

At no point should parents attempt to persuade or worse, coerce the subject into a particular decision. If the wrong one is taken then this might destroy the trust that family life depends on. Rather, parents need to research and then patiently explain the problems that the individual will face in being either Gender Conforming Homosexual (GCH) or HSTS. Remember at all times that the person is homosexual and that cannot be changed; we are simply trying to assess what would be the life-path that would be most successful in providing long-term stability and happiness.

In brief, the issues that have to be addressed are as follows. These are for males, in the West:


• Must operate within the ‘gay’ community, especially for males.
• Must change sexuality from desiring masculine men to gay men
• The ‘gay’ community is notorious for promiscuity, sexual risk-taking, emotional abuse, substance abuse
• May suffer discrimination and/or abuse, including violence, unless their homosexual status is completely hidden
• Within the ‘gay’ community, feminine behaviours or presentations, ‘effeminacy’ are rigidly policed and perpetrators are shamed
• Little or no relief from Gender Dysphoria


• Can operate in society as a woman, unremarked; especially if GRS
• May have to change name and identity, disappear and ‘woodwork’
• May suffer discrimination and/or abuse, including violence, if HSTS status is discovered
• Will have to take cross-sex hormones to feminise and stave off masculinisation for life, (these are relatively mild in side-effects for males)
• May require orchiectomy (castration) to prevent masculinisation in later life (this allows a great reduction in cross-sex hormone use)
• Will require or desire minor feminising surgeries eg breast implants
• May desire or require GRS, a moderately severe surgery (though by no means all do)
• Complete relief from Gender Dysphoria

For females, the situation is quite different. In the first place there is no equivalent to the ‘gay’ meat-market that the male community revolves around. Lesbians are far less promiscuous than GCH homosexual males and may establish and maintain lifetime partnerships. There is no equivalent to the repression of feminine behaviours found in ‘gay’ male culture; masculine lesbians are generally well treated.

On the downside, the differences are also marked: while it is less likely that the individual would have to ‘woodwork’ and cut off all ties to previous life, the principal cross-sex hormone is testosterone, which is literally poison to a woman’s system and will induce sterility. If surgery is desired it is much more drastic and invasive than for MtF, including double mastectomy, hysterectomy and phalloplasty.

Only in rare cases does even the most radical therapy produce a convincingly passable man, unlike MtF, who are often completely passable, at least when young, even without hormones.

On balance it is my view that transition, in view of the above, is a more weighty undertaking for FtM than for MtF, with far fewer social advantages.

What are the indications that you, or your child, is HSTS?

First and foremost is a long history of GNC. It will have been remarked on at home and at school. You or your child, if male, were probably bullied for being ‘sissy’, hated contact sports, disliked rough-and tumble and preferred the company of girls. You liked to dress as a girl and to ‘be’ a girl in your relations with others. Your friends were all girls and you have girly secrets with them. You began having crushes on boys very early — as early as you remember. As you approached puberty, these feelings did not go away but crystallised instead. You began to have real sexual feelings for men.

If you saw a penis, you were fascinated by it. You thought about it all the time. You desired to be penetrated. You ached for it. Yet your own penis did not stimulate you and you may even have disliked it, especially if you knew that girls did not have them. You yearned for a man, with an agony that was unrequited. You might have had relationships, even sexual ones, with boys, but they left you hungering for more.

Once you were through puberty, this just got stronger. Performing as a boy in society was next to impossible for you, a torture. Your sexual desire — always powerful in adolescent boys — was now fixed on the idea of being penetrated, being the submissive partner. You might have thought you were a ‘gay boy’ and may have experimented sexually with ‘frotting’, fingering and even being penetrated, with other boys, perhaps transgender homosexuals like yourself or maybe straight boys who just wanted to have sex. But these encounters did not slake your thirst, even if you enjoyed them. You wanted a man, not a boy and especially not a ‘gay boy’ whom you recognised as being as much a girl as you were.

This understanding, that you were a girl, was strong and resilient. It was tough enough to stand up against parental and social intolerance, beatings, religious hatred and even, if you were unlucky enough to be exposed to them, the attentions of professional therapists whose intention was to make you conform to socially-accepted standards, to be a ‘gay boy’ and to stop being feminine. If you were really unlucky you might have been abused by ‘therapists’ who used testosterone injections to ‘man you up’ — an egregious cruelty which is nothing short of criminal abuse. But you survived all that and still knew that you were a girl.

As you got older, into your teens, your sexuality crystallised. As it did so, your gender followed suit and the Gender Dysphoria you felt, if you were not able to align these, became intense. You began to realise both what you were and that you had a limited time to make a final decision. The ‘gay scene’ held no attraction for you, you thought it an ugly, sex-obsessed meat market. You dreamed of a nice man who treated you well, a nice house and maybe even, if he already had kids, of being their stepmother.

(Similar applies in the inverse to FtM.)

Not every HSTS has these precursors but the overwhelming majority do. And not everyone who has these will be HSTS; many will be gender-conforming. But they will all be transgender homosexuals and will suffer varying degrees of Gender Dysphoria.

We can tell, with reliability, which transgender homosexual boys will be HSTS and which will remain gender conforming. Often this can be assessed before puberty, but in some cases, and for certainty, it might be better to wait until about the age of 13-15.

In girls this is much more difficult. Genuine HSTS transmen are very rare. Given that, and the much more intrusive surgery required for full FtM transition, together with the drastic effects of testosterone, great care must be taken. If you are a girl or the parents of a girl in this position, do not allow yourself to be persuaded by the transactivist lobby.  Real HSTS transmen, just like HSTS transwomen, can pass as the opposite sex, even without hormones or surgery. If this does not apply to you or your child, you should pause and reflect.

Self identification

This is promoted ruthlessly by activists as the only real test. It is not. Self identification, especially in adolescents, is unreliable, especially when taken alone. Within the context of the behaviours I have listed above, however, it can be a useful confirmation of the diagnosis. But the diagnosis itself must be based on behaviours and the self-identification should conform.

However, it may be the case that some individuals remain confused about what they really are. In this case, therapy should never involve irreversible procedures and may instead involve, especially in boys, so-called ‘puberty blockers’ for a period of time while this issue is resolved by the individual concerned. During this period, parents and therapists, if involved, should do everything they can to present the facts and the options for life-paths in as neutral a manner as possible, avoiding bias either for or against transition.

Further, social transition should be regarded as a phase — supported with HRT — that lasts at least a year. If the subject is identified between the ages of 14 and 16, as is often the case, and given that, in most jurisdictions, GRS is not permitted before the age of 18, or 16 at the earliest, then this delay will not cause an added problem for the individual, since they would have to wait anyway. During this time they should be encouraged to present in every way as the sex they desire to appear as but at the same time they should always be made aware that there is no shame at all in changing your mind. If they find that the shoe does not fit, then they should not be embarrassed to say so.

This requires great delicacy on the part of those around the young person and parents may have to take a strong line not only with relatives and friends, but also with enthusiastic supporters of transition. It is vital that the subject arrives at the final decision in a neutral but supportive, informed environment. There are clear advantages and disadvantages both to remaining gender-conforming homosexual and to transitioning to HSTS and the individual needs to consider these. HRT and GRS, today are well understood and the risks have been minimised; but there still are risks, even those which always occur when a patient has to be anaesthetised.

Are there any other conditions that could be mistaken for HSTS?

Only on the most superficial examination, but it’s still possible for confusion to occur.

The first and most common phenomenon that somewhat resembles HSTS MtF is male non-homosexual Gender Dysphoria. This is found in all males who are dysphoric, that is, desire to present as women, but who are not ‘exclusively attracted to same sex since childhood’. This is a narrow definition of homosexuality, but it allows us to divide people into two clear groups — homosexual and non-homosexual.

All male non-homosexual GD, according to Dr Blanchard, is caused by autogynephilia, ‘a man’s propensity to be sexually aroused by the thought or image of himself as a woman’. Many AGPs dislike that definition and Blanchard, thoughtfully, provided a few others, like ‘love of self as a woman’. Essentially, this is a narcissistic condition in which the subject, a heterosexual male, becomes infatuated with himself. Since he is heterosexual, he cannot love a man, so he has to turn himself into a woman, or behave in manners he considers ‘womanly’.

We don’t know how many there are, but the sites that provide the materials they need — outsize lingerie, wigs, hip pads, prosthetic breasts and penetrative sex toys — are numerous.

AGP sets on at or after puberty, typically. It seems to be associated with the beginnings of masturbatory behaviour, when, for reasons we do not know, a miswire occurs, a false association between the object of sexual desire and sexual satisfaction itself. In brief, an Erotic Target Location Error is developed, which places the target of erotic desire inside the self. As a result, a second personality begins to evolve, which we call the autogynephilic pseudo-feminine personality.

In a sense, AGP could be described as a form of multiple personality disorder. The subjects are likely to show somewhat vague or alternating self-ideation. They will become increasingly protective of the pseudo-feminine personality, as if it were a real lover under threat. If this is allowed to continue unchecked and worse, reward (usually but not always through masturbation) continues, the pseudo-feminine personality may become dominant and, far from protecting the host personality, will reject it. At this point the subject may experience intense discomfort known as non-homosexual Gender Dysphoria.

So, could this describe you or your child?

Here are some clues.

Firstly, autogynephilia does not manifest before puberty, although ‘straw in the wind’ indicators, such as a delight in cross-dressing, might appear earlier. Although subjects often claim, in later life, to have ‘known’ in childhood, these are usually false recollections manufactured by the pseudo-feminine personality in her construction of a plausible history. Any gender dysphoria that sets on after puberty with little or no prior indication in childhood, is less likely to be HSTS.

In almost all cases of transgender homosexuality, the precursor to HSTS, the condition is telegraphed years before puberty. We’ve seen that such children might begin non-conforming behaviour as early as 3 and this persists throughout childhood, becoming more insistent. We have shown, above, the characteristics that are normally shown by a child like this.

This never happens in AGP. They are almost always completely normal boys who enjoy sports, rough and tumble and typically boyish behaviour. They might like to hunt, to wrestle, to play with guns, real or otherwise; they might be ‘computer geeks’ or otherwise technically minded and so on. Nobody will have remarked anything unusual about them, before puberty. They might well be likeable and well-liked boys.

After puberty they may begin dating. Their girlfriends, if they have them, will be conventionally pretty girls, highly feminine. Remember, at this time an MtF HSTS will be experimenting with boys, the more masculine the better, and her sexual behaviour — whether known to her parents or not — will be markedly feminised..

AGPs are likely to be extremely secretive about dressing, if they do this; indeed they may become more covert after puberty, if they enjoyed cross-dressing before. This is because the sexual nature of their experience is now clear. ‘Dressing’ may become an intensely private experience for them, the exact opposite of a transgender homosexual male or ‘proto-HSTS’, who will be displaying her flamboyance as often and as forcefully as she can get away with. Her persona as a girl is outward, it is how she projects into society. For the AGP it is internal and the lover is like a dark vampire, kept away from the light of exposure and the prying eyes of others. She is the ‘Precious’. Meantime, the male transgender homosexual is strutting up the High Street with her hand on her hip and her elbow out, wiggling her bottom and deliberately trying to stop traffic (and quite possibly succeeding.)

In the past, in the West, AGPs were characterised by the fact that they typically ‘came out’ in middle age, and only rarely before 30. This led some to assert that the condition did not exist in other parts of the world, but it does, although the middle-aged profile is very rare. I have travelled widely in southeast Asia and have interviewed significant numbers of ‘ladyboys’ as they are called, and many of these are AGP themselves. This has also been reported to me by HSTS ladyboys, who are often the subjects of sexual predation by AGPs.

AGPs here, appear in their mid-teens, and studying them helps us to understand the new generation of Western AGPs who are appearing in their mid-teens too.

Rapid Onset

This form of AGP sets on very suddenly. What seems to be happening is that, instead of the long closet phase that is typical of the classic Western type, as soon as the subject begins to have autogynephilic experiences, he comes out.

In Asia this is due to cultural differences. It is simply not possible for an AGP to survive into middle age without being outed, in societies where people live so closely together and in which traditional male roles are so strongly defended. As a result, the few instances of Western-profile AGP I have encountered occur in wealthy, Westernised families who live as such families do in the West. In all other cases, the boy’s predilections will be identified and at that point he will be forced to join the society of transgender homosexuals. In these cultures, if you wish to be penetrated, you are a ‘not-man’ and probably ought to present as a girl, and if you want to present as a girl, you must also be a ‘not-man’ and should seek masculine sexual partners.

This social structure does not exist in the West and the increase in teenage incidence of autogynephilia is almost certainly due to the effect of Social Media, which somewhat replicates the real-life networks found elsewhere. This probably does not trigger the condition, but whereas, 30 years ago, an autogynephilic male would have been completely isolated, a few taps of the screen today and he can be amongst a community of boys and men just like him. Further, this is a narcissistic condition and the appearance of media, that reward narcissistic behaviour, has caused many to ‘come out early’. This applies particularly to YouTube, where users can post their own videos about their lives.

So, in this profile we see: a perfectly normal childhood; perhaps a fixation with computer games and technology; no evidence at all of homosexuality. He will be masculinising normally in line with his peers and then, almost overnight, an expression that the individual ‘must be trans’ and needs to transition.

Needless to say, this can cause great disruption.

It’s relatively easy, in the light of the above, to distinguish HSTS from AGPs, even in the earliest presentations of AGP, which are in mid to late teens, and the differences just get more and more pronounced. AGPs are usually not in the least bit ‘girly’ or feminine and struggle to appear so; they usually, in the West continue to have romantic attachments to women, and refuse those with men.

Some of these young-transitioning Western AGPs can appear superficially feminine, especially if they begin full transition HRT in mid teens. These are the exact equivalent of the tall, statuesque AGP transwomen seen in cabarets all over southeast Asia. However, they are always very different from HSTS and parents are unlikely to be in any doubt what they are dealing with.

Specifically identifying hidden AGP

AGP can be difficult to diagnose, absent a confession or being ‘caught in the act’ because it has so many forms. Many AGPs do not even cross-dress; they might enjoy self-penetration with a dildo or other object. They might excessively use ‘shemale’ pornography (this is almost certainly a trigger for AGP itself) but otherwise show no signs. Some allow the pseudo-feminine character to ‘go public’ online only and frequent virtual spaces where they can either interact with other AGPs or where they can simply pretend to be women.

If you think a member of your own family might be autogynephilic, then there are some clues. Transvestite AGPs, the ones we are most familiar with, will invariably have a cache of props. These might include: clothes they have stolen or clandestinely bought (these might show evidence of masturbation); dildos; possibly magazines, though this is becoming rare, replaced by internet resources. A concerned parent or partner should search the subject’s personal spaces thoroughly, including, if possible, their internet browsing history.

A parent or partner who discovers evidence suggesting autogynephilia should NOT confront the subject. Remember he is intensely protective of the pseudo-feminine personality and will defend her, possibly in a violent narcissistic rage attack. Even if this does not occur, the subject will likely deny everything and all you’ll do is drive the problem further into the shadows. Any approach will have to be subtle and cautious.

Parents should consult a specialist who is not a transactivist. Partners should quietly make preparations to end the relationship. While it is sometimes true that women do stay with their husbands if the AGP becomes clinical (ie, he ‘transitions’) they do so at great emotional cost and most would be well advised to protect themselves. It is possible that, in non-clinical cases, where the AGP is still closeted, a woman can assist her AGP partner, by, for example, ‘pegging’ him with a strap-on dildo, by helping him to dress, doing his makeup and so on. Without psychotherapy and a desire to maintain control, however, this is likely to be a temporary measure.

Remember always that AGP is a severe narcissistic personality disorder that is often co-morbid with other disorders. It must be addressed and treated. HSTS is not a disorder at all; HSTS are only disordered when they are forced to express themselves in a gender that does not match their sexuality.

Resources: outwith the scope of this book but list a few.

Rapid Onset Gender Dysphoria (ROGD)

ROGD is a condition that was unknown until the last few years and took everyone by surprise. It is a general rule of thumb that, across the world, male clinical GD outnumbers female clinical GD significantly, at least 2:1 and most likely much more. These numbers are inverted in ROGD.

In males, ROGD seems hard to distinguish from AGP and I have not seen convincing evidence that it is anything other than a Western form of the teenage-transitioning AGP seen all over the rest of the world. In females, the situation is much more worrisome.

In recent years ‘transgender’ clinics have seen massive increases in the numbers of young women coming forward. The Portman & Tavistock clinic in UK, for example, has seen a 4500% increase in referrals over 8 years. Two thirds of these are female. This is replicated elsewhere. Everywhere, both the increase and the overall numbers are more striking for females than males.

Why is this happening and do I have it?

ROGD is typified by the rapidity of its onset. This means that it is easily distinguishable from HSTS, just as AGP in males is. ROGD does not have the long telegraphing of the condition that is typical of HSTS, and remember, only HSTS is really transsexual.

Women are generally less prone to paraphilias than men, but they are prone to social disorders. These include anorexia, bulimia, self-harm, promiscuity, attempted suicide and many others. One is a condition called teenage body dysmorphia, which has been known about for many years. In this, the subject is repelled by her own body. This is rooted in anxiety about the changes to the female body that occur at puberty, associated with the ‘male gaze’, the fact that they become attractive to men.

At puberty, typically, girls put on weight. While some of the classic female ‘shape’ is the result of the skeleton, most of it is down to fat distribution. Adolescent females carry a great deal more fat than female children, at normal weights. This change can be hard to accept. At the same time, the girl begins to develop breasts and womanly hips. This is difficult for many to deal with, especially as the development of breasts is often associated with chronic pain and greatly increased sensitivity, which can make any contact, even with a blouse, maddening.

Girls in our culture are protected from sexualisation in childhood, which I think we would all agree is a good thing, but women’s bodies are sexualised. So the change from childhood to womanhood involves a new understanding of self, which is not as a child, but as a sexually potent woman and potential mother. This change is not well handled in our culture at all and this is increasingly the case. Compare it with, say the Philippines, where women tend to have larger families and girls are introduced slowly to the idea of womanhood and motherhood.

This tendency, strong in modern Anglo-Saxon cultures, means that, as girls enter womanhood, they can become anxious about their bodies. This can cause the body dysmorphia I mentioned before.

This suggests that if a girl presents with body dysmorphia prior to claiming that she ‘must be trans’, it is likely that this is ROGD rather than a genuine Gender Dysmorphia.

The problem is that if ROGD is misdiagnosed, there is a possibility that the subject will be placed on masculinising HRT and scheduled for surgeries. These will permanently and irreversibly change her body. Now, in the case of HSTS and particularly the MtF form, this is justifiable. The subject is homosexual and will never change; even if the individual were to desist, that individual would still be homosexual and have no desire for the opposite sex. If ROGD is not a real Gender Dysphoria but instead a combination of other factors being misdiagnosed, then other possibilities obtain. One of these is that the condition will vanish completely after a few years. But if the subject, who is in this case female, has been given masculinising doses of testosterone, then she will have been rendered sterile and her body changed irreversibly; and even worse if surgery has been carried out.

Parents have to be very careful not to fall into the trap of trans enthusiasm. Even in areas where trans is commonplace, eg southeast Asia, FtM is massively less common than Mtf. While it is certainly not either a statistically valid sample, the author, in years living in the Philippines, has met, interviewed and become friends with many transwomen, but in that time I have met just one genuine transman. That suggests that we might be talking about 50:1 or an even greater disparity. And this is in an environment which could not be more favourable to the development of HSTS identities, because not only is social intolerance low, separation of sex roles is high and both of these have been identified as contributing to a higher incidence of HSTS.

So-called ROGD remains unstudied, but in terms of diagnosis, its very nature, of setting on rapidly in a matter, sometimes, of days, with no prior indications, tells us it is not HSTS and should not be treated as if it were.

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