Clinical patterns among male transsexual candidates with erotic interest in males.

Male-to-female transsexuals who reported an erotic interest in males showed different patterns of sexual activity. Sexual history was used to categorize a transsexual sample into three groups: 44% abstained from sexual activity (Inactive group), 19% were sexually active but avoided using their penis in sexual activity (Avoidant group), and 37% were sexually active and derived pleasure from their penis (Pleasure group). The groups were compared for differences in gender identification, developmental patterns, and personality. Transsexuals in the Avoidant group showed patterns of traits and experiences that generally conformed to characteristics of the nuclear transsexual. They were dissimilar from the other two groups on measures of feminine functioning, heterosexual history, and fetishism. Transsexuals who interact with males in ways that are viewed as more classically homosexual shared more in common with the transsexual group which abstained from sexual activity with males. Both groups displayed more masculinity in development and more evidence of emotional disturbance. The implications of these findings for diagnosis and treatment are discussed.