“In 2010, I published a study of the relative prevalence of nonhomosexual and
homosexual MtF transsexualism across national cultures (Lawrence, 2010c )
that had implications for understanding the phenomenon of autogynephilic transsexualism. In this article, I attempted to explain the observation that nearly all MtF
transsexuals in Asian cultures are homosexual, whereas most MtF transsexuals in
the USA, Canada, and the UK are nonhomosexual. I demonstrated that differences
in a measure of societal individualism —the degree to which a culture condones its
members pursuing personal happiness and self-expression, regardless of the opinions of others—accounted for most of the differences in the relative prevalence of
nonhomosexual MtF transsexualism. If one assumes that nonhomosexual MtF
transsexualism is equivalent to autogynephilic transsexualism—a justi fi able
assumption, in my opinion—these results suggest the hypothesis that the permissible expression of autogynephilia , rather than the prevalence or severity of autogynephilia, primarily accounts for these cross-cultural differences. Undergoing MtF
sex reassignment probably feels far more permissible to autogynephilic men living
in individualistic Western cultures than to their counterparts in cultures in which
individual self-expression is discouraged.”