“It seemed evident to me that this client was not genuinely androphilic: He was
clearly an autogynephilic man whose most intense source of erotic arousal involved
the most common type of behavioral autogynephilia, autogynephilic interpersonal
fantasy involving a male partner. But what was evident to me was not at all evident
to this client, even though he was probably more intelligent than 99.9% of the population and had read more about autogynephilia than most psychologists and psychiatrists who specialize in the treatment of gender dysphoria. The most intense and
rewarding sexual experiences of this man’s life had involved sex with male partners.
How could he not wonder whether his real sexual attraction was toward men? His
uncertainty about an issue that seemed so straightforward to me was a reminder of
how profoundly confusing this type of behavioral autogynephilia can be, even to
highly intelligent, well-informed people. Eventually, this client recognized that he
was not genuinely androphilic, but this realization occurred only gradually.”