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62-475: The terms are used for identifying a person's objects of attraction without attributing a sex assignment or gender identity to the person. They may be used when describing intersex , transgender , and non-binary people. Magnus Hirschfeld , an early-20th century German sexologist and physician, divided homosexual men into four groups: paedophiles , who are most attracted to prepubescent youth, ephebophiles , who are most attracted to youths from puberty up to

124-549: A gerontologist . Benjamin lived to be 101. Benjamin dedicated his 1966 major work to Gretchen. They were married for 60 years. They were married December 23, 1925. Gretchen revealed to Charles L. Ihlenfeld that "about six months after they were married Harry brought his mother from Germany to live with them" and that "from then on their bedroom door remained open". In 1979, the Harry Benjamin International Gender Dysphoria Association

186-485: A 17-month-old boy whose penis was destroyed during circumcision . However, this claim was later shown to be largely false. The subject, David Reimer , later identified as a man. The number of births with ambiguous genitals is in the range of 1 in 2,000 to 1 in 4,500 (0.05% to 0.02%). Typical examples would be an unusually prominent clitoris in an otherwise apparently typical girl, or complete cryptorchidism in an otherwise apparently typical boy. In most of these cases,

248-540: A euphemistic adjective to describe Zeus 's lust for women. Sigmund Freud used the term gynecophilic to describe his case study Dora . He also used the term in correspondence. The variant spelling gynophilia is also sometimes used. Rarely, the term gynesexuality has also been used as a synonym. Following Hirschfeld, androphilia and gynephilia are sometimes used in taxonomies which specify sexual interests based on age ranges, which John Money called chronophilia . In such schemes, sexual attraction to adults

310-671: A given context, this more precise terminology will be used throughout the book. Since homosexual, gay, and lesbian are often associated with bigotry and exclusion in many societies, the emphasis on sexual affiliation is both appropriate and socially just." Author Helen Boyd agrees, writing, "It would be much more accurate to define sexual orientation as either 'androphilic' (loving men) and 'gynephilic' (loving women) instead." Sociomedical scientist Rebecca Jordan-Young challenges researchers like Simon LeVay , J. Michael Bailey , and Martin Lalumiere , who she says "have completely failed to appreciate

372-489: A hermaphrodite had to be classed as either male or female. The 12th-century Decretum Gratiani states that "Whether a hermaphrodite may witness a testament, depends on which sex prevails". The foundation of common law, the 16th Century Institutes of the Lawes of England , described how a hermaphrodite could inherit "either as male or female, according to that kind of sexe which doth prevaile." Legal cases where sex assignment

434-447: A homosexual man? "Yes," if pedantry and technicalities prevail. "No" if reason and common sense are applied and if the respective patient is treated as an individual and not as a rubber stamp. Many sources, including some supporters of the typology, criticize this choice of wording as confusing and degrading. Biologist Bruce Bagemihl writes "...the point of reference for "heterosexual" or "homosexual" orientation in this nomenclature

496-579: A man of immense caring, respect and kindness, and many kept in touch with him until his death. He was a prolific and assiduous correspondent, in both English and German, and many letters are archived at the Magnus Hirschfeld Archive for Sexology , Humboldt University, Berlin. The legal, social and medical background to this in the United States, as in many other countries, was often a stark contrast, since wearing items of clothing associated with

558-429: A man respectively. So a gynephilic man is a man who likes women, that is, a heterosexual man, whereas an androphilic man is a man who likes men, that is, a gay man. For completeness, a lesbian is a gynephilic woman, a woman who likes other women. Gynephilic transsexed woman refers to a woman of transsexual background whose sexual preference is for women. Unless homosexual and heterosexual are more readily understood terms in

620-457: A member of another gender and a gynephilic transwoman (ie one attracted to women) as homosexual because she has a same-gender preference. My usage is contrary to much Western literature (particularly medical) which persists in referring to androphilic transwomen and gynephilic transman as homosexual (indeed as homosexual transsexual males and females, respectively). Sex assignment Sex assignment (also known as gender assignment )

682-423: A sex is tentatively assigned and the parents told that tests will be performed to confirm the apparent sex. Typical tests in this situation might include a pelvic ultrasound to determine the presence of a uterus , a testosterone or 17α-hydroxyprogesterone level, and/or a karyotype . In some of these cases a pediatric endocrinologist is consulted to confirm the tentative sex assignment. The expected assignment

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744-449: A sex of rearing, but also began to include surgical treatment. Undescended testes could be retrieved. A greatly enlarged clitoris could be amputated to the usual size, but attempts to create a penis were unsuccessful. John Money and others controversially believed that children were more likely to develop a gender identity that matched sex of rearing than might be determined by chromosomes, gonads, or hormones. The resulting medical model

806-430: A similar argument: Terms such as 'homosexual' and heterosexual (and 'gay', 'lesbian', 'bisexual', etc.) are Western conceptions. Many Asians are unfamiliar with them, there being no easy translation into their native languages or sexological worldviews. However, I take the opportunity to put on record that I consider an androphilic transwoman (ie one sexually attracted to men) to be heterosexual because of her attraction to

868-577: A similar manner, often without accepting any payment. Many of his patients were referred by David Cauldwell , Robert Stoller , and doctors in Denmark. These doctors received hundreds of requests from individuals who had read about their work connected with changing sex, as it was then largely described. However, due to the personal political opinions of the American doctors and a Danish law prohibiting sex reassignment surgery on noncitizens, these doctors referred

930-565: A successful industrialist, sought treatment from Benjamin in 1963. Erickson was the founder and funder of the Erickson Educational Foundation , which published educational booklets, funded medical conferences, counselling services, and the establishment of gender clinics. The EEF funded the Harry Benjamin Foundation. Apart from endocrinology and sexology, he worked on life extension and now would be described as

992-490: A synonym for androphilia . In biology , androphilic is sometimes used as a synonym for anthropophilic , describing parasites who have a host preference for humans versus non-human animals. Androphilic is also sometimes used to describe certain proteins and androgen receptors . A version of the term appeared in Ancient Greek . In Idyll 8, line 60, Theocritus uses gynaikophilias ( γυναικοφίλιας ) as

1054-638: Is an "objective biological reality" determined at conception and observed at birth, rather than assigned. They say that using "assigned" terminology, which they view as an example of "social constructionism gone amok", distorts scientific facts and could undermine trust in medical institutions. There is a consensus in the use of the term "sex assignment" for newborns with intersex conditions; observed chromosomal sex and assigned sex may intentionally differ for medical reasons (based upon predictions of psychosocial and psychosexual health in later life). Observation or recognition of an infant's sex may be complicated in

1116-428: Is both confusing and controversial among males seeking sex reassignment. Critics argue that the term "homosexual transsexual" is " heterosexist ", "archaic", and demeaning because it labels people by sex assigned at birth instead of their gender identity . Benjamin, Leavitt, and Berger have all used the term in their own work. Sexologist John Bancroft also recently expressed regret for having used this terminology, which

1178-453: Is called teleiophilia or adultophilia. In this context, androphilia and gynephilia are gendered variants meaning "attraction to adult males" and "attraction to adult females", respectively. Psychologist Dennis Howitt writes: Definition is primarily an issue of theory, not merely classification, since classification implies a theory, no matter how rudimentary. Freund et al. (1984) used Latinesque words to classify sexual attraction along

1240-585: Is necessary for, or directly related to, one or more of the agency's functions or activities" Sex registration was introduced in the Netherlands in 1811 due to gender-specific rights and responsibilities, such as military conscription. Many gender-specific provisions in legislation no longer exist, but the provisions remain for rationales that include "speed of identification procedures". Harry Benjamin Harry Benjamin (January 12, 1885 – August 24, 1986)

1302-422: Is needed to overcome immense difficulties in characterizing the sexual orientation of transmen and transwomen. For instance, it is difficult to decide whether a transman erotically attracted to males is a heterosexual female or a homosexual male; or a transwoman erotically attracted to females is a heterosexual male or a lesbian female. Any attempt to classify them may not only cause confusion but arouse offense among

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1364-414: Is reinforced by mention of the fact that similar birth order equations have been found for 'homosexual men'. The possibility of sexual orientation towards (masculine) men emerging from (rather than causing) feminine gendered identities is not considered. Schmidt argues that in cultures where a third gender is recognized, a term like "homosexual transsexual" does not align with cultural categories. She cites

1426-529: Is solely the individual's genetic sex prior to reassignment (see for example, Blanchard et al. 1987, Coleman and Bockting, 1988, Blanchard, 1989). These labels thereby ignore the individual's personal sense of gender identity taking precedence over biological sex, rather than the other way around." Bagemihl goes on to take issue with the way this terminology makes it easy to claim transsexuals are really homosexual males seeking to escape from stigma. Leavitt and Berger stated in 1990 that "The homosexual transsexual label

1488-459: Is the discernment of an infant's sex, typically made at birth based on an examination of the baby's external genitalia by a healthcare provider such as a midwife, nurse, or physician. In the vast majority of cases (99.95%), sex is assigned unambiguously at birth. However, in about 1 in 2000 births, the baby's genitalia may not clearly indicate male or female, necessitating additional diagnostic steps, and deferring sex assignment. In most countries

1550-422: Is usually confirmed within hours to a few days in these cases. Some infants are born with enough ambiguity that assignment becomes a more drawn-out process of multiple tests and intensive education of the parents about sexual differentiation . In some of these cases, it is clear that the child will face physical difficulties or social stigma as they grow up, and deciding upon the sex of assignment involves weighing

1612-663: The Diagnostic and Statistical Manual of Mental Disorders (DSM) maintained by the American Psychiatric Association . Initially, the third edition of the DSM referred to "anatomic sex". By the fourth edition in 1994, the term "assigned sex" was introduced, with subsequent editions also using "biological sex" and "natal gender". The latest revision in 2022 streamlined the language to consistently use "sex assignment". A 2006 consensus statement on intersex conditions also adopted

1674-403: The 1950s, assignment was based almost entirely on the appearance of the external genitalia. Although physicians recognized that there were conditions in which the apparent secondary sexual characteristics could develop contrary to the person's sex, and conditions in which the gonadal sex did not match that of the external genitalia, their ability to understand and diagnose such conditions in infancy

1736-611: The Modified Androphilia–Gynephilia Index (MAGI). Magnus Hirschfeld distinguished between gynephilic, bisexual, androphilic, asexual, and narcissistic or automonosexual gender-variant persons. Since then, some psychologists have proposed using homosexual transsexual and heterosexual transsexual or non-homosexual transsexual. Psychobiologist James D. Weinrich has described this split among psychologists: "The mf transsexuals who are attracted to men (whom some call 'homosexual' and others call 'androphilic') are in

1798-548: The United States in 1913, to work with a quack doctor who claimed to have found a cure for tuberculosis. The liner in which Benjamin was returning to Germany was caught mid-Atlantic both by the outbreak of the First World War in 1914, and the Royal Navy . Given the choice of a British internment camp , as an " enemy alien ", or returning to New York, he used his last dollars to travel back to America, where he made his home for

1860-463: The advantages and disadvantages of either assignment. Intersex activists have criticised "normalising" procedures performed on infants and children, who are unable to provide informed consent. In European societies, Roman law , post-classical canon law , and later common law , referred to a person's sex as male, female, or hermaphrodite , with legal rights as male or female depending on the characteristics that appeared most dominant. Under Roman law,

1922-420: The affected subjects. In such cases, while defining sexual attraction, it is best to focus on the object of their attraction rather than on the sex or gender of the subject. Sexologist Milton Diamond , who prefers the term gynecophilia , writes, "The terms heterosexual, homosexual, and bisexual are better used as adjectives, not nouns, and are better applied to behaviors, not people." Diamond has encouraged using

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1984-499: The case of intersex infants and children and in cases of early trauma. In such cases, the infant may be assigned male or female, and may receive intersex surgery to confirm that assignment. These medical interventions have increasingly been seen as a human rights violation due to their unnecessary nature and the potential for lifelong complications. Cases of trauma include the famous John/Joan case , where sexologist John Money claimed successful reassignment from male to female of

2046-484: The dimensions of sex and age: Gynephilia. Sexual interest in physically adult women Androphilia. Sexual interest in physically adult males The nine-item Gynephilia Scale was created to measure erotic interest in physically mature females, and the thirteen-item Androphilia Scale was created to measure erotic interest in physically mature males. The scales were developed by Kurt Freund and Betty Steiner in 1982. They were later modified by Ray Blanchard in 1985, as

2108-421: The early twenties; androphiles, who are most attracted to persons between the early twenties and fifty; and gerontophiles , who are most attracted to older men, up to senile old age. According to Karen Franklin , Hirschfeld considered ephebophilia "common and nonpathological, with ephebophiles and androphiles each making up about 45% of the homosexual population." The term androsexuality is occasionally used as

2170-555: The gender identity that most people with a similar intersex condition develop, although such assignments may be revised as the individual matures. The use of surgical or hormonal interventions to reinforce sex assignments in intersex individuals without informed consent is considered a violation of human rights, according to the Office of the United Nations High Commissioner for Human Rights. Sex assignment refers to

2232-631: The grant, my publications, lectures, etc." Similar cases in other countries (such as that of Roberta Cowell , whose surgery by Harold Gillies in England was in 1951 but was not publicised until 1954; Coccinelle who received much publicity in France in 1958, and April Ashley , whose exposure in 1961 by the British tabloid press was reported worldwide) fuelled this. But most of Benjamin's patients lived (and many still live) quiet lives. Reed Erickson (1917–1992),

2294-587: The healthcare provider's determination, along with other details of the birth, is by law recorded on an official document and submitted to the government for later issuance of a birth certificate and for other legal purposes. The prevalence of intersex conditions , where a baby's sex characteristics do not conform strictly to typical definitions of male or female, ranges between 0.018% and 1.7%. While some intersex conditions result in genital ambiguity (approximately 0.02% to 0.05% of births ), others present genitalia that are distinctly male or female, which may delay

2356-488: The identification of an infant's sex at birth, typically based on observable physical characteristics. This is also known as gender assignment. In clinical and medical contexts, terms such as "birth-assigned sex" or "birth-assigned gender" are used to describe the sex identified at birth, while "assigned sex" and "assigned gender" may also refer to any subsequent reassignments, especially common among intersex individuals. The terminology has evolved across various editions of

2418-505: The implications of alternative ways of framing sexual orientation." Some researchers advocate use of the terminology to avoid bias inherent in Western conceptualizations of human sexuality. Writing about the Samoan fa'afafine demographic, sociologist Johanna Schmidt writes: Kris Poasa, Ray Blanchard and Kenneth Zucker (2004) also present an argument that suggests that fa'afafine fall under

2480-508: The language used to describe sexual anomalies . For example, he proposes the terms gynephilic and androphilic to indicate the type of partner preferred regardless of an individual's gender identity or dress. Those who are writing and researching in this area would do well to adopt his clear and concise vocabulary." Psychiatrist Anil Aggrawal explains why the terms are useful in a glossary: Androphilia – The romantic and/or sexual attraction to adult males. The term, along with gynephilia,

2542-404: The letter-writers to the one doctor of the era who would aid transsexual individuals, Harry Benjamin. Benjamin conducted treatment with the assistance of carefully selected colleagues of various disciplines (such as psychiatrists C. L. Ihlenfeld and John Alden, electrologist Martha Foss, and surgeons Jose Jesus Barbosa, Roberto C. Granato, and Georges Burou ). Benjamin's patients regarded him as

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2604-474: The lower left-hand corner of the XY table, in order to line them up with the ordinary homosexual (androphilic) men in the lower right. Finally, there are the mf transsexuals who are attracted to women (whom some call heterosexual and others call gynephilic or lesbian)." The use of homosexual transsexual and related terms have been applied to transgender people since the middle of the 20th century, though concerns about

2666-492: The opposite sex in public was often illegal, anything seen as homosexuality was often persecuted or illegal, and many doctors considered all such people (including children) at best denied any affirmation of their gender identity, or involuntarily subjected to treatments such as drugged detention, electroconvulsive therapy , or lobotomy . . Though he had already published papers and lectured to professional audiences extensively, Benjamin's 1966 book, The Transsexual Phenomenon ,

2728-522: The psychiatrists Benjamin involved in the case not agreeing on a path of treatment, Benjamin eventually decided to treat the child with estrogen ( Premarin , introduced in 1941), which had a "calming effect", and helped arrange for the mother and child to go to Germany, where surgery to assist the child could be performed but, from there, they ceased to maintain contact, to Benjamin's regret. However, Benjamin continued to refine his understanding and went on to treat several hundred patients with similar needs in

2790-421: The recognition of an intersex condition until later in life. Societally and medically, it is generally assumed that a person's gender identity will align with the sex assigned at birth, making them cisgender . However, for a minority, assigned sex and gender identity do not coincide, leading to transgender identity experiences. When assigning sex to intersex individuals, some healthcare providers may consider

2852-939: The rest of his life. However, he maintained and built many international professional connections and visited Europe frequently when wars allowed. After several failed attempts to start a medical career in New York , in 1915 Benjamin rented a consulting room, in which he also slept, and started his own general medical practice. In 1937 he moved his practice to a ground floor office suite at 728 Park Avenue in Manhattan, then briefly to 125 East 72nd Street in 1957, and sometime between 1959 and 1962 he moved his practice again to 44 East 67th Street before finally relocating to 1045 Park Avenue in 1963 where he continued to practice until his retirement in 1968. Sometime before 1948, he also began maintaining an office in San Francisco where he practiced during

2914-439: The rubric of 'transgenderal homosexuality', applying the same birth order equation to fa'afafine's families as have been used with 'homosexual transsexuals'. While no explicit causal relationship is offered, Poasa, Blanchard, and Zucker's use of the term 'homosexual transsexual' to refer to male-to-female transsexuals who are sexually oriented towards men draws an apparent link between sexual orientation and gender identity. This link

2976-447: The social weight of the former ones." Psychologist Rachel Ann Heath writes, "The terms homosexual and heterosexual are awkward, especially when the former is used with, or instead of, gay and lesbian. Alternatively, I use gynephilic and androphilic to refer to sexual preference for women and men, respectively. Gynephilic and androphilic derive from the Greek meaning love of a woman and love of

3038-611: The summer of every year (at 450 Sutter Street , Suite 2232), with many of his patients coming from the nearby Tenderloin neighborhood ). Prior to arriving in the United States, Benjamin studied at the Institut für Sexualwissenschaft ; from about this time onward he began to encounter and treat patients who he would later describe as transsexuals. In the 1930s he studied in Austria with Eugen Steinach . In 1948, in San Francisco, Benjamin

3100-403: The terms "assigned sex" and "assigned gender". Sex is assigned as either male or female, leading to specific terms: More visible adoption of the terminology of sex assignment has led to public debate and criticism. Mathematician Alan Sokal and biologist Richard Dawkins have argued against the "assigned at birth" terminology. In a 2024 op-ed for The Boston Globe , they contended that sex

3162-409: The terms androphilic, gynecophilic, and ambiphilic to describe the sexual-erotic partners one prefers (andro = male, gyneco = female, ambi = both, philic = to love). Such terms eliminate the need to specify the subject and focus instead on the desired partner. This usage is particularly advantageous when discussing the partners of transsexual or intersexed individuals. These newer terms also do not carry

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3224-401: The terms have been voiced since then. Harry Benjamin said in 1966: ....it seems evident that the question "Is the transsexual homosexual?" must be answered "yes" and "no." "Yes," if his anatomy is considered; "no" if his psyche is given preference. What would be the situation after corrective surgery has been performed and the sex anatomy now resembles that of a woman? Is the "new woman" still

3286-430: The work of Paul Vasey and Nancy Bartlett: "Vasey and Bartlett reveal the cultural specificity of concepts such as homosexuality, they continue to use the more 'scientific' (and thus presumably more 'objective') terminology of androphilia and gynephilia (sexual attraction to men or masculinity and women or femininity respectively) to understand the sexuality of fa'afafine and other Samoans." Researcher Sam Winter has presented

3348-599: Was a German-American endocrinologist and sexologist , widely known for his clinical work with transgender people. Benjamin was born in Berlin , and raised in a German Lutheran home. His mother was German and his father at least part-Jewish in ancestry. He joined a regiment of the Prussian Guard . He received his doctorate in medicine in 1912 in Tübingen for a dissertation on tuberculosis . Sexual medicine interested him, but

3410-471: Was a friend of Hirschfeld's, and so I met both men. That was around 1907. They repeatedly took me along on their rounds through the homosexual bars in Berlin. I especially remember the 'Eldorado' with its drag shows, where also many of the customers appeared in the clothing of the other sex. The word "transvestite" had not yet been invented. Hirschfeld coined it only in 1910 in his well-known study. Benjamin visited

3472-570: Was asked by Alfred Kinsey , a fellow sexologist, to see a young patient who was anatomically male but insisted on being female. Kinsey had encountered the child as a result of his interviews for Sexual Behavior in the Human Male , which was published that year. This case rapidly caused Benjamin's interest in what he would come to call transsexualism , realizing that there was a different condition to that of transvestism , under which adults who had such needs had been classified to that time. Despite

3534-514: Was especially important as the first large work describing and explaining the affirmative treatment path he pioneered. Publicity surrounding his patient Christine Jorgensen brought the issue into the mainstream in 1952 and led to a great many people presenting for assistance, internationally. In the preface of Christine Jorgensen's autobiography, Dr. Benjamin also gives Jorgensen credit for the advancement of his studies. He wrote, "Indeed Christine, without you, probably none of this would have happened;

3596-405: Was not part of his medical studies. In a 1985 interview he recalled: I do remember going, as a young person, to a lecture by Auguste Forel , whose book The Sexual Question was a sensation at the time and which impressed me greatly. I also met Magnus Hirschfeld very early on through a girl friend, who knew the police official Kopp, who was in charge investigating of sexual offenses. He, in turn,

3658-442: Was placed in doubt have been described over the centuries. With the medicalization of intersex, criteria for assignment have evolved over the decades, as clinical understanding of biological factors and diagnostic tests have improved, as surgical techniques have changed and potential complications have become clearer, and in response to the outcomes and opinions of adults who have grown up with various intersex conditions. Before

3720-409: Was standard when he used it, to refer to transsexual women. He says that he now tries to choose his words more sensitively. Sexologist Charles Allen Moser is likewise critical of the terminology. Use of androphilia and gynephilia was proposed and popularized by psychologist Ron Langevin in the 1980s. Psychologist Stephen T. Wegener writes, "Langevin makes several concrete suggestions regarding

3782-610: Was termed the "Optimal gender model". In recent years, the perceived need to legally assign sex is increasingly being challenged by transgender, transsexual, and intersex people. A report for the Dutch Ministry of Security and Justice states "Gender increasingly seems to be perceived as a 'sensitive' identity feature, but so far is not regarded, nor protected as such in privacy regulations". Australian government guidelines state that "departments and agencies that collect sex and/or gender information must not collect information unless it

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3844-534: Was too poor to attempt to predict future development in most cases. In the 1950s, endocrinologists developed a basic understanding of the major intersex conditions such as congenital adrenal hyperplasia (CAH), androgen insensitivity syndrome , and mixed gonadal dysgenesis . The discovery of cortisone allowed survival of infants with severe CAH for the first time. New hormone tests and karyotypes allowed more confident diagnosis in infancy and prediction of future development. Sex assignment became more than choosing

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