The Anne Who Would Be Queen

The Pseudoscience of "Autogynephilia" and Identity Politics

Synopsis

This essay explores three issues regarding Anne Lawrence:

1. A pattern of sexualized obsession with ritualized genital modification and the devastating effect self-hatred has had throughout Dr. Lawrence's life.

2. A pattern of professional and intellectual arrogance, and the corrosive effect it has had on Dr. Lawrence's personal and professional life.

3. Endorsement of The Man Who Would Be Queen by J. Michael Bailey and the book's similarities to Dr. Lawrence: extremely sexualized and full of arrogant assumptions.

Author's note

Because Dr. Lawrence was once a respected member of the transgender community, and because of the subject matter, this essay has a very different feel than most of my writings. I have tried to remain generally respectful when presenting the facts and my commentary. The author would like to thank everyone who shared their experiences and research. Anyone with additional information may contact me.

Contents

Introduction

Ray Blanchard and systemizing through sexuality

Dr. Lawrence and “autogynephilia"

Biographical outline

Childhood and adolescence: truth from a "type two"?

1980-1994: failed attempt at "reparative therapy"

Fascination with ritualized genital modification

1995-1996: ends marriage

A side note on sexualization of professional services

Erotic motivation

1997: ends career

1998: affects community position

1999: ends our collaboration

Negative peer response

2000: leads to revision of autogynephilia essay

2001 and 2002: leads to revision of website

2003: leads to further isolation from peers

Conclusion

A personal note

References

Appendix One: 1997 professional conduct investigation and subsequent resignation

Appendix Two: Observations from my encounter with Dr. Lawrence


Introduction

Sexologist Anne Lawrence considers J. Michael Bailey’s The Man Who Would Be Queen “easily the best” book of its kind and “highly recommended.” [1] Bailey’s book claims the film quoted below features people such as Dr. Lawrence “and their like”:

… not a real transsexual, but he thinks he is. He tries to be. He's tried to be a lot of things, I expect… hates his own identity, he always has - and he thinks that makes him a transsexual. [2]

Given Bailey's breathtaking assertions, why would Dr. Lawrence feel this book is “remarkable for its insight”[3]? It seems almost incomprehensible at first, but a closer look into the mind and actions of Dr. Lawrence gives a glimpse into why a book which most people would consider an outrageous slur fits into Dr. Lawrence's self-identification.

Taking the quotation above as a starting point, this essay explores a lot of things Dr. Lawrence has tried to be:

  • . . husband
  • . normal male”
  • . . anesthesiologist
  • . “socially appropriate woman”
  • . . book collaborator
  • . . seducer
  • . . self-crowned “queen” of those who seek feminization

This essay will elaborate on how Dr. Lawrence’s erotic interest in genital modification and near-insatiable levels of autoerotic sexuality ended up damaging or destroying a lot of these things Dr. Lawrence has tried to be.

For almost anyone who isn’t Dr. Lawrence, the publication of Bailey’s book marks a low point in the history of transsexualism. Bailey makes observations and claims in the name of “science” which many consider to be scientifically unsound and deeply biased. Many feel it’s the most defamatory book on transsexualism since Janice Raymond wrote The Transsexual Empire in 1979. Beyond the book’s general offensiveness, many find the influential positions of the three people aggressively promoting this book and the theories behind it even more troubling.

Dr. Lawrence is one of the great champions of Bailey’s book and of Ray Blanchard’s invention of “autogynephilia,” or the fetishization of oneself as a woman. I dismantle this wrongheaded concept in my essay on disease models of gender variance, which examines Blanchard’s obscure and largely forgotten body of published work on transsexualism. This essay seeks to explain why Blanchard’s vague and inaccurate neologism is so personally important to Dr. Lawrence.

Dr. Lawrence has the near-obsessive need for categorization that has a rich history in the study of transsexualism. In the parlance of Dr. Lawrence’s academic cohorts, this need for systemizing is considered a hallmark of a “male brain.” [4] The people who seem most caught up in which “type” they are seem interested in creating a hierarchy for leveraging power from those constructed categories. Seemingly lacking from Bailey’s, Blanchard’s, and Lawrence’s minds are what peers like Dr. Baron-Cohen call the “female” cognitive profile of empathizing.

Ray Blanchard and systemizing through sexuality

I fell for this simplistic trap of categorization myself early on. Back when I first got on the internet in 1995, I had come across some of Ray Blanchard’s early writings on the “types” of transsexuals and summarized them online. It seemed like a useful rudimentary way to think about sexuality in our community, and I still believe it has its limited uses in explaining that sexual orientation and gender identity are not the same thing. As many others have, I also did not grasp that this was a paraphilic model which casts our motivations as a sex-fueled mental illness. One of my majors was classical Greek, so I assumed "philia" (friendly love, affection, friendship) could be considered in apposition to "phobia" (panic fear/hatred) and suggested to Dr. Lawrence that my own motivation might be better described as "autoandrophobia," a hatred of my self as male.

The problem is that Blanchard later collapsed all but one of the sexual orientations we might have (even the lack of one) into a fetish he calls “autogynephilia.” I believe this effaces important distinctions between interest in feminization, erotic interest in feminization, and autoerotic interest in feminization. It also effaces typical clinical distinctions between transsexual and non-transsexual gender variance. Blanchard's decision to change his label for the other type from “androphilic” to “homosexual” ensured that virtually any transsexual woman would find his taxonomy offensive.

As I have said many times, erotic interest is a perfectly valid reason for seeking feminization. In fact, I have frequently counseled people who appeared to have erotic or autoerotic interest in feminization to write to Dr. Lawrence. I have also decried the Standards of Care for forcing people like Dr. Lawrence to live in a female role, if all they want is to get genital modification and admire their altered bodies in a mirror or among others who share their fetish.

Why should body mod enthusiasts like Dr. Lawrence be forced to jeopardize jobs, relationships, and even their own safety by making a potentially abortive attempt at being socially accepted as female, just because they want to modify their bodies?

As I came to understand the deeper issues and problems of taxonomy, I began to see how Blanchard’s seemingly benign categories were ultimately dehumanizing to transsexual women, by suggesting our motivation can be placed along an axis of sexuality. Not only is this inaccurate, it plays into the most pervasive stereotypes we deal with on a daily basis. Add to that the breathtaking stories of treatment at the hands of Blanchard by women forced to pass through the gates he kept at Toronto’s Clarke Institute, and I started to see how we were dealing with a modern-day Procrustes: a petty tyrant with a penchant for making vulnerable people conform to his specifications in order to get access to treatment he controlled. Anyone with any other option financially steered clear of “Jurassic Clarke,” as it came to be known.

I have dealt with Bailey and Blanchard elsewhere. Since Dr. Lawrence is part of the transgender community, I plan to treat Dr. Lawrence with as much inclusion and empathy as possible, in hopes Dr. Lawrence will come to understand how much damage this systemizing does to those who do not share Dr. Lawrence’s feelings and motivations. This article lays out my personal experiences with Dr. Lawrence, and explores some of the reasons Dr. Lawrence may be promoting “autogynephilia” with near-religious zeal, everything else be damned, whether it’s the larger political issues or the opinions of those who have differing views.

Dr. Lawrence and “autogynephilia

Before I start, I want to reiterate that I consider Dr. Lawrence’s work on behalf of those seeking feminization to be among the finest medical information on the net. In fact, Dr. Lawrence and I both had the same basic ideas of what needed to be done for anyone seeking feminization: to discuss options and resources that help everyone, no matter what their goals. Dr. Lawrence’s own focus from the onset was two of the so-called "triadic therapies": hormones (HRT) and vaginoplasty, which Lawrence calls sex reassignment surgery (SRS). The social component, sometimes called the Real Life Test (RLT), was of considerably less importance to Dr. Lawrence. As we will see, after completing most physical aspects of gender transition, Dr. Lawrence was still unable to pass this real life test and was forced to resign because of the combination of (auto)erotic obsession and lack of social acceptance in the workplace.

As a consumer activist, I have a great deal of admiration for what Dr. Lawrence has done online. We both realized early on that the internet is one of the most important advances for people with gender identity syndromes. It’s a place where a scattered group of people can gather and share information and experiences, anonymously if needed, and on a global scale. Our goals were so much in synch that we had even split up tasks for writing a book together on the practical aspects of transition in 1999. At the time, I saw Dr. Lawrence’s devotion to “autogynephilia” as a way to shore up sagging self-esteem. Dr. Lawrence had confided in feeling inadequate around me (see Pink Triangulation), and this theory seemed to give Dr. Lawrence’s life meaning and mitigate the inadequacy Dr. Lawrence felt around assimilated transsexual women. It was not until 2003 that I came to understand the larger issues and problems surrounding this taxonomy.

I find it very telling that since this essay was written, Dr. Lawrence has removed links and materials on annelawrence. com that contradict the image Dr. Lawrence wants to present. That includes removing links from this site and several other resource sites.

I have written a great deal on "autogynephilia" elsewhere, but here's a good way to think about what it describes.

"Autogynephilia" is like a horoscope: so vague and generalized that anyone can see themselves or others in it if they want to.

Unfortunately, Dr. Lawrence is a true believer, even believing it has predictive life-shaping powers, as if "autogynephilic" were a zodiac sign.


Biographical outline

Childhood and adolescence: truth from a "type two"?

Let’s take a look at the events that led up to Dr. Lawrence’s obsession with the identity politics surrounding the concept of “autogynephilia.”

Dr. Lawrence makes this self-report, though we find ourselves in a bit of a conundrum here. “Autogynephiles” are liars when they do not agree with Blanchard's and Bailey's two-type theory, but “honest and open” when they do. [5] Dr. Lawrence’s friend Blanchard would suspect there’s a fair amount of “systematic distortion” in Lawrence’s tale. [6] Bailey would be less generous, saying Lawrence’s narrative below is full of “common lies” [7]:

I have wished to be female since early childhood. I began cross-dressing at age eight. In adolescence I affected an effeminate appearance, and was widely regarded as gay. At age 18, I began to self- administer chemical-grade diethylstilbesterol, in an attempt to feminize my body. I continued to cross-dress and to self-administer hormones in college, in medical school, and during my residency. [8]

As Bailey notes, "members of one type sometimes misrepresent themselves as members of the other" [9]. Since much of this self report is "type one" behavior according to Dr. Lawrence's mentors (feelings since early childhood, adolescent effeminacy, taken to be gay), this report calls into question whether Dr. Lawrence can be trusted to tell the truth. These claims might be dismissed by Bailey as "misleading, and in important respects, false." [10]

In their model, these early childhood feelings Dr. Lawrence claims to have had did not have anything to do with gender identity (these people seem to question if that even exists), but were rather part of a sex-fueled mental illness they call "autogynephilia." Blanchard has been busy trying to get this term shoehorned into the American Psychiatric Association's big book of mental disorders. Children like Dr. Lawrence are little perv-- um, I mean "paraphilics," to use the term Bailey-Blanchard-Lawrence prefer.

1980-1994: failed attempt at "reparative therapy"

In the binge-and-purge cycle common among self-hating crossdressers, Dr. Lawrence attempted a "cure" similar to the kind done by other self-hating queers.

The following is from Dr. Lawrence's website:

In my thirties, I tried to put aside my cross-gender leanings and to function as a normal male, socially and mentally. This was, of course, unsuccessful. [11]

I won't get into however Dr. Lawrence defines a "normal male," but it appears to involve a belief in some social imperative of marriage and some biological imperative of procreation. Dr. Lawrence married in December 1987, but the marriage was “rocky from the start.” That didn’t stop them from conceiving a child within a few weeks and a second one half a year after the first was born.

In 1992, when their tiny daughter was two, Dr. Lawrence went back to old ways and started on hormones again, upping dosages and undergoing electrolysis through 1994. By the end of that year, Dr. Lawrence had heard about the work of surgeon Toby Meltzer.

By 1995, the stage was set. Dr. Lawrence was done trying to be the first two of a lot of things: husband and "normal male."

1995-1996: fascination with ritualized genital modification ends marriage

Two months after their daughter’s 5th birthday [12], Dr. Lawrence abandoned their “empty marriage.” [13] That summer, Dr. Lawrence observed surgeon Toby Meltzer do a procedure on a transsexual patient. Dr. Lawrence obtained a court order for name change on 26 October 1995, three weeks before turning 45. Dr. Lawrence revised records with the Department of Motor Vehicles the next day and requested that medical license records be revised in a letter sent out on Halloween.

It is interesting to note that Dr. Lawrence and friends self-identify as "politically incorrect," yet Dr. Lawrence cites "politically correct" gender-friendly laws in the coming out letter written to Swedish staff. Dr. Lawrence expected people to respond in a "politically correct" way (i.e. respect and sensitivity), yet seems genuinely unconcerned when political activists try to explain what a political nightmare Dr. Lawrence is now, by undermining the laws which give us rights as women. We can legislate against discrimination, but we cannot legislate social acceptance. That has to be earned slowly, by convincing those who think it's all just "political correctness" to use certain words and to be more empathetic. People like Bailey-Blanchard-Lawrence are dismissive of "political correctness," but when forced by irresistible social pressures, find other more subtle ways to act out their contempt and bigotry. Prejudice can be driven underground, but it can rarely be killed outright.

Although a member of HBIGDA, a trade group which advocates a one-year "real-life test" for gender-variant people seeking genital modification, Dr. Lawrence was getting genital modification less than half a year after going full-time. Perhaps this truncated real-life test partially explains Lawrence's later problems adjusting at work. On 29 April 1996, Dr. Lawrence underwent genital modification.

Dr. Lawrence's remarkable account of the event, called Taking Portlandia's Hand, is worth reading in its entirety [14]. Much of it, like the section on the procedure itself (unironically titled "The Parts I Miss") reads like standard Lawrence fare. The remainder is imbued with the language of religion and ritual Dr. Lawrence reserves for narratives of genital modification.

Three themes emerge in reading Dr. Lawrence's surgical account which are indications of problems to come:

  1. Expectation of special treatment by peers
  2. Conflation of medical procedures and sexualized rites
  3. Cathexis and apotheosis

1. Expectation of special treatment by peers (which feels much like bragging):

  • Dr. Lawrence requested to observe a surgical procedure and "I liked what I saw."
  • "I get to call him Toby."
  • Meltzer makes special arrangements for Dr. Lawrence's surgery date.
  • Dr. Lawrence makes special arrangements with the anesthesiologist for an epidural.

    This expectation of deferential treatment led to a running feud with Eugene Schrang, which culminated in threats of litigation by Dr. Schrang and other surgeons (see 2001-2002 below)

2. Conflation of medical procedures and sexualized rites

In this aspect, it is clear that this surgical procedure was one of the most meaningful events in Dr. Lawrence's life, to the point of being religious. Dr. Lawrence mentions an invented "goddess" no fewer than 8 times in the essay, and imagines beind a "priestess" of said deity Portlandia.

The morning of surgery starts with an invented ritual:

"I wake up enough for the obligatory ritual of 'wringing the turkey's neck.' I half expect this will be the last orgasm of my life. Looking at my rapidly waning erection, I can summon no sadness or hesitation at my impending emasculation." [14]

Most women I know did not do this supposedly "obligatory ritual." My mom was in my hotel room, and even if she hadn't been, I would not have bothered. It does make me wonder what Dr. Lawrence was focusing on when this orgasm occurred. I have my own theories on that, but maybe it would be better to hear from Dr. Lawrence.

After surgery, when most of us are too groggy to remember anything, Dr. Lawrence was already taking a look before leaving the recovery room. Perhaps this is why Dr. Lawrence had an epidural: the ritual itself was something to remember. "Twice that night I take out my hand mirror and check my genitalia." Later in the shower, "I finally get a really good look at my crotch."

This next part reads like amateur pornography written specifically for people who get off sexually on stories of this sort (usually called "forced feminization" stories):

"Dr. Nguyen smiles reassuringly, lubes up the smallest dilator, and gently but very quickly slides it into me, a full six inches. I let out an involuntary squeal of surprise, indignation and intense feeling - - it's not exactly painful, but it's surely not pleasurable, either. Next, he inserts the 1-1/8 inch dilator. This time I'm ready, and I merely pant loudly, anticipating pain that never comes. However, when he lubes up the 1-1/4 inch dilator, I'm again incredulous: "That will never fit!" But somehow it does. Grinning with insane delight, I pick up my hand mirror and take a good look. There it is, thick as a closet rod, inserted 6 inches into me. For so many years I have longed to be penetrable, to be a vessel, a receptacle: and now I am." [14]

Hey, news flash, Dr. Sexology: you were penetrable before you got genital modification. Sometimes I just have to shake my head that someone this cluelessly sexist is considered an expert on anything pertaining to sex. I mean, seriously. I could go off on all this, but I promised I'd go easy, didn't I.

In Dr. Lawrence's mind, this medical procedure seems to fall somewhere between a female circumcision at puberty and the deflowering of a virgin bride, participation in the most fundamentally sexist of social rituals. We'll be talking more about female circumcision in a moment, unfortunately.

3. Cathexis and apotheosis

Cathexis is a psychological term that could be described as concentration of emotional energy on an object or idea, or more elegantly, "the conscious expression of an unconscious intentionality." [15]

Among the examples of taking Dr. Meltzer as a symbolic lover/god (cathexis/apotheosis):

"Why have I never before noticed what a handsome man he is?"

"I thank Toby sincerely for the care he has so skillfully and gently provided me. He watches me dilate, and says candidly that he thinks this one of his nicer looking results."

I’ve gone through some frightening surgeries, not to mention a whole second puberty, with a kind of existential calm, putting myself almost like a child into my physicians’ hands. It has felt very much like giving my body to a lover – I’ve relished the intimacy, the loss of the weight of aloneness. Most important of all have been simply the blessings of touch, which convey my caregivers’ acceptance, at some level, of a body that I have struggled to accept. I’ve learned something about healing from giving control of my body to a benevolent other – physician, or lover – whose acts of caring or desire, seemingly beyond my control, have finally let me believe, at least at times, that my body is worthy of love, worthy to be in this world. [16]

Whether priest or lover, or both, Meltzer became the intercessor or facilitator of Dr. Lawrence's prayers. For this he apparently has Dr. Lawrence's undying loyalty, to the point that Dr. Lawrence defiles and blasphemes lesser gods like Euguene Schrang and some of the Thai doctors who do not show what Dr. Lawrence considers the appropriate deference to Meltzer or his self-appointed "priestess." (see 2001-2002 below)

For someone like Dr. Lawrence, a surgeon appears to be standing in for the male lover they will never have.

A side note on sexualization of professional services

Because of its popularity, I spun my consumer information on hair removal for transsexual women off into a general market site, including a popular hair removal forum. Because of the level of interest and possible offensiveness to more sensitive readers, I decided to make a separate forum on genital hair removal.

Dr. Lawrence's story has remarkable similarities to stories I hear from a certain type of client of professional hair removal practitioners. Many practitioners lament that they get an occasional "creepy" (their word) customer who gets off sexually on the performance of the procedure. These male consumers frequently want genital hair removal, and they frequently get very aroused. In fact, the majority of electrologists will not work on male genital areas because they've had a run-in with one of these types.

Below are excerpts from a post by one such male consumer:

"Intimacy

"Laser required that the woman shave me, very intimate, then she would apply a thick gel all over me, also very intimate, then after being treated she would remove the gel and then apply aloe. Well I am only human and she caused me to become aroused and luckily for me she liked it.

"Electrolysis is a little bit more straight forward. She does have to touch me a lot more than laser. She will use both hands to get at the areas being treated. She will hold the scrotum and penis in her hands to be able to get at the hairs, and of course this is done for a much longer time, in my case one full hour.

"She did not say anything at all about me becoming aroused. I did also very much enjoy having my buttocks treated too.

"I think electrolysis is a lot more intimate than laser but there are more fun things that happen at laser than electrolysis." [17]

And a second post from the same man:

"I found myself getting aroused whenever I thought about going for my second appointment because of how good it felt to have these things done to me. So at my second appointment I was pretty nervous about getting an erection. I had no choice I had to tell her this because it was beginning to happen.

"I'm going to miss her. She treats me more like a friend than a client." [18]

I know a masseuse who has the same client issue. There are some people who find the tension of "professionalism" and intimate or embarassing procedures to be very arousing.

The doctor/patient roleplay is well-known in fetish circles, but what we have in Dr. Lawrence is an erotic interest involving the procedure itself, and breaking the taboo of turning it into an erotic event.

Erotic motivation

I believe that Dr. Lawrence's erotic interest is not of "oneself as a woman" (whatever that bit of vagueness means), but as a passive recipient of medicalized feminization. I see Lawrence's interest as somewhat akin to people who watch surgical procedures on The Learning Channel. It's clear from the email I sometimes receive that some people who read my surgical journal do not do so for practical consumer information (the intended audience), but for sexual reasons.

One reason I know this is because my own SRS experience pages get read by a very different crowd than the rest of my site. The majority of people who enter my site directly on the SRS page versus coming to my main page are coming from links on Dr. Lawrence's site. These sort of people usually have questions about what it "feels like," or what a specific part of the procedure was like. Many request to see photos of the procedure itself, or "before and after photos." They wish to live the experience vicariously; for them, it's a sort of porn verité.

I have come to see Dr. Lawrence as an erotic fancier of genital modification, rather than a consumer reporter on a medical procedure as I originally thought. A crotch connoisseur, a "gyno fetish" enthusiast.

This erotic interest, which is far more specific than whatever "autogynephilia" is supposed to mean, is something others share. For instance, a story that seems related resides on Dr. Lawrence's site, about Tess Cowell who wanted a very specific genital modification in which a vagina was created but the testicles were left intact to improve sexual response, under the extraordinarily telling title of Meet Tess: A New Dance of Scalpel and Soul. The body modification enthusiasts also overlap with those who contact me about my orchiectomy section. In fact, I ended up creating an entire section on other issues and motivations for the non-transsexual audience.

By the time that first year of full-time living comes around, Dr. Lawrence has completed genital modification and is officially divorced.

Dr. Lawrence heard an invented Goddess say that genital modification "is likely the only way to find peace." Would the genital modification and divorce of 1996 end Dr. Lawrence's troubles and allow for moving on to happier days? Far from it.

1997: fascination with ritualized genital modification ends career

After indulging an erotic interest surrounding medically-constructed vaginas and genital modification in 1996, Dr. Lawrence subsequently learned the hard way that society's current threshold for acceptable "female" presentation is more nuanced than simply buying a vagina. Dr. Lawrence’s inability to be accepted socially by coworkers and patients culminated in a forced resignation in 1997, after a March 31 incident where Lawrence examined an unconscious Ethiopian patient’s vagina for signs of ritualized genital modification. Below is a synopsis of the case summary from the state investigation:

05-22-97 Call from Lee Norman. Lawrence resigned. Reason threat of adverse action. She plea bargained to stave off investigation. Unauthorized exam of pateint [sic]... Question of moral turpitude.

Dr. Lawrence had just anesthetized a patient whose legs were spread and in stirrups in preparation for a hysterectomy. The circulating nurse noted that the patient was already shaved.

Dr. Lawrence came around the head of the table to see, and asked the gynecologist if the patient had her genitalia altered.

Gynecologist: “No.”

Dr. Lawrence: “Are you sure that she has not been circumcised?”

Gynecologist: “She has not.”

Dr. Lawrence: “She looks like she had something done, she doesn’t look right.”

Gynecologist: “It probably looks different because she shaved herself, which may be a cultural thing.”

Dr. Lawrence: “I still think she has something done.”

Gynecologist: “No, its just aging.”

The gynecologist then left the operating room to scrub. Dr. Lawrence then put on an exam glove and checked the patient’s genitals.

Dr. Lawrence: “Oh, there is her clit, I guess she is OK.” and then returned to the head of the bed.

This led to adverse action reports filed on 19 May, and Dr. Lawrence's resignation a few days later, according to Lee Norman, Senior Vice President for Medical Staff Affairs at Dr. Lawrence's hospital. From the investigation's activity report:

05-22-97 Call from Lee Norman. Lawrence resigned. Reason threat of adverse action. She plea bargained to stave off investigation. Unauthorized exam of pateint. [... edited* ...] The patient was not harmed. Question of moral turpitude.

* The online transcription which originally reported this incident alleges the edited line was: "Respondent has been having bizarre behavior for a while."

The lawyer response and Dr. Lawrence's response suggest that this incident was a pretense for getting rid of Dr. Lawrence.

The unauthorized exam seems more understandable in the context of eroticism and professional hubris. Dr. Lawrence arrogantly refused to believe a peer who repeated several times something Dr. Lawrence did not believe regarding ritualized genital modification.

It appears that this arrogance and sexualized fascination clouded Dr. Lawrence's judgment and caused the destruction of Dr. Lawrence's 20-year career in anesthesiology.

For details, including selected original documents from the state investigation, please see the section on Dr. Lawrence's 1997 incident and resignation.

By the end of 1997, Dr. Lawrence had left anesthesiology behind and was enrolled at the Institute for the Advanced Study of Human Sexuality in San Francisco. I will be writing an entire sordid essay about this school in upcoming months. Suffice it to say for now that the deeper one digs into this whole story, the more disturbing it gets.

Thus marks the end of two more things Lawrence tried to be: anesthesiologist and “socially appropriate woman.” It turns out that acceptance as female, like anesthesia and academic work, is subject to peer review.

1998: fascination with ritualized genital modification affects community position

Dr. Lawrence found out the hard way that lying on an operating table does not make you a woman, at least in the eyes of many others. There is certainly a great deal of psychic trauma that occurs when your self-identification is not reflected by others, or even rejected outright.

Without a spouse, a career, or acceptance as female outside a tiny peer group, Dr. Lawrence redoubled efforts in this last area. The TWR website expanded greatly during this time, but perhaps the most notable incident was the meaning Dr. Lawrence found in "autogynephilia" at a time when many other things that gave Dr. Lawrence's life meaning had disappeared.

In October, 1998, Dr. Lawrence web-published an essay called "Men Trapped in Men's Bodies: An Introduction to the Concept of Autogynephilia." [19]

The deliberately provocative title and suggestion that transsexual women shared this fetish touched off a fierce debate. In time, Dr. Lawrence got a Ph.D. to increase credibility while proselytizing for this theory among academics and helping professionals.

Dr. Lawrence notes that Blanchard's writings were so "personally meaningful" that "I continue to regard this as one of the most brilliant and insightful analyses in the entire clinical literature devoted to transsexuality." [20] According to Blanchard:

Autogynephilia takes a variety of forms. Some men are most aroused sexually by the idea of wearing women's clothes, and they are primarily interested in wearing women's clothes. Some men are most aroused sexually by the idea of having a woman's body, and they are most interested in acquiring a woman's body. Viewed in this light, the desire for sex reassignment surgery of the latter group appears as logical as the desire of heterosexual men to marry wives, the desire of homosexual men to establish permanent relationships with male partners, and perhaps the desire of other paraphilic men to bond with their paraphilic objects in ways no one has thought to observe." [21]

As with similar devotion to Dr. Meltzer, Dr. Lawrence’s devotion and gratitude to Ray Blanchard transcend professional admiration, perhaps being better described as deification. This is rather common. Many women have worshipful attitudes about their SRS surgeons, so much so that even the mildest criticism or comparison of two surgeons can be met with a most unpleasant response.

Milder forms of this occur throughout our community. In my own case, I am at the forefront of evangelists for facial feminization surgery (now called simply FFS thanks to efforts to cast its importance as similar to other abbreviated procedures like SRS, HRT, RLT, etc.), and specifically for Douglas Ousterhout, whose work changed my life and remains the best investment I have ever made. Lynn Conway’s praise for Harry Benjamin (who created his own troublesome taxonomy). The devotion some have to Jennifer Reitz’s COGIATI, an online test with what I consider facile questions to determine what “type” of gender issues you are dealing with. Lynn and I certainly do not consider Benjamin or Ousterhout above criticism, and we both discuss our concerns about Benjamin's taxonomy and Ousterhout's occasional patient complications among our praise for their pioneering efforts.

In my “note on gender tests” I list the problems with taxonomies, ending with the problem that is hardest for some people to see: that gender tests propose rigid categories that are in reality arbitrary and fluid. Classifications and categories can have their uses, but there is ultimately a point where any classification system fails. There will always be an exception, and the simpler the categories seem, the more likely there will be exceptions. I discuss these issues in detail in my essay “The uses and limitations of transsexual categories.”

Ironically, Dr. Lawrence states: "I think that both the COGIATI and the Moir-Jessel tests are little more than pseudo-scientific nonsense, and that anyone trying to figure out his or her gender identity issues would be well advised to ignore both." [22] It is interesting that Dr. Lawrence considers these earlier tests nonsense, yet unironically endorses Bailey, whose own gender test is based on equally questionable methodology and assumptions. Dr. Lawrence called one of these earlier tests “a sloppy piece of pop science, full of oversimplifications, unsupported inferences, and speculations presented as though they were facts,” the very charges leveled by myself and others at Bailey.

So why does Dr. Lawrence dismiss these other tests and categories, but embrace "autogynephilia" and any ancillary theories with such religious zeal?

The pseudoscientific term "autogynephilia" allows Dr. Lawrence to lump a highly unusual erotic interest surrounding ritualized genital modification in with an established condition (transsexualism).

Doing so makes Dr. Lawrence's sexual activity more "socially acceptable," the way a compulsive overeater might claim to have a thyroid condition.

Had Dr. Lawrence remained focused on medical resources, I have no doubt Dr. Lawrence would have gone down in history as not only a priestess, but a truly beatific figure. Had these erotic feelings been reported in an expressive and personal way, some may have been uncomfortable, but most would have admired Dr. Lawrence's honesty. But in joining the Bailey-Blanchard crowd by projecting this compulsive eroticism onto the rest of us, Dr. Lawrence once again dismantled years of efforts. Once again, the same tragic arrogance and presumptive attitudes of superiority come back to destroy something Dr. Lawrence had worked hard to earn.

1999: fascination with ritualized genital modification ends collaboration

Let me say at the onset that I planned to take the following incident to my grave until late 2002, when I first learned about Dr. Lawrence's unauthorized exam spurred by a fetish for genital modification. I was still planning to keep this private until 2003, when Dr. Lawrence called me a fundamentalist for coming out against Bailey's bigotry. When Dr. Lawrence said accuracy must not be important to me, that was the day I decided to order the dossier from the state of Washington. Let's get accurate.

Some background: I began a website on transsexualism in late 1996, mainly to focus my mental energy while I was in transition. I had found it very frustrating to find reliable information since I was 11, when I first saw the word "transsexual" in a book. Before then, I'd heard rumors it was possible, but I'd never seen proof.

When creating the site, I took a pragmatic viewpoint. My years in advertising had trained me to spot consumer fraud, and there was a lot of it targeted at transgender women. While most fraud was devoted to gouging crossdressers and late transitioners with lots of disposable income, I was concerned that the Wild West atmosphere of the internet at the time might lure younger people in our community into wasting a lot of money they could not afford to lose.

Hormones and SRS were already covered quite well online by the crowd who felt those things “made you a woman,” and my own interest was to discuss what I felt was the more important part of transition: being able to function in society and be accepted as female by coworkers, friends, family, and acquaintances.

In 1999, Dr. Lawrence and I discussed collaborating on a book, to the point that we met at Dr. Lawrence's home and split up chapters to write. During a pleasant afternoon talking with someone whom I admire greatly, we discussed a number of interesting topics, the more relevant of which I discuss here.

We also discussed transsexual sexuality, my own motivation, as well as voice and transsexualism, both at Dr. Lawrence's home and at a restaurant. I relate pertinent parts in the Appendix on my encounter.

Failed seduction

Because I had found contributions by others helpful in narrowing down surgeon choices, and because of my interest in consumer issues, I was happy to share my surgical results after seeing Dr. Meltzer. Though I had my surgery experiences on my site, I did not want to have photos of my own vagina up on my site. A little too personal.

In retrospect, I suppose I was being idealistic or naive. It honestly had not occurred to me that anyone might get off on the photos submitted for Dr. Lawrence's site, though I suppose it should have. I have since found out that people have masturbated to my before/after FFS pictures, which combined with being spread all over the web for commentary by people outside the community, prompted me to remove them. Others have told me they have masturbated to breast augmentation before/after photos I have linked on my site. It turns out there are people who masturbate to the diaries and blogs of transsexuals going about their daily lives. Shoulda seen it coming, so to speak.

At this point, I will not be the least bit surprised if I learn that someone masturbates to the story I'm about to tell, or that people think I'm telling it because I get off on it myself. For what it's worth, it was anything but sexy, believe me.

Before I got there, I told Dr. Lawrence I was willing to have my surgical result photos put in the section of Meltzer results. I also requested that Dr. Lawrence put up photos of my problems with my right breast implant, which had to be repositioned under a local when I had labiaplasty. Besides being excruciating, it had left a much worse scar and still caused considerable capsular contraction. Dr. Lawrence never put this unsatisfactory Meltzer result up, although the vagina photo Dr. Lawrence took is still up.

Before we started, I showed how far I can push my right implant up out of the pocket (less than 2 inches from my collarbone), and Dr. Lawrence took some photos. Dr. Lawrence didn't seem to think it was a big deal, but I kept saying I thought the photos should be put online. Dr. Lawrence then undressed partially and pushed both implants to the side using both pectoral muscles. I talked about how I felt that was unsatisfactory and how I wished I'd gone to someone who specializes in actresses and dancers.

Dr. Lawrence had all the photographic and medical equipment in the bedroom closet. Dr. Lawrence laid down a cloth on the bed for me to lie on, the kind you get when you have SRS. I don't have hangups about my body, and I was thinking of this in a very non-sexual way.

Dr. Lawrence had a very specific set of instructions for how I was to lie and place my hands, similar to the diagram above, but with my heels on the edge of the bed. I'd been wearing a bodysuit that snapped in the crotch, and I could feel the creases where it had left lines on the skin. I asked if it looked weird, like a surgical issue, and Dr. Lawrence said it didn't.

This is going to sound like a cliché, but everything from this point on in the day didn't seem real.

After snapping a couple of shots, Dr. Lawrence spun around on one heel and spun back around in one fluid motion with a surgical glove and some KY jelly. "While I have you here, let me do a quick exam so I can report on your depth.

Dr. Lawrence inserted two gloved fingers inside me and felt around. It all seemed professional enough at the time, and I mentioned that I had something like a tiny seam about an inch in on the left side that often bled after my boyfriend really went to town on me.

Dr. Lawrence removed the gloved finger, and I got up and cleaned up a bit. As I was putting on my clothes, Dr. Lawrence stood still. I looked up.

"Would you like to see my result?"

"Um... I guess."

Dr. Lawrence was on the bed and lifting that dress before I finished putting my underwear back on.

"Looks good," I said as matter-of-factly as possible.

I picked my jeans up off the floor, and when I looked up, Dr. Lawrence was getting undressed. I started feeling as if the floor was tilting. Dr. Lawrence looked me in the eye and backed away from me toward the side of the bed. Without saying a word, Dr. Lawrence started pulling down the covers.

(Typing that sentence just now made me shudder slightly the way I did that day.)

"What are you doing." I said, not posing it as a question.

"I thought..."

"I don't think so." It was as if I could feel the words floating out of my mouth.

Dr. Lawrence didn't press the issue, and quietly dressed.

That was the moment our book collaboration was over in my mind.

I tried not to think about it again until 2002, when I read about Dr. Lawrence's career-ending incident with the unconscious patient. The similarities were so eerily familiar, that I felt violated for the first time. Then I thought about the pictures of my vagina and breasts in Dr. Lawrence's closet, in a stack with who knows how many others. Prior to that, I thought it was weird, and I'd never told anyone, but ever since then I found it very disturbing.

I believe Dr. Lawrence’s site and body of work may be one of the most elaborate personals ads ever created. By being the Queen of the Web and the Queen of Gender and Sexology Conventions, Dr. Lawrence can maintain a position as "respected authority" and, with luck, score a little action.

That Seattle trip marked the end of much of my socializing with the transgender community. I have been much more reclusive until this Bailey-Blanchard-Lawrence outrage.

Thus ended two more things Dr. Lawrence tried to be: book collaborator and seducer of yours truly.

2000: Negative peer response leads to revision of autogynephilia essay

In 2000, Dr. Lawrence came out with a revision of the original Men Trapped In Men's Bodies essay. In it, Dr. Lawrence expressed surprise that this sexualized taxonomy was controversial at all: "Many were angered and offended by my public advocacy of a theory that seemed to deny or devalue their feelings and identities. The reactions of this latter group left me feeling defensive, perplexed, and deeply troubled."

Dr. Lawrence looks at several critiques of Blanchard's theory :

Autogynephilia as "Motive"
Autogynephilia in Androphiles
Gender Non-Conformity in Autogynephiles
Gender Dysphoria Preceding Autogynephilia
Blanchard's Theory in Perspective

I will be dismantling this bizarre and troubling theory and showing how it reflects its adherents' worldviews and motivations in upcoming essays, but I see a direct connection to Dr. Lawrence's 1997 incident.

The unrelenting devotion to this sexualized concept seems more understandable in the context of eroticism and professional hubris. Dr. Lawrence arrogantly refuses to believe peers who have repeated several times something Dr. Lawrence does not believe regarding ritualized genital modification.

2001 and 2002: Negative peer response leads to revision of website

Denigrating work other than Dr. Meltzer's led to threats of litigation from around the world, and forced Dr. Lawrence to remove materials.

As a consumer activist, I have applauded those of us who are willing to make critical commentary about our care provider. Our community rewards these surgeons handsomely for their efforts, and we entrust them with our lives as well as our hard-earned money. For these reasons, they should not be placed above criticism. When Eugene Schrang had a patient die, Dr. Lawrence wrote a highly critical commentary and was roundly criticized for it. I wrote to Dr, Lawrence in support:

I was hoping someone would take this matter seriously. I was amazed to see the topic get almost no response/coverage in TS newsgroups, etc. It seems that people are willing to forgive a massive life-threatening hemorrhage or death once in a while as long as the doctor is "helping the community." Personally, as a consumer group, I think we should demand better, as you so eloquently did.

However, it turned out that some of the anger was based on Dr. Lawrence's apparent anger at not getting the sort of deferential treatment from Schrang that Dr. Lawrence expected. Many noticed a pattern of denigration in Dr. Lawrence's commentary on his surgical outcomes as well.

Dr. Lawrence defiles and blasphemes lesser gods like Schrang and some of the Thai doctors who do not show what Dr. Lawrence considers the appropriate deference to Meltzer or his self-appointed "priestess."

That left Dr. Lawrence with this:

"Note: Information concerning two well-known SRS surgeons was removed from TWR in 2001 and 2002, due to threats of litigation." [24]

The loss of ability to collect data on all surgeons has significantly lessened the value of Dr. Lawrence's site, and raised serious questions about the wisdom of having so much information on a topic concentrated on a single site. Several of us are working on solutions to address the problem of centralized repositories, to avoid significant losses in the event of threats of litigation, and to reduce the potential for abuses of power.

2003: Yet another rejection by peers

Dr. Lawrence's denigration of work other than Bailey and Blanchard led to the writing of this essay and many more in upcoming months exposing the fallacies and fraud of Bailey-Blanchard-Lawrence.

In the same way Bailey has created a belief system in which he is a "single, heterosexual male," Dr. Lawrence has created a system in which "real transsexual" applies to someone sexually obsessed with genitalia. Problem is, they simultaneously cling to rigid medical models which come in direct conflict with their arbitrary and fluid forays into identity politics. It is this contradiction of rigidity and fluidity that make their position so untenable and problematic for transsexual women.

It is my honest belief that Dr. Lawrence and Dr. Bailey are both deserving of intense study by the most notable scholars and therapists of our time. Bailey in particular is going to go down as one of the most celebrated cases in the history of psychological literature, but Dr. Lawrence will make a significant ancillary contribution as well.

I have tried to keep this factual and not very theoretical, because these abstractions are lost on Bailey-Blanchard-Lawrence. Those who imagine sex and sexuality as biological essentialism completely miss the gendered character of sexual desire. If gender is a system of social meanings by which a body enters into sociality, bodies becomes socialized as subjects of states through what R.W. Connell calls “gender regimes.” [23] That is, states are constituted within gender relations, which influence the positions of women and men within a given state. It is within these regimes, and in what I call the tyranny of the binary, that the motivation for transsexual women can be found. I cannot speak to Dr. Lawrence's motivations, but they appear to fall outside the experiences of me and my peers.


Conclusion

We don't see things as they are.
We see things as we are.

For more sophisticated thinkers, the notion of authorial intent went out of fashion a long time ago, as did looking to the body for absolute truths. Problem is, Bailey-Blanchard-Lawrence still desperately try to limn our intent in authoring our own identities with their ridiculous "body phrenology" of plethysmographs and pornography, and zodiac-like "autogynephilic" and "homosexual" sex-signs. Though they don't realize it, their need to do this is merely a projection of their own experiences, which some might characterize as illnesses, onto others.

If necessary, there is much, much more that can be said, things which plumb dark depths I feel are better left undisturbed if possible. You may not believe me, gentle reader, but every sentence in this essay is an exercise in restraint, out of what remains of my respect for Dr. Lawrence.

I have come to see Bailey and Blanchard, and to a lesser extent Lawrence, as critics of our community, rather than "helping professionals." Where I see life, they see sickness. Where I see love, they see sex. Where I see women, they see homosexuals and autogynephiles. Critics.

One becomes a critic when one cannot be an artist, just as a man becomes a stool pigeon when he cannot be a soldier.

-- Gustave Flaubert [24]

I hope I may provoke other critics to make similar confessions. My justification must be that there is no other critic, living or dead, about whose work I am so well informed as I am about my own.

-- T.S. Eliot [25]

When "Cher," aka Anjelica, tried to meet with Dr. Lawrence at Mike Bailey's suggestion, Anjelica instead met with resistance and avoidance. This is a real shame. I have learned a great deal in the short time I've known her, and Dr. Lawrence could have too, if it weren't for that pesky sense of hubris:

To the extent that transsexuals seek validation at the temple of science, with its secular priests, (most often void of spiritual and symbolic understanding of nature and myth).......we risk forsaking (and invalidating) our innate, intuitive, instinctive and "shamanic" heritage........We allow the Blanchards and Baileys and Anne Lawrences, the Zuckers and Susan Bradleys and Clarke Institutes to pull off our delicate butterfly and dragonfly wings (that are made of spirit as much as they are made of flesh....spirit glue?) and triumphantly declare, after dissecting, lumping and splitting, that TS's are merely caterpillars, genetically, ...have always been caterpillars and will always be caterpillars.

--Anjelica Kieltyka [26]

A personal note

My laid-back life is now rarely touched by people like these, who carry around this much pain, anger, and entitlement. I actually had to lie down and weep a few times, for Dr. Lawrence, for myself, and for the women in my community who will be hurt by Bailey, Blanchard, and Lawrence before their misguided ideas are inevitably and completely discredited.

Finally, I want to say that writing this has been one of the most depressing experiences of my life. The source materials I had to read made me feel foul and dirty, and dredging up some of these memories have left me saddened beyond measure. You may think I am a terrible person for writing this, or you may think less of me, but I couldn't remain silent while these three set the course for our community's treatment over the next decade. To quote Dr. Lawrence's quotation of Audre Lorde, at the start of Men Trapped In Men's Bodies, "My silences had not protected me. Your silence will not protect you."


References

Please note: Dr. Lawrence is notorious for removing website materials as soon as comments in them become difficult to defend or no longer match the "respected authority" persona Dr. Lawrence tries to cultivate. While every effort has been made to keep up-to-date links, some materials may no longer be available online.

1. annelawrence. com archived 4/22/2003

2. From Silence of the Lambs (1991), referenced at pp. 142-143 in Bailey, J. Michael. The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism. Joseph Henry Press, 2003.

3. Anne Lawrence’s unattributed review on Amazon.com, dated 4/18/2003, titled “Outstanding Scholarship.”

4.“The male brain is defined psychometrically as those individuals in whom systemizing is significantly better than empathizing, and the female brain is the opposite cognitive profile.” From correspondence with Cambridge University Psychologist Simon Baron-Cohen regarding his book “The Essential Difference,” out in summer 2003.

5. Bailey 147.

6. Blanchard 1985: "Social desirability response set and systematic distortion in the self-report of adult male gender patients." in Archives of Sexual Behavior, v.14(6) pp.505-516).

7. Bailey 173.

8. http://www.annelawrence. com/mytrans.html

9. Bailey 146.

10. Bailey 146.

11. For details on Dr. Lawrence's self-reported life from 1980 to 1996, please see:

12. http://www.annelawrence. com/mytrans.html

13. Lawrence p. 2.

14. Taking Portlandia's Hand

15. http://www.psychomedia.it/rapaport-klein/modell02.htm

16. http://www.annelawrence. com/nottocure.html

17 http://www.hairtell.com/cgi-bin/ubbcgi/ultimatebb.cgi?ubb=get_topic;f=22;t=000079

18. http://www.hairtell.com/cgi-bin/ubbcgi/ultimatebb.cgi?ubb=get_topic;f=22;t=000044

19."Men Trapped in Men's Bodies: An Introduction to the Concept of Autogynephilia."

20. http://www.annelawrence. com/newintroagp.html

21. (pp. 245-246) Blanchard R (1991) Clinical observations and systematic studies of autogynephilia. J Sex Marital Ther 17(4), 235-251.

22. http://www.annelawrence. com/faqs2.htm

23. Connell, R. W. "Gender Regimes and Gender Order" in Connell, R.W. Gender and Power. Stanford: Stanford University Press, 1987, pp. 23-66

24. http://www.annelawrence. com/srsindex.html

25. Gustave Flaubert, letter to Madame Louise Colet (August 12, 1846)

26. T.S. Eliot, To Criticize the Critic (p. 11) 1965: Noonday Press, New York.

27. Personal correspondence with the author, June 2003.

Appendices

Appendix One: 1997 professional conduct investigation and subsequent resignation

Appendix Two: Observations from my encounter with Dr. Lawrence

If there are any factual errors in this report, they are inadvertent. Please contact me to report them.