The she-male phenomenon and the concept of partial autogynephilia

Abstract

The term autogynephilia denotes a male's propensity to be sexually aroused by the thought or image of himself with female attributes. Some autogynephiles imagine themselves, in their sexual fantasies, as complete women. Others, here called partial autogynephiles, imagine themselves with a mixture of male and female anatomic features, usually women's breasts and men's genitals. Partial autogynephiles evince a particular sexual interest in those individuals known in the vernacular as she-males. These are men, often involved in prostitution or pornography, who have undergone breast augmentation while maintaining their male genitals. Partial autogynephiles appear less likely to pursue surgical sex reassignment than gender-dysphoric men whose erotic self-image includes a vagina. Some patients with a persistent desire for women's breasts but no or conflicted desires to live as women full-time or undergo vaginoplasty may be pacified with mildly feminizing doses of estrogenic hormones.