AGP - Avoid General Population

Let's make Autogynephilia taboo

In previous work, I have argued that The Cass Review did not go far enough. Specifically, Dr Cass's report failed to examine the ethical questions posed by both the nature of sex-trait modification treatments and the clinical decision making behind their prescription. If there is a reason why The Cass Review put too much weight on the idea that some patients benefit from demonstrably harmful interventions, and not enough weight on the inability of doctors to accurately diagnose those who will not come to regret them, then that reason is ‘lived experience’. Cass consulted far more widely and deeply with self-proclaimed beneficiaries of such treatments than she did with sceptics. The trouble is, those advocates of transgenderism have a range of reasons why their testimony is unreliable. The three main ones are: the desire to be seen as normal (validation), the associated dopaminergic addiction, and the sunk cost fallacy.

So-called ‘lived’ (is there any other kind) experience is subjective, making it less reliable than objective sources. In the realm of gender medicine this unreliability is compounded with powerful cognitive biases.

It is an objective truth that the normalisation of transgenderism is a contributory factor in the epidemic of adolescents adopting trans identities. This is because transgenderism is an ideation.

Photo by Alexander Grey on Unsplash

The essay Autogynephilia at 35 by Dr Anne Lawrence provides a retrospective examination of autogynephilia (AGP), a paraphilia characterised by male sexual arousal at the thought or image of oneself as a woman. While Lawrence's work aims to explore the personal experiences of those living with AGP, it largely frames the condition sympathetically, overlooking critical safeguarding concerns.

It was the line in that paper: “AGP will inevitably become part of the curriculum” that prompted me to write this article. AGP must never be taught in schools as if it is somehow equivalent in status to heterosexuality or homosexuality. That was not the only red flag in the paper. On examination, there are concerns that highlight the need for society to adopt a far more cautious approach to AGP as part of safeguarding vulnerable populations, particularly women and children, as well as protecting individuals from irreversible harm.

One of the primary safeguarding concerns with AGP is the potential for individuals manifesting this ideation to undermine established sex-based protections in public spaces, particularly in environments such as bathrooms, changing rooms, or women’s shelters. In Lawrence’s retrospective view, the focus remains largely on the individual’s experience of AGP without addressing the broader societal implications. Exactly the sort of perspective that hindered Cass. Safeguarding measures are primarily designed to protect vulnerable groups, such as women and children, by maintaining clear boundaries based on biological sex. Manifesting AGP in public, particularly through transitioning or accessing female-only spaces, threatens these boundaries by blurring the lines between real sex and its imitation.

Such blurred boundaries can create opportunities for exploitation or abuse. Safeguarding policies, especially in educational settings or places that involve intimate care, rely on biological distinctions to protect individuals from harm. Allowing individuals with AGP, a male paraphilia, into female spaces undermines these protections. The fact that AGP is tied to sexual arousal heightens the risk. Beyond these well-documented risks is the effect any acceptance of AGP in the public realm will have on children’s perception of reality. The push to destigmatise and affirm all forms of transgenderism, including those rooted in paraphilic ideation like AGP, risks exposing young people to confusing messages about sexuality. The risk is especially acute during the critical years of identity formation. Adolescents may internalise these messages and be led toward life-altering decisions based on what may only be transient feelings. Safeguarding children and adolescents requires promoting clear, stable sex-based distinctions rather than affirming paraphilic behaviours that could lead to psychological or physical harm. Lawrence’s paper takes no account of these safeguarding concerns, and so overlooks vital aspects of public safety and wellbeing.

The rising trend of medical interventions in youth struggling with transgender ideation—such as puberty blockers, cross-sex hormones, and surgeries—can be exacerbated by the normalisation of paraphilias like AGP. If AGP, with its strong sexual component, is presented as a valid expression of identity, it could further complicate the treatment of transgender ideation in youth, encouraging them to pursue irreversible medical transitions based on ideations that might otherwise have been managed through psychological support.

The concept of autogynephilia as an ideation—persistent, ruminated thoughts or fantasies that can become compulsive—should be viewed similarly to other forms of cognitive distortions or paraphilic disorders. Ideations, when repeatedly ruminated upon, can become ingrained and potentially harmful if acted upon. Lawrence's work primarily focuses on affirming AGP as part of the individual’s identity, yet this perspective fails to recognise the potential dangers of reinforcing these ideations. When AGP is treated as an inherent part of one’s identity rather than a modifiable thought pattern, it opens the door for harmful behaviours to be legitimised and enacted publicly.

The Role of Taboo in Safeguarding

Society often uses taboo as a cultural safeguard, signalling that certain behaviours, while perhaps present, are best kept private and managed through therapeutic interventions rather than normalised in public. In the case of AGP, maintaining a taboo around its public manifestation serves an important safeguarding function. It protects both individuals experiencing AGP and society from the potential harms associated with acting out ideations that could be better addressed in private settings.

Lawrence’s retrospective analysis of AGP largely glosses over the importance of this taboo, treating AGP as a condition that should be publicly accepted and normalised. However, by removing the cultural safeguards that come with taboo, we risk encouraging behaviours that could lead to broader harm. Instead, AGP should be treated as a private issue—something to be managed therapeutically rather than displayed or affirmed in public spaces. This would not only help prevent individuals from making irreversible decisions, such as medical transitions, but also protect vulnerable groups from being exposed to potentially harmful behaviours rooted in paraphilic ideations.

Conclusion

Tellingly, Dr Anne Lawrence’s Autogynephilia at 35 includes the following sentence:

If adolescents with AGP and severe gender dysphoria can be identified in middle childhood they can be offered puberty blocking and feminizing hormones in their early teenage years, allowing them to develop the bodies they desire and to move through the world more comfortably as adults.

AGP in adolescents is, in my experience, vanishingly rare (possibly because one likely hypothesis is that AGP comes about after prolonged exposure to pornography). Adolescent transgender ideation (which can lead to feelings of gender dysphoria) is predominantly a social phenomenon, although there will be some exceedingly effeminate young homosexual men among their number. However, worse than treating gender dysphoria as the valid diagnosis that it is not, Lawrence’s advocacy for the medical ruination “to develop the bodies they desire” puts the wants of the deluded ahead their mental and physical wellbeing needs.

It is unfortunate that Autogynephilia at 35 has received the attention that it has, it deserved to be kept in private shame. Like those with autogynephilia.

By maintaining a cultural taboo around the public manifestation of AGP, society can protect vulnerable populations, such as women and children, and susceptible individuals from making irreversible decisions that may stem from compulsive thought patterns. Cognitive-behavioural approaches, rather than affirmation, provide a more responsible and effective framework for managing transgender ideations.

The well-being of all society requires safeguarding, and it requires taboos.