Dressed to thrill? A brief overview of transvestic fetishism

There is arguably more debate about whether transvestism can be classed as a disorder and/or sexually deviant than any other paraphilia. Transvestism has traditionally been defined as the cross-dressing in clothes worn by the opposite sex for sexual pleasure. However, there are a number of groups of people who may dress themselves in the clothes of the opposite sex but may experience absolutely no sexual arousal whatsoever. Therefore, those who study paraphilic behaviour are more likely to use the term ‘transvestic fetishism’ to describe the small group of people (typically male but there are some documented female cases in the literature) who derive their sexual pleasure from cross-dressing. Therefore, transvestite groups (where the word simply refers to cross-dressing) may comprise:

• Transvestic fetishists who cross-dress for sexual pleasure and that in some cases may involve sexual arousal from a very specific piece of clothing
• Female impersonators who cross-dress to entertain
• Effeminate homosexuals (who may occasionally cross-dress for fun)
• Transexuals who cross-dress because they fell they have been biologically assigned to the wrong sex and typically suffer from a gender identity disorder. It has also been speculated that some transsexuals may be psychologically similar to paraphilias such as apotemnophilia (i.e., the desire to be an amputee)

These different groups show that unlike all other paraphilias (e.g., necrophilia, zoophilia, hypoxyphilia), the motivations for cross-dressing may not necessarily be sexually motivated, and therefore are unlikely to be viewed as either deviant or disordered.

In the World Health Organization’s International Classification of Diseases (ICD-10), transvestic fetishism is defined as “the wearing of clothes of the opposite sex principally to obtain sexual excitement and to create the appearance of a person of the opposite sex”. Similarly, the latest version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defines it as “recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing”. Interestingly, Dr Kirk Newring (Nebraska Department of Correctional Services, USA) and his colleagues think is possible that future books on sexual deviance will not include transvestic fetishism as a sexual deviance, but rather as a sexual variance.

There have been a couple of relatively large-scale studies of transvestism including that of Dr Richard Docter and Dr Virginia Prince (California State University, USA) who surveyed 1,032 transvestites, and Dr Niklas Långström (Centre for Violence Prevention, Karolinska Institutet, Stockholm, Sweden) and Dr Kenneth Zucker (Centre for Addiction and Mental Health, Toronto, Ontario, Canada) who examined tranvestism in a Swedish community survey of 2,540 adults. This, and other research, has suggested there appear to be at least two distinct sub-groups of transvestic fetishists (‘periodic transvestites’ and ‘marginal transvestites’).

• Periodic transvestites: These transvestites are said to have psychological satisfaction with both their male gender and sexual identity, and with the activity of cross-dressing activity. Furthermore, they have no desire to pursue any other form of feminization.
• Marginal transvestites: These transvestites experience psychological dissatisfaction with their male gender and sexual identity. The sexual arousal experienced from cross-dressing is typically lower than that of periodic transvestites. They may also engage in other feminization activities including hormone treatment, bodily hair removal, and (in extreme cases) surgical reconstruction. Some marginal transvestites may therefore include transsexuals who cross-dress not only for sexual pleasure but also for gender synchrony.

As with many other paraphilic behaviours, there is a relative lack of data and much of it comes from clinical case studies. Based on the published papers, the data suggest that the majority of transvestic fetishists report cross-dressing in secret before the onset of adolescence. As children, cross-dressing may provide excitement and pleasure but the activity is unlikely to be particularly sexualized (e.g., clothes that belong to females in the house may trigger and/or facilitate highly pleasurable sensory experiences [such as perfumed fragrances] accompanied by feelings of familiarity and comfort. During adolescence, case study evidence suggests that the act of cross-dressing becomes increasingly paired with sexual urges and arousal (e.g., erections, ejaculation) and in some cases it may lead to thoughts of being female in public or in private.

However, some sexologists have speculated that the transvestic behaviour develops via classical conditioning after an accidental exposure to female clothing or a female undressing. Similarly, it has also been suggested transvestic behaviour may be negatively reinforced when it is used as a means coping during times of emotional distress (for instance, a number of studies have reported high rates of parental separation during transvestic men’s childhood). The etiology of transvestism appears to be similar to other paraphilic behaviours (i.e. early conditioning experiences) although there are case studies of parental punishment by humiliation of wearing girls’ clothes leading to transvestism. According to Dr Kenneth Zucker and colleagues such separation may explain the need for transitional objects that many children eventually develop.

Smaller scale studies carried out in the 1970s to the 1990s reported that transvestites were more likely to be heterosexual and married. In 2005, Långström and Zucker’s study of 2,450 Swedes appeared to confirm these earlier findings. The archetypal transvestite was reported as being in his mid-30s, in a steady relationship and having at least one child. Perhaps surprisingly, there were no major socio-demographic differences between transvestic males and non-transvestic males. In Långström and Zucker’s study, nearly 3% of males (n=36) and 0.4% of females (n=5) reported sexual arousal from cross-dressing at least once. The transvestic behaviour occurred more in heterosexual males (85.7%, n=35). This finding was similar to findings of Docter and Prince’s large-scale study of 1,032 transvestites where up to 89% transvestic males identified themselves as heterosexual. Findings from small-scale studies indicate that most men do not tell their wives prior to marriage and when the wives do find out, they tend to tolerate it rather than support it.

Långström and Zucker also examined the co-occurrence of other paraphilic behaviours. The transvestic men were more likely than non-transvestic men to report sexual sadism and/or masochism, exhibitionism, and voyeurism. In a 1981 study of 222 transvestic males, Buhrich and Beaumont reported high rates of bondage fantasies while dressed in women’s clothing. However, over time and into middle age, sexual desires may diminish but the cross-dressing may remain (and therefore would no longer be classed as transvestic fetishism). Most transvestites do not seek professional help (as they do not experience any distress associated with their behaviour) and even with therapy it is unlikely the behaviour will be altered if the person wants to carry on cross-dressing.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Buhrich, N. (1978). Motivation for cross-dressing in heterosexual transvestism. Acta Psychiatrica Scandinavica, 57, 145–152.

Buhrich, N., & Beaumont, T. (1981). Comparison of transvestism in Australia and America. Archives of Sexual Behavior, 26, 589–605.

Docter, R. F., & Prince, V. (1997). Transvestism: A survey of 1032 cross-dressers. Archives of Sexual Behavior, 26, 589-605.

Långström, N., & Zucker, K. J. (2005). Transvestic fetishism in the general population: Prevalence and correlates. Journal of Sex and Marital Therapy, 31, 87-95.

Moser, V. & Kleinplatz, P.J. (2002). Transvestic fetishism: Psychopathology or iatrogenic effect? New Jersey Psychologist, 52(2), 16-17.

Newring, K.A.B. Wheeler, J. & Draper  (2008). Transvestic fetishism. Assessment and theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (Second Edition) (pp.285-305). New York: Guildford Press.

Stoller, R. J. (1971). The term, “transvestism.” Archives of General Psychiatry, 24, 230–237.

Sullivan, C.B.L., Bradley, S.J., & Zucker, K.J. (1995). Gender identity disorder (transsexualism) and transvestic fetishism. In V. B. Van Hasselt & M. Hersen (Eds.), Handbook of adolescent psychopathology: A guide to diagnosis and treatment (pp. 525–558). New York: Lexington Books.

Wheeler, J. Newring, K.A.B. &  Draper, C.  (2008). Transvestic fetishism. Psychopathology and Theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (Second Edition) (pp.272-284). New York: Guildford Press.

Zucker, K.J., & Blanchard, R. (1997). Transvestic fetishism: Psychopathology and theory. In D. R. Laws & W. T. O’Donohue (Eds.), Sexual deviance: Theory, assessment, and treatment (First Edition) (pp. 253-279). New York: Guilford Press.