(This is a review of J. Michael Bailey’s controversial 2003 book, The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism)
I read this book because it set off a massive controversy involving some transgender activists, as well as parts of the medical establishment, and I’ll try to talk about why later on. Overall, the book reads like a pop-science review of the culture and science of gay men, intersex individuals, and trans people. The feature that stands out throughout the book is Bailey’s willingness to take seriously connections between gender identity, sexuality, and their associated stereotypes.
To understand how the book is written, as well as why it was contentious, it might be fruitful to start off with a methodological question: How reliable are oppressed people who are self-reporting? There is a certain strand of thought that insists that oppression gives people special epistemic standing in some ways- after all, they’re bound to be able to see the mechanisms of the oppressive system better than someone who isn’t oppressed. But as useful as this might be as a rule-of-thumb, it isn’t quite as straightforward.
Consider a 2005 paper co-authored by the the author of this book, Michael Bailey, where the sexual response of men were studied using a penile plethysmograph . It was found that self-identifying gay men showed genital arousal when they were shown gay porn, and self-identifying straight men showed arousal to straight porn. However, in the case of self-identifying bisexual men, they found most of them showed arousal only to gay porn, while a few others showed arousal only for straight porn. This seemed to lend support to a snide rumour in the gay community that bisexuality was a myth. In 2011, Bailey repeated the experiment, only this time imposed a more stringent condition for eligibility as “bisexual” for the sake of the experiment- this time they would have had to have had “at least two sexual partners of each sex and a romantic relationship of at least three months’ duration with at least one person of each sex.”  This time, they did find arousal for both sort of porn, and hence bisexuality could be “detected” as other orientations had been.
Going back to the methodological question we began with, this was clearly a case in which disregarding what people were saying at face value actually was a good idea in terms of science. It wasn’t that people were lying on purpose, but oppressed people frequently chose to identify as bisexual to avoid the stigma of being gay, and so disregarding their personal narrative can at least sometimes be a good idea methodologically. The problem now becomes clear- when should people’s narratives about themselves be accepted and when shouldn’t they? We can see arguments for both sides: historically, oppressed communities have been marginalized, pathologized, and talked over, and their status in society has been determined by gatekeepers from mainstream institutions. No wonder oppressed communities are reasonably suspicious of non-members talking for them. On the other hand, by virtue of their status as oppressed, communities often develop elaborate cultural myths which are needed to survive their oppression as well as for political expediency (consider for instance, how the gay “born this way” narrative often acquires dense metaphysics in peoples’ minds, even though the science is extremely sparse in many respects).
The controversy over this book can can be thought of as playing out this dynamic in the open: Bailey has little qualms openly admitting he simply doesn’t believe certain people’s descriptions about themselves, including their recollections of their past as well as their current erotic interests. Following the account of another researcher Ray Blanchard, he claims there are two kinds of “transexuals” (a lot of the terms used seem dated in the decade that has passed), one the “homosexual transexual” who loosely fit the trope of “woman born in a man’s body,” who show gender conformity from a young age, who pass easily (ie., appear as women “convincingly”) and who choose to transition (at least in part) to get to get involved with straight men. The other kind of trans person is supposed to have “autogynephilia”, where a typically a typically older man gets aroused by the idea of himself in a woman’s dress and sexual position, and eventually wants to transition (in major part) to enable this erotic fantasy.
(One aspect of all of this is that Bailey’s position itself isn’t completely clear. He seems to thinks that diving into categories, as Blanchard’s done, is a “lumping” process that helps further diagnosis, but whether he means that this is an approach of the true psychological make-up of an individual is at least unclear. I ignore this issue here)
Unsurprisingly, this whole account has been attacked by trans people/activists/scholars for a number of reason: it’s pointed out that a lot of people’s experiences don’t fit either model, that Bailey ignores people’s description of their experiences to make this theory work (eg: at one point in his story he diagnoses someone as having autogynephilia, even though they insist they do not), doesn’t respect trans people’s right to self-identity, overly sexualizes and objectifies trans people, relies on stereotypes, continues to pathologize trans individuals and is hence dangerous, peddles bad science, etc.
A lot of this is certainly reasonable, and has been documented elsewhere. I want to return to the original methodological concern: one criticism that was lobbed at Bailey was that autogynephilia was considered a paraphilia (loosely, to do with unusual sexuality), and might be used as an excuse to deny trans people medical care. But Bailey points out that he recognizes that autogynephilia will be less palatable to people because it involves eroticism, but this isn’t a good enough reason to deny it. According to him, the solution to this is to make people get over their ickiness about sex, not give in to (what he would consider) bad science. (For a loose analogy, consider how the gay rights movement has systematically tended to de-emphasize gay sex, and instead use platitudes about “equality” and “love”). We can see how the great importance we place on science ensures that scientific results are enmeshed in political conflicts. But even here we should be careful not to draw simplistic lines between objective science and politicised science- after all objectivity is a worthy aspiration, but often incredibly dangerous ideology has passed under the banner of “objectivity”.
As for the actual science in the book, the story has been mixed. When people tried replicating Blanchard’s work (used in the book), some of the results were reproduced, some weren’t, and some had less pronounced effects . What this means for the theory seems unclear to me.
The most interesting part of this story is, of course, the blowback and resistance this book has induced. Bailey for his part seems to think that regardless of whether we subscribe to the theory, trans people should get respect and the medical care they need (“I suspect that both autogynephilic and homosexual gender dysphoria result from early and irreversible developmental processes in the brain. If so, learning more about the origins of transsexualism will not get us much closer to curing it. Given our present state of knowledge, saying that we should focus on removing transsexuals’ desire to change sex is equivalent to saying that it is better that they should suffer permanently from gender dysphoria than that they obtain sex reassignment surgery” [pg. 207]). Of course, this story has always been bigger than just this book, so how important Bailey’s own political views are, compared to the corpus to which his work adds to, is contentious. A lot of the criticism has come from people who seem to have not read his book, or read it incredibly poorly. There’s certainly space for criticism, but it seems that a lot of what has actually been produced has been nonsensical.
To read more, I recommend Alice Dreger’s write-up about the whole incident in the Archive of Sexual Behaviour  as well as her book “Galileo’s Middle Finger”, although she has been accused of being too sympathetic to Bailey.