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In a detailed account of her SRS experience, Griggs ( 1998 , another MtF transsexual, discussed her lifelong analloeroticism and obligatory reliance on fantasies of being female to achieve orgasm during masturbation. Based on a subsequent autobiographical work (Griggs, 2004 , in which she described one long-term nonsexual relationship with a man and two long-term relationships with women, Griggs’ sexual orientation appeared to be nonhomosexual. She wrote: When I lived as a man, I had no desire to have intercourse with a woman. I likewise had no inclination for a homosexual relationship with a man. Erotic imagery was invariably contingent on my being female, and even during masturbation, whether the object of my desire was man or woman, I could not reach a climax without imagining that I was female. This is still true. When confronted as a teenager by the reality that I was male, my private experience of sexuality was void, and the resulting appetite, or speci fi cally the lack of it, was vaguely questioned by friends, family, and the women I dated. (Griggs, 1998 , p. 50

Paraphilias tend to cluster or co-occur: Men with one paraphilia have an increased likelihood of having one or more other paraphilias as well (Abel & Osborn, 1992 ; Wilson & Gosselin, 1980 ) . Because autogynephilia is conceptualized as a paraphilic phenomenon, it is not surprising that many informants described other paraphilias as well. These included sexual masochism and forced feminization, gynemimetophilia and gynandromorphophilia (attraction to feminized men), pedophilia, autonepiophilia (infantilism or adult baby syndrome), abasiophilia and autoabasiophilia (leg brace paraphilia), and unspecified paraphilias.

I seem to fall pretty squarely into the group Blanchard calls autogynephilic. I have been married once, and all my sexual partners have been female. Starting when I was about three years old, I became conscious of an extremely pleasurable sensation from fantasies of sadomasochism. I found delight in the thought of being brutalized, humiliated, tied up, slashed, dismembered, and killed. At fi rst, my imagined persona might be man, woman, child, or animal. After about age seven or eight, however, I usually liked to be a pretty young woman being tortured to death by a psycho. My fantasy would almost always end in being stabbed to death with a knife in the belly, which I found exquisitely satisfying and powerfully compelling. Shortly after I turned 14, one of these fantasies produced penile contractions and I soon discovered the concept of sex. I abandoned my longstanding childhood fantasy of being a pretty young woman being tortured to death and replaced it with the fantasy of being a pretty young woman being forcibly raped. Since that time, variations on the rape fantasy have always been my most compelling source of sexual excitement. These fantasies presume that I am a biological woman. Less commonly, but with increasing frequency in recent years, I have also enjoyed fantasies of being turned into a woman. These fantasies are less exciting than the rape fantasies.

This narrative provides another example of the phenomenon of “paraphilic substitution.” This is the term I introduced in Chap. 9 to describe the process by which very disturbing or unacceptable paraphilic fantasies sometimes become
replaced by less distressing, more acceptable ones. Autogynephilic fantasies, even those involving rape, are probably less distressing than many other paraphilic fantasies (e.g., those involving being tortured to death).