+> In both adolescent and adult natal males, there are two broad trajectories for development of gender dysphoria: early onset and late onset. _Early-onset gender dysphoria_ starts in childhood and continues into adolescence and adulthood; or, there is an intermittent period in which the gender dysphoria desists and these individuals self-identify as gay or homosexual, followed by recurrence of gender dysphoria. _Late-onset gender dysphoria_ occurs around puberty or much later in life. Some of these individuals report having had a desire to be of the other gender in childhood that was not expressed verbally to others. Others do not recall any signs of childhood gender dysphoria. For adolescent males with late-onset gender dysphoria, parents often report surprise because they did not see signs of gender dysphoria in childhood. Adolescent and adult natal males with early-onset gender dysphoria are almost always sexually attracted to men (androphilic). Adolescents and adults with late-onset gender dysphoria **frequently engage in transvestic behavior with sexual excitement.**
+
+(Bolding mine.)
+
+Or consider Anne Vitale's ["The Gender Variant Phenomenon—A Developmental Review"](http://www.avitale.com/developmentalreview.htm), which makes the _same_ observations as Blanchard-and-friends and arrives at essentially the _same_ two-type taxonomy of MtF, but dressed up in socially-desirable language—
+
+> As sexual maturity advances, Group Three, cloistered gender dysphoric boys, often combine excessive masturbation (one individual reported masturbating up to 5 and even 6 times a day) with an increase in secret cross-dressing activity to release anxiety.
+
+Got that? They _often combine excessive masturbation_ with an _increase in secret cross-dressing activity_ to _release anxiety_—their terrible, terrible _gender expression deprivation anxiety!_
+
+Don't trust scientists or clinicians? Me neither! (Especially [not clinicians](/2017/Jun/memoirs-of-my-recent-madness-part-i-the-unanswerable-words/).) Want first-person accounts from trans women themselves? Me too! And there's lots!
+
+Consider this passage from Dierdre McCloskey's memoir _Crossing_, writing in the third person about her decades identifying as a heterosexual crossdresser before transitioning at age 53 (bolding mine):
+
+> He had been doing it ten times a month through four decades, whenever possible, though in the closet. The quantifying economist made the calculation: _About five thousand episodes_. [...] At fifty-two Donald accepted crossdressing as part of who he was. True, if before the realization that he could cross all the way someone had offered a pill to stop the occasional cross-dressing, he would have accepted, since it was mildly distracting—though hardly time consuming. **Until the spring of 1995 each of the five thousand episodes was associated with quick, male sex.**
+
+Or consider this passage from Julia Serano's _Whipping Girl_ (I know I [keep](/2017/Dec/lesser-known-demand-curves/) [referencing](/2020/Dec/crossing-the-line/) [this](/2021/May/sexual-dimorphism-in-the-sequences-in-relation-to-my-gender-problems/#whipping-girl) book, but it's _so representative_ of the dominant strain of trans activism, and I'm never going to get over the [Fridge Logic](https://tvtropes.org/pmwiki/pmwiki.php/Main/FridgeLogic) of the all [the blatant clues that I somehow missed in 2007](/2016/Sep/apophenia/))—
+
+> There was also a period of time when I embraced the word "pervert" and viewed my desire to be female as some sort of sexual kink. But after exploring that path, it became obvious that explanation could not account for the vast majority of instances when I thought about being female in a nonsexual context.
+
+"It became obvious that explanation could not account." I don't doubt Serano's reporting of her own phenomenal experiences, but "that explanation could not account" is _not an experience_; it's a _hypothesis_ about psychology, about the _causes_ of the experience.
+
+I could go on ... but do I need to? After having seen enough of these _laughable_ denials of autogynephilia, the main question in my mind has become not, _Is the two-type androphilic/autogynephilic taxonomy of MtF transsexualism approximately true?_ (answer: yes, obviously) and more, _How dumb do you (proponents of gender-identity theories) think we (the general public) are?_ (answer: very, but this assessment is accurate).
+
+An important caveat must be made: [different causal/etiological stories could be compatible with the same _descriptive_ taxonomy.](/2021/Feb/you-are-right-and-i-was-wrong-reply-to-tailcalled-on-causality/) You shouldn't confuse my mere ridicule with a serious and rigorous critique of the strongest possible case for "gender expression deprivation anxiety" as a theoretical entity, which would be more work. But hopefully I've shown _enough_ work here, that the reader can perhaps empathize with the temptation to resort to ridicule?
+
+Everyone's experience is different, but the human mind still has a _design_. If I hurt my ankle while running and I (knowing nothing of physiology or sports medicine) think it might be a stress fracture, a competent doctor (who's studied the literature and seen many more cases) is going to ask followup questions about my experiences to pin down whether it's stress fracture or a sprain. I can't be wrong about the fact _that_ my ankle hurts (that's a privileged first-person experience), but I can easily be wrong about my _theory about_ why my ankle hurts.
+
+Even if human brains vary more than human ankles, the basic epistemological principle applies to a mysterious desire to be female. The question is, do the trans women whose reports I'm considering have a relevantly _different_ psychological condition than me, or do we have "the same" condition, and (at least) one of us is misdiagnosing it?