Here's my theory. As a very rare biological anomaly, there have always been an extreme right tail of very masculine lesbians who fit into Society better as men and very feminine gay men who fit into Society better as women, and twentieth-century doctors developed medical interventions to aid them in this transformation. This worked pretty well.
-Separately, there are, and [perhaps](http://www.transtorah.org/PDFs/On-Becoming-A-Woman.pdf) [always](/2017/Mar/nothing-new-under-the-sun/) have been, perverted men who wished they were women—autogynephiles—and the extreme right tail of them also sought out interventions from the twentieth-century doctors. Tragically, this [didn't usually work as well](https://sillyolme.wordpress.com/2016/01/01/a-passing-privilege/), but it was rare enough for autogynephiles to actually attempt it (as opposed to privately fantasizing or playing dress-up) that it didn't have much impact on the social order.
+Separately, there are, and [perhaps](http://www.transtorah.org/PDFs/On-Becoming-A-Woman.pdf) [always](/2017/Mar/nothing-new-under-the-sun/) have been, paraphilic men who wished they were women—autogynephiles—and the extreme right tail of them also sought out interventions from the twentieth-century doctors. Tragically, this [didn't usually work as well](https://sillyolme.wordpress.com/2016/01/01/a-passing-privilege/), but it was rare enough for autogynephiles to actually attempt it (as opposed to privately fantasizing or playing dress-up) that it didn't have much impact on the social order.
The legal changes required for the twentieth-century doctors' innovation was sponsored by [the political coalition of individually non-hegemonic identity groups](http://benjaminrosshoffman.com/hierarchy-wings/), whose organizing principle had always been to fight on behalf of the marginalized—those who, without the coalition's sponsorship, would have been victimized by the hegemonic social order.