Criminal Offenses

2typesofFetishism.pdf

Home >Social Science homework help >Sociology homework help >Criminal Offenses

Pergamon S0005-7967(96)00047-2

T W O T Y P E S O F F E T I S H I S M

K U R T F R E U N D * , M I C H A E L C. SETO and M I C H A E L K U B A N Forensic Division, Clarke Institute of Psychiatry, 250 College Street, Toronto, Ontario,

Canada K7L 3N6

(Received 24 May 1996)

Summary--This study attempted to differentiate two clinical types of fetishism--fetishism proper and tranvestism--and to determine if tranvestites are truly fetishistic. The transvestites were further divided into gender-conforming and gender-noncomforming groups according to their score on a gender identity scale. These groups were compared using a self-report scale measuring fetishistic interests, and a set of questionnaire items regarding their childhood history, parental characteristics, and their emotional closeness with their parents. In addition, the penile responses of a subset of fetishists and tranvestites were recorded while they were presented with visual depictions of female and male pubic regions and potentially fetishistic objects (nylon stockings, female and male shoes, panties, male underwear, female and male feet). The fetishists proper and the transvestite subgroups did not differ from each other in terms of self-reported fetishistic interest or childhood and family histories. Moreover, there were no differences between these groups in their penile response to the potentially fetishistic stimulus they were most aroused by, relative to the depictions of the pubic region of their preferred gender. These results suggest that transvestites are in fact fetishistic, and that they are difficult to distinguish from fetishists proper. Copyright © 1996 Elsevier Science Ltd

I N T R O D U C T I O N

The paraphilias can be broadly divided into two categories, pathologic target preferences and pathologic activity preferences. In the former, the targets of erotic cognition and/or activities are not primarily other physically mature persons, and in the latter, erotic preferences are for sexual activities which are highly atypical for individuals who erotically prefer physically mature persons. Fetishism is a paraphilic target preference.

The great French psychologist Alfred Binet (1887) was the first to direct the interest o f psychologists and psychiatrists to an erotic peculiarity that he called fetishism. This peculiarity was an unusually strong erotic interest in certain physical characteristics o f potential sexual partners. Krafft-Ebing (1886/1978), the foremost expert on the paraphilias among the 19th century sexologists, confirmed Binet's observations, including his differentiation between a nearly normal and a clearly pathologic mode. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV: American Psychiatric Association, 1994) briefly defines and characterizes the pathologic, paraphilic mode which is the topic of the present study.

There are two clinical types of fetishism: fetishism proper and transvestism (see DSM-IV, pp. 526, 530-531). According to Binet, fetishism is caused by certain experiences in early childhood, where the later fetish has an unusual emotional impact. The etiological role of the early event appears to be supported by the variety of possible fetishes. Binet viewed fetishism as the result of pathological imprinting. However, both Binet and Krafft-Ebing believed that a certain predisposition is also necessary for such an event to result in fetishism with Epstein's (1975, 1987) demonstration of a relatively frequent co-occurrence o f fetishism with epileptogenic brain foci points at the possibility that this predisposition may be a neurological anomaly. The only publication about the possible innateness of fetishism we could locate was by Gorman (1964), who described a pair o f identical male twins who were concordant for rubber fetishism.

Transvestism appears to be a very different kind of fetishism. It has a complex target structure that usually includes three components. The main component appears to be "autogynephilia" (Blanchard, 1991--gynephilia is an erotic preference for physically mature women), in which the patient is erotically interested in himself with fantasized female genitalia and breasts. Then there

*Author for correspondence.

687

688 Kurt Freund et al,

is a fetishistic component represented by an array of objects, almost always female attire. Finally, there is, for some time at least, women as the third kind o f erotic target. One could imagine this target structure as a spectrum.

Transvestism and heterosexual transsexualism appear to be closely related. Therefore, the finding o f Z h o u , Hofman, Goorem and Swaab (1995), if valid, may be etiologically relevant to transvestism. Zhou e t al. reported that the central part o f the bed nucleus o f the stria terminalis, which is smaller in females than in males, is not different between females and either heterosexual or homosexual transsexuals. Zhou e t al. further argue that (according to experiments in rodents) this finding is not due to medication. However, their study examined only six brains.

The present study investigated whether transvestites are truly fetishistic, and not only autogynephilic (which may be misinterpreted as fetishism), and, if so, whether these two (according to the autogynephilia theory) etiologically different types of fetishism can be differentiated in any way. The study consisted of three parts. Part One compared fetishists proper and transvestites in regard to their self-reported fetishistic tendencies. Part Two compared the two groups in regard to self-reports about their parents, their family situation in childhood, and their early physical development. Part Three investigated the possibility o f comparing these two groups in regard to the erotic impact of potential fetishes by means of a phallometric test (see Freund & Watson, 1991).

M E T H O D

P r o b a n d s . The probands in the study were patients seen at the sexological department o f a metropolitan psychiatric hospital. A group o f gynephilic controls was recruited from community colleges. A group o f sex offenders against women, also seen at the department, were used as a second control group. As in earlier studies (Freund e t a l . , 1991; Freund & Watson, 1991), patients who only put on panties or their equivalents were not diagnosed as transvestites, but as fetishists proper.

The selection o f transvestites posed particular problems. Heterosexual transsexuals and markedly gender dysphoric transvestites, two groups whose members could be expected to dissimulate fetishism in a clinical setting, were excluded from the study (gender dysphoria is discomfort with the gender o f one's body). The reason was that markedly gender-dysphoric biological males try to impress the professional observer as being psychologically female and not having other reasons for donning female attire. Their exclusion was by means of the following question: " H a v e you ever wished to have a female body rather than a male one?" (yes/no/unsure). This question, as well as all questionnaire items used in the study, are contained in an erotic preferences evaluation scheme (EPES: Freund, 1965). Only transvestites who answered " n o " were included in the study.

To ensure that only unequivocally gynephilic transvestites were included, an " A n d r o - G y n e index" was used. This index is derived from two scales, an "Andro" scale containing 13 items (~ = 0.93) measuring an erotic inclination toward men, and a " G y n e " scale containing 9 items (a = 0.85) measuring an erotic inclination toward women (Freund, Seto & Kuban, 1996; Freund & Blanchard, 1988). For a transvestic patient to be included in the study, his Andro-Gyne index had to be < - 2 . Values smaller than zero indicate gynephilia.

P a r t O n e

Part One o f the study compared 30 fetishists proper, 74 transvestites, 78 sex offenders against women and 43 gynephilic volunteering paid controls on the Fetishism scale (Freund & Blanchard, 1988; Freund e t a l . , 1982). Group means for age and education are presented in Table 1.

Two scales were used: an 8-item scale for the measurement o f fetishism (~ = 0.91) and a modified version o f Part A o f the Feminine Gender Identity Scale FGIS (Freund, Langevin, Satterberg & Steiner, 1977; Freund & Blanchard, 1988). The items o f the FGIS (Part A) elicit self-reports about gender conforming vs gender non-conforming cognition and behavior in the probands' childhood. The higher the score, the more gender non-conformity in childhood is reported. However, several items (6, 11, 12, and 13) o f the FGIS(A) do not pertain directly to childhood

T w o t y p e s o f f e t i s h i s m

Table 1. Age a n d e d u c a t i o n f o r the subject samples in Parts One a n d T w o ( s t a n d a r d deviations in parentheses)'

6 8 9

C o n t r o l s

Fetishists F G I S - tranvestites F G I S + transvestites Offenders Students

Part One Age (yr)*

Education*

Part Two Age (yr)**

Education**

n = 30 n = 35 n = 39 n = 78 n = 43 30.7 34.3 34.1 28.9 29.3 (9.8) (9.7) (11.1) (7.7) (7.1)

n = 30 n = 34 n = 39 n = 78 n = 43 3.2 3.2 3.1 2.6 3.0

(1.26) (1.00) (1.07) (0.92) (1.17)

n = 3 4 n = 4 2 n = 4 2 n = 5 0 0 n = 1 5 6 31. I 34.4 34.2 27.6 30.0

(10.6) (9.4) (11.1) (8.2) (7.3) n = 3 4 n = 4 1 n = 4 2 n = 5 0 0 n = 1 5 6

3.1 3.1 3.1 2.5 3.1 (I.18) (1.01) (1.05) (0.89) (I.13)

' E d u c a t i o n is c o d e d as follows: 1 = u p to grade 8; 2 = some high school; 3 = high school g r a d u a t e ; 4 = some college or university; 5 = college o r university g r a d u a t e .

* P < 0.01; **P < 0.0001.

and were therefore excluded. The modified version FGIS(Ch) contains 15 items (a = 0.65). A similar modification of the FGIS was applied by Blanchard (1988).

In contrast to fetishists proper, a considerable proportion of transvestites report that in their childhood their cognition and behavior was in various ways already conforming_to the opposite gender. This could be perceived as a childhood precursor of transvestic fetishism. However, transvestites' apparent gender non-conformity in childhood could be attributed to retrospective report bias.

To avoid this uncertainty, the transvestites were divided into two groups, one indicating cognitive and behavioral gender conformity in childhood, the other indicating gender non-conformity. This was achieved by ordering the selected transvestites according to their FGIS(Ch) scores and then dividing them using a median split. In the following, the group of transvestites with the lower FGIS(Ch) scores will be denoted " F G I S - " and the group of transvestites with the higher scores will be denoted " F G I S + "

Part Two

Part Two compared the retrospective self-reports of 34 gynephilic fetishists proper, 84 transvestites, 500 non-fetishistic sex offenders against women, and 156 gynephilic paid volunteers acting as controls. Group means for age and education are also presented in Table 1. The comparisons were in regard to 18 EPES questions about potential deficiencies of the family environment, about father age and mother age at the proband's birth, and in regard to the patient's physical health in childhood (see Table 2). Additionally, two scales, of 4 items each, were used: A "Father-son distance" scale (a = 0.89) and a "Mother-son distance" scale (~ = 0.85) which measure deficiencies in father-son and mother-son relationships (Freund & Blanchard, 1983).

Table 2. Eighteen developmental a n d family history items for P a r t T w o

1. Subject's formal e d u c a t i o n ended before grade 8 (yes/no) 2. Lived with b o t h biological p a r e n t s a t least until age o f 12 (yes/no) 3. Lived in institution (reform school, o r p h a n a g e , b o a r d i n g school, etc.) before a g e o f 15 (yes/no) 4. E d u c a t i o n o f father was less t h a n grade 8 (yes/no) 5. E d u c a t i o n o f m o t h e r was less t h a n grade 8 (yes/no) 6. F a t h e r was heavy d r i n k e r or alcoholic (yes/no) 7. M o t h e r w a s heavy d r i n k e r o r alcoholic (yes/no) 8. Parents were m a r r i e d a t time o f subject's birth (yes/no) 9. H a d male caregiver (biological father o r o t h e r a d u l t male) before age o f 12 (yes/no) 10. H a d female caregiver (biological m o t h e r o r other adult female) before age o f 12 (yes/no) I I. Biological f a t h e r h a d psychiatric t r e a t m e n t (yes/no) 12. Biological m o t h e r h a d psychiatric t r e a t m e n t (yes/no) 13. Subject was p r e m a t u r e b a b y o r h a d birth complications (yes/no) 14. Subject h a d accident which resulted in being unconscious for at least h a l f a n hour, before the age o f six (yes/no) 15. Subject h a d accident which resulted in being unconscious for at least h a l f a n hour, between ages o f 6 a n d 12 (yes/no) 16. Period o f unexplained, frequent " b l a c k i n g o u t " before age o f 6 (yes/no) 17. P e r i o d o f unexplained, frequent " b l a c k i n g o u t " between ages o f 6 a n d 12 (yes/no) 18. Subject did n o t stop wetting his bed (enuresis) until at least the age o f 12 (yes/no)

690 K u r t F r e u n d e t al.

Table 3. Age a n d e d u c a t i o n f o r subject sample in P a r t Three ( s t a n d a r d deviations in brackets)"

C o n t r o l s

Fetishists F G I S - tranvestites F G I S + tranvestites Gynephilic Androphilic

Part Three A g e (yr)**

Education**

n = 1 6 n = 1 0 n = . l l n = 16 n = 8 29.1 52.1 35.1 26.5 28.2 (6.3) (10.7) (11.0) (6.1) (4.7)

n = 13 n = 10 n = I1 n = 19 n = 8 2.9 4.1 3.5 4.5 4.1

(0.95) (0.85) (0.90) (0.51) (0.84)

' E d u c a t i o n is c o d e d as follows: 1 = u p to g r a d e 8; 2 = some high school; 3 = high school g r a d u a t e ; 4 = some college or university; 5 = college o r university g r a d u a t e .

**P < 0.0001.

Part Three

Probands. There were 16 fetishists proper, of whom 3 had a concomitant diagnosis of masochism and 5 had a concomitant diagnosis of courtship disorder (i.e. voyeurism, exhibitionism, frotteurism-toucheurism, the preferential rape pattern, or one of the variants of these main expressions--see Freund et al., 1996). Also included were 21 transvestites, 19 gynephilic controls, and 9 androphilic controls.

The gynephilic controls were paid volunteers, recruited among university students, and the androphilic controls were paid volunteers, recruited at a gay-oriented bookstore. An additional 3 fetishists proper and 1 control had to be excluded because their responses in the test did not reach the minimum level (see below). Group means for age and education are provided in Table 3. Short case vignettes of the fetishists proper who underwent the phallometric test for fetishism, together with their age when first seen are provided in the Appendix.

Procedure. The phallometric method (Freund & Watson, 1991) was used. The stimuli were photographs on slides presented on a screen. There were 10 stimulus categories, each represented by 3 different photographs presented once in each of 3 blocks in a fixed, pseudo-random order. Each stimulus was presented for 15 sec. The stimulus categories were: nylons, panties, female feet with parts of the lower legs, female shoes, the female pubic region showing the external genitalia, male underwear, male feet, male shoes, the male pubic region showing the penis, and sexually neutral slides (landscapes). The phallometric method has been used before in the context of fetishism. This was in a conditioning study (Rachman, 1966; Rachman & Hodgson, 1968).

The phallometric responses were expressed in standard scores, calculated for each participant separately. In addition an output index (O.I.--the mean of the 6 highest responses in raw scores) was calculated. Only participants with an O.I. larger than 1.00 cc were included in the study. Prior to testing every participant was shown the phallometric device and signed a consent form indicating that he could discontinue testing at any point, and that he consented to the use of his test results in research publications. After testing all participants were debriefed.

RESULTS

Part One

There was a significant difference in age between groups, F(4,220) = 3.92, P < 0.005. The two transvestic groups were older than the offenders. There was also a difference in educational level, F(4,219) = 3.70, P < 0.1. The FGIS - transvestites were older than the offenders (see Table 1).

(a) The groups were compared on the FGIS(Ch) scale: F(4,755) = 19.63, P < 0.0001. According to the Tukey HSD test, the FGIS + transvestites had a significantly higher FGIS(Ch) score than the remaining groups and the FGIS - transvestites had a significantly lower FGIS(Ch) score than the remaining groups. There were no other significant differences. The result did not change when age or education were used as covariates.

(b) The groups significantly differed in their scores on the fetishism scale: F(4,220)= 25.97, P < 0.0001. The Tukey HSD test showed that the gynephilic fetishists proper, as well as the FGIS - transvestites and the FGIS + transvestites, differed significantly from the sex offenders against women and the gynephilic controls, in the expected direction. There were no other

Two types of fetishism 691

significant differences. These results did n o t change if age or education was covaried. There was no significant correlation between the F G I S ( C h ) scale and the fetishism scale [r(223) = 0.06, NS]

However, when the relevant options o f items 3 and 6 o f the fetishism scale were compared they indicated a difference between transvestites and fetishists: more transvestites t h a n fetishists indicated they were more aroused when they wore the fetish objects t h a n when otherwise in contact with them, X2 [1] = 8.42, P < 0.005, a n d that they had n o t just one but a multiplicity o f fetish objects (X 2 [1] = 5.22, P < 0.025). These two differences were expected and are trivial, but point towards some further, less trivial difference (see S u m m a r y and Discussion).

Part Two

There was a significant difference across groups for age, F(4,769) = 12.91, P < 0.0001. According to a T u k e y H S D test, the two transvestic groups were significantly older than the gynephilic offenders or controls, and the gynephilic offenders were significantly younger than the gynephilic controls. There was also a significant difference between groups in terms o f their educational level, F(4,768) = 16.08, P < 0.0001. Offenders reported less education than the other groups according to a T u k e y H S D test (see Table 2).

N o n e o f the items in Table 2 distinguished groups at the 0.01 level (controlling for the number o f statistical comparisons). There were also no differences between groups in terms o f mother age, F(4,600) = 1.56, NS, or father age, F(4,577) < 1.00, NS, at the time o f the proband's birth, or in terms o f f a t h e r - s o n or m o t h e r - s o n distance, F(4,622) = 1.54, NS, and F(4,647) = 1.22, NS.

Part Three

In regard to age, there was a significant difference between the groups o f probands with phallometric data, F(4,56) = 7.29, P < 0.0005. The Tukey H S D test showed that the mean age o f the F G I S - transvestites was higher than that o f both control groups and the fetishists proper; there were no other significant differences. There were differences between the groups in educational level, F ( 4 , 5 6 ) = 16.67, P < 0.0001, but education was not a significant covariate in subsequent analyses (see Table 3).

There was no difference between the groups in regard to O.I. A comparison o f phallometric responses o f fetishists proper, transvestites, and controls was

carried out. Figure 1 depicts these responses o f the fetishists proper, transvestites, and control groups to the pubic region a n d external genitalia o f the erotically preferred gender as well as the mean responses to the most responded to fetish stimuli.

The groups differed in their responses to the external genitalia o f their erotically preferred gender relative to their responses to their most arousing fetish stimulus, F(4,60) --- 11.05, P < 0.0001; the T u k e y H S D test showed t h a t the group o f fetishists proper and the F G I S - transvestites differed from b o t h control groups. The controls responded relatively more to the pictures o f the genital region. The fetishists proper a n d the transvestites were n o t different from each other (the F G I S + transvestites differed only from the homosexual controls). There were no other significant differences.

S U M M A R Y A N D D I S C U S S I O N

The study compared the Binet type o f fetishism proper and fetishistic transvestism. The latter type was represented by a group selected in a way that minimizes as much as possible the intrusion o f gender dysphoria, because gender dysphorics tend to dissimulate fetishism. After this selection, the remaining transvestites were divided into two groups, one reporting gender conformity o f cognition a n d behavior in childhood ( F G I S - ), the other reporting their behavior and cognition in childhood as c o n f o r m i n g with the opposite sex ( F G I S + ).

There were two main comparisons, one in regard to self-reported degree o f fetishism by means o f a fetishism scale, the other in regard to penile responses to depicted fetish objects. The result supported the model o f transvestism, in which there is (in addition to the autogynephilic component) a c o m p o n e n t o f fetishism proper (and in the majority o f cases an erotic attraction to

692 K u r t F r e u n d e t al.

women). Further, the study suggested the family situation or the physical development in childhood was unlikely to be involved in the etiology of fetishism proper or transvestism.

The demonstrated usefulness o f the phallometric method for the assessment o f fetishism makes it likely that it will be possible to test a model o f the disposition toward imprinting of fetishes as hypothesized by Binet. At present such a predisposition for fetishism cannot easily be imagined in any other way than as an anomaly o f a probably innate neural template o f erotic partner recognition. Such templates can be imagined as parts o f Lorenz's (1942) " s c h e m a t a " - - a term borrowed from Kant. The existence o f such schemata for objects o f important species-specific activities has been established by ethologists for many species o f animals. The anomaly underlying fetishism proper could easily be envisaged as being either a pathologically loose description or a pathologic degree o f sensitivity o f parts o f such a template.

In contrast to fetishism proper, among non-fetishistic men who erotically prefer adult partners or children there is no such gross variation of targets. This implies that in these latter modes of erotic target preferences any imprinting, if at all necessary, is likely to be an event akin to instant recognition. This is in agreement with the observation o f cross-cultural invariance (Witam & Mathy, 1986) and the detection of strong biological factors in sexual orientation (Blanchard & Bogaert, 1996; Hamer, Hu, Magnusson, Hu & Pattatucci, 1993; LeVay, 1991). These findings support the notion o f a very strong biological factor underlying erotic gender-age preferences in a wide variety o f social conditions from birth to puberty.

The hypothesis of fetishism proper being based on an imbalance o f the various parts o f a brain template for erotic partner recognition could be phaIlometrically tested with fetishists for objects other than parts o f the body, using stimuli depicting parts o f the body. According to the model

¢t'J

"2 ¢0 10 ¢:

O0 ¢:

_ ~

- 1 -

- 2 I I I I I IbUshi~s FGIS- FGIS+ g~ne cm~rols andre controls

G r o u p s

Fig. 1. Penile reponses to the m o s t a r o u s i n g fetish stimulus relative to preferred genitalia.

Two types of fetishism 693

presented here, fetishists proper should respond to some body parts other than genitalia significantly more than transvestites and controls. This kind of result would also clearly show, as already indicated in Part One of the study, that fetishism proper and transvestism do not have a totally common end-path.

Note: For technical reasons the authors will not be able to carry out the proposed test themselves. It is hoped that readers of this report will have the interest and the opportunity to carry out this test.

A P P E N D I X

Short vignettes o f the fet&hists proper who had the phallometric test

S.X. age 23, was charged for touching the legs of two 16-yr-old girls who were unknown to him. He complained about fetishism for pantyhose. C.E. age 27, borderline intelligence and living with his parents on an isolated farm. He had been charged many times for stealing female underwear. N.W. age 29, was charged for threatening a 16-yr-old boy in order to lick his shoes and at another time threatening a 17-yr-old boy to have him present his shoes. G.I. age 34, would walk the street urinating into diapers he was wearing, and then showing the soiled diapers to female passersby. X.I. age 17, of borderline intelligence, made anonymous telephone calls to men and women and conversed with them about jeans, while masturbating. In early childhood he often clung to his mother's leg while she was wearing jeans. When she stopped wearing jeans, he started clinging to his father's jeans. N.C. age 29, a constable, would stop cars driven by young women in order to "search" them, would order them to take off their bras and then inspect and touch their breasts. U.T. age 24, was referred because of getting highly aroused by female and male feet. He would suck his girlfriends" toes. X.H. age 37, looked up the skirts of women, sometimes even lifting them and inspecting the panties. This aroused him. He also used his wife's panties for masturbatory purposes. B.C. age 36, was erotically aroused by walking into malls, and defecating into his underpants, while wearing thin pants So that women could see it. B.M. age 30, complained about masturbation fantasies of licking women's feet, being ordered around by such women and urinated upon. H.Y. age 31, was aroused by licking the high heeled boots of his " a m a z o n " mistress, who also urinated and defecated into his mouth. QN. age 27, complained about being fetishistic for women smoking. He made anonymous telephone calls to females, asking them whether they smoked, and masturbated at these occasions. He also got aroused by pictures of women on cigarette boxes. He, as well as the following patients, also had a courtship disorder. He was voyeuristic and had a preference for prostitutes. K.N. age 28, was referred because of voyeurism, toucheurism, and panty fetishism. He once broke into a home and stole panties. S.B. age 42, was charged for sexually molesting his stepdaughter, and complained about exhibitionism and voyeurism, including triolism. F r o m age 38 to 40 he had been put on female underwear and shoes for the purpose of masturbation. S.S. age 29, complained about exposing. Since age 12 he had put on panties or held them to his penis while masturbating. U.I. age 30, was referred because of voyeurism and toucheurism and indicated that he put on female underwear for masturbation.

R E F E R E N C E S

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.) Washington, DC: Author.

Binet, A. (1887). Le fetichisme dans l'amour [Fetishism in love]. Revue Philosophique, 24, 252-274. Blanchard, R. (1988). Nonhomosexual gender dysphoria. Journal of Sex Research, 24, 188-193. Blanchard, R. (1991). Clinical observations and systematic studies of autogynephilia. Journal of Sex and Marital Therapy,

17, 235-251. Blanchard, R. & Bogaert, A. F. (1996). Homosexuality in men and number of older brothers. American Journal o!

Psychiatry, 153, 27-31. Epstein, A. W. (1975). The fetish object: Phylogenetic considerations. Archives of Sexual Behavior, 4, 303-308. Epstein, A. W. (1987). Phylogenetics of fetishism. In G. D. Wilson (Ed.), Variant Sexual Research and Theory (pp. 142-149).

London: Croon-Helm. Freund, K., Watson, R., Dickey, R. & Rienzo, D. (1991). Erotic gender differentiation in pedophilia. Archives of Sexual

Behavior, 20, 555-566. Freund, K. & Blanchard, R. (1983). Is the distant relationship of fathers and homosexual sons related to the son's erotic

preference for male partners, or to the son's atypical gender identity, or both? Journal of Homosexuality, 9, 7-25. Freund, K. & Blanchard, R. (1988). Gender identity and erotic preference. In C. M. Davis & W. L. Yarber (Eds.),

Sexuality-related Measures: A Compendium (pp. 143-155). Lake Mills, IA: Graphic Publishing. Freund, K. & Watson, R. (1991). Assessment of the sensitivity and specificity of a phallometric test: An update of

"Phallometric diagnosis of pedophilia". Psychological Assessment, 3, 254-260. Freund, K., Seto, M. C., & Kuban, M. (1996). Frotteurism and the courtship disorder theory. In D, L. Laws & W.

O ' D o n o h u e (Eds.), Handbook of Sexual Deviance: Theory and Application. New York: Guilford, (in press). Freund, K., Steiner, B. W. & C h a n , S. (1982). Two types of cross gender identity. Archives of Sexual Behavior, 11, 4 9 ~ 3 . Freund, K., Langevin, R., Satterberg, J. & Steiner, B. W. (1977). Extension of the Gender Identity scale for males. Archives

of Sexual Behavior, 6, 507-519. Gorman, G. F. (1964). Fetishism occurring in identical twins, British Journal of Psychiatry, 110, 255-256.

694 Kurt Freund et al.

Hamer, D. H., Hu, S., Magnusson, V. L., Hu, N. & Pattatucci, A. M. L. (1993). A linkage between D N A markers on the X chromosome and male sexual orientation. Science, 261, 321-327.

Krafft-Ebing, R. (1886/1978). Psychopathia Sexualis. New York: Stein & Day. LeVay, S. (1991). A difference in the hypothalamic structure between heterosexual and homosexual men. Science, 253,

1034-1137. Lorenz, K. (1942) Die angeborenen Formen moglicher Erfahrung [Innate patterns of potential experience]. Zeitschriftfur.

Tierpsychologie, 5, 16-409. Rachman, S. (1966) Sexual fetishism: An experimental analogue. Psychological Record, 16, 293-296. Rachman, S. & Hodgson, R. J. (1968). Experimentally induced "sexual fetishism". Psychological Record, 18, 25-27. Weinberg, M. S., Williams, C. J. & Calhan, C. (1994). Homosexual food fetishism. Archives o f Sexual Behavior, 23, 611-626. Witam, F. L., & Mathy, R. M. (1986). Male Homosexuality in Four Societies: Brazil, Guatemala, the Philippines, and the

United States. New York: Praeger. Zhou, J. N., Hofman, M. A., Goorem, L. J. & Swaab, D. F. (1995), A sex difference in the human brain, and its relation

to transsexuality. Nature, 378, 2.