Transvestic Disorder

(See also Overview of Paraphilias and Paraphilic Disorders Overview of Paraphilias and Paraphilic Disorders Paraphilic disorders are recurrent, intense, sexually arousing fantasies, urges, or behaviors that are distressing or disabling and that involve inanimate objects, children or nonconsenting... read more .)

"Cross-dresser" is a more common and acceptable term than "transvestite." Cross-dressing in and of itself is not considered a psychiatric disorder. Cross-dressing occurs in both heterosexual and homosexual men. It occurs less commonly in women, although they have a broader range of clothing considered consistent with gender. Nonbinary people who dress in clothing typically associated with a different birth sex are generally not engaging in "cross-dressing." Some people who engage in cross-dressing do so for a variety of reasons that are not now, and may never have been, associated with sexual arousal (eg, costumes). However, for those cross-dressers who experience clinically significant distress or impairments based on their cross-dressing urges or behaviors, the diagnosis of transvestic disorder may be appropriate.

Males who dress in women’s clothing typically begin such behavior during late childhood. Up to 3% of men have cross-dressed and been sexually stimulated by it at least once, but far fewer report regular cross-dressing (1 General reference Transvestism involves recurrent and intense sexual arousal from cross-dressing, which may manifest as fantasies, urges, or behaviors. Transvestic disorder is transvestism that causes clinically... read more ). Cross-dressing is associated, at least initially, with intense sexual arousal. Sexual arousal that is produced by the clothing itself (not by wearing the clothing) is considered a form of fetishism Fetishistic Disorder Fetishism is use of an inanimate object (the fetish) or nongenital body parts as the preferred method of producing sexual excitement. Fetishistic disorder refers to recurrent, intense sexual... read more and may occur with or independent of cross-dressing.

Personality profiles of cross-dressing men are generally similar to age- and race-matched norms. Gender dysphoria Gender Incongruence and Gender Dysphoria Sex and gender are not the same thing, and they should be considered clinically as distinct characteristics. Terminology regarding sex and gender includes ( 1, 2) Sex: Defined by the traits... read more is more common in birth sex males with transvestic disorder. Such individuals may report arousal to wearing typically female clothing as teens that diminishes or disappears later in life, accompanied by a desire to live fully in the female gender. Some with transvestic disorder may also experience intermittent gender dysphoria associated with loss, grief, substance use, or depression.

When their partner is cooperative or willing to participate, cross-dressing men may engage in sexual activity in partial or full feminine attire. When their partner is not cooperative, they may feel anxiety, depression, guilt, and shame because of their desire to cross-dress and may experience sexual dysfunction in their relationship. In response to these feelings, these men often purge their wardrobe of female clothing. This purging may be followed by additional cycles of accumulating female clothes, wigs, and makeup, with more feelings of shame and guilt, followed by more purges.