This paper examines transvestitism from clinical and behavioral perspectives, presenting definitions from the World Health Organization and DSM-IV, exploring multiple etiological theories including developmental exposure, classical conditioning, and parental influence. It distinguishes between transvestic fetishists, female impersonators, and transsexuals, and evaluates treatment efficacy through psychotherapy and behavioral aversion techniques. The paper concludes that while behavioral interventions show promise, psychotherapy effectiveness remains unproven due to methodological challenges and patient compliance issues.
Transvestitism is defined by the World Health Organization as "the wearing of clothes of the opposite sex principally to obtain sexual excitement and to create the appearance of a person of the opposite sex." Similarly, the latest version of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defines it as "recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing."
The causes of transvestitism are both varied and unproven. Many theories believe that transvestitism begins during the adolescent stage as children are exposed and aroused by clothes of the opposite sex. For example, children may experience pleasurable sensory experiences from the smell of female perfume. These feelings are generally accompanied by feelings of comfort, familiarity, and understanding. This arousal ultimately manifests itself in cross-dressing as the activity is paired with sexual urges. In many instances, males may experience thoughts of being female in both public and private settings.
Other theories suggest that transvestitism begins with classical conditioning after exposure to clothes of the opposite sex. This conditioning combined with emotional distress causes transvestic behavior to occur. Some studies have also shown that parents have been the cause of transvestic behavior. Parents, in some instances, have punished boys by making them wear female clothes. This activity may have conditioned the male to accept transvestic behavior.
Characteristics of an offender are easily seen and recognized. The first and most obvious characteristic is the offender's gender identity or gender expression not matching one's assigned sex. This can occur with both male and female offenders, who cross-dress as an individual of the opposite sex. In addition, offenders will take sexual pleasure in dressing as the opposite sex. Literature has separated transvestic behavior into distinct groups:
"Psychotherapy and behavioral aversion efficacy"
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