Physiologic Autogynephilia
having female bodily functions
Chapter 2.4 of Autoheterosexual: Attracted to Being the Other Sex
Each sex has specific bodily functions that support its reproductive strategy. Males ejaculate semen. Females menstruate, lactate, and become pregnant.
Sexual interest in having these female bodily functions is physiologic autogynephilia.
Just like any other aspect of autogynephilia, physiologic autogynephilia can occur in the realm of emotions and underlie a wistful longing to become pregnant, give birth, or breastfeed. For some, this longing is experienced as a desire for motherhood rather than an interest in having the bodily functions themselves.
Physiologic autogynephilia can even cause psychosomatic period symptoms such as abdominal cramping or headaches. It’s unlikely that these symptoms are caused by hormones: autogynephilic people reported having these symptoms before synthetic hormones even existed.
Writing four decades before scientists isolated and named various forms of estrogen, the Hungarian physician alluded to her monthly period symptoms when she spoke of her molimen:
Every four weeks, at the time of the full moon, I have the molimen of a woman for five days, physically and mentally, only I do not bleed; but I have the feeling of a loss of fluid; a feeling that the genitals and abdomen are (internally) swollen.[i]
The full moon served as a timing cue for her psychosomatic period symptoms. After the permanent onset of her cross-gender identity, this “periodicity of the monthly molimina”[ii] was a regular feature of her life.
Twenty years later, another case of period symptoms in a male appeared in the sexology literature[iii]. According to Ellis, this “man…desired to be a woman and in his day-dreams imagined himself physically changed to a woman. There was a tendency to identification with his mother, and, like her, he had attacks of headache every month which he called his ‘periods’”[iv].
During this patient’s childhood, her mother suffered from headaches accompanying menstruation which left her overly sensitive to any stimulus and unable to do much of anything for a few days at a time. After her mother’s passing, this patient experienced headaches every four weeks. Each one lasted three to four days, one or two of which were spent in bed, unable to work[v]. The calendar likely served as the timing cue for her symptoms.
Pregnancy Transvestites
In classic sexology narratives from the early 1900s, many autogynephilic transfems wanted to become pregnant or give birth. These feelings were often intense and held close to their hearts. Although they longed to be women, they particularly wanted to be mothers.
Hirschfeld called this pregnancy transvestism[vi]. It came up in first-person narratives much more than other physiologic interests. These pregnancy transvestites were particularly prone to envy when their wives became pregnant and gave birth—a reaction Hirschfeld described as “very characteristic”[vii].
One transfem even described her feelings about her wife giving birth as “the most acute suffering I ever felt in my life”[viii]. Another teared up when recalling her first gender euphoria experience at the idea of having a child:
There came a day when I felt that I wanted to have a child! The feeling was beautiful! I can write no more now for I am crying. The feeling came one evening, when I was in bed with influenza. The sensation began in my penis and then it was only a feeling in my heart, I will have a child! I will have a child!…That evening I cried terribly…I was 11 or 12 at the time.[ix] [emphasis in original]
The bodily sensation that started in her penis and made its way to her heart is reminiscent of autogynephilic feelings in general: an initial sexual spark can develop into a profoundly deep attachment to feminine embodiment or the idea of being a woman.
After that first experience, this transfem dressed up as though she were pregnant, gazed at her reflection in the mirror, and had “the most blissful feeling”[x]. She repeated this behavior hundreds of times.
Another transfem felt “hopeful and joyful” when she had the impression of being a pregnant woman[xi]. For another, dreaming of being pregnant and giving birth was the only time she was truly happy[xii]. Even though waking up was a disappointment, she was thankful for the dream experience nonetheless: it was the closest she could get to what she wanted.
When recounting her earlier sexual experiences with an energetic woman, a transvestite reported that she “had the burning wish to become a mother by her”[xiii]. Another felt crazy because of her “burning desire to be pregnant”[xiv].
The Hungarian physician wanted to get pregnant, too. She was plagued with thoughts of pregnancy and even had psychosomatic symptoms:
For about three years I had a feeling as if the prostate were enlarged,—a bearing-down feeling, as if giving birth to something; and also pain in the hips, constant pain in the back, and the like. Yet, with the strength of despair, I fought against these complaints, which impressed me as being female or effeminate.[xv]
Perhaps because of her medical knowledge, she also felt another kind of female bodily function: female ejaculation during intercourse[xvi].
In these historical narratives, the thought of becoming pregnant and giving birth had great emotional significance. The feelings expressed about pregnancy ranged from great euphoric heights all the way down to the darkest depths of dysphoria. It moved them.
I focus on the strength of these emotions because it’s easy for non-autogynephilic people to be squicked out by these interests in periods and pregnancy, or to deride them as simple fetishes, but the truth is more complex.
Female bodily functions are powerful signifiers of womanhood. The ability to get pregnant and give birth drastically alters the lives of females and the role they play in society, so some autogynephilic people attach great emotional significance to the idea of having the female bodily functions that allow that possibility.
Lactation and Breastfeeding
It wasn’t common, but a few historical narratives mentioned an interest in lactation or breastfeeding. Like other aspects of autogynephilia, these functions carried an emotional weight that transcended eroticism.
Some transfems found breastfeeding appealing because of its association with motherhood. “The acme of physical human happiness often appears to me to be a woman suckling a healthy child”[xvii], reported one such transfem. After seeing a mother breastfeeding her child, another transfem lamented, “If only I had such breasts and could give milk!”[xviii].
One of Hirschfeld’s transfems was downright obsessed with the idea of lactation and thought about it for much of her life. At around ten years of age, she had a powerful experience while simulating lactation: “I…took out a teaspoon of milk, and let it fall in drops over my teats to lead myself to the illusion of being a soothing mother. This brought on a strong feeling, naturally without ejaculation”[xix].
Unfortunately for her, she died before medical technology allowed males to lactate.
Modern Physiologic Autogynephilia
Scientific advances in medicine have allowed trans women to induce lactation if they really want to and can afford to pay for it.
The first case report of induced lactation in a trans woman was summarized in a New York Times article[xx] that brought the news to a mainstream audience. In that case report, the study’s authors reported a peak output of eight ounces per day and enough overall milk production to be the sole source of nourishment for a newborn’s first six weeks[xxi]. A second case study reported a peak output of three to five ounces per day[xxii].
While the desire to lactate among trans women isn’t the norm, it’s prevalent enough that about a third of clinicians surveyed at a major transgender health conference reported encountering trans women who expressed interest in inducing lactation[xxiii]. Approximately one in five of these clinicians knew of places that would help trans women induce lactation[xxiv].
One trans woman who induced lactation in her late fifties reported that it gave her strong personal satisfaction because it affirmed her womanhood[xxv]. Once she was confident in her ability to lactate, she stopped trying to do so: she had already succeeded at her goal of reinforcing her womanhood.
Some trans women claim to have period symptoms such as mood swings, food cravings, headaches, and bloating[xxvi]. In response to perceiving being on their period, some have experienced feelings they describe as “gender euphoria”, “strangely validating”, and “wonderful”[xxvii]. One trans woman reported that before she awakened to being transgender, she obsessed over the idea of having periods because it symbolized the ability to get pregnant and give birth[xxviii].
Trans women who feel they are experiencing symptoms on a somewhat regular basis may be getting a timing cue from their environment—perhaps from using a period tracker app or from syncing up with a female they live with.
It’s common for trans women to attribute these feelings to feminizing hormones, but old sexology narratives reveal that hormones aren’t needed for these feelings to occur. And besides, estrogen taken at consistent intervals is unlikely to create a monthly hormonal cycle like that of females.
In Sum:
Physiologic autogynephilia is a sexual interest in having a woman’s bodily functions. Since bodily functions that differ between the sexes pertain to sexual reproduction, physiologic autogynephilia may drive interest in menstruating, becoming pregnant, giving birth, or lactating. It may also lead to interest in having female ejaculation.
The desire to have female bodily functions can lead to psychosomatic period symptoms. Autogynephilic people who experience these at regular intervals may be getting a timing cue from their environment.
Some trans women receive medical help to induce lactation because they see the ability to lactate as a symbolically important part of being a female or mother. If they succeed at lactating, it is a powerful validation of their womanhood.
[i] von Krafft-Ebing, 316.
[ii] von Krafft-Ebing, 322.
[iii] Abraham, “Über hysterische Traumzustände”; Abraham, Klinische Beiträge zur Psychoanalyse, 71–74.
[iv] Ellis, “Eonism,” 16.
[v] Abraham, Klinische Beiträge zur Psychoanalyse, 74.
[vi] Hirschfeld, Sexual Anomalies and Perversions, 218.
[vii] Hirschfeld, 199.
[viii] Ellis, “Eonism,” 96.
[ix] Hirschfeld, Sexual Anomalies and Perversions, 216.
[x] Hirschfeld, 217.
[xi] Hirschfeld, Transvestites, 119–20.
[xii] Hirschfeld, Sexual Anomalies and Perversions, 216.
[xiii] Hirschfeld, Transvestites, 89.
[xiv] Hirschfeld, 31.
[xv] von Krafft-Ebing, Psychopathia Sexualis, 311.
[xvi] von Krafft-Ebing, 317.
[xvii] Ellis, “Eonism,” 98.
[xviii] Hirschfeld, Transvestites, 63–64.
[xix] Hirschfeld, 54.
[xx] “Transgender Woman Breast-Feeds Baby After Hospital Induces Lactation - The New York Times.”
[xxi] Reisman and Goldstein, “Case Report,” 25.
[xxii] Wamboldt, Shuster, and Sidhu, “Lactation Induction in a Transgender Woman Wanting to Breastfeed,” e2049.
[xxiii] Trautner, McCool-Myers, and Joyner, “Knowledge and Practice of Induction of Lactation in Trans Women among Professionals Working in Trans Health.”
[xxiv] Trautner, McCool-Myers, and Joyner, 3.
[xxv] Burns, “Yes, Trans Women Can Breastfeed — Here’s How.”
[xxvi] Unnamed Author, “6 Transgender Women Talk Menstruation”; Kailyn, “Trans Girl Periods. Yes, That’s Right. No, I’m Being Serious. Just Read the Damn Article.”
[xxvii] Unnamed Author, “6 Transgender Women Talk Menstruation.”
[xxviii] Unnamed Author.