Trans Phantom Anatomy
feeling phantom body parts
People who long to be the other sex sometimes say they feel phantom anatomy which corresponds to their desired form of embodiment. Some FTMs report prior experience of phantom penis, and some MTFs report prior experience of phantom breasts or vulva.
This phantom anatomy is probably a byproduct of autosexuality. Hirschfeld mentioned this phenomenon in Transvestites:
In the case of most of these congenitally most strongly predisposed patients, a genuine drive to cross-dress is rare. Typical is that they feel that their genitals have changed into those of a woman. They imagine that they are growing women's breasts, that they have long pigtails, that their clothing is women's when in fact they are men's. [emphasis added]
The Hungarian physician (whose intense and wide-ranging narrative of autogynephilia was presented in Psychopathia Sexualis) also reported sensations indicative of phantom anatomy:
General feeling: I feel like a woman in a man's form; and even though I often am sensible of the man's form, yet it is always in a feminine sense. Thus, for example, I feel the penis as clitoris; the urethra and vaginal orifice, which always feels a little wet, even when it is actually dry; the scrotum as labia majora; in short, I always feel the vulva.
Analogous phantom anatomy also appears in FTMs. For example, one study of post-op FTMs found that “18 of the 29 (62%) reported having felt vivid phantom penises (including phantom erections) for many years”.
A particularly interesting case of phantom penis can be found in Stoller’s Splitting, a thick book devoted solely to the case of Mr. G. I find it interesting how Mr. G always perceived that his phantom penis was in a location that allowed it to exist:
S: Where’s the penis?
G: It’s in my vagina. What I mean is, I still rub my clitoris, but I feel my penis.
S: Is it inside in your vagina, or in your pelvis?
G: It depends on whether I'm having intercourse or I’m with a woman or I masturbate. If I masturbate, it’s inside my vagina. During intercourse with a man, it’s not in the vagina, but in my pelvic area. I think it’s only in my vagina when I masturbate.
S: How about when you’re with a woman?
G: Then it’s outside.
S: And fills up the whole vagina? Right to where it would stick out, but it doesn’t stick out? Have you ever put a finger in to feel if it’s there?
G: I don’t want to. If you have a vagina, you have a hole; but if you have a penis, you don’t have a hole.
[pps. 16–17]
As part of psychotherapy, Stoller tried to convince Mr. G that he didn’t actually have a penis and that it was a delusion. But Mr. G resisted. He was deeply attached to his penis:
“[Shouting] I have this. I have it and I use it and I love it and I want it and I intend to keep it, and there’s nothing you can do about it. It’s mine. It makes me what I am.
[p. 15]
Although Mr. G’s phantom penis first appeared at age 4 and had been with him his whole life, it did not endure. After several decades of proud penis ownership, Mr. G’s penis emerged from his body and exploded during a fateful LSD trip and reportedly never returned. (R.I.P.)
Bigender-identified people have also reported prior experience of phantom anatomy. One study of big found that 71% of such people had felt phantoms before.
But phantom anatomy is not constrained to gender—it also occurs in transspecies people. Theirs, however, is animalistic in nature:
The vast majority of therians report prior experience of animalistic phantom anatomy, a phenomenon they call “phantom shifts”:
This data from therians is useful for further raising one’s confidence that phantom anatomy is a byproduct of autosexuality. Although there are multiple etiologies of transgender identity, the autosexual type of transspecies seems to be the only type of transspecies. If 1) autosexuality is the only cause of transspecies identity and 2) most transspecies people report having experienced animalistic phantom anatomy, it’s reasonable to conclude that autosexuality is the ultimate cause of transspecies phantom anatomy.
Transgender Phantom Prevalence
Last year, a study on transgender phantom anatomy came out (PDF) which finally estimated the prevalence of phantom anatomy in a large sample of gender-diverse people. A major strength of this study is that much of the data was presented in relation to birth sex instead of gender identity.
Of the 1072 females and 344 males surveyed, 51% of females and 39% of males reported prior experience of cross-gender phantom anatomy. I’ve compressed the relevant data from the first three tables in this study into one table for easier viewing at a glance:
Given the autosexual roots of phantom anatomy, the specific body parts described are not at all surprising. Phantom penis was by far the most common kind of phantom anatomy experienced by gender-variant females—43% of whom reported prior phantom penis. Phantom anatomy was less prevalent among gender-variant males, but nonetheless 26% reported prior phantom vagina and 14% reported prior phantom breasts.
In a major win for the autosexuality hypothesis, the vast majority of respondents said their phantoms had erotic sensation associated with them. Unfortunately, once it came time to report how many respondents reported erotic sensation associated with their cross-gender phantom anatomy, the authors diverged from their transparency around birth sex (they also declined to share their data on erotic phantom sensation with respect to birth sex when I requested it). However, if you compare the N’s for erotic sensation in the above table with the N’s for the respective phantom anatomy in each sex, it’s obvious that erotic sensation was strongly associated specifically with cross-gender phantoms. The cross-gender nature of phantom eroticism is perhaps most blatant for phantom penis: 407 respondents reported erotic sensation associated with phantom penis, but only 5 males reported phantom penis, so at least 402 of 407 reports of eroticism must have come females.
The study also reported the onset of trans phantoms:
Both the onset of phantoms and the lifetime prevalence of phantom anatomy was overall quite similar between sexes—a pattern that what might be expected if the etiological makeup of the transgender population is similar in both sexes.
Phantoms As A Diagnostic Indicator
Although knowing about phantom anatomy might be useful to autosexuals who are trying to make sense of their experiences, I’m most interested in phantom anatomy for its potential to help infer the etiology of someone’s gender dysphoria without having to directly ask them about their sexuality.
Sexuality can be a touchy subject. This is especially relevant in the context of transgender medical care, where gatekeeping based on sexuality has historically been quite common. However, it’s not immediately obvious that phantom anatomy is related to sexuality, so asking about it is probably less likely to trigger alarm bells. And since cross-gender phantom anatomy seems like the kind of thing that would signal to a transgender person that they have a genuine brain/body mismatch, falsely denying it seems unlikely. If anything, I suspect that some gender-dysphorics would falsely report having phantom anatomy if they thought it signaled legitimacy, so inquiries about phantoms should be just one of several lines of inquiry.
I’m also optimistic about the potential for using phantom anatomy to guess the future trajectory of anatomic gender dysphoria. There aren’t hard numbers on this yet, but I suspect that autoheterosexuals with strong/frequent phantom genitals would be more likely to develop severe genital dysphoria (or benefit from bottom surgery) than those who didn’t experience phantoms.