An amateurish review of ‘Male Femaling: A grounded theory approach to cross-dressing and sex-changing’

Male Femaling A Grounded Approach to Cross-Dressing and Sex-ChangingI’ve re-read Male Femaling: A grounded theory approach to cross-dressing and sex-changing (Routledge, 2002. ISBN 0-203-42645-2 [eBook]) by sociologist Richard Ekins (I got a PDF somewhere). It’s not light reading, and probably the longest academic study I have read about the whole subject. Some things will be familiar to all kinds of crossdreamers, and many others will be hard to follow, as Ekins describes in detail his methodology of research. If you’re unfamiliar either with psychology as an academic study, or of the particular methodologies used by psychologists, then you’ll be a bit lost — as I am.

This is not an academic review. You can find a lot of them online (most are free). This is merely a review from the perspective of someone without any training and knowledge about psychology and sociology. I do have some academic training in completely different areas, however, so the style is familiar to me. Nevertheless, I’m not doing a professional, academic review, which is beyond me.


Every good book or article on transgenderism/crossdreaming/transexuality starts with defining concepts. Without knowing what the words mean, it’s pointless to discuss anything seriously. Ekins avoids the usual definitions, and prefers to call everything ‘male femaling’. The actual act of dressing/modifying one’s body/adopting the role of the desired gender is called by Ekins ‘femaling’. Apparently, he hopes that his labels are sufficiently neutral to avoid being offensive to anyone in the multiple communities.

Ekins also uses the same concepts and approach to all kinds of ‘femaling’. This might be a bit surprising for some readers. The whole ‘T’ community is very fragmented, and tends to view their own problems and issues in isolation to the rest of the community. Approaches that tend to unify a whole spectrum of very different individuals will often be seen with some suspicion. No wonder, thus, that so many concepts are strange and unique to Ekins.

Still, some concepts will be familiar. Ekins clearly separates sex, sexuality, and gender, something which is still somewhat confusing in our community. Sex is mostly body; sexuality is the preference of partner; and gender is a social role. While crossdreamers are supposed to know the difference among the three, many still automatically assume that by assuming a gender role as female, it implies a preference for male partners (at least while crossdressed). So many new threads on crossdresser forums start with ‘you can only be a full woman by experiencing sex with a man’. That would sound extremely offensive to the millions of genetic females who are lesbians.

Another familiar concept, although Ekins uses different words to describe it, are the three major kinds of crossdressers. One way of labeling them is as fetishist, libidinous, and narcissistic. The first group gets excited with the notion of wearing women’s clothes; clothing is the object of desire. Ekins calls them ‘body femalers’ (‘femalers’ is Ekins’ terminology to describe MtF crossdreamers) and extends the notion of ‘clothing’ to the entire body, i.e. the fetish can also include things like wearing wigs, breast forms, padding, etc., going through hair removal, grooming the eyebrows, manicuring the fingers, and finally going all the way with surgery and hormones. In this case, the focus is to derive arousement from one’s feminised appearance.

The second group is by far the largest. For the libidinous crossdresser (Ekins calls them ‘erotic femalers’), the whole point of dressing as a woman is to get intercourse with a partner (or to make it more intense/pleasant). This doesn’t mean that the libidinous crossdresser doesn’t worry about her appearance or dress; it just means that the care put into a feminine image has a strong motivation, which is to have sex with a partner. This group is so large and widespread that it gets easily taken as the stereotypical crossdresser; it is also the group which shows a tendency towards hypersexuality. And because of its size, the libidinous crossdresser tends to look down on the other two groups, considering them ‘inferior’ to a degree — as said, ‘not wishing to become complete women’, something which is, for them, only possible by having sex (usually to a male).

The third group is probably the smallest. Some call it narcissistic crossdressers; Ekins prefers ‘gender femalers’. In this case, the crossdresser is less interested in the sexual aspect of crossdressing (either as a masturbation aid, like the fetishists, or as a way to get sexual partners for intercourse, as the libidinous). Rather, the excitement and arousal comes from adopting the female gender role. Physical sex is secondary; becoming a woman socially is what turns them on. Again, this doesn’t mean that narcissistic crossdressers are not interested in sex, or that they despise it, or that they don’t turn to masturbation occasionally, and prefer to masturbate when acting as members of the female gender. It’s just that their primary desire — and its fulfillment — comes from an identification with the female gender. I personally believe that most narcissistic crossdressers are mostly transexuals before going into transition. Sociologists like Ekins and many psychologists prefer not to differentiate. Instead, they prefer more neutral classifications — like, for instance, crossdreaming, which does not imply transition, but certainly that is part of the list of options. A ‘gender femaler’, using Ekins’ word for it, is a MtF crossdreamer, who might use crossdressing as a way to fulfill her desires, but might opt for transition instead, if merely crossdressing is not enough. Thus, crossdressing becomes a process, not a classification of a person; similarly, going into transition is a process, not a state. As I love to point out, there are not really ‘transexuals’: once they have gone through transition, they are, legally and physically, persons of the opposite sex and gender than the one they started from. Labeling a transitioned person as ‘transexual’ is as wrong as labeling an adult as a ‘former teenager’ and addressing them as such; we become adults by going through puberty, but once we achieve adulthood, it makes little sense to call us ‘former teenagers’. This, however, is a personal opinion.

By contrast, many psychologists do not view fetishist or libidinous crossdressers as potential candidates for transition. The argument often employed is that merely desiring ‘better sex’ is not strong enough for someone to live their lives as a member of the opposite gender. Nevertheless, even for fetishist/libidinous crossdressers, hormone therapy may be available (because it can help with dealing their constant urges, and, in some cases, help in keeping hypersexuality in check), and, of course, surgery — except perhaps for SRS which is not reversible — might be an option as well.

Critics of Ekins and similar authors with these kinds of classifications like to point out that this leaves out people who don’t identify with any gender (or are gender-fluid, i.e. adopting whatever gender they like, depending on the occasion) and, in the case of libidinous crossdressers, don’t have explicit preferences in sexual partners (fetishist crossdressers might prefer not to ‘mix’ things; when not crossdressed, they have their own sexual preferences, but, while crossdressed, they will just direct their attention to the female self-image as an object of sexual arousal).

Critics also notice that Ekins has only studied male-to-female adults. This might have been deliberate, though. Ekins is honest enough to explain that further studies might address FtM, and that his approach might be extended to cisgendered individuals; however, he doesn’t seem to view minors as worthy of his studies — at least not on this book.

Let’s turn to one concept of Ekins, which I understand to be common to many other areas of sociology and psychology: the career path.

The ‘Career Path’

Because this is central to Ekins argumentation, I will try to convey his ideas with my own words as best as possible; if I fail in my attempt, rest assured that it’s not Ekins fault.

Ekins tends to view all ‘male femaling’ as proceeding according to a set of what initially seem to be very clearly defined ‘stages’: Beginning Male Femaling, Fantasying Male Femaling, Doing Male Femaling, Constituting Male Femaling, and Consolidating Male Femaling. These are, in fact, whole chapters on the book.

I’ll try to resume the five phases for you. The first one is when it ‘happens’. For some reason — mostly unknown, mostly unplanned — the ‘male femaler’ starts to think of themselves as female, often putting on some item of women’s clothes. Usually there might be mixed feelings about this: both a sense of pleasure, of calmness, of ‘being right’, but also of doubts, guilt, and questioning. This is a phase of mostly confusion, which progresses towards the next phase, where the fantasies of being female become almost obsessive, as the ‘male femaler’ tries to understand what is happening to them. Ekins explains that these phases are common across the three types of ‘male femalers’. Thus, the fantasies might be sexual (wishing to have a different body), related to sexuality (wishing to have sex presenting as a female, or masturbating as a female, etc.), or gender-related (wishing to assume the female role in society). Ekins is careful to explain that most ‘male femalers’ might not be strictly confined to a single category. Thus, the fantasies might be of the three aspects at the same time, or just one (or two) might predominate. For instance, for some ‘male femalers’, the desire to assume the female role in society might be so overwhelming that it drives them to masturbation just thinking about it.

‘Doing femaling’ is when the ‘male femaler’ wants somehow to ‘manifest’ their fantasies. This is also straightforward. For most crossdressers, this means actually buying a female wardrobe and starting experimenting with the wonderful world of female attire, and eventually going out in public and presenting themselves as females. But crossdreamers might merely ‘manifest’ their fantasies by writing TG stories, or exercising any other artistic form. So even Ekins does not limit himself to saying, ‘every male femaler has to wear women’s clothes’ at some stage, but leaves the options open on how the ‘male femaling’ is actually manifested. Each and every person will be different. Some might just partially crossdress. ‘Body male femalers’ might just start to shave themselves and possibly groom themselves with more care. Erotic ones might have routines where they would masturbate while wearing some female lingerie. The possibilities are endless, but what happens in this phase is that there was a decision: this is what I am, this is what I have to do, even if I really don’t know where it’s going to lead, or what it means.

The other phases are a bit harder for me to understand and to explain. I believe that they draw much from the scientific expressions used by experts in the field. ‘Constitution’ happens when the ‘male femaler’ starts giving meaning to their activities; in other words, when they figure out an explanation for their actions that satisfies them. At this stage, it’s normal that they start applying tags and labels to themselves, often after reading about the subject and interacting with others ‘suffering’ from similar symptoms and conditions. Ekins explains that the ‘constitution’ phase is by no means static; as the ‘male femaler’ continues to develop and explore, they might find that different tags and labels — or the absence of such classifications — is what applies better to them. He illustrates this point with some anedoctal evidence, showing reports from people who started crossdressing, then came upon the label ‘crossdresser’ which would fit them, kept that explanation for several years, until it became unsatisfactory; then they re-labeled themselves as ‘transexuals’ and proceeded to transition. Many others might have gone the opposite route. Others, in very rare cases, might find themselves in a new, stable relation in a family and suddenly ‘give up’ all their ‘career paths’ as ‘male femalers’, forever. All possibilities are open.

‘Consolidation’ is the result of constitution, i.e. a stage of final acceptance, where the ‘male femaler’ recognises that ‘femaling’ is part of their identity and experience, and it has to be dealt with successfully and integrated into one’s life. Ekins identifies three possible types of consolidation: ‘aparting’, when the whole ‘femaling’ world is kept completely separate from the ‘male’ world. This is easily seen in cases like crossdressers who will never go public; other types of ‘male femalers’ might ‘live in two worlds’, which are kept in complete isolation from each other.

The second type is ‘substitution’. In that case, the female world is progressively replaced by the male world. This would be more typical of transexuals, but also of those ‘gender male femalers’, who, not embracing surgery and hormone replacement therapy, might opt to live as women for the rest of their lives.

The third type is ‘integration’. This is more typical of those who transcend the gender roles and define a new identity that goes beyond the bipolarity of traditional gender. A lot of possibilities exist, from gender-fluid individuals, who present themselves as either gender depending on their mood, to androgynous individuals who either assume a fusion of both genders or clearly do not identify themselves with either; Ekins is not exhaustive about the possible ways of ‘integration’, he just points out some typical examples to illustrate his arguments.

Modes of ‘doing femaling’

There are ‘career paths inside the career path’; I’ll illustrate the examples that Ekins gives for the ‘doing’ stage. He focuses here more on the more typical case of crossdressers (all three kinds), whether they later consolidate as transexuals or ‘merely crossdressers’.

The first mode is ‘doing’ it in solitude — which also means in complete privacy. This is probably the more frequent case: the beginning crossdresser starting to regularly put on women’s clothes at a secluded spot, without ever having the intention of being found out.

Then comes ‘solo doing’. This is when there is a desire to be seen — a certain perversity and obsession of proving to oneself that one can ‘pass’ in public — but where the ‘male femaler’ goes out all by herself. At this stage, it’s very unlikely that the ‘male femaler’ will interact with others (they might fantasise about it, though), but sees their ‘male femaling’ as a personal, individual, independent thing, to be done outside the scope of their family, group of friends and acquaintaces, etc. This includes all kinds of activities that might take place away from one’s homeplace, safely away of the possibility of being recognised by pesky neighbours or even friends or colleagues.

The next mode might be an evolution or not of the first ones. The first mode is ‘dyadic doing’, where the ‘male femaler’ has a single person in which they confide their ‘male femaling’. It can be a fellow crossdresser with whom they have been open, helping each other mutually. In the case of the ‘erotic male femaler’, it can be a sexual partner in some form of relationship (either a compatible fetish, a domme/sub relationship, a sissification role-playing situation, etc.). But it can be something as simple as a ‘solitary/solo male femaler’ coming out to their wives and ‘doing’ it with their consent and in their presence — either in the privacy of their homes, or even outside it. For ‘dyadic doers’, ‘solitary doing’ makes little sense. Thus, there can either be an evolution — progressing from solitary to solo to dyadic — or a jump straight into this mode (i.e. an erotic male femaler suddenly revealing to their own wife that they have a fantasy of having sex while fully crossdressed).

The final mode, again, can be either a progression or not. Ekins calls it simply ‘group doing’. In this scenario, the ‘male femaler’ seeks the company of a group of fellow ‘male femalers’ to spend some time together, usually in a closed, safe environment, but not necessarily so. Typically, this would be a crossdresser joining a crossdressing association, club, or society, and participating in group events. But there is also the possibility of the event not being specifically a ‘crossdresser-friendly environment’. One example is of the little boy who gets a female role at a school play and finds that performing in front of an audience while dressed as a girl is terribly exciting. Thus, their ‘male femaling’ may become a stage performance, either as an amateur or even as a professional. At the amateur stage, there is even the possibility of only dressing up on special occasions to amuse and entertain some friends. I remember a story told me by my mother who, while working in an office in the early 1960s, there were contests of who had the better legs. To make the contest fair, girls would walk in heels and mini-skirts behind a panel, so that it would be impossible to know who was the contestant. The winner would often be a guy, who had wonderful legs, and walked flawlessly on heels. Although my mother was probably not familiar with the concept, from the description, I believe that this person was clearly a ‘male femaler’ who had this need to crossdress — even if just partially! — in front of an audience.

Ekins argues that all ‘male femalers’ will fit in these categories, but that it’s not necessarily true that all will go through all those phases. He also explains that ‘doing femaling’ might lead to constitution under a label; but that label might not be satisfactory after a while; so the ‘male femaler’ might go back, ‘doing femaling’ in a different mode, and consolidate under a different label. Let me give you a typical example. A ‘male femaler’ might be doing only ‘solitary’ modes, considering that, for her, crossdressing is something done only in private. Thus, when going through constitution, she will label herself as a ‘closet crossdresser’, and try to consolidate along an ‘aparting’ mode — all that happens in that bedroom behind a mirror is to be kept in secret, forever.

Due to her contacts with fellow crossdressers, she might, at some point, get the opportunity to some ‘dyadic doing’: a crossdresser gains her confidence and joins her, challenging her for a ‘girly night out’, where they go to a public place together and generally ‘pass’ as genetic females. The ‘male femaler’ is excited about what happened. She de-consolidates and de-constitutes the ‘closet crossdresser’ label, and starts from scratch, thinking about what label really applies to her. She might consider herself a ‘regular crossdresser’ instead, and continues an ‘aparting’ lifestyle, but this time experimenting with dyadic and group doing. There is an increase in familiarity which leads to higher self-esteem and confidence that this is ‘the right way’ — she feels better and better about her experiences. Maybe, she now thinks, she’s not really a crossdresser at all, but a transexual.

This can go back and forth, and, in some cases, never reach a ‘stable’ phase. Ekins has followed the ‘career paths’ of hundreds of ‘male femalers’ for a period of 17 years before publishing this book. During that time, a few of his informants never consolidated permanently on a single label and category, but were constantly going back and forth in search of a label. Most, however, reached a ‘permanent’ stage of development and achieved stability — and happiness about their choice as well.

Fluidity, dynamics, process

Ekins comes from a class of scientific researchers that are more interested in acquiring knowledge about processes — which, by definition, are always fluid and dynamic — than to capture a ‘static’, stable, unchanging definition. For readers without scientific training, and still caught in the pre-20th-century empiricism, Ekins’ book might sound strange. Although Ekins attempts to introduce several concepts, labels, and categories — even though his own words and definitions are not so common — he is quite clear that he doesn’t see everything in black and white, but rather as swirling gradations of gray, which show black and white aspects while never settling definitely on either extreme.

Thus, his theory is able to simultaneously address crossdressers and transexuals, applying the same criteria to both. For some people in the T community, used to a decades-old discussion on the subject, this sounds like anathema. Similarly, by splitting the crossdresser types in three, he is careful enough to explain that all ‘male femalers’ exhibit all three aspects, while possibly (or not) giving some preference to one. Thus, the discussion of what is a ‘true crossdresser’ or a ‘real transexual’ makes no sense for Ekins. At Ekins’ time, the word ‘crossdreamer’ was not yet invented, but I would argue that what he calls ‘male femaler’ applies to MtF crossdreamers (‘crossdreaming’ is just more embracing, since it applies to MtF, FtM, or to anyone defying any gender classification), even though the consolidation on the ‘integration’ path shows that Ekins is aware that ‘femaling’ might lead to a point where the former ‘male femaler’ is not worried about presenting themselves as being ‘part’ of either gender (or adopts both; or ‘fuses’ both gender roles into a single one).

He also presents a path with five stages (and some sub-stages inside each) but also clearly explains that those stages are also fluid and dynamic, like in the many examples where a ‘male femaler’ consolidated on a specific label, but, after some changes of circumstances, questions the consolidation and goes back. There is also no ‘time period’ required for each stage. For some, there might be swift progress across all stages, so that they might get easily blurred together. This, for me, provides a good explanation for someone who suspected that their gender identity was never aligned with their genitalia and phenotype, but never had a ‘beginning’ phase where they put on female clothes. They might just have jumped straight into the fantasising phase. Much later, the urge to become physically a woman was so great that they skipped all stages and dropped directly into consolidation with full substitution — and that happens quite quickly. So quickly, in fact, that the stage of ‘doing’ and ‘constituting’ happen after ‘consolidation’. Under Ekins’ model, this is not only possible, but he gives some hints at how it might happen. Put into other words: the ‘career path’ is mostly a guideline which will ‘fit’ to many, but not all, crossdreamers. For those where it ‘fits’ — in the sense that they can point out where in the path they are — there might be some identification with Ekins’ model. But some might skip the whole path altogether, or the whole phases might be so close together as to defy separation. Consider the case of a male actor who only very vaguely imagined himself as a woman, but never gave any serious thoughts about it. Then they get the role of a lifetime, acting the lead role dressed as a woman. All of a sudden this feels so ‘right’ that, after putting on female clothes and makeup for the very first time, they have absolutely no doubts that this is exactly what they want to be, forever. All five stages might have been compressed to a single instant. Others, by contrast, might be ‘stuck’ to a single phase and never leave it.

More likely, however, Ekins’ theory might be misread as ‘demanding’ a progression through a well-defined path, while this is absolutely not the case. Consider a crossdreamer that, at the ‘beginning’ stage, starts wondering how they would look like as a woman. This might become a source of confusion, of worrying about where that thought had come from, but then they go further into the fantasising stage, where they spend most of the time obsessed with thoughts of being female. However, they seem content never to leave that stage: they are more than happy with the fantasies, and would never dream of doing anything ‘physical’ about it. Is Ekins’ theory wrong?

I would argue that Ekins’ theory covers that example as well, and, again, I can only provide anedoctal evidence. Two friends of mine have certainly gone through the first two stages. Although sympathetic towards crossdressers, they feel very strongly that they don’t ‘need’ any manifestation of their fantasies by dressing up as women (even though they have absolutely nothing against the idea). Instead, their ‘doing male femaling’ is exercised by artistic creativity. They invent femme names for themselves, create female avatars in Second Life, engage in writing ‘fem dom’ literature, or participate in online meetings with other females, in anonymity (one of my friends is even a sound engineer and has access to studio technology where he can transform his voice in real-time to sound absolutely female on a voice call — I’m not talking about low-end voice morphing technology where there are always some flaws and tell-tales, but absolutely clear, perfect, female voice pitch, who cannot be distinguished by the human ear in any way whatsoever). While there is no ‘crossdressing’ involved, all these activities are most certainly ‘doing male femaling’, and often involved in group activities, even if there is absolutely no ‘physical’ activity. They might proceed through constitution, and being fine in tagging themselves as a ‘special’ kind of crossdreamer, and consolidate that aspect of themselves in an ‘aparting’ setting. Thus, they have, in fact, gone through the same career path, covering all stages. But none wishes ever to wear women’s clothes, much less go through transition. While the proponents of the ‘crossdreaming’ concept would certainly include them as ‘crossdreamers’ — as probably Ekins would classify them as ‘male femalers’ — some less open-minded ‘experts’ would be hard to classify them as ‘transgendered’, since they don’t have any physical manifestations of their desires to express themselves as female. In fact, while the number of crossdressers and transexuals might be low (every study seems to find different values), I might argue that those crossdreamers who never ‘manifest physically’ might be actually a much large proportion of the population — perhaps as high as 10%. The gender-bender culture which is popular on online gamers, as well as the ‘crossplayers’ — cosplayers who attend conventions crossdressed — tend to support the view that there are far more people interested to present themselves as the opposite gender than most people believe. Why, then, would crossdressing be so popular at Carnival or Halloween or similar environments?


Again, this aspect of the book is highly technical and I had to struggle to make some sense of it. It draws heavily from sociology jargon which I’m not familiar with. From what I understand, especially in the ‘doing’ stage, Ekins tries to be extensive in the way ‘male femalers’ present themselves. He talks about how this presentation can be fully private — as would be the case in ‘solitary doing’. It could also be fully open — like a transvestite performance, where everybody is aware that the ‘male femaler’ is really a male in women’s clothes. All else in-between is much more trickier. For instance, a crossdresser — specially of the ‘gender femaling’ type — might take pains to ‘pass’ in a certain environment. This is not an ‘open’ presentation — the audience might know or not that they are in the presence of a crossdresser, and it is the wish of the crossdresser that they do not know. If they succeed in passing, then there is a ‘private masked awareness’ situation: the crossdresser is aware that she’s not truly female, but she’s also not revealing that she’s not a female, but nobody else is aware of her assigned gender at birth. If they do not succeed, however, there are two alternatives. Either they are ‘read’ and the ‘deception’ is exposed (which might turn into rejection, confusion, outrage…), or, by contrast, they can get along with it, and ‘pretend’ that the crossdresser is truly female and act accordingly. A typical example is a crossdresser joining a crossdresser club. Everybody is perfectly aware that everybody else is a crossdresser, but all keep the pretense that they are truly female, and act accordingly. Thus, in this scenario, everybody is accepting everybody else’s female gender and acting — and responding! — accordingly, while obviously everybody also knows that everybody else has not been born female.

Ekins uses this very complex terminology and the many scenarios to illustrate the cases of mental anxiety which might delay the progression of a ‘male femaler’ along some paths, or, by contrast, how it might give a strong encouragement to go on. For instance, a ‘bad’ experience where a ‘solitary male femaler’ (i.e. going out on their own) is ‘read’, and the reaction is not positive, might drive her back to home and forget everything about crossdressing — or, by contrast, push her to strive to be better at makeup, clothing, etc. By contrast, a crossdresser-friendly environment where everybody knows perfectly well who the others are, but pretends otherwise, might afford a place free of tension, of anxiety, of fears — ‘we are all women here, no matter what’ — and where good advice can be doled out — ‘you don’t need to “pass” to be accepted as a woman by us, all that matters is that you are a woman inside‘ — can improve the mood of a frustrated/anxious crossdresser and allow them to evolve and explore their female feelings and needs for self-expression further, in an environment where there is no failure, just good advice and encouragement.

Ekins sociological terminology, however, is really beyond my understanding, but I imagine that the need to explain all possible interactions and focusing on them is required by sociological studies in order for them to be scientifically validated. I don’t know anything about that, really…

Discussion and some conclusions

Ekins, as said, neglects the whole FtM side of the issue, as well as excluding minors from his studies, and, as such, there are flaws in his theories (or maybe they are just incomplete). It can also be argued that Ekins has a strong sense of bipolar gender roles, or, at least, that he accepts that our society is mostly established according to bipolar gender roles, and, as such, ‘male femalers’ — as the name implies — tend to ‘switch poles’. However, by including the possibility of ‘consolidating integration’, clearly he’s aware that gender is not bipolar but also quite fluid.

Ekins also clearly prefers to focus on the majority of cases — which also means that future sociologists and psychologists might be trained to be better at recognise the specific needs of ‘male femalers’ — while still enumerating the more extreme exceptions, so that those can be recognised and understood better. He cannot be extensive, though. As such, the casual reader might be led to believe that Ekins somehow is proposing an ‘ideal path’ (while he’s not, he’s just averaging many possible paths and trying to get an overarching framework to study them). For instance, a first reading tends to give this idea that the typical ‘male femaler’ will go through the following path:

  1. Beginning: at infancy, puts on some of the mother’s clothes and is thrilled by the feeling
  2. Fantasising: during adolescence, imagines having a woman’s body, in order to masturbate
  3. Doing: starts with solitary sessions, dressing up in front of a mirror. Then takes some pictures or videos of themselves, keeping them in secret. Progresses towards going out on their own. Then finds a crossdressing friend, a BDSM dominatrix, or reveals their crossdressing urges to their wives. Finally, finds crossdresser/transexual help groups and starts spending more and more time with them
  4. Constitution: Becomes happy and relieved while crossdressed; crossdressing becomes part of their routine and gets integrated more and more into it. At some point, however, the urge to crossdress more and more starts to develop, and finally gender dysphoria is considered.
  5. Consolidation: either as a life-long crossdresser (‘aparting’) or as a transexual (‘integration’) while leaving open the option of becoming neither a male, nor a female, nor both together (‘integrating’)

This is, however, just a possible path and by no means the only path.

How can this very technical book actually be helpful to crossdreamers? First, I believe that it allows them to recognise that the ‘urge to label oneself’ is very strong among all kinds of crossdreamers. This book allows them to see what ‘options’ are available, but also is quite clear that there are plenty of terms, categories, designations, and none might apply — all that is fine and normal. Once a classification is settled upon, it is by no means definitive. Ekins will illustrate a few possible ‘career paths’ in terms of possibilities based on that classification, but he is also careful in explaining that there are other possibilities, and that they are not exclusive.

Ekins also fails to mention in detail co-morbidity with some conditions. For instance, depression (after breaking up with a beloved one) might be the trigger for a crossdreamer who never expressed themselves to finally start some crossdressing as a means to fight depression. Conversely, a crossdreamer who is absolutely denied the ability to manifest themselves as crossdressers, might be thrown into depression as a consequence. Hypersexuality and the drive to explore new, different forms of sexuality as a potential drive to ‘sexuality doing femaling’ is not explored deeply; it is mentioned, but the reader feels that Ekins does not believe it’s crucial (i.e. we are lead to believe that ‘sexuality-oriented male femaling’ is only very marginally connected with hypersexuality; rather, some people, who are crossdreamers, might express their sexuality by crossdressing, while others don’t). I think that there is quite an opportunity for further studies to complete those relationships — and, in fact, they have done so since 2002.

All in all, I would definitely recommend this book to anyone interested in very technical information about how scientific researchers tackle the issue. It might be a good textbook for academic researchers, especially those wishing to avoid the pitfalls of using more ‘conventional’ terminology which might be emotionally charged with prejudice, as felt by the transgender/crossdreaming community. For the casual reader, this book might be simply too technical. It doesn’t actually offer any advice or hints. It points out solutions without going very deep into them. It also might leave the reader undecided: so many terms, so many concepts, so many labels, tags and categories, and I don’t identify myself with any of them.

In my case, it helped me to deal with my hesitation in ‘consolidating’ around a single term that describes what I feel I am, while at the same time explaining that this hesitation, this going back and forth, this ‘experimenting’ with different manifestations of my inner feelings as a female — from ‘solitary doing’ to ‘solo doing’ to ‘dyadic doing’ and, hopefully, to ‘group doing’ at some point — is perfectly natural for a vast majority of crossdreamers and that I should expect this to happen and be relieved that I’m no different from any other crossdreamer that went through this back-and-forth process — all of us do that, sometimes quicker, sometimes slower.