How the S.A.G.E. test scores:

For an in-depth explanation of how it calculates the scores and delivers its analysis, read the technical notes.

Classifications used for analysis:

Unconflicted

This is pretty self-explanatory. If this was your result, it means you are happy with who and what you are. Kudos!

Normal doubts or curiosities:

A lot of people have wondered what it would be like if they'd been born the opposite sex, or enjoy a good story where people "swap bodies." Showing interest in such things or thinking about them doesn't mean you WANT to be the opposite sex, and doesn't mean you want to DO anything contrasexual either. If this was your result you're in the majority of people who are curious and okay.

Crossdresser:

This is a broad category. As loose guidelines for it I considered the following diagnostic nomenclature:

From The ICD-10:

Dual-role Transvestism (F64.1) has three criteria:

1. The individual wears clothes of the opposite sex in order to experience temporary membership in the opposite sex;
2. There is no sexual motivation for the cross-dressing;
3. The individual has no desire for a permanent change to the opposite sex.

Yes, it is possible for the S.A.G.E. test to correctly identify a crossdresser who is not motivated by sexual arousal.

The DSM-IV places greater emphasis on sexual arousal as a motivation for crossdressing:

302.3 Transvestic Fetishism

1. Over a period of at least 6 months, in a heterosexual male, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing.
2. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
3. Specify if: With Gender Dysphoria: if the person has persistent discomfort with gender role or identity.

Note that the DSM definition says that there is no such thing as a gay or bisexual crossdresser, or a "female crossdresser" for that matter. This seemed a bit too exclusionary as I'm sure most gay male "Drag Queens" would be considered "crossdressers" by most people.

Transsexual

The spectrum of analyses delivered by S.A.G.E. for the "Transsexual" catagory are:

• in doubt about ability to successfully transition
• a serious candidate for Gender Reassignment who has not begun transition in earnest
• in transition, living in-role, or even post-operative.

Again, from the ICD-10:

Transsexualism (F64.0) has three criteria:

1. The desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment;
2. The transsexual identity has been present persistently for at least two years;
3. The disorder is not a symptom of another mental disorder or a chromosomal abnormality.

The S.A.G.E. test has no way to directly check the last point. However, if there is sufficient reason for the program to assess that the person is Intersexed (i.e., a chromosomal abnormality), the numbers for gender conflict are subsequently lowered and the persons "score" would theoretically be too low to place them in the "Transsexual" category. So in that respect, theoretically, this program should be able to accommodate the ICD-10 diagnostic criteria. It also places greater weight on the conflict if the answers indicate it was present in childhood, which satisfies criteria number two. Other questions determine if the person is contemplating or has begun physical alteration to make their body "as congruent as possible witht he preferred sex."

The term "transsexual" was removed from the DSM-IV in favor of the broader Gender Idenity Dysphoria classification. The criteria of which are:

• A strong persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex). In children, the disturbance is manifested by four (or more) of the following:
  1. Repeatedly stated desire to be, or insistence that he or she is, the other sex.
  2. In boys, preference for cross-dressing or simulating female attire; In girls, insistence on wearing only stereotypical masculine clothing.
  3. Strong and persistent preferences for cross-sex roles in make believe play or persistent fantasies of being the other sex.
  4. Intense desire to participate in the stereotypical games and pastimes of the other sex.
  5. Strong preference for playmates of the other sex.

  In adolescents and adults, the disturbance is manifested by symptoms such as

  1. a stated desire to be the other sex,
  2. frequent passing as the other sex,
  3. desire to live or be treated as the other sex,
  4. or the conviction that he or she has the typical feelings and reactions of the other sex.
• Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex. In children, the disturbance is manifested by any of the following:
  • In boys, assertion that his penis or testes are disgusting or will disappear or assertion that it would be better not to have a penis, or aversion toward rough-and-tumble play and rejection of male stereotypical toys, games, and activities.
  • In girls, rejection of urinating in a sitting position, assertion that she has or will grow a penis, or assertion that she does not want to grow breasts or menstruate, or marked aversion toward normative feminine clothing.
  • In adolescents and adults, the disturbance is manifested by symptoms such as preoccupation with getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she was born the wrong sex.
• The disturbance is not concurrent with physical intersex condition.
• The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The bulk of the questions S.A.G.E. considers for a "Transsexual" diagnosis are based on these diagnostic criteria.

According to the DSM-IV,

302.6 Gender Identity Disorder Not Otherwise Specified

This category is included for coding disorders in gender identity that are not classifiable as a specific Gender Identity Disorder. Examples include:

• Intersex conditions (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia) and accompanying gender dysphoria
• Transient, stress-related cross-dressing behavior
• Persistent preoccupation with castration or penectomy without a desire to acquire the sex characteristics of the other sex

S.A.G.E. may be able to identify some of these individuals, since it can theoretically identify Intersexed people. The test does not do any specific checks for stress-motivated behaviors or other "flavors" of gender conflict.

Autogynephilia/Autoandrophilia

I need to emphasize that this is a THEORY about motivation for some contrasexual behavior! That is why it is calculated and analyzed independent of all other considerations and has no bearing on the main conflict analysis, but is provided as a possible explanation of motivation for any activity or beliefs the main analysis has identified.

The term autogynephilia was coined in 1989 by Ray Blanchard, a clinical psychologist at the Clarke Institute of Psychiatry in Toronto. Blanchard hypothesized that there are two fundamentally different types of gender dysphoric males: those who are exclusively or almost exclusively aroused by men, i.e., who are androphilic ; and all the rest, who, as it turns out, are primarily aroused by the idea of being women, i.e., who are autogynephilic. Note that it says IDEA - which means that a person could be unconflicted, never actually engaging in any contrasexual behaviors, but could be aroused by the fantasy of it. This is another reason I chose to make this analysis an independent calculation, since many of the questions that affect the main analysis are driven by ACTIONS, rather than IDEALS.

Perhaps Blanchard explained this motivation best when he wrote: "Autogynephilia takes a variety of forms. Some men are most aroused sexually by the idea of wearing women's clothes, and they are primarily interested in wearing women's clothes. Some men are most aroused sexually by the idea of having a woman's body, and they are most interested in acquiring a woman's body. Viewed in this light, the desire for sex reassignment surgery of the latter group appears as logical as the desire of heterosexual men to marry wives, the desire of homosexual men to establish permanent relationships with male partners, and perhaps the desire of other paraphilic men to bond with their paraphilic objects in ways no one has thought to observe."

I want to make it clear that I do not agree with the DSM-IV classifications of "Paraphilias" - which is the broader term under which sexually-driven behaviors are categorized. The DSM-IV unneccesarily stigmatizes some gender-related problems by grouping them in a general category with what are largely considered "perversions" or even criminal activities:

DSM-IV Sexual and Gender Identity Disorders: Paraphilias [defined as recurrent, sexually arousing fantasies, sexual urges or behaviors generally involving 1) non-human objects, 2) the suffering or humiliation of oneself or one's partner, or 3) children or other non-consenting persons.]

• 302.4 Exhibitionism
• 302.81 Fetishism
• 302.89 Frotteurism
• 302.2 Pedophilia
• 302.83 Sexual Masochism
• 302.84 Sexual Sadism
• 302.3 Transvestic Fetishism
• 302.82 Voyeurism

Strictly speaking, though, if it is recurrent, sexually motivated fantasy, urges, or behaviors regarding oneself it would be categorized as a "Paraphilia." Notice that "Transvestic Fetishism" is also lumped into this category, much to the chagrin of the estimated 60% of the male population that would be classified there. I should also note that the Greek root "philia" means "love or fondness," NOT "perversion!"

The S.A.G.E. test uses a similar criteria to Blanchard's to identify the presence of autogynephilia/autoandrophilia. If the person is NOT a homosexual, did NOT have gender conflicts early in life, and IS aroused by contrasexual fantasy, behavior, or activities; the condition is found to be present. It then checks 10 questions scattered throughout the test to classify the type(s):

• whether it be crossdressing or clothing of the opposite sex (transvestic)
• acting in a contrasexual manner or showing an interest in contrasexual activities (behavioral)
• fantasizing about having physical attributes of the opposite sex (physiologic)
• and/or arousal from actually altering their physical appearance to be more like that of the opposite sex (anatomic)

Remember, this is just a THEORY of possible motivation, and I provide it as a notation to the main analysis where the program deems it may be present. It does not in any way "diminish" the validitity of the subjects level of gender conflict. Lastly I should say that I invented the term "Autoandrophilia" for this test. To my knowledge no research has been done that would identify this concept among Female-to-Male Gender Dysphorics, but this test had to have some way to calculate this subcategory for a female subject, so I simply reversed the terminology and provided additional questions in the test that would aid the program in identifying a woman with a similar, albeit polar-opposite, motivation.

If you really want to know more about this theory, you might start by reading Dr. Anne Lawrence's article HERE.

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