I have wrangled with this variant of the nature/nurture question for a very very long time. I can certainly acknowledge the possibility that cross dressing has at times offered some sort of reward/pleasure and in turn that reward took the form of a chemical boost. Lots of life experiences can do similar things - such as running for some people. I used to run, but the promise of an endorphin rush has been entirely canceled out by the pain in my joints.
I am left with the question of why the attraction to womens wear, why the affinity? In my own case, buried in the murk of memory there was something going on that provoked the attraction/affinity. I really do not recall what it was that I did to cause my older siblings to label me as a house boy...whatever that meant. My very young understanding was that I was behaving too much like a girl, though not exactly sure how. I only know that by the time I was six, I had learned certain defensive behaviors to avoid being whatever it was that had led to these vaguely recalled admonitions.
As Reine well knows, there is more to addiction that pleasurable habit. I like coffee...habitually...but that doesn’t make my daily coffee habit an addiction... or more specifically...a pathology. Addiction is ultimately defined by behavior that has damaging consequences on health, self-esteem, interpersonal relationships, potential legal problems, taking dangerous risks and suffering economic consequences. In other words, if pursuit of the pleasurable experience results in harm, then one is sliding into the realm of addiction. The high has become so appealing that the risks and consequences are ignored.
In my own life, clearly I can point to losses that I would fairly attribute to sexual addiction, and it seems likely that my cross dressing had deleterious impacts on my self esteem, intimate relationships, and even on rarer occasions induced risk taking behaviors and poor economic decision making. And I have had episodes where I sought to deny myself the pleasurable experience successfully for periods of months and even years. But once an addict...
Where this all falls short is in treatment. Addicts can and do rise above their habits. Maybe they always carry a hunger for another cigarette or drink, another orgasm or a big win at the casino, but somehow many addicts are successfully treated. I’m sure there are cross dressers who succeed in abstaining, but the standard line of therapy is to accept yourself and balance the desires to dress with the competing needs and preference of the partner. No other addiction is treated in that manner.
You’re all familiar with the pronouncement that cross-dressing is not a pathology. Something termed Transvestic disorder, according to DSM-5. As per Psychology Today, “A person with a history of transvestic disorder is considered to be in remission when their desire to cross-dress has not caused them distress or impaired their daily life in at least five years.”
If the difference between cross dressing and transvestic disorder is the presence or absence of distress or daily life impairments, then on the distress alone, I must have this disorder. And if I merrily go through life cross dressing without accompanying distress, then I do not have a disorder.
Frankly, I struggle to make much sense of this. So, the behavior doesn’t require treatment but the distress does. My translation of this would be that if I manage to be substantially indifferent to interpersonal, social or economic consequences of my behavior, then its not a problem. Having qualms about the consequences, makes it pathological.
It seems that by this standard, a healthy cross dresser must be a sociopath.
