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The term “transvestism” literally means cross-dressing. In psychiatry, however, the term has been used not only phenomenologically, but also diagnostically. Thus, the designation “transvestite” is traditionally reserved for the heterosexual cross-dresser who uses clothing fetishistically for sexual arousal. All reported cases, as far as we know, have been males. The transvestite's heterosexuality differentiates him from the homosexual cross-dresser, and his desire to retain his penis differentiates him from the transsexual: the fetishism differentiates him from both. The definition is accurate as far as it goes, but in our opinion it is incomplete, since many transvestites also use female clothing nonfetishistically in order to relieve anxiety about gender identity and gender role.
The etiology of transvestism is unknown. Most investigators agree that the disorder occurs in the context of a disturbed parent-child relationship, although there is no agreement as to the genesis of the disorder. Different researchers emphasize intrapsychic conflict, conditioning, or biologic predisposition. This dispute should not surprise us, since the same arguments are used to explain the development of normal masculinity and femininity. Thus, psychological conflict, learning, cognitive development, and biological differences have each been proposed as the leading cause of