Clinical assessment of distress or impairme nt, like clinical assessment of transvestic
sexual arousal, is usually dependent on the in dividual’s self-report. The pattern of behav-
ior “purging and acquisition” often signifies the presence of  distress in individuals with
transvestic disorder. During this behavioral pattern, an individual (usually a man) who
has spent a great deal of money on women’s clothes and other apparel (e.g., shoes, wigs)
discards the items (i.e., purges  them) in an effort to overc ome urges to cross-dress, and
then begins acquiring a woman’s wardrobe all over again.
Associated Features Supporting Diagnosis
Transvestic disorder in men is often accompanied by autogynephilia  (i.e., a male’s para-
philic tendency to be sexually aroused by th e thought or image of himself as a woman).
Autogynephilic fantasies and behaviors may focu s on the idea of exhibiting female phys-
iological functions (e.g., lactat ion, menstruation), engaging in stereotypically feminine be-
havior (e.g., knitting), or posses sing female anatomy (e.g., breasts).
Prevalence
The prevalence of transvestic di sorder is unknown. Transvesti c disorder is rare in males
and extremely rare in females.  Fewer than 3% of males repo rt having ever been sexually
aroused by dressing in women’s attire. The percentage of individuals who have cross-
dressed with sexual arousal more than once or  a few times in their lifetimes would be even
lower. The majority of males with transvesti c disorder identify as heterosexual, although
some individuals have occasional sexual in teraction with other males, especially when
they are cross-dressed. 
Development and Course