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Research on the sexual orientation of transwomen (male-to-female transsexuals) is sparse. Many studies on this issue have suffered from reporting bias, since many transsexuals feel they must give the "correct" answers to such questions in order to increase their chances of obtaining hormone replacement therapy. Patrick Califia, author of Sex Changes and Public Sex, has indicated that this group has a clear awareness of what answers to give to survey questions in order to be considered eligible for hormone replacement therapy and/or sex reassignment surgery:

"None of the gender scientists seem to realize that they, themselves, are responsible for creating a situation where transsexual people must describe a fixed set of symptoms and recite a history that has been edited in clearly prescribed ways in order to get a doctor's approval for what should be their inalienable right".

Therefore, there is a considerable difference between what most of the few scientific papers dealing with the subject claim and what most support groups, help lines etc. report. Both however report that the number of transwomen who consider themselves lesbians or bisexual or asexual is higher than it is in the general female population (at least in studies done from the 1980s on). Most sources from within the transgender community report that the number of lesbian transwomen roughly equals that of transwomen who prefer male partners, and many also consider themselves bisexual or asexual. Scientific papers on the other hand usually report a higher number of heterosexual-identified transwomen.

A few transsexual activists claim the orientation of transsexual women corresponds to that of the cisgendered female population; however, these claims so far have not been substantiated and appear to be politically motivated rather than based on facts. Others point to evidence that same-sex attraction may be common within the cisgendered female population, so perhaps a large proportion of lesbian and bisexual transwomen is nothing that should evoke surprise.

A number of transwomen have reported that their sexual interest shifted from one gender to the other during the course of their transition. Effectively, their sexual orientation remained unaltered: they were hetro - or homosexual - both before and after transition. There appears to be little or no research either on the prevalence or the cause of this phenomenon. See this link for a detailed report on this experience by one transwoman.

People of conservative cultural backgrounds or beliefs tend to look upon transwomen, if they are attracted to men, as effeminate gay men who took their effeminacy to an extreme level.

If attracted to women, they are perceived by the proponents of the Autogynephilia theory as otherwise straight men with an abnormal fetish. This view is contested, as part of the debate on the associations and distinctions between homosexuality and transgender, and the issue of autogynephilia.

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