[5] In 1995 Blanchard was named Head of Clinical Sexology Services in the Law and Mental Health Programme of the CAMH, where he served until 2010.

[11][12][13][14] The fraternal birth order effect has been described by one of its proponents as "the most consistent biodemographic correlate of sexual orientation in men",[15] with each older brother increasing a man's odds of being gay by about 33%.

[22] Blanchard defined autogynephilic as "a man's paraphilic tendency to be sexually aroused by the thought or image of himself as a woman".

A majority felt that the sexual attraction to become a woman weakened with age, but others reported that they had noticed a change after physical transition.

[24] They believe that their gender identity, defined as "one's inner sense of being male or female, masculine or feminine",[25] did not match the body they were in.

[32] The National LGBTQ Task Force issued a statement questioning the APA's decision to appoint Ray Blanchard and Kenneth Zucker to the DSM-5 working group for Gender and Sexual Identity Disorders, stating that, "Kenneth Zucker and Ray Blanchard are clearly out of step with the occurring shift in how doctors and other health professionals think about transgender people and gender variance.

[34] The paper, coauthored mostly with colleagues from CAMH and the University of Toronto, triggered a number of reactions, many of them critical on the basis that it pathologizes reproductively valid behavior in order to uphold current social and legal standards.

Critics include Richard Green,[35] DSM-IV editor Michael First,[36] forensic psychologist Karen Franklin,[37] and Charles Allen Moser,[38] while William O'Donohue argued that the proposal did not go far enough.

[40] The DSM-5 diagnosis initially proposed a new name ("pedohebophilic disorder") and the rationale for the change cited several of Blanchard's scientific publications.

[42] Blanchard noted that both Richard Green[43] and William O'Donohue[44] remarked that a so-called "contented pedophile"—an individual who fantasizes about having sex with a child, but does not commit child sexual abuse, but just masturbates fantasizing it, and who does not feel subjectively distressed afterward—does not meet the DSM-IV-TR criteria for pedophilia, because Criterion B is not met.

[46][47] In an interview with Vice, Blanchard expressed the view that trans people, "should be considered as whatever their biological sex is plus the fact that they are transsexuals.

"[48] Blanchard rejected the idea that treating gender dysphoria as a mental disorder contributes to stigma against the trans community, adding: "I mean, how many people who make a joke about trannies consult the DSM first?

"[48] In November 2023, Blanchard stated on his official Twitter account that in his view "it’s irrelevant whether a man can become a woman or vice versa.