PSYCHOSEXUAL AND EGO REGRESSION IN MALE TRANSSEXUAL

This paper presents data from a detailed study of a man hospitalized for a severe depression 15 months after a “sex conversion” operation. His mother, a depressed, empty woman, had strongly wished for the birth of a daughter; when a son was born she kept him, her only child for 5 years, too close too long, discouraging those activities which separated him from her. However, although she wished him to be “soft and cuddly like a girl,” she did not wish him to be a girl. She did not dress him in girl’s clothes. She also wished him to carry out her own unrealized strivings for intellectual achievement and success. His father, although generally ineffectual and distant, was at times warm and affectionate, at other times terrifying in his violent rages. It is the authors’ hypothesis that the maternal overcloseness and excessive physical contact created too strong a feminizing symbiosis in infancy, and that the maternal overconcern and the paternal inconstancy and inconsistency made successful individuation-separation and effective masculine identification impossible. These disturbances of pregenitality left the patient unable to cope adequately with the phase-specific tasks of the oedipal and later stages of development. Forced into increasingly regressive ego and psychosexual resolutions, he developed a basic depressive state, and later increasingly severe depressive episodes appeared. He became a feminized boy though not one with a clear feminine gender identity, a transvestic adolescent, a young adult with transsexual fantasies, and a father with hormonal transsexualism; at the time of full adulthood and parenthood he abandoned his career and family and underwent the sex conversion operation. © Williams & Wilkins 1969. All Rights Reserved.