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Int J Psychoanal. 1991;72 ( Pt 2):221-31.

The wish for a sex change: a challenge to psychoanalysis?


This paper approaches different facets of male transsexualism from the point of view of different current psychoanalytic theories and the criticisms to which some of them give rise. On the basis of the author's observations, the determining psychological factor is stated to be the hatred of masculinity. The central thesis is that the clinical challenge made to psychoanalysis is an integral part of the pathology and that it highlights the working of this disorder, just as the 'reflection theories' of the manifest content of what the patients say represent in their objectifying reification a fundamental aspect of this disturbance. Based on two clinical vignettes, an attempt at reconstruction is proposed, in which the narcissistic aspects of this pathology are emphasized. Current theory tends to stress the concepts of deficit and developmental arrest, which are generally inconsistent with those of conflict and defence, but they are here linked organically together.

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