Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
JASON ARONSON
New York
CONTENTS
Part II
TESTS
8 The Male Transsexual as ‘Experiment’ 117
9 Tests 126
10 The Pre-Natal Hormone Theory of Transsexualism 134
11 The Term‘Transvestism’ 142
12 Transsexualism and Homosexuality 159
13 Transsexualism and Transvestism 170
14 Identical Twins 182
15 Two Male Transsexuals in One Family 187
16 The Thirteenth Case 193
17 Shaping 203
18 Etiological Factors in Female Transsexualism: A First Approximation 223
Part III
PROBLEMS
19 Male Transsexualism: Uneasiness 247
20 Follow-Up 257
21 Problems in Treatment 272
22 Conclusions: Masculinity in Males 281
References 298
Index 313
Part I
THE HYPOTHESIS
6
94
* This chapter is modified from a paper by Dr. Newman and myself (1).
THE OEDIPAL SITUATION 95
become not men but women. Our Clinic data indicate that adult male
transsexuals have the same childhood as these little boys (2).
The transsexual boy passes through the years in which in other boys,
oedipal dynamics are ordinarily active without altering his femininity or
his relationship to his parents. As he grows older and sees that other boys
his age disapprove of his feminine behavior, he begins to play only with
little girls willing to accept him as a feminine companion, sharing in
fantasy games of caring for dolls or playing ‘house’. Under the protection
of his mother at home he continues to enjoy dressing
96 THE TRANSSEXUAL EXPERIMENT
For all their femininity, however, these boys are not psychodynamically
like oedipal girls. The latter are romantic, seductive or maternal with their
father (more or less). They show evidence of deep feeling for father and
are rivalrous toward mother while also increasing their identification with
her. The extremely feminine boy shows none of this. He is preoccupied
instead with outer aspects of the feminine role—especially clothing, hair
style and adornment—rather than with the object relationships
characteristic of normal boys or girls during this period.*
At this point, let us contrast the oedipal period of the transsexual boy
with that of a masculine boy. In his case report on the phobia of a 5-year-
old boy, Freud describes the development of an oedipus complex and how
oedipal conflict is resolved via symptom formation (3).
* An interesting point in this connection is that the little boys’ interest in feminine
things (beautiful dresses, jewelry, make-up, etc.) far exceeds that of their mothers.
This is also true of adult male transsexuals, who are more graceful, attractive, and
obviously feminine than were their mothers. Perhaps these mothers’ blunted
femininity can find expression only in their sons’ femininity: It is as if these mothers
are saying, ‘My son is myself, but he is more complete than I am because he
possesses a penis. He shall express the femininity I have always denied myself.’ The
pleasure these mothers take in their son’s prettiness is in contrast to their own lesser
interest in being attractive.
THE OEDIPAL SITUATION 97
Prior to the onset of the phobia, Hans showed great curiosity about
sexual matters, especially interest in his penis and a desire to learn about
others’ ‘widdlers’. Once when she found him masturbating, his mother
threatened him with castration. Freud writes: ‘Meanwhile his interest in
widdlers was by no means a purely theoretical one; as might have been
expected, it also impelled him to touch his member. When he was three
and a half his mother found him with his hands to his penis. She threatened
him in these words: “If you do that, I shall send for Dr. A. to cut off your
widdler. And then what’ll you widdle with?”’ Hands replied: ‘“With my
bottom”.’ (pp. 7-8). Freud points out that this initial threat of castration did
not at the time it was made produce any symptoms.
Several months after this occurrence Hans first learned through his
father’s explanation, that girls did not have penises. Freud writes: ‘At the
time it [the threat of castration] was made, when he was three and a half,
this threat had no effect. He calmly replied that then he should widdle with
his bottom. It would be the most completely typical procedure if the threat
of castration were to have a deferred effect, and if he were now, a year and
a quarter later, oppressed by the fear of having to lose this precious piece
of his ego. . . . The piece of enlightenment which Hans had been given a
short time before to the effect that women really do not possess a widdler
was bound to have had a shattering effect upon his self-confidence and to
have aroused his castration complex. For this reason he resisted the
98 THE TRANSSEXUAL EXPERIMENT
* Starting before the recent fad; now the same length in males no longer
need signify lessened masculinity.
THE OEDIPAL SITUATION 99
not denied him. With his feminine postures and mannerisms and striking
physical attractiveness, he is often mistaken for a girl by strangers. When a
waiter, referring to the patient, asks his mother, ‘What would your
daughter like to eat?’ neither becomes upset. On the contrary, the boy
smiles with pleasure. His mother says that people have told her since he
was an infant that ‘He is too good looking to be a boy; he should have
been a girl.’
As with the other transsexual boys, no clear separation between his
mother’s and his body and psyche developed as infancy passed into
childhood. During his first years of life, he was held against his mother’s
body many hours each day, carried from room to room when she moved
about the house, and never purposely frustrated. When he began to walk
and talk and his fascination with feminine clothing appeared, his mother
could not bear to deny him access to these articles. Often when they were
shopping together, she would buy him a doll or feminine clothing he
wanted.
His mother is efficient, energetic, and business-like. She dresses in a
mannish manner, with her hair cut short and severe, almost always wearing
slacks and her husband’s shirts. She envies men and is cutting and
condescending toward them, dominating social situations. She says her
marriage is unhappy with great distance between her and her husband. She
is unmistakeably the decision-maker in the family.
The patient’s father is a passive, hypochondriacal man who readily
admits he cannot stand a close relationship with his wife or children. He
does not play with or discipline his children. He is away from home in the
day, leaving for work before the children get up and returning after the
evening meal. He has never intervened between mother and son, and
although he now may express mild irritation at his son’s obvious
femininity, he has made no effort to end it or establish a friendly
relationship with his son. Both parents are overtly heterosexual and both
conform to our culture’s expectation of male and female roles (i.e. father
works and is the breadwinner while mother cares for the children). Yet
both betray ambivalence about their assigned gender roles.
Typically, the mother brought the patient to treatment not because she
was disturbed by his femininity but because a
100 THE TRANSSEXUAL EXPERIMENT
neighbor woman, concerned by his appearance, urged her. During the early
months of treatment, the patient could not bear to be without his mother in
the playroom unless continuously reassured that she was just outside the
door. He avoided eye contact with his therapist and preferred to play by
himself. He spent these early hours playing with dolls and inventing
homemaking scenes in which only females were present. Another favorite
activity was drawing; an excellent artist, he spent hours drawing beautiful
and dramatic women dressed in brilliantly colored gowns, jewelry, and
high heels. He did not draw men or boys nor did he talk about them.
In conversations with the therapist the patient would talk about the
beautiful jewelry or chandeliers that belong to his grandmother, about his
sister’s dresses, about ladies’ fashion, but never about his father or other
males. He knew that his father existed, that he lived in the home, but the
boy seemed to have no emotional connection with him. On one occasion
he was asked to draw the entire family. He drew his mother, his sister, and
himself, as usual with long hair and girl’s clothes so that he seemed one
more sister. In contrast to the other figures, which were boldly outlined and
colored, the father’s figure was only lightly traced with the point of the
pencil. When asked about this, the patient replied he would like to ‘make
up a story about it’: ‘You see, Dr. Newman, that looks like a real man but it
isn’t. He’s not really a father. Actually he’s just a balloon shaped to look
exactly like a man and operated by an electronic control. He moves around
like a man but he’s not. He’s just air. But he fools everybody and nobody
knows that he’s not really the father.’ When questioned about the
whereabouts of the ‘real’ father, he replied: ‘Oh, nobody knows where he
is. They never even heard from him.’ This story represented quite well the
real situation in which the boy’s father deliberately absented himself from
the family psychologically in order to ‘avoid stress’. But the patient’s
fantasy suggested that an involved masculine personality, perhaps the
therapist, might be able to ‘fill up the balloon’ for the child and as such
was a harbinger of later stages of treatment.
When male dolls were brought into the patient’s games during this early
period, he either discarded them or else dressed them to look like women.
During this earlier part of the treatment his
THE OEDIPAL SITUATION 101
life. He also had become angry and verbally abusive toward his mother for
the first time, she said with dismay.* Aggression toward women increased
in his drawings. For instance, he drew a man with a woman lying at his
feet. He smiled as he said that the woman had made the man angry, who
had then thrown her down into the mud and beaten her.
* Simultaneous therapy for the mother in order to allow her to accept signs of
masculinity and aggressiveness in her son is always indicated. The loss of closeness
that she previously had with her son is painful, and therapy for her is essential if she
is to be able to accept these dynamic shifts in the relationship.
THE OEDIPAL SITUATION 103
He urinated sitting down until the age of 3½, despite his mother’s urging
that he urinate like daddy did’ (p. 399). Greenson encourages the boy to
express hostile feelings and notes, ‘Gradually he becomes more aggressive
and slams Barbie [a female doll] in the face with mud, shouting, “Shut up”
or “Take this, Barbie”, or some other girl’s name’ (p. 399). Aggressive
themes appear in the child’s fantasy life: ‘Lance wants to play murder with
Barbie, Ken [a male doll], and me. Barbie falls down and her skirts fly
over her knees. He denies any knowledge of how babies are made but
seems anxious so I explain it to him’ (p. 400). At the same time overt
aggression toward his mother appears: ‘His mother reports he hit her one
day and for the first time said “I hate you” ’ (p. 401). Greenson notes also
that the boy has begun to masturbate and for the first time seems anxious
about the possibility of injury to his penis. All this occurs simultaneously
with a slowly developing masculinity and a renunciation of his earlier
profound femininity. Identification with the male therapist, sexual
curiosity, aggression, increasing distance from mother, and castration
anxiety develop in parallel. These signs of an oedipal complex seem to us,
as in our patient, to be the product of therapy.
Sperling also described the treatment of a very feminine boy (5). His
mother is described as : ‘A sturdy woman who wore a short, straight
haircut and tailored clothes’ (p. 471). The patient’s father was hospitalized
and thus absent. The boy loved to dress up in his sister’s clothes and to
collect dolls. After a period of treatment, Sperling notes: ‘There were
noticeable changes in Tommy’s behavior after some of this material had
been worked through. He was becoming more aggressive and was
beginning to fight back with the boys’ (p. 474). In his fantasy play much
aggression appeared. There were fights between male and female puppets.
For the first time the patient said: ‘I’ll grow up and I’ll be a daddy’ (p.
477). Sperling also underlines the need to end the child’s feminine play
and especially cross-dressing outside of treatment. ‘It is essential for a
successful outcome that the treatment be carried out in an atmosphere of
instinctual deprivation. The analyst cannot be a party in the child’s
transvestite acting out in the treatment situation. The child has to know that
he is in treatment because of the transvestite behavior’ (p. 483).
106 THE TRANSSEXUAL EXPERIMENT
data: does the transsexual’s mother encourage his separating from her
body? Does she encourage those activities which she considers masculine?
Does she admire his maleness? Does she encourage his heterosexual urges
toward her but at the same time sufficiently frustrate them so that he can
both appreciate their value and recognize the necessity to defer their
gratification? Does she admire her husband and keep his masculinity as a
presence in the home? Perhaps these questions can be summarized in this
one: Is she a feminine woman?
For the boy’s father: Does he encourage his son’s moves in a masculine
direction ? Does he encourage the boy’s separation from his mother? Does
he encourage the boy’s heterosexual urges for his mother and at the same
time clearly limit the possibilities? Does he encourage the boy’s other
heterosexual interests? Is he present to perform these tasks of fathering?
And, as with the boy’s mother, we may ask in summary: Is he manly?
The already very feminine boy enters an oedipal situation in which the
dynamics are so constructed that unless therapy intervenes, no interruption
in his feminine orientation is likely. Only when the therapist intrudes are
the family dynamics altered. Then certain oedipal themes not previously
present begin to appear. In brief, successful treatment creates an oedipus
complex.
The importance of early therapy cannot be stressed too strongly. As
described elsewhere (6), beyond puberty alteration of the femininity of the
transsexual male by psychotherapy does not seem possible. Treatment of
the transsexual boy may be the only way to prevent adult transsexualism.
Still, the final outcome is not yet known. Only one of the boys we have
treated has yet reached puberty. Perhaps while such therapy can succeed in
introducing enough masculinity into the personality of the very feminine
boy to abort the development of transsexualism, sufficiently strong
feminine identifications may remain that an adult masculine heterosexual
life is not possible. Perhaps homosexuality will be the outcome in such
cases.
This raises a question important for theorizing about etiology: Might
some forms of homosexuality be due to just this kind of dynamic — the
late introduction of masculinity, as a result
108 THE TRANSSEXUAL EXPERIMENT
Chapter 6
1. Newman, L. E. and Stoller, R.J. (1971).‘The Oedipal Situation in Male
Transsexualism’. Brit. J. Med. Psychol. 44.
2. Stoller, R.J. (1968). Sex and Gender. New York: Science House;
London: Hogarth Press.
3. Freud, S. (1909). ‘Analysis of a Phobia in a Five-Year-Old Boy’. S.E.
10.
4. Greenson, R. R. (1966). ‘A Transvestite Boy and a Hypothesis’. Int. J.
Psycho-Anal. 47.
5. Sperling, M. (1964). ‘The Analysis of a Boy with Transvestite
Tendencies’. Psychoanal. Study Child 19.
6. Green, R. and Money, J. (eds.) (1969). Transsexualism and Sex
Reassignment. Baltimore: The Johns Hopkins Press.