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Transsexualism as a nosological unity in men and women
Author(s) -
Sørensen T.,
Hertoft P.
Publication year - 1980
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/j.1600-0447.1980.tb00573.x
Subject(s) - transsexual , femininity , psychology , character (mathematics) , transvestism , anxiety , identity (music) , psychoanalysis , gender identity disorder , social psychology , transgender , gender identity , psychiatry , aesthetics , philosophy , geometry , mathematics
Wishes for and conceptions of sex change have existed in widely different cultures for millenniums. Aetiological theories about the cause of transsexualism are reported, but it is concluded that we have no decisive knowledge favouring either one or the other theory. Treatment of the condition, including surgical operation, is therefore symptomatic. The importance of a careful phenomenologic elucidation of the condition is emphasized as a necessary precondition of the diagnostic demarcation, of creating the necessary contact with the transsexual, and necessary as a starting point for a therapeutic effort. The phenomenologic difference between the two transsexual sexes is emphasized by comparison with two narcissistic character types, both described by Wilhelm Reich – the passive feminine character and the phallic narcissistic character. Both the transsexual male and female are characterized by an insecure gender identity. The transsexual male reacts to this insecurity and anxiety by withdrawing to conceptions of living in a submissive over‐aesthetical femininity. Aggressive and libidinal powers are pushed away from the consciousness, resulting in the often observed pseudo‐femininity in transsexual males. The transsexual female, on the other hand, seeks to subdue a similar insecure gender identity by obtaining ego‐satisfaction in adoption of strong outer attitudes and actions. She takes on a caricatured masculine attitude. It is shown how these phenomena are reflected in the sexual area. The transsexual man does not find the sexual genital satisfaction important, while the transsexual woman, on the contrary, is genitally fixated and preoccupied with sexual display. Among the transsexual males there is a delimited core group that is characterized by a stable ego‐structure, a good reality testing, plus the above‐mentioned character traits, specified by the special pseudo‐feminine narcissism and the lack of genital interest. We have not been able to make a similar cleavage of a core group among female transsexuals and the deliminations of this group are on the whole more difficult, especially concerning certain homosexual women. The necessity of delimiting the transsexual syndrome phenomenologically from psychotic conditions in persons with a desire for sex change is emphasized.