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E XT RE ME FE MININIT Y IN B O YS 36

Sex and Gender


VOLUME II
THE TRANSSEXUAL EXPERIMENT

Robert J. Stoller, M.D.


Professor of Psychiatry
DEPARTMENT OF PSYCHIATRY,
SCHOOL OF MEDICINE
UNIVERSITY OF CALIFORNIA AT LOS ANGELES

JASON ARONSON
New York
CONTENTS

Acknowledgements page vii


Introduction
1
Part I
THE HYPOTHESIS

1 Bisexuality: The ‘Bedrock’ of Masculinity and Femininity 7


2 Extreme Femininity in boys: The Creation of Illusion 19
3 * The Transsexual Boy: Mother’s Feminized Phallus 38
4 Parental Influences in Male Transsexualism: Data 56
5 The Bisexual Identity of Transsexuals 74
6 The Oedipal Situation in Male Transsexualism 94
7 The Psychopath Quality in Male Transsexuals 109

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
3
THE TRANSSEXUAL BOY:
MOTHER’S FEMINIZED PHALLUS
Despite Hartmann’s work,* there may be risks in saying that there are post-
natal, non-constitutional, psychologically determined, major aspects of
personality having non-conflictual roots, especially when these aspects are
essential parts of sexuality. Because the sexual impulses must be modified
starting in infancy, we analysts are confronted in our practice and in our
observation of children with the results of pressures placed on the infant’s
sexuality and his struggle, nonetheless, to retain his pleasures. These
conflicts and their resolutions are so massive that non-conflictual
undercurrents or precursors may be unnoticed, accepted so automatically
as given that one never speaks of them. We should watch for them,
however; they may help us understand the development of masculinity and
femininity. In this chapter, which looks more closely at the mother- infant
symbiosis in male transsexualism, I wish only to put forward ideas about
non-traumatic forces acting in the first two or three years. I shall not yet
discuss the more dynamic effects of conflict although these are well known
to be essential for gender development.

The transsexual boy begins to show his extreme femininity by age 2-3,
though first signs may appear as early as age 1, as soon as any gender
(masculinity or femininity) is expressed. One aspect of my research has
been to find out why this occurs to children so young. What seems to
happen is this. The transsexual boy’s mother is a woman who in childhood
develops a

38

* Hartmann (1, 2) has talked of the primary autonomy of certain ego functions
(e.g. ‘a child’s intelligence, his perceptual and motor equipment, his special gifts’ 1,
p. 123), but these all are constitutional qualities with a fixed maximum biological
potential; they are ‘atomic’. Masculinity and femininity, which are made up of many
‘atomic’ elements, including those Hartmann mentioned, are not as essentially
biologically determined as maleness and femaleness (sex) are.
THE TRANSSEXUAL BOY 39

strong streak of masculinity that is interwoven with her femininity. The


masculinity is so strong that from around age 7 or 8 to puberty, the young
girl appears as if she would grow up to be a transsexual female (that is, a
female who while biologically normal nonetheless believes she should be
transformed into a male):* ‘When I was a youngster, I wanted to be a boy
my whole life. Now this was every morning that I woke up hoping that I
had changed to a boy. And I dressed in boys’ clothes. ... In regard to boys’
penises, I was very put out God didn’t give me one of those. This started
when I was 4 or 5. I kidded myself and probably thought that maybe I
would have one eventually.’ But, as distinct from transsexuals, when the
girl’s breasts develop and her periods start, she consciously gives up any
hope of changing into a boy: ‘I would always hold my own with the boys
until I got to be about 15. Then I started working and changed right along
—growing up. My periods didn’t start until I was 16 …. It was a little
disappointing to me, because, you know, I rode bicycles and everything,
but the feeling I had of having to give up masculinity came mostly from
the boys.’ She makes herself behave and dress in a feminine way: ‘I
outgrew it around 12 or 13. This was the end of it. I wasn’t interested after
that’; and, though without any real heterosexual needs, she eventually gets
married ‘It [feeling like a boy] practically ruined my life because I didn’t
want a boy near me. . . . [After knowing her husband-to-be for three years
but without a romantic or sexual relationship] I believe both of us out of
loneliness we just decided on the spur of the moment to get married and
we did.’ Along with this kind of bisexuality, there is another essential
feature to this mother’s personality; she is chronically depressed: ‘I am a
nothing, a cipher, a mirage.’ This comes from having a distant, empty, and
yet powerful mother† who never treated her with affection but used her
more as a servant to do the household chores: ‘My mother was extremely
strict. Don’t spare the rod. She spanked me often and hard. My teens were

* These quotes are taken from three mothers of a pool of fifteen with transsexual
sons, in all of whom most or all these factors were found. See Chapter 4 for more
details.
† I have learned that only if one studies three generations — the patient, his
parents, and his grandparents — does the etiology grow clearer.
40 THE TRANSSEXUAL EXPERIMENT

unhappy. I paid no attention to my mother. If she would slap me, I would


just stand up to her and defy her. My mother and I clash an awful lot. She
leans on people to get them to do things for her. . . . My mother was a very
hard-working and humorless woman. She lives very well for a person with
no income. I don’t know if she has any feeling for me. She isn’t very
demonstrative.’ The depression is also the effect of the little girl having
turned to her father for the comforts her mother would not provide, getting
enough from him to raise her hopes that he could make her whole, and
then his failing either by his open rejection of her or by his leaving via
death or separation: ‘My father was very attentive. When I was 3 he taught
me to play ball. My mother did not spend much time with me—but my
father did. There was a terrible void in my life when my father passed
away [age 12]’.

These two factors (her bisexuality and depression) compel this type of
mother forcefully and continuously to overwhelm her infant son with her
presence from birth until the symbiosis* is pried apart by the child going to
school, or by treatment. Because these separation effects do not occur until
age 3 or 4 or later, the massive disturbance in the development of her son’s
masculinity has already occurred: ‘Actually I didn’t consider it a problem.
As I told you, I just didn’t think about it really. I thought it was a part of
growing up. I thought every child likes to dress up. However, he was still
doing it and doing it much more strongly by the time he was 3. [And still
she waited till he was 5 to look for help.] I think other people’s reactions to
it bothered me and really made me aware that there might be something
that I hadn’t been thinking about. And he’s been doing it as far as I can
remember, he has been dressing up. He has been wearing high heels since
he’s . . . since he can walk really.’ Without treatment, it may be too late for
the boy to develop as a masculine person.

These mothers carry their infants, nude and clothed on their

* Running through this report, the informed reader will sense a counterpoint (and
debt) to Mahler’s work on separation and individuation (e.g. 3); although not cited
except here, her concepts and case material are implied at many points herein. The
work of Greenacre (e.g. 4, 5), Khan (e.g. 6, 7) and Winnicott (e.g. 8, 9) on earliest
mother-infant relationships serve similarly.
THE TRANSSEXUAL BOY 41

own nude and clothed bodies, for many hours a day, from birth until years
after the babies have grown too large and heavy and are walking. Almost
all additionally take the babies to bed with them nightly (for hours) for
many months or years.* (This is quantitatively and qualitatively different
from what is seen in boys who will become homosexuals and what is
reported in other cultures where infants are also carried nude upon their
mothers’ bodies [10].)
Once, responding to my musing how the first mother in the research
would quiet her crying son by placing him nude against her nude
abdomen, Dr. R. R. Greenson, who treated the boy, said it sounded like a
kangaroo infant in its mother’s pouch, which is as intrauterine as
extrauterine existence can be. I see now that Greenson’s imagery is even
more apt, for this mother was in this way frequently (several times a day)
placing the infant where she felt a penis should be. In addition she reported
that she regularly sat with the baby in her lap (that is, not simply on her lap
but between her spread-apart legs as she sat on the floor) for hours a day
and for several years, this often occurring with both nude. Regarding the
appearance of penises, she said all looked ugly to her except her son’s
which was beautiful.
Recently, Dr. Richard Green has told me of such a mother, who reports
often placing the infant between her thighs and oiling its stiffened, ecstatic
body. ‘The transsexual’s mother as she told me how she would oil her
son’s body, in her effort to convey his delight at being oiled; changed her
posture in her chair from one of normal sitting to one in which her body
slowly extended to a perfectly straight position, hands at her sides, with an
absolutely delighted expression on her face.’
These mothers have the most powerful penis envy: ‘My mother forbid
me to play ball with the boys. That’s the only thing I ever done in life that I
loved to do, and I had to sneak

* ‘It has also seemed to me that prolonged and unrelieved contact of an infant
(during the first year or year and a half after birth) with another individual, usually
another child, leaves a permanent effect of diminished differentiation of the self from
the other, and consequently weakens and confuses the sense of identity, producing an
effect somewhat simulating twinning. I have especially noticed this in certain
perversions, where it seemed to contribute, along with other factors, to the uncertain
sexual identity’ (5).
42 THE TRANSSEXUAL EXPERIMENT

away to play ball. Of course football was a pretty boisterous game, and my
mother couldn’t see all them boys tackling me and everything. Every boy
knew that I could lick them; I was a kind of leader of my day.’ This envy is
probably exceeded only by those women who, frankly transsexual,
demand that their bodies be changed by the removal of their ovaries,
uterus, breasts and vagina, and the construction of a penis. Mothers of
transsexuals have fantasies of their own sex transformation during latency,
and while they give these fantasies up and recognize they can never come
true, the fantasies are reignited in disguised form when these women
deliver a beautiful male child. Because of the unconscious needs created in
this mother’s past, this infant son is fated to serve as the treasured phallus
for which she has yearned. So he is to be the cure of the lonely, hopeless
sadness instilled in her by her cold and powerful mother* and rejecting
father, and he is also to be the penis that will equalize the feeling she has
had of being inferior by not being male.†

Why is this son chosen? Often there is another son; he is almost never
raised in the same manner and is unremarkably masculine‡ (as distinct
from homosexuals’ families, where more than one son will receive
mother’s attention). Seeing fifteen such families, we have heard the
mothers describe a quality in their sons that was at first disregarded and
later explained away. Only now can I feel it is best not explained away and
suggest it may be a crucial factor in their choosing this particular son.
Many of the mothers have mentioned spontaneously how beautiful their
sons are now and were as infants: ‘Everybody said how beautiful she
[transsexual son] was as a girl. . . . She was dressed as a girl. For a long
time she had worn a bob that came way back. [Now] she had a permanent.
I looked at her and I started to laugh and she started to cry and I said
“What have I got here? A girl?” And I took

* The mothers of transsexual boys, having cold, powerful mothers themselves,


have good reason to believe in phallic women. Thoughts on how this contributes to
their own need for a penis or for creating their sons as women with a phallus would
carry us far beyond my data.
† None of these mothers created a similar blissful symbiosis with their daughters. It
fits this present explanation that the birth of an infant girl would not produce the
adoration seen with the chosen son.
‡ See Chapter 15 for the exception.
THE TRANSSEXUAL BOY 43

her in my arms.’ At first it seemed to me no more than the admiration one


often hears mothers express toward a child they want. However, one
becomes aware that these mothers feel their infant to be beautiful with an
intensity one is not used to hearing. This feeling is present the first time the
mother sees the baby (and is not felt for her other infants) and persists
unchanged through the years right up to the moment when we first begin
interviewing the mothers.

There may, unfortunately for the infant, be some truth in the mother’s
statement. While none of us on the research team has been struck, as the
mothers have, that the boys are dazzlingly beautiful, we have noticed that
they often have pretty faces, with fine hair, lovely complexions, graceful
movements, and — especially — big, piercing, liquid eyes. Not knowing
that this might be an essential feature in the etiology, I never systematically
asked mothers if they felt their sons to be beautiful and so cannot say if
this is an invariable finding or not, though the frequency with which
mothers tell of this spontaneously is what gradually alerted me to it. The
joy and admiration she has from the moment the baby is born sound like
what we can also hear in more normal mothers who are thrilled with their
infant son. But there are marked differences in the extravagance and
pervasiveness throughout the day of the transsexuals’ mothers’ feelings,
and in the fact that these feelings persist unchanged for years, almost
uninterrupted by the irritations, discordances, and personal needs that
usually crack open the symbiotic unity of mother and infant. For all
mothers, baby equals penis,* especially when the baby is a male, but for
these mothers, with their life-long hunger for a penis and with their lonely
emptiness, this phallus takes on an intensity one just does not see in more
normal situations.†

* And vice versa. Webster’s Third International Dictionary gives the derivation of
‘penis’ as: ‘L, penis, tail; akin to Gk peos, posthe penis, Skt pasas penis, OE faesl
fetus, offspring, OHG faselt penis, fasel fetus, offspring, ON fosull’.
† However, these are not the only types of mothers with beautiful babies who
overvalue this product of their bodies; among others, this danger also threatens
‘hysterical’ women who are themselves not only beautiful but very exhibitionistic. It
is not uncommon to see pathological feminization of the sons of beautiful, narcissistic
women, such as actresses. However, these boys become effeminate homosexuals, not
transsexuals, for not all the factors necessary to produce a transsexual are present in
the family. (See Chapter 12).
44 THE TRANSSEXUAL EXPERIMENT

These boys are not feminized because their mothers wanted a girl, as
some might say (11).* Rather, the mothers all remark how happy (often
ecstatic) they were on delivering a boy, and all the boys are given
unequivocally masculine names. For a long time I was puzzled that these
names were heroic, mythical, or traditionally kingly or warrior names, but
now it seems obvious, for such names increase these mothers’ sense of the
phallicness needed for this infant. One is reminded of papers by Greenacre
(12) and Parkin (13) on penis awe and sexual enthrallment. The mothers
reported here have an interesting mixture of penis envy and penis awe, the
latter, however, only expressed openly toward their transsexual son, never
toward any other males (except in the transference, where the one analyzed
mother routinely felt me sitting behind her-straight, stiff, huge, swollen,
and red).

One can expect, then, that signs of masculinity in the chosen son will not
be appreciated by these women, and if there should be innate ‘masculine’
tendencies such as ungentleness, restlessness, and ungracefulness, these
will be powerfully, even if subtly discouraged by this mother whenever
such attributes appear. On the other hand, these boys are especially
creative and artistic starting even from before age 2. They love colors and
drawing, textures, music and sounds, have poetic sensibilities about words,
and are unusually empathic for what is going on in women. I presume that
these qualities are formed by ‘positive reinforcement’; that is, the slightest
indication of such interests will be encouraged in every way this mother
has for delivering sensations of pleasure upon her infant. Since she is with
him almost all the time, day and night, she has ample opportunity to
express by means of her body, the quality of her voice, the appearance of
her face, and the other modes of communication between mother and
infant, what she loves and what she hates in her infant.

Almost invariably, the transsexual boys have been the youngest child in
the family, either permanently or for many

* See Chapter 17 for a discussion of a boy feminized by a mother who wanted a


girl.
THE TRANSSEXUAL BOY 45

(five or more) years.* These mothers have decided these sons’ closeness to
them will be uninterrupted by another child (usually by reducing
intercourse drastically), for, with their adoration of their infants, they have
no wish to disturb the blissful symbiosis. Obviously, an infant receiving all
this joy will respond as required for maintaining his half of the symbiosis
(that is, he gives what his mother wants), and equally so, his mother will
continue keeping him close to her to assuage her depression and
loneliness. The daughter she may bear will not fill the need, though any
infant may reduce the loneliness somewhat. If she delivers a boy she does
not perceive as beautiful, he will not serve unless he has a special charm or
grace (which only the mother need sense; it is not necessary that others see
it). But, given a mother with these needs and a male infant who shows
promise of gratifying these needs by sweetness and beauty, then one has
the mixture that is likely to ignite into the astonishing relationship where
the two are so close that a mother treats her son as part of her own body
and the child rather considers himself as part of her own body: female.

Of all the vehicles upon which the communication of sweet endless


closeness is carried, the eyes may be the most important. I heard and
repeatedly discarded this finding, but now finally I am willing to attend to
it. When one hears these mothers talk about their sons’ deep, dark, limpid,
searching, infinitely understanding eyes, one can picture these two
completely opening the gates of their souls to each other interchanging
their most essential substance through these eyes.

For the sake of completeness, I shall mention briefly what is described


elsewhere: this ultimate in intimate symbioses is uninterrupted not only
because this youngest child is adored for years but because his father,
hardly ever at home, not only does not interrupt the symbiosis but may
even encourage it by agreeing that his son is indeed beautiful, lovely, and
in no danger. He is there neither as a model for masculine identification
nor to protect his son from the mother’s feminizing effects.

As the child grows, his easy femininity flowers, encouraged by his


parents, especially his mother, who states openly to everyone (including us
in the beginning) that she gets great joy

* This does not hold up with less profoundly feminine boys (14).
46 THE TRANSSEXUAL EXPERIMENT

from seeing her son dressed in women’s clothes, showing feminine


interests, talking of wanting to be a girl, and carrying himself like a
normally feminine girl.
We know it is not inevitable that a pretty infant boy need stir up so
much feminizing. So, in contrast, listen to another mother* who also had a
pretty infant. She had been talking of how her mother, her sister, and the
nurses in the hospital all responded to his prettiness, and now she is
remembering the moment after he is born:
G: The doctor held him up for me to see; it was a boy and I was pleased. In
fact I wasn’t just pleased. I knew it was going to be a boy. There was no
question in my mind. I never would consider the possibility that I might
have a girl. I wanted a boy so bad. To say I was pleased doesn’t mean
anything because it doesn’t tell you how I felt. I was ecstatic. I was just all
full of love and life for that boy. Then they cut the cord and did whatever
they do and they put him in my arms and they drove [wheeled] me out of
the delivery room and my mother and my sister were standing there.
Dr: When did you see that he was pretty?
G: When they laid him down on me . . . And he was pretty. He’s got a
beautiful complexion; he was dark, kind of an olive complexion and big
eyes and long eyelashes like a girl and curly hair; and oh, he had the most
beautiful hands. If I hadn’t known that he was a boy, if I hadn’t seen his
penis and known he was a boy I could have thought he was a girl. If I were
a stranger walking down the hall and saw him I would have thought he was
a girl. Dr: O.K., so they wheel you down the hall and the strangers or at
least outsiders, nurses, what did they say?
G: ‘What a pretty baby. He looks just like a girl’.
Dr: Did they really say that in those first few moments ?
G: My sister did specifically. I remember it very distinctly.
Dr: What did your mother say ?
G: I don’t remember.
Dr: O.K.
G: Then they opened the blanket up and they showed everybody; they
showed my mother and my sister his penis which proved he was a boy.
That’s very important that you remember that. And I saw again that he was
a boy. Then they put me to bed and they
* This woman has been the subject of another study (15).
THE TRANSSEXUAL BOY 47

took the baby away. I am not sure about the time element. They brought
him back. They brought all the babies to all the mothers. There were 6 of
us. I had the only boy; all the rest of them had girls. I had the only one that
looked like a girl. And the nurses would comb his hair and put a curl down
on his forehead. And I don’t know if you know, dark babies, but they look
pretty in pink and they put a pink blanket on him. Sometimes a yellow
blanket but usually a pink blanket. And they would take him and show him
to all the mothers before they brought him to me, commenting on how
pretty he was. Nobody commented that he was a nice big boy. A ten and
one-half pound boy is a good sized boy. Nobody said, ‘Boy, that’s a nice
big boy.’ They said, ‘That’s a pretty baby.’ And they wouldn’t let me
unwrap him. They wouldn’t let me take his clothes off. Every time I
unwrapped him I got hell for it.
Dr: Why did you unwrap him ?
G: Because I wanted to see that he was a boy. Then we took him home. First
of all, my mother brought the stuff for me to take him home in, and she
brought me girl’s clothes. They looked like, you know, a flowered
nightgown. That’s for girls. So I took him home in a tee shirt and a diaper.
And then I got him home and my brothers and the neighbors and everybody
that comes to see a new baby commented on how pretty he was and how he
looked just like a little girl.
Dr: What did your other children look like when they were born?
G: M was really pretty awful. He really was awful. He looked just like a boy
but a pretty awful looking boy. He had big hands and big feet and a big
penis and he was skinny all over. . . . He was long and lanky, you know, just
like a boy. There was no plumpness to him and no prettiness to him. He had
short hair, looked like it had been cut like a boy’s haircut. The first boy
looked like a boy too.
Dr: Did anybody say about M or any of the others, ‘He’s pretty’?
G: No.
Dr: Did any of them respond to him as if he were pretty?
G: No.
Dr: Did any of them pink blanket him or frilly clothes him ?
G: No.
Dr: Did they treat him always as if he were a boy ?
G: Yes.
48 THE TRANSSEXUAL EXPERIMENT

While the mother-infant symbiosis that produces a transsexual boy is


very rare and pathological, some of its components are part of more
normal symbiosis. In a happy mother-infant unit we expect to see a mother
idealizing her infant, just as we expect a normal mother to feel herself
anatomically more complete (in fantasy) on giving birth to a son. We
expect to see moments of total openness of joyous communication
between mother and infant. We expect to see a mother getting sensual
pleasure from feeling her baby’s skin up against hers. We expect to see a
mother treating her infant not only as if he were a product of her body but
as if he were still a part of it. In other words, we expect to see, if we are
hoping for a baby’s healthy development, that there will be times of
perfect closeness and bliss. But we do not expect that she will so overvalue
her son, so submerge her own desires and make such superhuman efforts
to prevent any physical or emotional suffering. And, especially, we expect
to see all this diminish with time; we do not expect her to make this effort
so unswervingly and to keep it up for years. To me, the most important
difference between the blissful episodes of normal mothering and the bliss
of the symbiosis that produces male transsexualism is that the latter is
unending. It is voluntarily interrupted neither by mother nor father.

Likewise, the transsexual’s mother’s own dynamics are related to those


of a more normal mother. First, in both types of mothers the birth of a son
really serves for resolving penis envy, for by creating a male infant’s body,
both women in unconscious fantasy have finally created a penis for
themselves. Second, in both instances, a cure for loneliness is instantly
available, if needed. But with the dynamics as with the symbiosis, the
differences lie in the quantitative. Relatively normal mothers may need to
fantasy their son as a penis, but they just cannot, do not need to, so badly
that they can unvaryingly submerge their own needs day and night for
years. More normal mothers cannot help but create separation between
their female bodies and feminine identities and their son’s body and
identity, even if their son is their fantasied penis. More normal mothers can
also get joy from their infant but do not need that sensation continuously
as a defense against envy, profound sadness, and hopelessness.
THE TRANSSEXUAL BOY 49

Finally, however mixed are the feelings of many women about maleness,
they do not succeed so completely in preventing the development of their
sons’ masculinity.

Here emerges again the question: to what extent does hostility play a role
in transsexuals’ mothers preventing the development of masculinity in
their transsexual sons? They have a lifelong hatred and envy of males.
Therefore, it is logical, when they have their own defenseless little male
and with no one looking (not even father), that they would create this
transsexual as a culmination of their rage against males, doing to the little
boy what they have always dreamed of doing to the other males of their
lives; we see the mothers of homosexuals doing something of this sort.
This is so likely that it is disappointing that the data collected so far* fail to
show it.† In all these cases, the hatred of men is clear, yet in none is there
evidence of such hatred toward the son who will be transsexual. One hears
these mothers express toward their sons of 4 and 5 (the age when we first
see them) the same complaints and irritations that one hears in more
normal mothers, though in the case of the transsexuals’ mothers, their
patience is almost infinite and the satisfaction they get from their sons’
femininity adequate payment for their lost sleep, exhausted days, and
unselfish solicitude.

We analysts must be careful; just because our theory and the observation
of other types of pathological mothering have indicated overt and hidden
hatred, the logical thought that these mothers have created their
transsexual boy by means of hidden rage is not proven. On the contrary,
though less ‘logically’ (possibly only because less familiar) it seems that
malignant rage, while in these mothers, is not in this mothering experience
transmitted through her skin, breath, muscles, movements, or voice to her
infant (though she will have ample opportunity for massive discharge of
hatred upon other males in her environment, especially her husband).

* One mother in analysis for three years, one mother in twice a week
psychotherapy for three years, one mother in once a week psychotherapy for one
year, one mother in once a week psychotherapy for a year and a half, and eleven other
mothers seen only for a few hours’ evaluation each.
† However, there is reason to believe that this contributes to the development of
fetishistic transvestism and effeminate homosexuality, as we shall see later (Chapters
12 and 13).
50 THE TRANSSEXUAL EXPERIMENT

She need not hate this son, who is her beautiful, long-awaited penis, the
perfect cure for her feeling of lifelong abandonment. Because she knows
(anticipates unconsciously at his birth) he will serve as the bringer of
pride, peace and joy, she does not hate him. He is to be for her what her
mother(’s breast) failed to be as a supplier of love. (The mother who was
analyzed dreamed as a girl of toy wooden milk bottles out of reach on a
shelf.) We seem to have here, then, another instance of the rule, familiar to
analysts, that penis equals (serves some of the functions of) breast. Also,
by eternally gratifying her son she does unto him what was not done for
herself as an infant.

Unhappily, as with other women, but more intensely, her opinion that a
penis is marvelous is poisoned by her envy so that she disparages man and
penis but can still fantasy an ideal man and ideal penis. The chosen son
seems, in his role as phallus-to-be, an attempt to compromise between
these opposing positions of awe and hatred. Perhaps the only penis such a
woman can stand is a ruined one: beautiful, graceful, but without the
‘masculine’ attributes of dirty, brutal, penetrating sexuality. And so,
imagine her despair when this mother begins treatment, and she discerns
that the solution to her anguish—the joining of her son’s body to her own
—as to be broken into ruins and that he will finally be cut off from her.

There are certain points that may be worth underlining or made manifest
at this point.

(1) Mother’s Impingement upon her Infant


I have not looked at the mother-infant relationship from the viewpoint of
the infant’s fantasies or psychodynamics (which, since they cannot be
measured, must be inferred). I did not do so because I believe, along with
others (e.g. 3), that there is no psychic structure adequate in the first
months of life to carry the burden of such intricate fantasies as, for
instance, are required by Kleinian theory. Agreeing with many that the
infant is at first primarily a physiological organism and only gradually
develops a psyche, I feel that the infant is especially susceptible in these
earliest months to such influences as conditioning and imprinting, which
are demonstrable in animals
THE TRANSSEXUAL BOY 51

lower on the evolutionary scale.* If there has been a process at work,


somewhat like conditioning and imprinting, that has influenced the
development of femininity in transsexual boys, one might wonder if more
normal mothers do not just as powerfully, though in a different way, non-
traumatically, non-conflictually influence their infants,† setting them upon
a path of gender development more in keeping with their biological
endowment (it is far more efficient if psychological masculinity is
potentiated by biological maleness).

This obviously does not mean that influences such as conditioning and
imprinting are all there is to gender development, or even that they are the
most important; there is an overwhelming body of psychoanalytic data
demonstrating the essential importance of conflict, defense, and restitutive
fantasy in the development of masculinity. What I am doing here is only
emphasizing these early factors which are part of the matrix from which
masculinity and femininity evolve. ‡

Then, as psychic structure develops, psychodynamics in themselves are


etiological for differentiating psychic structures. With the development of
experience and memory, the child learns to create defenses that blunt
painful, parental influences, transforming them into something less painful
(e.g. by denial) or into something pleasurable (e.g. by fantasy). But in the
beginning, mothers impinge quite directly on their infant, who, without the
protection of adequate psychic structures, is as vulnerable to these direct
impingements (if they are painless or blissful) as are animals, who also,
unable to fantasy, cannot build up protection to weaken the direct
influences.

* This implies that memory and the capacity for fantasy formation may function to
lessen the obligatory effects of conditioning and imprinting, and increase the
likelihood of the development of more freedom of choice, that hallmark of the human
animal.
† Spitz (16, p. 127) talks of ‘moulding’, the academic psychologists, of ‘shaping’.
‡ ‘Dr. Arlow: . . . Do you think that the conflicts originating during the 1 st year or
so of life are more significant for the origin of neurosis than the conflicts of the
Oedipus phase? If so, how does it [sic] effect [sic] the analysing of deviations of the
Oedipus complex? Miss Freud: It is not an easy question, but one might find a way
out by saying that it is the experiences of the 1st year of life which shape the
personality. It is then this personality which acquires the pathology.’ (17).
52 THE TRANSSEXUAL EXPERIMENT

(2) Methodology—Psychoanalytic Research on Infant Development


More and more, workers are questioning whether the analyses of adults
are sufficient sources of information about what went on in infancy.* When
one has only symptoms to work on (including dreams and the transference
manifestations†), one cannot be sure what was done to the patient in
infancy and childhood but at best only what it meant to the patient at that
time. That is essential in treatment but inadequate in research.
Interpretation of the transference and reconstruction may be therapeutic,
but we must not forget that in analysis—even in the analysis of children—
we reach, even with good work, only the infant’s version of the original
experiences.

That version is essential but incomplete. In addition, we must observe


the mother-infant relationship microscopically, but even that is not enough.
In the best of all research worlds we would also be analyzing the mothers
and fathers and in addition observing them in action together. A few such
programs of research have been under way, as we all know, for some
years, and one can only hope that the great effort involved in such research
will not discourage people into taking shortcuts that are rationalized as
adequate when they are not.

* e.g. Hartmann: ‘The analytic method does not provide us with data (memories)
about the undifferentiated phase during which the demarcation lines between the ego
and the id, and between the self and the objects, are not yet drawn; and it does not
provide us with direct information on the preverbal stage. Direct observation here
helps first of all to discard hypotheses which are not consistent with behavioral data.
But it is equally relevant in giving positive cues for the formation of our
developmental propositions.’ (2, pp. 102-3).
† I disagree with Winnicott (9, p. 594), who says, ‘Indeed it is not from direct
observation of infants so much as from the study of the transference in the analytic
setting that it is possible to gain a clear view of what takes place in infancy itself.’ As
long as infants cannot talk and be analyzed, infant observation (with all its
inadequacies) and the study of the transference in adults—and the analysis of the
parents and the observation of families in action—will be necessary. I would also
quibble by saying that it is impossible to get a ‘clear view’ of any event years later;
one can get a clear view of a re-living (especially of the original emotional state), but
one far from guaranteed to be a clear view of the original experience.
THE TRANSSEXUAL BOY 53

(3) The ‘Too Good’ Mother


Winnicott has written about the good enough mother (8; see also 18),
and Khan has been thinking in the same area when describing the mother’s
function as a protective shield (6). Much work has been done on what
happens when a mother is not good enough, for instance, because she is
withdrawn, depressed, or enraged; because she physically leaves the child
as with sickness, divorce, or death; or because she mixes too much
blackmail in with her loving (‘overprotective mothers’). Had we thought
of it, we would have long since presumed that a ‘too good’ mother also
creates effects that keep her child unsuited to an environment expecting a
male to be more masculine than feminine. But such a situation had never
been seen; what looks like it, the overpowerful and overprotecting
mothers, in fact inject hostility into their love, giving blissful experiences
to their little boy only if he pays by forfeiting his freedom. (The effect such
mothers have in producing homosexual sons is well known [e.g. 19, 20;
see Chapter 12].) If ever confronted by a mother overwhelmingly driven to
prevent frustration in her son, we are prepared also to see hostility in the
moment-by-moment handling of the infant.

Instead, in these transsexuals’ mothers, one finds: an ecstatic acceptance


because this is her treasured phallus, an excessively close, blissful, and
prolonged symbiosis, and a resultant profound disturbance in the infant’s
body ego, in that he feels himself to be somehow female despite his
knowing that he is a male. These mothers do not do their part in getting
their sons to separate from their bodies and to discourage the boys’ first
moves toward masculine behavior. They not only reinforce their sons’
identifying with their femininity, but they also prevent what Greenson calls
dis-identification, the boys’ ridding themselves of the excessive bond of
feminine identifications. Then, with the boys’ fathers withdrawn from the
family and disparaged by their wives, the way is blocked to what Greenson
calls the counter-identification with father. In normal boys, the latter,
somewhat like a reaction formation, covers over, ‘detoxifies’, dilutes the
powerful feminine identifications (21).
54 THE TRANSSEXUAL EXPERIMENT

(4) Intactness of Ego Functions in Transsexual Boys


These mothers do not cripple the development of ego functions in
general or even body ego, except in regard to this sense of femaleness. In a
manner that is unclear so far, they permit their sons to sit, crawl, walk,
talk, think, abstract, and relate to animate and inanimate objects in
unremarkably healthy ways. None of these boys has shown the slightest
evidence of psychosis or precursors of psychosis. They are creative,
charming, outgoing children with an ease in developing friendships
(unfortunately almost only with girls) and in winning the affections of
peers, teachers and therapists (until the femininity puts almost everyone
off). Their mothers permit them unhampered opportunity for separation
and individuation, except around the area of attachment to their mother’s
femaleness and femininity. I wish I knew how this was done (reward and
punishment?); I only know that it has occurred.
(5) Conditioning, Imprinting, and the Like : Beyond the
Pleasure Principle?
For a long time, I presumed that the essential process by which these
little boys developed femininity was identification. This is not likely,
though. Identification requires psychic structure, or, more accurately, the
development of memory and fantasy enough that the infant can believe
itself to be taking in (incorporating) its mother, who is then remade as
aspects of himself inside his psyche (identification). While there is theory
that says an infant has a rich fantasy life in its first months, there is of
course no direct evidence. There is evidence, however, (starting as long
ago as 1920) that conditioning (e.g. 22) and perhaps imprinting (e.g. 23,
24, 16) occur.

Identification is an inner-motivated process and an instance of the


pleasure principle at work. But I believe that in the earliest stages these
boys do not seek femininity (they are not motivated to seek it) but rather
receive it passively via excessive impingement of the too-loving bodies of
their mothers. This is not a function of the pleasure principle (a matter of
choice) at work but of reception of an external extremely gratifying force
against which the child does not (would not need to) raise a defense.
THE TRANSSEXUAL BOY 55

But once this matrix is laid down, identification will increasingly play a
part; these boys are like vacuum cleaners by the end of their first year or
so, sucking up everything feminine that comes their way.

Is it possible that what is called primary identification does not result


from an active taking-in process motivated by a search for pleasure or
reduction of tension but rather is impressed upon the malleable infant’s
unresisting proto-psyche and unfinished CNS?
(6) Gender Identity as the Result of a Concatenation of Events
For emphasis, I wish to repeat that little boys do not become transsexuals
unless there is the very rare coincidence of a number of factors, each of
which is essential. These are: a bisexual mother, a physically and
psychologically absent father who permits the excessive symbiosis to
develop and then does not interrupt it, a period of several years in which
mother and son can keep up their blissful symbiosis, and a special beauty
in the boy at birth and in the later months which sparks the reaction that
was latent in this family until he was born.
56 THE TRANSSEXUAL EXPERIMENT

Chapter 3
1. Hartmann, H. (1939). Ego Psychology and the Problem of Adaptation.
New York: Int. Univ. Press, 1958; London: Hogarth Press.
2. ― (1950). ‘Comments on the Psychoanalytic Theory of the Ego’. In
Essays on Ego Psychology. New York: Int. Univ. Press, 1964;
London: Hogarth Press.
3. Mahler, M. (1968). On Human Symbiosis and the Vicissitudes of
Individuation. New York: Int. Univ. Press; London: Hogarth Press.
4. Greenacre, P. (1959). ‘On Focal Symbiosis’. In Dynamic
Psychopathology in Childhood, eds. L. Jessner and E. Pavenstedt.
New York: Grune and Stratton.
5. ― (1960). ‘Considerations Regarding the Parent-Infant Relationship’.
Int. J. Psycho-Anal. 41.
6. Khan, M. M. R. (1963). ‘The Concept of Cumulative Trauma’.
Psychoanal. Study Child 18.
7. ― (1969). ‘On Symbiotic Omnipotence’. Psa. Forum 3.
8. Winnicott, D. W. (1936). ‘Primary Maternal Preoccupation’. In
Collected Papers. London: Tavistock, 1958.
9. ― (1960). ‘The Theory of the Parent-Infant Relationship’. Int. J.
Psycho-Anal. 41.
10. Stoller, R. J. (1968). Sex and Gender. New York: Science House;
London: Hogarth Press.
11. Freud, A. (1965). Normality and Pathology in Childhood. New York:
Int. Univ. Press; London: Hogarth Press.
12. Greenacre, P. (1953). ‘Penis Awe and Its Relation to Penis Envy’. In
Drives, Affects, Behavior, ed. R. M. Loewenstein. New York: Int. Univ.
Press.
13. Parkin, A. (1964). ‘On Sexual Enthrallment’. J. Am. Psa. Assoc. 12.
14. Green, R. (1974). Sexual Identity Conflict in Children and Adults. New
York. Basic Books.
15. Stoller, R. J. (1973). Splitting. New York: Quadrangle; London:
Hogarth Press.
THE TRANSSEXUAL BOY 57

16. Spitz, R. (1965). The First Year of Life. New York: Int. Univ. Press.
17. Panel Discussion (1969). Int. J. Psycho-Anal. 49.
18. Robertson, J. (1962). ‘Mothering as an Influence on Early
Development’. Psychoanal. Study Child 17.
19. Bieber, I., et al. (1962). Homosexuality. New York: Basic Books.
20. Socarides, C. W. (1968). The Overt Homosexual. New York: Grune and
Stratton.
21. Greenson, R. R. (1968). ‘Dis-Identifying from Mother’. Int. J.
PsychoAnal. 49.
22. Watson, J. B. and Rayner, R. (1920). ‘Conditioned Emotional
Responses’. J. Exper. Psychol. 3.
23. Bowlby, J. (1960). ‘Ethology and the Development of Object
Relations’. Int. J. Psycho-Anal. 41.
24. Gray, P. H. (1958). ‘Theory and Evidence of Imprinting in Human
Infants’. J. Psychol. 46.

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