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E XT RE ME FE MININIT Y IN BO YS 16

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
2
EXTREME FEMININITY IN BOYS:
THE CREATION OF ILLUSION
From the endless list of ways we can grow to misperceive ourselves and
the outside world, I extract one that I have been studying—distortions in
the development of masculinity and femininity (gender identity). I have
tried, in working with people with the grossest disturbances in this area of
development, to find clues to some of the factors present but less obvious
in more normal people. The impression reached so far is not startling: to
the observer who studies origins of behavior in neurophysiology and
psychodynamics, all identity—behavior and belief—is illusion.

However, we accept as correct the view that a male is distorting reality


when, while acknowledging his body’s maleness in all its parts, he
nonetheless says he is a female. How that comes about and how similar is
the process by which the rest of us arrive at the conclusion—defined by us
in the majority as not illusion—that we are, say, males in a male body is
the subject of these next chapters. I am offering the hypothesis that we are
brought to our conclusion that we are suitable for our bodies by forces as
much external to us and beyond our capacity to shift (even by unconscious
decisions) as occur in these bizarre people that I discuss here.
Case Material*
The drawing on p. 20, entitled ‘Mother and Son’, was done and titled
spontaneously (that is, no one asked him to do it) by a 5 year old boy. It
was the manifest content of the ‘dream’ of his existence. The case history
below reveals a major part of the latent content. What does the drawing
show ? There is a woman with anatomical features drawn of her head and
one arm and hand. However, her other arm, non-anatomical, is her

19

* This description summarizes and extends work reported earlier on Lance and his
mother (1).
20 THE TRANSSEXUAL EXPERIMENT

son: while slightly separated by a line from her body, he is nonetheless still
part of her body. He has no features independent of her except for a pair of
eyes. The two of them are practically one even to sharing their looking out
at the world.

At the moment he was born, a number of factors fell into place, against
great odds that they would all be present at the same time. Remove any of
these factors, and while you may get a disturbance in the development of
masculinity, you will not get the extreme femininity found in boys like
this. Let us

look at both the fuel (the potentialities present in the mother and father)
and the spark (the infant’s physical appearance and manner) that fired off
the process. Then we can look at the process itself, the growing
manifestations of femininity in the boy.
The spark was his physical beauty from birth. His mother had been pleased
to become pregnant, had fervently wished for a boy, had enjoyed her
pregnancy through which she passed with no unpleasantness but rather in a
glow of procreative joy, and her delivery was uncomplicated and
gratifying. When told she had a boy, she was thrilled; that she wanted a
boy is seen in her choosing a heroic masculine name for him. At that
EXTREME FEMININITY IN BOYS 21

first moment, she found him beautiful. Perhaps as he grew, had he turned
ugly or awkward, he still might have been spared the femininity (though,
in her rejection of him, he would have suffered some of the more usual
consequences of rejection with which we are all too familiar as analysts).
Instead, however, his physical beauty unfolded and with it a grace of
movement that unfortunately matched his beauty. From the first, then, his
mother felt a supreme oneness with this boy and, not surprising when one
is blessed with a loving, infinitely intimate closeness with another, she did
every thing possible (and necessary) never to allow that blissful feeling,
created by his closeness, to be interrupted. He, on the other hand (we can
presume) also knew a good thing when he had it; undoubtedly enjoying
such unfrustrating pleasure, he would not be motivated—at least for many
months—to attempt to push himself away from her.
She had good enough reason to appreciate this blessing, for she had
never before known such completeness and contentedness. In fact, until his
birth, her life had been of that quiet, slow bitterness with which we are
familiar in those people, chronically depressed from earliest childhood,
who go through life sadly accepting that they are never to expect anything
good to happen to them. She had been the unwanted daughter of an angry,
drab, overworked, unfeminine mother—unwanted simply because she had
been born and then doubly so because she was not a boy. Her father, on the
other hand, during the infrequent episodes when his own psychopathology
permitted him to linger in closeness with his daughter (he was alcoholic),
gave her intermittent moments of feeling it was worthwhile to be a girl.
Unhappily, he could not consistently treat her so; and, in his failure to
shield her from her mother’s coldness, she could not adequately use his
love of her femaleness, that is, his appreciation that she was his daughter.
And so, as her mother undertook the process of grinding away his
masculinity and when he turned away from his daughter, the little girl
responded more to his being weak than to his having been a man who had
loved her. In disappointment, she looked to those models whom she had
admired and envied throughout early childhood, her brothers. She had seen
how differently they were treated than she was, especially by her
22 THE TRANSSEXUAL EXPERIMENT

mother, and she could not help but decide that the respect given them was
due to their maleness. She determined to become a boy herself.
And so, for six or seven years—until puberty and its feminizing changes
ruined her hopes—she dressed as a boy whenever possible and in boys’
(not just boyish) clothes, played boys’ games exclusively with boys and
was at least as good as they were, dreamed of growing up to enter a male
profession, and pictured herself in adult life as having a normally male
body. In other words, she seemed to be taking the same route as do female
transsexuals, the counterparts of the male transsexuals that her son
represented. However, as different from these female transsexuals, she had
had a significant piece of femininity built into her by her father’s positive
response to her femaleness and femininity in the first six years of her life.
While this earlier femininity was a damaged one, incomplete because her
mother had not contributed adequately to its development, it nonetheless
was a part of her personality (as it is not in the girls who grow up to be
transsexuals [see chapter 18]). She was forced to draw on it when the
feminizing effects of puberty broke her hopes of developing a male body.
And so, in her teens, she dropped the overt masculinity out of sight and
established herself in the eyes of the world as a boyishly feminine young
woman. During this time, she now demanded of herself that she grow up
to be a wife and mother and renounce her wishes to be a man and to be
professionally successful.
She met her future husband, the only man she had ever considered
marrying, while both were serving in the forces. Due to the exigencies of
military service, except for the first couple of days when they met, their
relationship was carried on only by mail. Under these hardly intimate
circumstances, they convinced each other they should get married, which
after a year or so they did. Despite the almost contact-less courtship, both
had discovered each other sufficiently to know that each in his and her
emptiness was the only proper spouse with whom survival could be
arranged. Time bore out this wisdom; day after day, year after year their
hopeless marriage continued, both working silently and powerfully to
protect its emptiness and withstanding any forces, including treatment, that
might
EXTREME FEMININITY IN BOYS 23

have led them on to the more dangerous ground of an intimate


heterosexuality. With her envious hatred of men, she could not have borne
a closer relationship.
The second experience in which she almost failed to crush her masculine
desires was professional. For a few years, up to the time she went in the
army, she was employed by a company, and because of her great abilities,
was given increasing responsibility. She was so skilled and so valuable
that, although only a young woman, she was asked to take full control for
several months while the owner was away. On the day this honor was
announced to her, she quit and never again returned to any professional
work.
Her husband was the only sort of man whom she could have married or
continued to live with. Although not effeminate, he was distant and
passive, unable to be close to his wife, unable to express his feelings
directly, whether warm or aggressive, and unable to stay in contact with
any members of the family if it required his noticing what they were doing
or how they felt. His wife and children went about their days’ activities
without his asking what they had done during the time he was not at home
or where they were going if, in the evening, he was around and they went
out. During his son’s infancy and childhood, he was almost literally never
at home, leaving for work in the morning before the boy was awake and
returning from work at night after he had gone to sleep. Even if this had
been necessary, he did not attempt to mitigate it as would a father who
wanted contact with his son. Instead, this man was not even available on
the week-ends because of his hobby, which was of a solitary nature. As the
boy grew older and did get to see his father in the evenings, the latter could
not be disturbed because he was tired or because he was busy working in
another room. So the only version of a father available to the growing boy
was the disparaged one created by the boy’s mother. She did not have to
say much in order to build her scorn of her husband as a constant presence
in the family. It was interesting to hear this woman in her analysis
unendingly express her rage and contempt for her husband on the one
hand, while on the other, at home, both understood there was a limit
beyond which she would not go for fear of threatening the constancy of
their marriage. He offered himself up to her
24 THE TRANSSEXUAL EXPERIMENT

rage, and she allowed herself to indulge in it. This understanding gave them
both satisfactions necessary for the equilibrium of each and for the homeostasis
of the family (at least until treatment caused the contract to break).

Thus, briefly, the parents. What happened to their son—to this son, for, no
matter how many other sons such parents have, almost always only this one is
feminized.* Father was out of the way; he was chosen because he would allow
that. He was comfortable abandoning his son to his wife for these next years,
not needing, as does the masculine father of his soon-to-be-masculine son, to be
close with his son and to feel the necessary joy in helping create a boy’s
masculinity.

And so, mother and son were alone together uninterrupted. Having created
this beautiful phallus for which she had yearned, and having finally felt herself
whole, intact, completed, and cured of her chronic, sad hopelessness, she could
not let go of her cure—this lovely son. Why would she not keep him close to
her at every moment and in every way, and why would he—no fool—not
respond in kind? Whatever biological tendencies there may be that assist a child
in separating from its mother and whatever methods a mother may employ to
encourage this process, these were distorted in the excessively close symbiosis
found between the extremely feminine boy and his mother.

Perhaps the situation does not sound much different from what one sees often
in the early mother-infant relationship that does not produce this pathology.
However, in the case of the transsexual, what one finds especially is that the
intensity of the closeness is so much greater. As a result, mother and infant son
are together more each day and for far more months (in fact years). This
mother’s intimacy with her infant contains those micro-behaviors so difficult
for the outsider to see but that make for profound human relationships—the
way two people look into each other’s eyes, the intensity of their embraces, the
extra moment’s lingering of a touch, the soft sound, yielding muscle in cradling
arms.† Why then would she

* See Chapter 15 for the exception.


† These acts in sexual love produce the most primitive feelings—of merging—but
in sexual love an exciting intensity is built up by the simultaneous presence of
awareness of separateness and difference in the partners; that tension is not felt in the
transsexual symbiosis.
EXTREME FEMININITY IN BOYS 25

give up this behavior; even if she became exhausted after the countless
hours of intimacy, her infant’s insistence that she continue (he cried and
she would yield) made her go on. She feared if she did not give him all he
demanded, he would abandon her—which would return her to her old
hopelessness.
As the months passed, what prevented him from remaining simply an
undeveloped blob of gratified tissue? The fact is that his mother did not
prevent ego development. She only minimized separation from her
enveloping body and personality. Her mothering was otherwise phase-
adequate and well-timed to permit his developing mastery of the
environment. He was encouraged to talk, to read, to become skilled in
using his body, and in time she also rewarded his growing sensitivity for
colors, textures, sounds, and smells that, already in the first few years of
his life, showed as a keen, creative, artistic sensibility. However, all of this
was learned, as it were, in her lap. They did everything together and, as
always, either physically touching each other or drinking each other in
through their eyes.* And when he did well, he could see the happiness so
clearly expressed in her eyes and face. However, it was all contingent upon
love—or, more precisely, that thrilling fragment of love in which ego
boundaries dissolve and one merges with one’s beloved. Such momentary
experiences between mother and infant can be the ground upon which
one’s future capacity to love and to accept the world will be based, but I
believe that one needs such experiences to have been occasional in
infancy, not continuous. At the least, chronic ecstacy is dull or debilitating.
With this little boy, it was even worse; it led to a defect in identification: he
never quite learned where his mother left off and he began.
Of course this is not literally true. She defined clearly enough the
dimensions of his body when she encouraged him to speak or walk, or
later on to paint and write. The defect lay in some psychological structure,
for which I have no adequate conception, much less name, which served as
a bridge always connecting them. It took the form of femininity and was
established already when he was a year old, by which time he began

* In the drawing, the only anatomical feature he represents for himself are his eyes.
The mothers of transsexual boys all comment on these sons’ beautiful, soulful eyes.
26 THE TRANSSEXUAL EXPERIMENT

putting on his mother’s or sister’s clothes. And as the first nuclei of this
femininity appeared, she encouraged their growth.* In her hatred and envy
of masculinity, she could never have responded with pleasure to rough,
ungraceful, or unsoft behavior. In this regard, she did not have to worry
about a budding heterosexuality that might have at first been directed at
her body. For that to develop, there must be frustration, need, a desire to
possess what is not one’s own. But in their relationship, her body had been
freely available to him as if it were his own not only at the beginning (as is
normally the case with a nursing infant) but long after; when frustration
should be imposed to create the tensions necessary for heterosexuality, he
was still free to be part of her. Using the rationalization that children
should not be thwarted and that it is enlightened to ignore sexual
differences and nudity, she made her female body be without mystery to
him. On the other hand, he never saw his father unclothed (he almost never
saw his father at all); his father’s maleness and masculinity were unknown
to him.

In order to keep him close, then, his mother had him with her constantly.
While he slept in a crib separate from his parents in infancy, he was in his
mother’s arms throughout a good part of the night because his sleep was
broken. She carried him whenever she was standing or walking during his
infancy and then, although physically exhausted by it, continued to do so
into his third and fourth year, now not all the time but still excessively so.
He was with her as she did the household chores, in the first year or so on
her hip and later at least in the same room so that he and she could
constantly link with their eyes, and, after he began to talk, with continuous
intimate, uninhibited conversation. He followed her as she went to the
bathroom and was with her when she bathed or showered. These minute
but unending contacts between this mother and her infant bound them to
each other continuously, with it being her constant wish, both in her mind
and in the yearning felt upon all the surfaces of her body, that they be one
—not absolutely, for then he would literally be part of herself, and

* A technically poor snapshot of him dressed as a girl appears in the family album.
Her only comment was, ‘I’m a terrible photographer’—no remark, and certainly no
concern, that her boy looks like a girl.
EXTREME FEMININITY IN BOYS 27

therefore not a cause of bliss—but that he be her and not her at the same
time, the most primitive of transitional objects.

It is not enough to counter that other mothers are also close to their
infants, or other mothers are nude with their infants, or whole societies are
found where mothers carry on their nude bodies their nude infants for
several years. The point is not that these two people were physically close
to each other but rather that if one wishes to be immeasurably close, one
can best start with physical closeness. But in the microscopic behavior and
sensations will be measured the contrast between her hungry, unending
need to absorb him and a more normal mother’s casual intimacy, or the
special bribery of intimacy alternating with punishment and rejection that
is frequently found in the mothers of effeminate homosexuals.

To summarize up to this point: a chronically depressed, bisexual woman


with severe penis envy and an only partially suppressed desire to be a male
marries the only kind of man she can—a distant, passive, though not
effeminate man who will not act as a competent husband or father. Then, if
she gives birth to a beautiful and graceful son, she keeps him so close to
her physically and emotionally that by the end of his first year, he is
already showing feminine tendencies. When these appear, they are
powerfully encouraged by this mother; father, not being present, neither
discourages them nor presents himself as a model of masculinity with
which the boy might otherwise identify. The excessive closeness between
mother and son is at no point heterosexual.

What sort of oedipal situation develops as the years progress ? As we


shall see in more detail in Chapter 6, there is apparently no oedipal conflict
in the oedipal situation. This is because there is (almost) no father. The
little boy has no rival for his mother; he possesses her perhaps more
completely than can any other child, for they are practically one. In other
boys, the oedipal conflict is made up at least of these elements: the boy has
separated himself sufficiently from his mother to want her as an object of
his love. His mother, while partly encouraging this, makes clear that her
ultimate choice is an adult, usually his father. Should the little boy oppose
his father, he discovers the latter is stronger. Perhaps the place of greatest
vulnerability for the boy, except the fear of being killed, is that he will lose
28 THE TRANSSEXUAL EXPERIMENT

his identity as a male. Not only may the insignia of that maleness, his
penis, be then endangered, but also more diffusely experienced, all the
myriads of ego accomplishments which are sensed as masculinity may
likewise be threatened. And so, he backs away from his desire for his
mother, turns to other females, and draws upon his identification with his
father to solidify the masculinity that makes possible not only the
renunciation but the psychic structures necessary for success as a
masculine man in the future. This sketches the classical oedipal conflict
and resolution; even with modifications, the description fits real life well
enough to suit our purpose now.

None of the above holds true for our little feminine boy. Since he could
express himself, he has shown that he would like to be a girl, and quite the
reverse of wanting to protect his penis, his maleness, and his masculinity,
he has asked that he be relieved of all and that he be allowed to grow up a
female and a girl. There is almost nothing (see Chapter 5, however, for
data about his sense of being a male) in his behavior, including dreams and
fantasies, play or drawing, avowed statements or subtleties of behavior that
shows any sign of developing masculinity, a desire to preserve masculinity,
or a fear of becoming female. While one may always theorize that
something unseen is nonetheless present, to be convincing, one should
present evidence that the unseen does somehow manifest itself. So far, no
such evidence in these little boys has been found by us or revealed by
anyone else.

A partial confirmation that the oedipal conflict is missing is found in


treatment. Only when these boys have been treated for several years and
masculine traits start appearing does evidence of oedipal conflict develop.
The boys start to value their penises (for instance, they now stand up to
urinate where before they sat); they develop phobias; they physically
attack females—dolls and girls, with pleasure more than anger the
dominant affect; much more intrusive play appears, such as throwing balls
and charging into their mothers and other females; they play spontaneously
for the first time using male dolls and masculine toys; in their drawings,
instead of showing only beautiful women, masculine males appear; and
stories of attacks with guns and swords, with violence, danger, and damage
are now invented. Then, after a total absence, pictures
EXTREME FEMININITY IN BOYS 29

of father begin to show up in drawings of families, first as a ghostly


outline or tiny figure, but gradually growing until he is as fully represented
as the other members of the family.
It is all too well known where this leads. Once he goes to school, if the
social pressures are great enough, the transsexual boy may attempt to
conform, but his efforts to be masculine fail no matter how severely he is
humiliated or physically punished. He learns discretion, hiding his wish to
become female, but by mid-adolescence, he will have begun the process of
passing as a member of the opposite sex. (We are no longer talking about
our little boy reported above, for he has not yet reached this point; as a
result of treatment, we hope he never will.*) Puberty brings with it the
proof of physiological and anatomical normality, for these boys develop in
an unremarkably male direction in all physical attributes. While the
fierceness of the struggle against their maleness is resolved in some by
their being able to diminish the development of erections and orgasms, for
many, unable to suppress these reactions, adolescence is a disaster. They
not only are incapable of being masculine and so are cut off from most
social contacts, but even their own bodies turn traitor; the hated penis
keeps insisting on its maleness in an inescapable way. Transsexuals deal
with this first by trying to avoid masturbation and second, if they do have
erections, by imagining that they have a vagina and that what sexual
excitement they feel is vaginal. It does not work very well, but that is all
they can do.
Distraught because of his male body, the transsexual now creates the
illusion he is female. With his lifetime of study, he is able to pass into the
new feminine role successfully and without further rehearsal. Over and
over, one sees such people, having made their decision, put on clothes of
the opposite sex and go out into the world without their secret being
discovered. They already know what clothes to pick, how to wear them,
how to carry themselves as they meet the innumerable social situations in
which one (usually) automatically expresses himself in the appropriate
masculine or feminine manner. As different from the fetishistic cross-
dresser and effeminate homosexual (in both of which conditions
preservation of one’s

* At the time of writing, he is 15, interested in sports, perhaps sexually interested in


girls, but—of guarded prognosis—entranced by the theater.
30 THE TRANSSEXUAL EXPERIMENT

penis is crucial and at the core of perversion), whose success is precisely


expressed by an erection, this cross-gender passing is not a caricature, a
mimicry, or an exhibition, nor is it intermittent. It is meant by the
transsexual to be permanent, and everything possible is done to make that
so since he wishes to become female and live only as a woman. Crucial in
the transformation will be anatomical change: removal of facial and body
hair, estrogens to produce breasts and other secondary sex characteristics
of a woman, and removal of penis and testes and creation of an artificial
vagina. When all this is done, the patient from then on does in fact live as a
woman.
In brief, the male transsexual is a remarkable approximation of a
feminine woman.
One last word about our case above. Except for a very few details of the
mother’s life, my report would be rather the same for the other families I
have observed (see Chapter 4). This is worth noting, because a single case,
while an interesting source of possibilities, needs confirmation.
We now face several problems related to this question: how can one
believe that such a profound distortion in character structure can result
without the interplay of hostility both between mother and infant, and, in
time, intersystematically within the growing child ?
First, is the transsexual’s belief in his femininity correctly described by
the benign word ‘illusion’ or is the process not more pathologically
defensive as implied in the word ‘delusion’ ? We must differentiate
between the dynamics of delusion and those of illusion, both of which are
false beliefs. The difference lies especially in the handling of hostile
aggression, i.e. aggression others directed against us (trauma), aggression
we directed against ourselves (repression, symptom formation), and
aggression we turn on others in revenge (hostility). Delusions are false
beliefs in which one erects a new reality to correct the unacceptable former
reality, but the old reality lives, buried in the unconscious. However, there
are false beliefs which do not remake reality but are simply based on
misinformation about external reality; this accounts for many differences
between cultures and religions. Illusion falls in the middle, a false belief
due to misinterpretation, not remaking of, external reality; the unconscious
belief is not strong enough to quite sweep away
EXTREME FEMININITY IN BOYS 31

the ego’s reality testing. By this latter definition, transsexualism is not


exactly an illusion, either, but perhaps we can keep it in that category
because the transsexual, as different from a delusional person, never denies
the external reality (of his anatomical sex). Those who believe transsexuals
are psychotic should contrast these patients with those like Schreber (5),
who felt God was changing his body to female: transsexuals cannot
manage to hallucinate body change; that is why they must take hormones
and seek ‘sex change’ surgery. They only deny that their identity is
appropriate to that biological state. As we know, delusions and other
symptom formations that require repression are dynamic, active, with a
constant interplay of ‘energies’ between what would rise to the surface and
the forces of repression. If you say the transsexual is repressing his
masculinity, then I ask: when did it ever exist ? What form did it take ?

My discussion attempts to separate out two processes, then―those with


such dynamics (‘delusion’) and those without such dynamics (‘illusion’).
In the world of gender psychopathology, these differences can also be seen
in the contrast between transsexual femininity, which is not a product of
trauma, repression, and defense and, for instance, homosexual effeminacy,
which is.

However, one might counter, there really was trauma; this depressed
woman, with her rage against maleness, simply could not keep those
affects out of her mothering of her infant son, whose maleness would be
never-ending stimulus to rage, no matter how much she repressed. And so
our second question: can a mother-infant son relationship be blissful if the
mother has suffered from life-long intense penis envy ? I am at a
disadvantage, for I have not actually observed such a mother-infant
relationship (nor has anyone else). My belief that the experience was
blissful comes from the mothers’ stories, from the observation of mothers
with their sons now aged 4, 5, or 6, from working with colleagues in the
treatment of the boys, and from the products of the children’s play, such as
drawings, in and out of treatment. Perhaps the disadvantage that I have not
observed the mothers and their infants in the first years of life is balanced
in the argument by the absence of data to refute the argument (though there
is of course plenty of theory available to serve either side).
32 THE TRANSSEXUAL EXPERIMENT

These mothers have no problem expressing hostility in general. They


treat their passive, distant husbands horrendously not only with the most
bitter remarks but raging fights. In the transference as well, there is no
absence of hostility (though in different form). But such a mother’s little
son is shielded from her hatred, easy to do because he is in fact her greatest
joy, her beautiful accomplishment, the completion of her hitherto
inadequate body and psyche. She is deeply indebted to him for having
brought her the sweet pride and tranquility she never got from her own
mother in infancy and never after attained with anyone else: in this sense
he is her first and only good mother. She need not even idealize him too
much, for with his beauty from birth on and with his plastic, unformed
ego, she can mould him into—as the expression goes—‘a living doll’.
This is not to say she does not become harassed by the extravagant effort
required to gratify all his wishes or that she is not physically exhausted at
the end of the days and months and years of catering to him. Certainly she
becomes irritable and certainly she will express this toward him (though
far less than toward his siblings and his father). But the amount of this is
so minimal, and the closeness so maximal that the balance, I believe, can
legitimately be called ‘blissful’.
She shields him from her rage, and she finds this easy enough because of
the return to her from having this baby. Her blissful experiences with him
are probably not qualitatively different from those in the first months of a
normal mother-infant relationship, except that the happy periods are longer
in the transsexual situation and attempts to make it infinite must in time
create a different atmosphere.*
* A philosophic point that needs to be dealt with only briefly here: there is no way
to prove that an alleged unconscious quality does not exist. So I cannot prove that
significant hostility does not exist. Theory would strongly suggest that in this
situation it must exist. But whether it does or not will depend on demonstration of
data. There are ways to infer that hostility is present but unseen, as for instance, in the
reaction formation of excessive kindness. But it leaks out in the form of symptoms or
behavior that, while disguised, nonetheless have the tinge of hostility. None of this
was found in what these mothers did to these sons. Nor did analysis reveal hatred of
the boy, although unending amounts of hostility were present in the analytic material
and in this mother’s relationship with others. What counts finally in communication
in human relations is what is actually perceived with one’s senses, and I believe that
these mothers deliver upon their sons’ bodies little behavior that is the product of
anything more severe than exasperation.
EXTREME FEMININITY IN BOYS 33

A last word about hostility: not only is it not really seen in the mothers
vis-à-vis their sons, but the boys do not feel it enough towards their
mothers either, before treatment. Then, with the development of
masculinity in treatment and with the appearance of an oedipal conflict,
ample hostility toward mother begins to show—and not disguised at all.

A third question: can a gross aberration in character structure be


produced without trauma? We are not used to hearing of a major piece of
identity, such as masculinity or femininity, arising without trauma or
conflict. Nor would I allege, when in a moment, I mention the normal
development of masculinity, that completed gender identity occurs without
trauma or conflict. However, I do believe that the first part of gender
identity (masculinity and femininity) may very well—and usually does—
so develop; I have called this the core gender identity, the first and
fundamental sense that one belongs to one’s sex (1). That later gender
identity is not so uncomplicated has been more than amply demonstrated
in innumerable psychoanalytic studies that need not be further indicated
here. But it may not be recognized that the earliest and, as it turns out,
unalterable, part of gender identity—the core gender identity—does
develop smoothly, silently, and without conflict. (Perhaps that is why it is
so fixed. Perhaps all of the fundaments of personality most unalterable by
life experience or by treatment are those that occur early in life without
trauma and subsequent conflict. Conflict, even when frozen into a piece of
character structure, always implies a dynamic equilibrium that could be
thrown off balance; we do much of our analytic work along the fracture
lines marking ‘splitting of the ego’.) Two examples of atraumatic, non-
conflictual gender development may be mentioned here, more to remind
the reader of the possibility than either to prove the point or exhaust the
possible examples.

The first comes from the work of ethologists who have shown us that in
birds and some mammals object choice may be created at wild variance
from the normal free-ranging species behavior. We know of birds, which,
if imprinted on a human
34 THE TRANSSEXUAL EXPERIMENT

during the critical period of early life, will attempt to mate only with a
human on reaching adulthood. Imprinting is atraumatic, non-conflictual.
Whether, how, or when imprinting occurs in humans is still being argued,
and it is fanciful at this point to presume that human object choice or
gender behavior have determinants produced by such psycho-biological
processes. Our data so far permit us only to recognize that earliest
childhood has the most powerful and usually permanent effects on identity
development, but we still do not know exactly how those effects are
created.
The second situation, however, is a common one, in fact the usual
situation seen in human behavior. If we remove from discussion the
discredited idea that masculinity and femininity are primarily biologically
produced in humans, and if we recall the many ‘natural experiments’ that
have demonstrated that the influences of ‘learning’* from birth on
determine the greater part of gender identity (2, 1), then we may look anew
at how gender identity develops in the more normal circumstance—and
see if in any way the typical process is similar to that in these very
feminine boys.
So a last question: how can there be any connection between the
processes that produce those opposites—femininity in a transsexual male
and masculinity in a normal male? The main point is that the non-
biological influences producing masculinity in males are just as much
selected arbitrarily from the personalities and behaviors of the boy’s
mother and father as are those that yield transsexualism. The infant will
not know it is a male and is to become masculine because of any innate
force. His parents teach that to him, and they can as effortlessly teach
something else. From the moment parents are told they have a boy, the
process of reinforcing certain behavior and of discouraging other behavior
in regard to what the parents consider to be masculinity will be under way.
Choice of names, color of clothes, style of clothes, ways of holding the
child, how much closeness and distance, and types of games played—all
this and so much more starts almost from birth on. Making up the greater
part of the infant’s ‘training’ as it develops gender, these experiences
produce little or no conflict. Certainly, in the happy family, the first nuclei
of what that

*A pallid term, but there is no other generic.


EXTREME FEMININITY IN BOYS 35

society and that family consider masculinity are greeted with pleasure and are
encouraged to grow until these nuclei have begun to coalesce sometime around
the end of the first year, giving by then a distinctly masculine quality to the little
boy’s behavior. One aspect of this, so far only a hint needing more rigorous
confirmation, is that mothers (with a few pathological exceptions) differentially
handle, caress, feed, and keep upon their bodies male as compared to female
infants. From birth on, then, non-traumatic and non-conflictual learning
experiences begin creating masculinity in boys . . . and, unfortunately,
femininity too, as in transsexuals.
So, in one sense the processes that end so differently—the one in masculinity,
the other in femininity—still have common features at the start. In the first year
or so of life, both create gender from parental attitudes and behavior impinging
upon an unformed psyche. Neither outcome is inevitable; both are opinions,
illusions.
But then come the clear-cut differences in process, in parents’ behavior. In the
transsexual, mother and infant remain bound together: mother interferes with
the separation process. This, I believe, dooms the child to femininity. On the
other hand, separation and conflict (of course not just any conflict) will make
masculinity possible in the non-transsexual.
Some of us believe (3, 1), unlike Freud, that the little boy, not the little girl,
has the more devious route toward an intact gender identity in the first year or
two of life. We believe that because little boys spend their most profoundly
intimate experience up against a female body and psyche, they are at special
risk of first identifying with that femaleness and then of not being able
adequately to end that identification by the creation of masculinity. Only now in
the process of separation from mother does trauma and conflict play a part, but
this trauma may be converted to pleasure by the developing neuromuscular
system with its potentials for mastery of the real world and by proud parents. If
a mother is able to permit and enjoy her son’s increasing strength and
independence, she will so encourage this otherwise frustrating and traumatic
process that in fact pleasure outweighs pain (4).*

* This leaves out a Kleinian explanation, which would describe this whole process
from birth on only in terms of trauma and conflict, but I must put aside a discussion
of this possibility primarily because the Kleinian literature has not discussed the
development of masculinity and femininity and so I shall not anticipate how to meet
such a discussion. At this point I can only say that my argument would be better met
with data than theory.
36 THE TRANSSEXUAL EXPERIMENT

Contrary to Freud’s opinion, I find that the earliest phase of development


of masculinity in a masculine boy is no more inevitable than the
development of femininity in a feminine boy. Both are the product of a lot
of activity, interchange, and work—even more so in achieving masculinity
—and both may be produced relatively atraumatically.

Trauma, conflict, and the resolution of conflict via identity formations,


rather than invariably being considered pathological processes, are
essential for the production of masculinity. A proof of this statement
perhaps lies in the transsexual boy, who, denied conflict, is also denied
masculinity, first in the too-loving closeness with his mother. Then, by the
odd nature of his family, he is denied the necessary trauma of the oedipal
conflict: he has not adequately separated out his mother as a desired
heterosexual object, and he does not have to lose a battle (and defer
victory) against a more powerful, masculine rival. With mother so
possessed by him that she is in many ways he himself and with father all
too absent from the family, his oedipal situation never takes on the tension,
dissatisfaction, and yearning for reduction of tension with a woman that
the oedipal conflict should produce in a boy.

We have seen that an anatomically normal male can become masculine


and believe himself male, or feminine and believe himself female, either
outcome growing from his family’s psychodynamics. Within the first year
or so of life, he will develop the fundamental and apparently unalterable
roots of his masculinity or femininity, and the processes by which he does
so, rather than inevitable, will be the result of his parents’ personalities and
the ways they relate to him physically and psychologically. Thus a
person’s destiny may in some regards be even more out of his hands than
the usual concept of a dynamic unconscious would indicate. It seems to me
that these earliest experiences ‘imprinted’ * permanently into the psyche
(and brain?) act as inexorably and unalterably as do ‘instincts’,

* The quote marks indicate that the true nature of the process is unknown but that
something like imprinting may play a part.
EXTREME FEMININITY IN BOYS 37

and while not primarily originating in biological drives, they create


permanent intrapsychic demands that will be felt by the individual as if
they were ‘instinctual’. These forces are to be differentiated from the also
powerful forces of those later developed parts of the unconscious wherein
the balance between conflict and resolution, between demand and
repression are forever fighting for balance.

The transsexual’s conviction of his femininity stems originally from his


parents’ acts, not from a defense against his own forbidden and thus
repressed wishes. So too does the core of normal masculinity. No wonder
poets (and schizophrenics) ruminate that what we feel to be our own
possession—our very existence—may only be someone else’s dream.

In this chapter, the major hypothesis as to the causes of extreme


femininity in males has been laid out, plus minor ones, for instance, that
masculinity is not a naturally occurring given, or that non-conflict forces
can produce important aspects of personality. From here on, I shall keep
referring back to such hypotheses, taking some of them up again and
again. I do this on purpose, as a different perspective arises that illuminates
a hypothesis, and only hope that these repetitions do not dismay the reader.
Thus, in the next chapter, I return to the mother-infant relationship; in
repeating the description, I wish to expand on how the transsexual’s
mother, with her feelings of deprivation and worthlessness as a female,
uses this son as the penis—her perfect phallus—she always wanted. This
makes clearer why she creates blissful symbiosis.
38 THE TRANSSEXUAL EXPERIMENT

Chapter 2
1. Stoller, R. J. (1968). Sex and Gender. New York: Science House;
London: Hogarth Press.
2. Money, J., Hampson, J. G., and Hampson, J. L. (1955).
‘Hermaphroditism’. Bull. Johns Hopkins Hosp. 97.
3. Greenson, R. R. (1968). ‘Dis-Identifying from Mother’. Int. J. Psycho-
Anal. 49.
4. Mahler, M. S. (1968). On Human Symbiosis and the Vicissitudes of
Individuation. New York: Int. Univ. Press; London: Hogarth Press.
5. Freud, S. (1911). ‘Psycho-Analytic Notes on an Autobiographical
Account of a Case of Paranoia (Dementia Paranoides)’. S.E. 12.

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