XVI Harry Benjamin International Gender Dysphoria Association Symposium
17 - 21 August 1999, London

Reflections on "Transsexualism and Sex Reassignment" 1969 -1999

Crossing Boundaries and Creating Some Missing Experiences for a Female-to-Male Transsexual

Juran, Shelley, Ph.D. Prof. Of Psychology, Pratt Institute, Brooklyn, New York, USA, private practitioner and affiliate of New York University’s Post-doctoral Program in Psychoanalysis and Psychotherapy, New York, NY, USA.

This paper covers aspects of an in-depth (6 year, twice/week) interpersonal and relational analytic treatment of a 35 year old female-to-male transsexual who had been chronically depressed and emotionally masochistic when he entered treatment. Etiological aspects of his case (including tortuous relations with an older brother) are presented, as well as client issues involving a sense of fraudulence, envy and a need to control others’ perceptions of himself. His internal world and external behavior were quite at odds with each other and his loneliness was intense.

The client’s need to maintain a sense of power in the face of felt deficiencies and powerlessness are explained and elucidated. Treatment issues involving stretching "normal" boundary lines in order to decrease the felt power differential are presented, beginning with coffee together in the office and progressing to sharing of poetry images and music discs resulting in keeping a representation or "sense" of the other outside of the therapy situation. Ultimately, in the wake of extreme depression and stuckness, the therapist and client co-created a group socialization experience involving young male adults (with the client as male, something missing in his history) in the therapist’s classroom. People were able to learn from him (an important experiential phenomenon), instead of the client always feeling unequal and deficient and he was able to interact with young males in a situation and manner that had been critically absent in his past. The client is now less depressed and has used this as a growth experience.