AMERICAN JOURNAL OF PSYCHOTHERAPY

Freud himself-I believe-would have disagreed with such a one-sided approach. During one of my visits to Vienna about 30 years ago I discussed the psyche-soma relationship with Freud and he agreed fully that a disharmony of the emotions may well be due to a dishormony of our endocrines.

All therapy, in cases of transsexualism-to the best of my knowl- edge has proved useless as far as any cure is concerned. I know of no case where even intensive and prolonged psychoanalysis had any success. If we are dealing with a constitutional deviation, we can hardly expect to influence it. Testosterone, for instance, would not change the desire for sex transformation either. It would merely increase libido and perhaps masculine appearance aggra- vating instead of diminishing the conflict. These people seem to me truly the victims of their genetic constitution, step-children of medical science, often crucified by the ignorance and indifference of society and persecuted by antiquated laws and by legal inter- pretations that completely lack in wisdom and realism.

THE NORMAL BOY

To complete the picture, I would like to mention the normal masculine boy who was exposed to adverse psychological condi- tioning. In former years it was quite customary that many boys kept their long curls till they went to school and some of them were dressed and treated more in a feminine than masculine fashion. That took place during the formative years of-say-2-5. Nat- urally not all of them became transvestites or homosexuals. When this kind of conditioning went against their nature, nothing hap- pened. They grew into normal manhood. But when it harmonized with a constitution of a high feminine component, then it was a different story.

In this connection I would like to raise a question of cause and effect. Parents who do bring up their boys as girls and give them female names usually do so to please themselves and to compen- sate for their disappointment in having a boy when they wanted a girl (or vice-versa). But is it not possible also that, in other in- stances, the boy-for constitutional reasons-looked and behaved so much like a girl that it seemed more natural to the parents to forget about his gonads for a while and bring him up as a female?

In one case that I observed recently a reversed situation actually seemed to exist. The parents wanted the boy that was born to them