tension or distress are because he is not living in conformity with his constructs, must be classified with other neurotics with obes- sional symptoms.

It is now necessary to consider the stress, event or situation which the transvestite is reacting against. There may be as many situations as there are transvestites. Many normal people, furthermore, may have faced the same situations and have found other responses that preserved their sense of integrity and security. Each person forms his own constructs and can therefore speak only for himself. By collecting a number of case-histories, eventually an investigator will find common factors emerging (providing he has included the rele- vant material in his histories). The following are the relevant details of my family background and the possible mechanism whereby I be- came a transvestite.

My mother married twice. Her first husband was a general medi- cal practitioner who died of a brain tumor only 10 weeks after the marriage which was never consummated. She married my father 12 years later. He was a "Harvard intellectual" who had originally intended to do Medicine but had stopped short and had made a career for himself in physiology. My mother was the dominant part- ner of the marriage, having much physical energy and a vigorous emotional temperament' My father was a quiet, intellectual and artistic person. I was the youngest of 3 boys and it was early decided that, as I alone showed an interest in biology, I should obtain medical qualification and become a physician. This had been firmly de- cided for some years before, in my 13th. year, I first began to have transvestite fantasies. (The actual onset of these was when, in a Geography lesson on Holland, I heard of the island village of Volen- dam which kept boys in girls' dresses and long hair until they were 14. I can still clearly feel the excitement and envy with which I heard this.)

Nothing of note disturbed these plans (which were as inflexible as the laws of the Medes and the Persians) until, at 25 years old, I began unaccountably failing in my medical final examinations. I went for help to a psychiatrist and had two years of analytical psycho-therapy. One significant fantasy that emerged during this was of a female patient, of my mother's build and age, who attempted to seduce me while I was conducting a physical examination on her. Such was my general level of anxiety over the consequences of medical qualifica-