The bisexual identity of transsexuals: Two case examples

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Abstract
Clinical data from two cases of male transsexualism, a child and an adult, illustrate the nature of the bisexuality typical of such patients. The first, an 8-year-old boy whose desire to be a girl is seen in his constant dressing and acting like a girl, confirms in play therapy, story telling, and drawings his fantasies of being a female. However, these fantasies are never free of the knowledge that he has a penis and a male identity as well. That this bisexuality persists into the transsexual's adulthood is exemplified in the fantasy life of the second case, a 30-year-old operated male transsexual. The memory, "I was once a boy" never quite fades away; no matter how successfully the passing as a woman is managed, she cannot rid herself of the secret maleness. The belief in such patients that they are fundamentally female though possessed of an anatomically normal male body will persist through adulthood, unaltered by "sex change," by hormonal or surgical procedures, or by living successfully for years as a woman. This bisexuality is conscious, painful, and not assuaged by symptom formation, forgetting, or other defenses that would remove the conscious sense of having two sexes. In the child the unwanted sense of belonging to the male sex, which causes a disquieting undercurrent, can be used as the base upon which a more solid sense of masculinity can be built. Unfortunately, for the adult transsexual the balance of the "two-sexed" awareness cannot be tipped to a willingness to live as a man; despite treatment aimed at making them more manly, adult transsexuals retain their wish to be female-and their secret knowledge that, after all the operations and female hormones, a male part remains untouched within.

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