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TRANSGENDER PSYCHOANALYSIS

Drawing on the author’s clinical work with gender-variant patients, Transgender Psychoanalysis: A Lacanian Perspective on Sexual Difference argues for a depathologizing of the transgender experience, while offering an original analysis of sexual difference. We are living in a “trans” moment that has become the next civil rights frontier. By unfixing our notions of gender, sex, and sexual identity, challenging normativity and essentialisms, trans modalities of embodiment can help reorient psychoanalytic practice.

This book addresses sexual identity and sexuality by articulating new ideas on the complex relationship of the body to the psyche, the precariousness of gender, the instability of the male/female opposition, identity construction, uncertainties about sexual choice—in short, the conundrum of sexual difference. Transgender Psychoanalysis features explications of Lacanian psychoanalysis along with considerations on sex and gender in the form of clinical vignettes from Patricia Gherovici’s practice as a psychoanalyst. The book engages with popular culture and psychoanalytic literature (including Jacques Lacan’s treatments of two transgender patients), and implements close readings uncovering a new ethics of sexual difference.

These explorations have important implications not just for clinicians in psychoanalysis and mental health practitioners but also for transgender theorists and activists, transgender people, and professionals in the trans field. Transgender Psychoanalysis promises to enrich ongoing debates on gender, sexuality, and identity.

Patricia Gherovici, Ph.D. is a psychoanalyst and award-winning author. Her books include The Puerto Rican Syndrome (Other Press, 2003, Gradiva Award and Boyer Prize), Please Select Your Gender: From the Invention of Hysteria to the Democratizing of Transgenderism (Routledge, 2010), Lacan On Madness: Madness, Yes You Can’t (with Manya Steinkoler, Routledge, 2015), and Lacan, Psychoanalysis, and Comedy (with Manya Steinkoler, Cambridge University Press, 2016).

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“In this strikingly original work, Patricia Gherovici makes a powerful argument for the compatibility of transgenderism and psychoanalysis. Not only that: far from suggesting how psychoanalysts might ‘treat’ transgender people, Gherovici persuasively proposes that transgenderism might provide new ideas for the clinic. Starting from the premise that the body is not a given, fixed entity, but entails a process of embodiment (a becoming of the body), she argues that psychoanalysis–Lacanian psychoanalysis in particular–is uniquely qualified to support transgenderism’s commitment to new forms of desire. [The frequently presumed ‘gender trouble’ of transgender people is in fact a universal condition: the impossibility of representing sexuality, an impossibility that implicitly subverts the fixity of all identitarian claims.]With its impeccable scholarship, lucid presentations of complex ideas, and impressive theoretical sophistication, Gherovici’s important work will surely attract a wide audience of readers interested in cultural studies focused on gender and sexuality.”—Leo Bersani, emeritus professor, UC Berkeley, author of Homos and Is the Rectum a Grave and Other Essays

“Patricia Gherovici is the psychoanalyst we need now, more so than ever, to show us how and why “sex” remains a problem, an enigma without adequate solution, even for psychoanalysis. Gherovici navigates the difficult terrain of our transgender cultural moment better than any clinician I’ve read. Her study will be tremendously illuminating for clinical practitioners, as well as for theorists of gender and sexuality.”—Tim Dean, author of Unlimited Intimacy and Beyond Sexuality

“Psychoanalysis, historically, has not had a good grasp on transgender issues. This is a shame, given that psychoanalytic theory generally offers one of the most robust accounts of subjectivity availabile to us, and that psychoanalytically-infomed clinical practice has great capacity to achieve good therapeutic results for people experiencing psychical suffering. Thankfully that’s changing, in no small part through the brilliant revisionist work of Patricia Gherovici, who demonstrates that Lacan was never as hostile to transsexual clients as some of his followers have made him out to be. In her deft handling, the existence of nonpathological transgender subjects brings a transformative pressure to bear on key psychoanalytic concepts, while demonstrating how psychoanalytic insight can help relieve suffering for transgender people without invalidating their way of being in the world.”—Susan Stryker, Ph.D., Associate Professor of Gender and Women’s Studies, University of Arizona, and co-editor of TSQ: Transgender Studies Quarterly

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TRANSGENDER
PSYCHOANALYSIS

A Lacanian Perspective on
Sexual Difference

Patricia Gherovici

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First published 2017
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN

and by Routledge
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Routledge is an imprint of the Taylor & Francis Group, an informa business

© 2017 Patricia Gherovici

The right of Patricia Gherovici to be identified as author of this work has been asserted by her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data

Names: Gherovici, Patricia, author.

Title: Transgender psychoanalysis : a Lacanian perspective on sexual difference / Patricia Gherovici.

Description: New York : Routledge, 2017. | Includes bibliographical references and index.

Identifiers: LCCN 2016057918 (print) | LCCN 2017020510 (ebook) | ISBN 9781315745107 (Master) | ISBN 9781317594185 (Web PDF) | ISBN 9781317594178 ( ePub) | ISBN 9781317594161 (Mobipocket/Kindle) | ISBN 9781138818675 (hbk : alk. paper) | ISBN 9781138818682 (pbk : alk. paper) | ISBN 9781315745107 (ebk)

Subjects: LCSH: Transgender people. | Sex (Psychology) | Sexology. | Psychoanalysis. | Lacan, Jacques, 1901-1981.

Classification: LCC HQ77.9 (ebook) | LCC HQ77.9 .G435 2017 (print) | DDC 155.3/3—dc23

LC record available at https://lccn.loc.gov/2016057918

ISBN: 978-1-138-81867-5 (hbk)
ISBN: 978-1-138-81868-2 (pbk)
ISBN: 978-1-315-74510-7 (ebk)

Typeset in Bembo
by Swales & Willis Ltd, Exeter, Devon, UK

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CONTENTS

Acknowledgements

Introduction

  1    Transamerica

  2    Depathologizing trans

  3    Gender in the blender

  4    Bring sex back

  5    Strange bedfellows: psychoanalysis and sexology

  6    Changing sex, changing psychoanalysis

  7    A natural experiment

  8    From trance to trans in Lacan’s revisions of hysteria

  9    Simulation, expression, and truth

10    The sweet science of transition

11    The singular universality of trans

12    Portraits in a two-way mirror

13    Plastic sex, the beauty of it

14    That obscure object: from beauty to excrement

15    Freud’s scatalog

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16    The art of artifice

17    Clinic of the clinamen

18    Making life livable

19    Body trouble

Coda: phallus interruptus, or the snakes’ lesson

References

Index

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ACKNOWLEDGEMENTS

I cannot name my analysands, but I want to thank them for all that I have learned and continue learning with them. Thank you for guiding me on how to realign the direction of the cure. Special thanks to Diana S. Rabinovich, who was instrumental in launching my first explorations of hysteria and transgenderism. I am grateful to Manya Steinkoler and Jamieson Webster for their friendship, tireless encouragement, and intellectual support.

Many thanks to Geneviève Morel for inviting me several times to participate in events at Savoirs et Clinique and CRIMIC Paris-Sorbonne in Paris where I was able to share my work and test a number of my hypotheses. Her intellectual rigor helped me formulate certain analyses more cogently. My conversations with Renata Salecl, Dany Nobus, Nestor Braunstein, Paola Mieli, Lázaro Lima, Nora Markman, Bruce Fink, Deborah Luepnitz, Colette Soler, Russell Grigg, Jean Allouch, Avgi Saketopoulou, Leo Bersani, Philippe Van Haute, and Paul Verhaeghe proved inspirational in the numerous stages of this book.

I extend my deepest thanks to the New Directions Program at the Washington Center for Psychoanalysis for asking me to present at the Queering the Couch program where I was able to discuss some of the material that helped launch this book. I feel fortunate to have had the opportunity of being a speaker for Dublin Gay Pride 2012 where I was able to share with trans activists some of the ideas that underpin this book. Friendly discussions with Carol Owens, Olga Cox Cameron, Ray O’Neill, and Eve Watson proved invaluable in the development of some of my concepts.

Interviews with Edward Helmore in April 25, 2015 for The Guardian, Brandon Baker for Philly Voice on May 13, 2015, Cassandra Seltman in February 8, 2016 for the Los Angeles Review of Books, and Rose Hackman in June 9, 2016 for The Guardian, provided a wonderful stimulation and new perspectives in my understanding of the transgender experience in a wider cultural frame.

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I have greatly benefited from generous invitations to present my work in progress. I am grateful for the opportunity to test and discuss many of the ideas presented in this book. I extend special thanks to Sheila Cavanagh of the Graduate Program in Women’s Studies, York University; Lee Damsky, John Muller, and Marilyn Charles at the Austen Riggs Center; Liliane Weissberg at the University of Pennsylvania; Mavis Himes at Speaking of Lacan in Toronto; Vaia Tsolas of the Association for Psychoanalytic Medicine, Graduate Society of the Columbia University Center for Psychoanalytic Research and Training; Joan Copjec and Tim Dean at the Center for the Study of Psychoanalysis and Culture, University at Buffalo, State University of New York; Todd Dean at the St Louis Psychoanalytic Society; Robin M. Ward at the Philadelphia Society for Psychoanalytic Psychology; Miguel Caballero Vazquez at the Princeton Psychoanalysis Reading Group at Princeton University; Donna Bentolila of the South East Florida Association for Psychoanalytic Psychology, Florida; Laurie Laufer, Monique David-Ménard, and Beatriz Santos at the Université Paris Diderot; Vivian Eskin of the Psychoanalytic Training Institute of the Contemporary Freudian Society in New York; Aleksandra Wagner at the New School for Social Research in New York; Fanny Chevalier and Isabel Fernandez of Aix-Marseille Université in Aix-en-Provence; Jennie Hirsh at the Maryland Institute of Contemporary Art; Rolf Flor and Marcos Cancado at the Boston Study Group; Martine Aniel, Jeanne Wolf Bernstein, and Deborah Melman at the Psychoanalytic Institute of Northern California in San Francisco; Chiara Bottici at the New School for Social Research in New York; Gabriel Rockhill at the Critical Theory Workshop at the Sorbonne University in Paris; Anouchka Grouse at the Centre for Freudian Analysis and Research in London; Danielle Dronet and Valentino Zullo at the Cleveland Psychoanalytic Center; Sheri Perlman and Anna Fishzon at the Institute for Psychoanalytic Training and Research in New York.

I have greatly benefited from the stimulating discussion and vibrant atmosphere in the Philadelphia Lacan Study Group and Seminar. The participants have been invaluable interlocutors. They asked searching questions and made useful objections.

The manuscript was carefully reviewed by Jennifer Mondal who provided useful comments and skillful edits. Her help and good cheer is greatly appreciated.

I want to acknowledge the many friends and colleagues who offered help, suggestions, and criticism during the various stages of this project: Thomas Bartlett, Claudia Gilman, Richard Sieburth, Oren Gozlan, Shanna Carlson, Cécile McKenna, Scott Jenkins, Tracy Morgan, Ray Ryan.

Immense gratitude is due to the members of the Smedley Writers Group, who provided crucial commentaries and suggestions on excerpts and chapters: Justine Gudenas, Bernard Stehle, Mona Doyle, Laurence McCarty, Ave Maria Merritt, Larry MacKenzie, Randall Couch, Ellie Rhymer, Rebekah Ray, Aldona Middlesworth.

For her indefatigable support, I thank my editor at Routledge, Kate Hawes. Special thanks to Michael Springer for his careful proofreading and his eye for content in the final revision of the manuscript.

p.ix

I am grateful to Beba and Marius Gherovici for their immense love, which has been an important source of support. Jean-Michel Rabaté, my best reader and editor, has offered me unending encouragement and loving support and deserves far more thanks than I can express. All my heartfelt gratitude to Sofía Milena Rabaté for her translations and guidance with syntax and diction but above all for her kindness at a challenging time. Writing a book while actively engaged in my psychoanalytic practice was a demanding endeavor; without her good spirit and forgiveness, it would not have been completed.

Earlier versions of sections of Chapters 5, 6, and 7 were published as “Psychoanalysis Needs a Sex Change,” Gay & Lesbian Issues and Psychology Review, Vol. 7, No. 1, 2011. Sections from Chapters 8 and 9 were included in “How to Be a More Perfect Hysteric,” European Journal of Psychoanalysis, No. 3, 2015. Short sections of Chapter 9 appeared in “Lacan’s Hysterization of the Unconscious: From Simulation to Stimulation,” Analysis, No. 15, 2009 and “Where Have the Hysterics Gone? Lacan’s Reinvention of Hysteria,” ESC English Studies in Canada 40, no. 1 (March 2014): 47–70. Passages from Chapter 16 were published in “The Art of the Symptom: Body, Writing, and Sex-Change,” in A Concise Companion to Psychoanalysis, Literature and Culture, edited by Laura Marcus and Ankhi Mukherjee, Wiley Blackwell, Oxford, 2014. Sections from Chapter 16 were part of “El Escato-Logos de Freud. Mojones de cultura,” in Freud: A cien años de Totem y Tabú. 1913–2013, edited by Nestor Braunstein, Betty Fuks and Carina Basualdo, Siglo XXI, Mexico, 2013. Parts of Chapter 17 were included in “Clinique du clinamen, matiere et manienre du nouage transsexuel,” Savoir et Clinique: Revue de psychanalyse, No. 16, 2013, “Jacques Lacan, materialiste.” A passage from Chapter 19 appeared in “Born This Way: l’Amérique à l’épreuve du transgenre,” in Genre et psychanalyse; La différence des sexes en question, edited by Jean-Jacques Rassial and Fanny Chevalier, Eres, Toulouse, 2016. All those sections have been extensively revised for inclusion in this book. I thank the editors of these publications for permission to use this material.

Every effort has been made to contact the copyright holders for their permission to reprint selections of this book. The publishers would be grateful to hear from any copyright holder who is not here acknowledged and we will undertake to rectify any errors or omissions in future editions of this book.

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INTRODUCTION

In 2010, inspired by my clinical practice, I published a book about transgender people titled Please Select Your Gender: From the Invention of Hysteria to the Democratizing of Transgenderism. This was before Caitlyn Jenner came out as a transgender woman amidst an outpouring of support, and soon after received the ESPY’s Arthur Ashe Courage Award. Before the actress Laverne Cox, from the Netflix original series, Orange Is the New Black, was named by TIME magazine one of the 100 most influential people in the world and became the first transgender woman nominated for an Emmy award. And before even the personal care behemoth Johnson & Johnson would choose trans teenager Jazz Jennings for Clean & Clear’s #SeeTheRealMe campaign.

There has been a whirlwind of mainstream transgender activity. Not a day passes without a transgender-related event on the news. Given this steady progression, the word transgender has experienced a “meteoric rise” and reached its threshold in popular culture; it has become an everyday term.¹ Not all has been glamour and exposure. With shows like Transparent, a new precedent has been set in the way the stories of trans people are presented in popular culture, not only by integrating the trans community into the development of the series, but also by depicting transgender people leading ordinary lives. This award-winning online series was the first to have a nuanced, richly drawn transgender character as protagonist, and even though its main character was played by a cis (non-trans) actor, it involved transgender persons in its production.

We are living a “transgender moment” (CNN, The New York Times), a “trans revolution” (Self magazine, Out magazine), a “transgender tipping point” (TIME magazine) as headlines in the United States have called it. It is America’s “new civil rights frontier” and psychoanalysts might have a role to play in it. When I began working on transgender issues, I had not foreseen then that I would be riding a wave that has swept away everything else in pop culture’s imagination and also engulfed most psychiatric and psychoanalytic practices; psychoanalysts started questioning the classical approaches to gender and sexuality. One only hopes that such transgender visibility will help propel the transgender fight for equality. This new dimension could be very promising for those identifying in the transgender spectrum. It is about time for the mass media to abandon the sensationalist tone of talk show reveals, and the fixation on absurd, intrusive questions about genitalia, and thus start a serious discussion about issues like oppression, discrimination, and violence. The present book aims at assessing the gains, the new trends, and the concepts necessary in understanding what has happened in such a short period. In this book, I explore various experiences of embodiment to show how they modify the construction of identity at the sexual, social, and racial levels.

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The moment is now

This is a unique moment for psychoanalysis because the psychoanalyst—at least in the Lacanian definition of the term—is in a privileged position to offer an ethics of choice and subjective responsibility. There is a growing interest in the works of Jacques Lacan among clinicians of other theoretical persuasions. The contributions of the so-called French Freud are no longer seen as doctrinaire—pure speculation divorced from the practice—but begin to appear as helpful when working with patients. Could it be that today’s psychoanalysts are no longer as afraid of Lacan as they were yesterday? Are they not more afraid of sexual and gender non-conformity?

There is no doubt that the transgender moment is changing our notions of gender, sex, and sexual identity. This evolution can reorient psychoanalytic practice. Historically, psychoanalysts have taken a normative position by reading transsexuality as a sign of pathology. Nothing could be further from what one learns in the clinic about sexuality. Psychoanalysis needs sex realignment, and the time is now.

At the precise moment the transgender moment reached a climax in media visibility, at the time of the televised revelation of Caitlyn Jenner’s gender transition, I was interviewed by Edward Helmore, a journalist from The Guardian. He wanted to talk with a psychoanalyst with experience on trans issues since there was concern among the trans community that Jenner’s revelation was a publicity stunt that would only “offer distortion and spectacle to the attention-seeking dysfunction presented by reality-TV’s first family.”²

Jenner was known to younger generations as Bruce, an athlete and motivational speaker, the father of supermodel Kendall Jenner and television personality Kylie Jenner, stepfather of Kim Kardashian, and ex-husband of the matriarch of the popular reality-TV clan, Kris Kardashian. To older ones he was known as a masculine role model who had set a world record in winning gold in the decathlon at the 1976 Olympics. In an exclusive television interview with Diane Sawyer awaited with great anticipation, Jenner revealed that “for all intents and purposes, I am a woman.”

p.3

Jenner also told the over twenty million viewers that while filming the family’s reality show—425 episodes over almost eight years—the only real story was the one she kept untold: “I had the story! . . . [T]he one real true story in the family, was the one I was hiding and nobody knew about . . . and I couldn’t tell that story.” To tell or not to tell, that is the question.

Jenner perhaps broke the protocol of reality shows by being truthful, and the 20/20 television interview was careful not to trivialize the announcement while still making public what is often a very private process, full of unknown factors. During the conversation with Sawyer, Jenner said that she “dreamt as a woman” and had a “female soul,” but at the time, she asked to be identified as “he” or “him.” I speculated that it was because Jenner was possibly still in the early stages of a long and slow transitioning process. I was wrong. The process moved forward very quickly thereafter. Less than three months later, on the cover of the July 2015 Vanity Fair under the banner “Call me Caitlyn,” Jenner appeared completely transformed into a 1950s pin-up beauty, in a satin one-piece bathing suit. She was a silver-screen goddess with long, flowing brunette hair, and a stunning face.

The transformation from male sex symbol to a femme fatale brought the former champion more fame than winning an Olympic gold medal. She became the first global celebrity to come out as transgender and shine, showing that coming out as a trans person did not mean living like a pariah. Quite the contrary: all records of popularity on the social network Twitter were broken the day Caitlyn Jenner made her debut in the public eye, unseating President Obama’s presidential mark as the fastest growing Twitter account. Her ascending popularity was consolidated by the reality-TV series I Am Cait. The documentary series included the participation of several trans activists, who offered a more politically nuanced counterpoint to Jenner’s conservative position as a right-wing Republican, in an attempt to use the show as a platform to educate the public on issues affecting the transgender community, such as suicide, discrimination, and violence.

Transitions

Transgender visibility has made evident that the community is very diverse. “Trans” is an umbrella term that applies to genderqueer people, to male-to-female and female-to-male transsexuals, to gender non-conforming folk, to drag queens and drag kings, to cross-dressers, to a large range of people who do not identify with the sex assigned on their birth certificate, and to everyone else in-between the sex binary. Trans people experiences may force us not just to re-evaluate our notions of gender, but also to reconsider how we think about other forms of difference as it unravels identity as a construction. Take a look at this example: Just two weeks after the very public gender transition of Caitlyn Jenner in the summer of 2015, Rachel Dolezal, the president of the Spokane branch of the National Association for the Advancement of Colored People (NAACP), who identified as a black woman despite being “outed” as white by her parents, found herself at the center of a controversy surrounding her race. The internet immediately exploded with comparisons to Caitlyn Jenner. Dolezal described herself as “trans-racial” and shared that she personally identified with Jenner.

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While some were offended by Dolezal’s passing as African-American and found the comparison insulting, accusing Dolezal of intentionally trying to deceive, of taking advantage of black suffering to play the victim in an offensive “cultural theft” paramount to “blackface,” others were supportive, appreciative of her activism in racial justice causes, and argued that both gender and race are social constructs. Her puzzling story sparked a heated discussion about identity, race, and gender. Is race a fixed biological fact like hair type or skin color, recognizable to the naked eye, a natural determination that cannot be changed at will? Or like gender, could it be manipulated or even changed according to a lived inner experience?

Many were upset because they thought that Dolezal misrepresented her true identity. Can one distinguish between a given identity and the authenticity of a sense of one’s self? When Jenner referred vaguely to a female brain in a male body to explain her transition, she was praised for daring to become her true self.

In the midst of the uproar, the prevailing opinion was that like gender, race is a social, cultural construct with no biological basis (genetic differences, for instance, are not consistent across racial lines). So why was Dolezal called a liar and a fraud, a “race faker”? Why, while arguing that the idea of race is a product of racism, did Dolezal insist on being recognized as black?

The views pertaining to gender were even more divided and contradictory. Some of the objections to Jenner’s transition implied a belief that gender is biologically based and cannot be changed at will: Jenner was born a man and would always remain one. Ironically, for those supporting Jenner’s observation that all along she had a “female brain,” the validating argument also located gender in the flesh, not between the legs but higher up, between the ears. In the multiple reverberations of the debate around Rachel Dolezal, the question that was left unanswered was how gender identity can be true while a racial identity is deemed to be fraudulent. This case exposed the tensions in identity politics between notions of choice and self-fashioning, on the one hand, and essence and nature on the other. The transgender experience, a movement that unravels identity as a construction, can help us rethink race and ethnicity, highlighting their ideological determinations.

In the Dolezal versus Jenner debate, gender and race were paired, forcing us to confront the purported immutability of race versus the fluidity and artificiality of gender, a paradox noted by the sociologist Rogers Brubaker, who writes: “while sex has a much deeper biological basis than race, choosing or changing one’s sex or gender is more widely accepted than choosing or changing one’s race.” ³ Brubaker welcomes the Jenner and Dolezal controversy as an opportunity for reflecting with great political potential. In Brubaker’s view, this polemic marked the arrival of a new “trans moment” in which we are “no longer thinking about trans” but rather we are “thinking with trans.”⁴ This can be seen as an indicator of a new trend: Susan Stryker remarked that transgender narratives were used as a cultural model to explore “other kinds of bodily transformations that similarly pose problems regarding the social classifications of persons.”⁵ This new paradigm allows us to use the transgender experience to think in new ways about the fluidity of racial identifications. As Brubaker notes, gender transition is not just a movement between categories; it also offers news positions between and beyond existing categories. In that sense, the transgender experience unsettles identity while it highlights the plasticity, contingency, and arbitrariness of categories like race or gender.

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Fact follows fiction. Rachel Dolezal’s unusual story had been anticipated by Jess Row’s 2014 book, Your Face in Mine.⁶ In this novel, Martin Wilkinson, born Lipkin and Jewish, pays a fortune to have a surgical procedure that transforms him from white to black. The diagnosis that Martin gives to his condition is “Racial Identity Dysphoria Syndrome,” a racial identity problem that can be treated and cured. Martin compares himself to a transsexual—he was born the wrong race. This race can be modified at will and traded in a new market of identity metamorphoses.

The imaginary reality proposed in Your Face in Mine is disturbing because it offers a caricature of the American belief in technology and self-reinvention; this belief converts race into a commodity, a personal choice available to those who can afford it. This novel addresses the intricacies and even the preposterousness of racial and gender categories while drawing attention to the social injustice inherent in the liberal, consumeristic dream of self-invention.

Like race in Your Face in Mine, sex change is often reduced to a consumerist lifestyle choice, comparable to changing diet and becoming vegan, or moving from a suburban community into an urban setting. As Jennifer Finney Boylan’s writes in She’s Not There: A Life in Two Genders, this is exactly what the trans experience is not: “it’s emphatically not a ‘lifestyle,’ any more than being male or female is a lifestyle.”⁷ This is my main contention in this book: being trans is not an experience of “having” but a strategy of “being.” As my clinical experience has taught me and as we will see in these pages, transitioning is more often than not a matter of life or death.

The epigraph of Your Face in Mine—“And I suggest this: that in order to learn your name, you are going to have to learn mine”—is taken from the book Conversations with James Baldwin.⁸ In the section of the conversation from which the quote was taken, James Baldwin says: “In a way, the American Negro is the key figure in this country; and if you don’t face him, you will never face anything.”⁹ With his call to “face it,” Baldwin was trying to make the white readership distinguish and understand the experience of being black in America. Paraphrasing Baldwin, we might say that Your Face in Mine wants us to face something we might not want to, but which if we do not, we may never be able to face anything.

In Your Face in Mine, one of the main characters is, not a black man, but a white man who has undergone “racial reassignment”—a man in blackface, perhaps? I find revealing the recurrence of the notion of “face,” as it calls up the fact that the face plays the most important role as a body marker for gender attribution, as I have argued in Please Select Your Gender. In most social interactions, we see each other’s faces, not each other’s genitalia. Emmanuel Levinas suggested as much when he defined ethics as the rapport of two faces.¹⁰ Such a phenomenological approach conceptualizes the face as a structure. What distinguishes those who have changed genders, though, is that the almost infinite distance between one face and the other can be crossed within one single person.

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The word “transgender” has entered everyday language, and we are now using the term “cisgender” more and more. The trans experience is becoming more widely accepted, challenging traditional ways of looking at gender embodiment and identity in general. America might be fascinated by trans issues, but we have not fully assessed the repercussions that the trans moment is bringing in the unsettling of not just sexual and gender identities but also those connected to race and ethnicity. In Chapter 1, “Transamerica,” I survey the consequences of the sudden visibility of the transgender movement in America by assessing the media representations of the transgender experience, which often appears to be in dissonance with what I hear in my practice from analysands who identify as trans. The trans body has become a social barometer for the politics of difference. I look at the gradual but increasing erasure of markers of sexual difference in today’s society, seeing a general movement towards more gender fluidity. Lacan’s most radical political intervention is his theory of sexuality, which introduced a separation of the phallus, as an instrument, from the penis, as an organ, clarifying the distinction between sexuality (he called it sexual difference or sexuation), anatomical sex, and symbolically constructed gender. Chapters 2 to 5, “Depathologizing trans,” “Gender in the blender,” “Bring sex back,” and “Strange bedfellows: Psychoanalysis and sexology,” all assess the notorious neglect of sexuality in contemporary relational psychoanalysis, while examining the controversial yet central role of sex-change theory for psychoanalysis, in particular the crucial part played by psychoanalysis in the history of transsexualism. This is an urgent matter given the changes taking place in society and the growing influx in our practices of analysands who identify as trans or outside the gender binary. The close connection between psychoanalysis and sexology is a lost chapter in the history of both fields. Indeed, the pioneer sexologist and activist Magnus Hirschfeld was among the founders of the Berlin Psychoanalytic Society. Hirschfeld was appreciated by Freud, although rejected by Jung. It is time to historicize and theorize the loaded connection between sexologists and psychoanalysts. Prejudice has prevented collaboration. Sexology and psychoanalysis took divergent, even opposed paths. Despite these tensions, the sexology of transsexualism has remained closely connected to psychoanalysis. This section of the book calls for a more fruitful dialogue between psychoanalysis and the clinic of transsexualism, exploring the way in which both fields meet and enrich each other.

Since we know that notions of gender and pathology are culturally determined, it is crucial to contextualize the historical exploration of transsexualism and offer a genealogy of the nomenclature. This will show that the discussion has tended to remain in the domain of the pathological through an opposition with non-Western cultures where loopholes have been invented for the legitimate expression of trans identities. Chapter 6, “Changing sex, changing psychoanalysis,” and Chapter 7, “A natural experiment,” analyze a number of groundbreaking psychoanalytic case studies that could be considered canonical but have been neglected in the literature. We will meet Elsa B, a 34-year-old woman who started an analysis with Emil Gutheil in the early 1920s in order to obtain permission to wear male clothing in public. I move on to discuss the important contributions of Wilhelm Stekel, Gutheil, David Caudwell, Robert Stoller, and Harry Benjamin, among others, all of which illustrate the complex position of psychoanalysis in the context of the then emerging clinic of sex change.

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I continue this survey of clinical examples and theoretical constructions about gender variance with a contrast: on the one hand, Karl Abraham’s case of “E,” a man diagnosed as hysteric, who wanted to be a woman and ended up becoming one but in a sort of trance; on the other, Lacan’s early approaches to hysteria and his rejection of Joseph Babinski’s claims about hypnotic suggestion in the treatment of a war-traumatized woman who refused to walk straight. I then explore the clinical advantages of using the model of hysteria to investigate gender variance, since, after all, the questions “What am I?” and “Am I a man or a woman?” were brought to psychoanalysis by hysteric patients like Dora, whose “virile disposition” is revisited and reassessed through the trans lens. Hysterical gender uncertainty exposes the psychic hesitations caused by living in a body that is sexed and mortal, expressing a universal foundation of sexual uncertainty for all speaking subjects, cis and trans.

Chapter 9, “Simulation, expression, and truth,” starts from Lacan’s lifelong engagement with hysteria, from his inauspicious point of departure as a follower of Babinski to his later depathologization and generalization of the term, when he took it as a form of social discourse. Lacan’s early work with hysterics like Freud’s Dora shows that he progressively incorporated the Freudian ideas until he reformulated them via his own philosophical concepts with the help of Hegel and Kojève. Finally, in the 1970s, Lacan’s theoretical program aiming at differentiating and describing discourses transforms hysteria into a powerful tool for the production of truth.

Chapter 10, “The sweet science of transition,” will discuss the clinical and political advantages of the use of hysteria in the consideration of non-confirming gender expressions. From Paul Preciado’s Testo Junkie to my case of Leslie, an adolescent athlete who identifies as a trans man, I engage with recent controversies on the determination of the “true” gender of athletes as well as raising the idea of whether there is identity outside of sex.

Chapter 11, “The singular universality of trans,” and Chapter 12, “Portraits in a two-way mirror,” return to case studies. I explore two examples of trans patients treated by Lacan that reveal an innovative ethics of sexual difference as well as the lineaments of a new theory of sexual difference. I juxtapose several clinical examples from my practice, like those of Melissa and Amanda, in order to assess the limits of the Oedipal model. This allows me to problematize the notion of castration and argue that transgender issues are relevant beyond the confines of the pathologization of trans experiences, and can thus be universalized.

p.8

In Chapter 13, “Plastic sex, the beauty of it,” I introduce the concept of “plasticity” as it has been considered in theorists ranging from G. W. Hegel to Catherine Malabou, to show that the search for a beautiful body transcending sex and gender as exemplified by Candy Darling, one of Andy Warhol’s favorite icons, has paved the way for the current staging of the trans moment. This model, oscillating between a camp femininity and an androgynous body, reveals a deeper change in our aesthetics of everyday life. I refer to a clinical vignette in which plasticity offers a creative solution to how to live with the death drive. I conclude this Chapter by examining the work of innovative video artist Ryan Trecartin, whose artwork is a good example of how plasticity frees sexuality from the constraints of the phallus, as sociologist Anthony Giddens proposes, and turns into a joyous, even riotous celebration of gender variance beyond the limitations imposed by binaries.

Chapter 14, “That obscure object: From beauty to excrement,” takes as a point of departure the case most often written about in the psychiatric and psychoanalytic literature, the famous story of President Daniel Paul Schreber, a man who thought that he was becoming a woman because God wanted to copulate with him so as to recreate the human race. Schreber was also concerned with the beauty of his transformation. Lacan’s approach to the case takes some distance from Freud’s hypothesis of repressed homosexuality and points instead to the dimension of transsexual enjoyment displayed on each page of his memoirs. Lacan is attentive to Schreber’s apprehensive and simultaneously voluptuous approach to defecation. He notes the curious role played by beauty and aesthetics in Schreber’s transsexual delusion. In Schreber’s delirium, the most repulsive excrement co-exists with the most beautiful image. This calls up Freud’s consistent equation in the unconscious of feces, replaced by money or gifts, and babies, a theme I elaborate upon in Chapter 15, “Freud’s scatalog.” If the relation between “baby,” “penis,” and “excrement” is at stake in Schreber’s case, we need to link such a symbolic lability with the movement of the drive. Because of its mobility, Lacan extends the concept of the object of the drive with his notion of the object a, further developed in this Chapter. This special psychical object commemorates loss but is not the end point of desire: it is its primal mover. Objects represent this original forever lost object and enter into a relationship of equivalence, or interchangeability. This is why Freud was fascinated by a catalog of excremental rites, John Bourke’s Scatalogic Rites of All Nations, a rarely mentioned book that I will explore. This Chapter tackles Freud’s use of mythology, which adds a twist to his use of the myth of Oedipus. Can psychoanalysis talk about sexual difference without a direct reference to the Oedipus complex and the contested notion of “phallus”? Lacan did not hesitate to go beyond the Oedipus complex when he proposed a new form of the symptom that he called “sinthome.” This notion will be further unpacked in Chapter 16, “The art of artifice,” and find clinical applications in Chapter 17, “Clinic of the clinamen,” and Chapter 18, “Making life livable.”

Thanks to the “sinthome,” we can rethink sexual difference without the notion of phallus. This last section of Transgender Psychoanalysis proposes that we should no longer think of the symptom as something to decode, as the carrier of a repressed message (a signifier) to be deciphered by reference to the unconscious “structured like a language,” but as the trace of the unique way someone enjoys his or her unconscious. Thus we move beyond the confines of the pathological and witness an act of creation. The symptom renamed by Lacan as “sinthome” can be defined as a singular invention allowing someone to live. This new definition of the symptom has important consequences for a positive ending of analysis in cases of analysands who identify as trans. In my practice, I take the “sinthome” as a variation on the “clinamen,” the “swerve” of atoms describes by Lucretius and the early materialists. I attempt to develop a clinic of the clinamen, which will function as an extension of Lacan’s theory of the sinthome. I highlight its practical advantages with the clinical example of the analysis of Jay. I compare this vignette from my practice with the work of a transgender artist, Swift Shuker, for whom bodily transformation is a reconciliation with life.

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The transgender experience illustrates the challenges of assuming a different or transformed body. This trajectory could become an artistic endeavor, a body of work. Then, an art similar to that of actual artists is to be found in transsexual artificiality. My clinical work with analysands who have changed sex has revealed a very peculiar relation to their bodies. Often, it is as if the imaginary consistency of their bodies had vanished like an open envelope, letting its contents fall. This issue is further disentangled in Chapter 19, “Body trouble,” where I explore how the practices of trans persons send us toward a “body written” that corresponds to Lacan’s elaboration—thanks to James Joyce—of the notion of the “sinthome,” a new kind of symptom that does not need to be removed or cured. Often, gender transition is explained as an identity kept by the brain in dissonance with the rest of the body. I will follow Lady Gaga’s lead when she sings about “Being born this way,” whose lyrics assert both an absolute freedom of choice and an apparent bodily determination. All this is not, however, a mere artistic production. My clinical experience has shown me that gender transition is more often than not an issue of life or death. In the coda, “Phallus interruptus, or the snakes’ lesson,” I assess the meaning and repercussions of following Lacan’s lead when he says that Tiresias, the mythical man-woman who was also a seer, should be a role model for all psychoanalysts, indeed the very patron saint of psychoanalysis.

Notes

  1    See Susan Stryker and Aren Z. Aizura, introduction to The Transgender Studies Reader 2, ed. Susan Stryker and Aren Z. Aizura (New York: Routledge, 2013), 2.

  2    Edward Helmore, “Bruce Jenner Throws Focus on America’s ‘New Civil Rights Frontier,’” The Guardian, last modified April 25, 2015, https://www.theguardian.com/society/2015/apr/25/bruce-jenner-kardashians-transgender-interview-civil-rights.

  3    Rogers Brubaker, Trans: Gender and Race in an Age of Unsettled Identities (Princeton: Princeton University Press, 2016), back matter.

  4    Ibid., 71. Italics original.

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  5    Ibid., 4.

  6    See Jess Row, Your Face in Mine (New York: Riverhead Books, 2014).

  7    Jennifer Finney Boylan, She’s Not There: A Life in Two Genders (New York: Broadway Books, 2003), 22.

  8    Row, Your Face in Mine, 1.

  9    James Baldwin, Conversations with James Baldwin, ed. Fred L. Standley and Louis H. Pratt (Jackson: University Press of Mississippi, 1989), 16. Italics original.

10    See Emmanuel Levinas, Totality and Infinity: An Essay on Exteriority, trans. Alphonso Lingis (Pittsburgh: Duquesne University Press, 1985), 85.

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1

TRANSAMERICA

Despite the tendency to sensationalize the trans experience, Americans’ perceptions of transgender people have been positively influenced by the increasing media presence of complex figures such as Caitlyn Jenner. As a recent survey from the Public Religion Research Institute (PRRI) showed, about two-thirds of today’s American population is relatively well informed about transgender people and issues, having a good understanding of what the term “transgender” means. Another recent survey from the Human Rights Campaign indicates that 22 percent of Americans know or personally work with a transgender person. This increasing awareness may have contributed to the fact that an overwhelming majority (89%) favors legal protection and equal rights for transgender people. In 2015, President Obama became the first president to use the word “transgender” in a State of the Union address. In doing so, he publicly recognized the transgender community while pushing for its protection against discrimination.

The American population, however, is still divided over whether transgender people should use the public restroom that corresponds to their gender identity. The need to establish sex-segregated public restrooms was discussed by Lacan in a 1957 essay where he called it “urinary segregation,” noting that “public life [is] subject [to] laws of urinary segregation.”¹ While Lacan was at the time discussing how language sets up sexual difference as an impasse, he had also foreseen the recent controversy when he observed that public life is subjected to the inequalities of “urinary segregation.” Lacan illustrated it with an anecdote of transit. Perhaps it can be read today as a journey of transition: A brother and sister take a train journey, sitting across from each other in the compartment. When they pull in to the station, they look at the platform from their window, and the boy exclaims: “We have arrived at Ladies!” while the girl states: “You, idiot! Can’t you see we are at Gentlemen?” As Lacan noted, it seems impossible that they would reach an agreement: “Gentlemen and Ladies will henceforth be two homelands toward which each of their souls will be all the more impossible for them to reach an agreement since, being in fact the same homeland, neither can give ground regarding the one’s unsurpassed excellence without detracting from the other’s glory.”²

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The binary order by which public restrooms are divided creates two mutually exclusive positions. Both boy and girl position themselves differently in relationship to identical doors. Only the signs make them different. Neither child has actually arrived at Ladies or at Gentlemen, as they believe. Both siblings are wrong, and based on their skewed perspective they will have to make a choice. Every time anyone uses a public restroom, one is forced to make a gender decision—choosing the world of men or women. But for folks who express their gender in non-normative ways, the choice of a public restroom could be quite a challenge, going from being a source of anxiety to creating a dangerous situation.

In recent debates about public restroom access, those who opposed the so-called bathroom law used arguments about religious liberty that soon turned into a public safety concern, successfully moving the debate away from the realm of civil rights—opponents argued that the law could allow sexual predators to access restrooms in disguise. The irony is that the topic under discussion was a basic civil rights protection intended to make everyday life safer for gay and transgender individuals.

Not without conflict, awareness is increasing, and as a society we are collectively learning to be more accepting of transgender individuals. A great deal has changed with the progressively increasing cultural and political mainstreaming of transgender identity, but much more yet needs to change. After a protracted discussion, the military lifted its ban on transgender personnel. As the quest for equality gains traction, the discussion is not about whether gender reassignment is acceptable but about whether to start gender transition during childhood.

Transgender lives are made visible not just by the “tipping point” appearance of Laverne Cox as the cover girl of TIME magazine, but also by the presence of two transgender artists in the 2014 Whitney Biennial, Rhys Ernst and Zackary Drucker, long time collaborators, who currently are also associate producers and consultants on the TV series Transparent. Not only did a major American art institution prominently feature two openly transgender life-and-art partners, but one of the main works displayed in the exhibition was a photographic diary of their gender transition, recently published as a book titled Relationship. It documents the evolution of Drucker, a trans woman, from male to female, and of Ernst, a trans man, from female to male. They met not long after they had both started taking hormones: testosterone injections for Ernst and “the slow incline” of hormone replacement therapy for Drucker—testosterone blockers, estrogen pills, and finally injections. They got together while still in the midst of “the unflattering throes of yet another puberty.” ³

The equivocal narrative tangles and untangles gender identity as a construction. Their “auto ethnography and bona fide aesthetic intent,” in the words of Maggie Nelson, shows them in love while capturing not just their relationship as a couple, but their relationship with their evolving genders, with their sexualities, and above all with their changing bodies in all their “bewildered singularity.”⁴ They write, “If our greatest art work is the way we live our lives, then a relationship is the ultimate collaboration.”⁵ The transsexual body as a work of art is an issue I will explore at length in Chapters 16, 17, and 18.

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The trans body is also a social barometer. Drucker’s own description of their six-year trans/trans “life collaboration” (the couple broke up in 2014) is illuminating: “Our bodies are a microcosm of the greater external world as it shifts to a more polymorphous spectrum of sexuality. We are all collectively morphing and transforming together, and this is just one story of an opposite-oriented transgender couple living in Los Angeles, the land of industrialized fantasy.”⁶ Can fantasy, which should be a very idiosyncratic, private, individual construct, be mass-produced? Drucker downplays the exceptionality of their case and makes it a symptom of a general historical drift, a swerve towards new forms of sexuality. Just as technology enables fantasy to become material, the combination of hormone treatments and surgical procedures effects a transition from one gender to another. According to Drucker, gender transition is turning into an industry, and the Drucker and Ernst story is just one among many.

This trend was anticipated in 1987 by French sociologist Jean Baudrillard who saw in transgenderism a new ideological horizon, “an artificial fate,” which he made out to be “not a deviation from the natural order” but rather “the product of a change in the symbolic order of sexual difference.”⁷ For Baudrillard, one of the unforeseen consequences of the sexual revolution of the 1960s was to erase traditional notions of sexual difference; this created gender uncertainty summed up by the basic hysteric question “Am I man or woman?”⁸ Baudrillard presented sexual liberation as having unleashed a certain hysterization, later rephrased as a more generalized hesitation about sexual identities in “a decisive stage in the journey towards transsexuality.”⁹ Overall, Baudrillard takes the figure of the transsexual metaphorically.

Like a car sent for repairs in a body shop, “we are in any case concerned with replacement parts, it is logical enough that our model of sexuality should have become transsexuality, and that transsexuality should have become the locus of seduction . . . we are all transsexuals symbolically,” as the body becomes a canvas for signs, less anatomical and more technological.¹⁰ Transsexuality is not seen by Baudrillard as radical and emancipatory, or even as a critique of the gender binary, but simply as simulation of difference, an “indifferent” simulacrum, a construction of a prosthetic body that leaves out the question of sexual enjoyment. Baudrillard acknowledges that the sexual revolution triggered indeterminacy, anxiety, and consumption, but also fostered choice, pluralism, and democracy. However, the political model does not work in matters of sexuality: “there simply is no democratic principle of sexuality. Sex is not part of human rights and there is no principle of emancipation of sexuality.”¹¹ This is precisely what trans patients have taught psychoanalysts: we cannot simply be postmodern and applaud the multiplication of groundless signs. Contrary to an argument such as that of Catherine Millot, most trans people are not trying to be outside sexual difference, but rather live trapped in it.

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Show and tell

Does the increasing visibility of transgender folk mean political empowerment? Does it make society safer for trans people? What will it look like when the apparent interest elicited by trans individuals goes beyond the obsessive and invasive curiosity about transgender issues, reducing this experience to issues of genitalia?

A well-known figure of the transgender rights movement can allow us to explore the predicament of transgender individuals in the increasingly intrusive public eye. When the journalist and activist Janet Mock published Redefining Realness: My Path to Womanhood, Identity, Love, and So Much More, a memoir of her transition as an impoverished multicultural person of color, her book was well-received and became a New York Times bestseller. Mock’s personal journey was challenging: she writes about how she encountered discrimination and engaged in sex work to save money for her reassignment surgery. Now, Mock is an established media presence, and hosts her own TV show. But her success story is not as simple as it sounds, nor is her relationship to the media.

What it is quite remarkable in Mock’s trajectory is that she initially was reluctant to come out publicly as a trans woman. As she writes, she feared “being ‘othered,’” that is, “reduced to just being trans.”¹² Mock wanted to distance herself from the pop-culture rendition of trans people as objects of pity or scorn. Mock expected that her professional accomplishments as a journalist would suffice to distance her from such stereotypes. According to her, there was a segment of the trans population that had never been known: these were the “real girls out there”; trans women who were vulnerable because they were “dismissed and dehumanized.”¹³ They were subject to violence and discrimination; their lives “stood at the intersections of race, gender, class, and sexuality.”¹⁴ Feeling that she was part of that group, Mock decided to tell her story to raise awareness. Mock has since become a major figure; she is a fierce advocate in the trans community who helped transform the image of transgender women in the media and empower trans women.

Mock came out publicly as a trans woman in 2011 in Marie Claire magazine. Yet the way she was portrayed contradicted the very message she wanted to spread. For starters, she was “misgendered,” since the article stated that she was born and raised as a boy. ¹⁵ Mock disagrees: “I was born in what doctors proclaim is a boy’s body. I had no choice in the assignment of my sex at birth. . . My genital reconstructive surgery did not make me a girl. I was always a girl.”¹⁶

Her definition of gender identity landed her at the center of controversies. Coinciding with the publication of her memoir, Redefining Realness, Mock was interviewed by Piers Morgan on the television network CNN. The interview ignited a Twitter feud between the two. While Morgan maintained that he had been supportive, she accused him of “sensationalizing” her instead of discussing important trans issues. For one, text displayed on the screen stated that Mock “was a boy until age 18” (although she identified as a woman at a much younger age) and Morgan referred to her as being “formerly a man.” After the show was aired their Twitter spat was ferocious. “Was a boy until 18 . . . get it the f*k together,” tweeted Janet Mock. Morgan replied with, “How would you feel if you found out the woman you are dating was formerly a man?” Mock objected, “I was not ‘formerly a man.’ Pls stop sensationalizing my life and misgendering trans women.” Piers Morgan tweeted in response, “A lot of very irate people accusing me of ‘transphobia’ because I devoted a third of my show to Janet Mock’s inspiring story. Weird.” He followed this with, “Very disappointed in Janet Mock’s tweets tonight. Deliberately, and falsely, fueling some sense of me being ‘transphobic.’ Unpleasant,” and, “I’ve never been subjected to the kind of nonsense that Janet Mock and her supporters are accusing me of now . . . wish I’d never booked her.” After getting dragged across Twitter over his comments, Morgan posted, “For the record, Janet Mock had no problem at the time with our interview—but now seems keen to score cheap points. Very disappointing.” It escalated to Morgan writing, “Being transgender doesn’t give you the right to slur, distort & ridicule someone who supports the issue 100%. Shame on you.” Finally, Morgan invited Mock back to his show to debate his “offensiveness” live on air: “Come back on my show again tonight, Janet Mock, and let’s debate my supposed ‘offensiveness’ live on air. #CNN.”

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In the media firestorm that followed this exchange, Morgan was so harshly criticized by the LGBTQ community that when Mock did return to the show, he asked her directly: “I want to learn why it is so offensive to say that you grew up as a boy and then, because you’ve always felt that you were female, you had surgery to become a woman—become a real woman, as you say in the book. Why is it offensive?”¹⁷

In her response, Mock made a powerful plea to change the manner in which trans bodies and trans lives are represented in mainstream media: “I think that we need to have a discussion about what gender is and gender expectations in our culture. I think that we are born and we’re assigned a sex at birth—none of us have control over [it]. But we do have control over our destinies and over our identities—and we should be respected. It’s not about the past, it’s not about what surgeries I may or may not have had, it’s not about how I disclose my gender to people—it’s about who I am right now.”¹⁸ As for her not correcting Morgan during the first interview, Mock clarified that if she had rectified every instance of misgendering, there would have been no time left to talk about poverty, unemployment, lack of healthcare, and violence against trans persons.

This spirit of semantic rectification compelled Mock to participate in a reversed version of the standard mainstream media interview—the usual procedure is that a trans person is repeatedly asked about genitalia. This time the tables were turned on the interviewer: Mock was the one asking the impertinent questions to television commentator and writer Alicia Menendez, whom she drilled with invasive questions such as “Do you have a vagina?” “Did you feel like a girl?” and “Who was the first person you told that you were cis?” Thus, Mock pretended to push Menendez to prove her gender as a cis-person. The interview went viral and offered a unique opportunity to discuss how trans people’s lives and bodies are represented in the media.

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The technique bears certain resemblances to the instance when actress Laverne Cox flawlessly shut down Katie Couric’s invasive questions about genitalia during a TV interview. Cox stopped Couric in her tracks, saying: “The preoccupation with transition and surgery objectifies trans people,” and turned Couric’s attention, and indeed ours, away from the stereotypes and toward the discrimination and the staggering rate of violence against trans people in the United States. “If we focus on transition, we don’t actually get to talk about those things.”¹⁹

Many transgender people want to become visible, being recognized and having their existences validated, but very few control how they are presented. Does visibility translate into change? For instance, the mounting speculation and excited curiosity about Jenner’s sex change falls within what Janet Mocks calls “a modern-day freak show.”²⁰ But like Jenner, who shared the news of her sex change on television, Mock herself could not escape the siren call of the press, and as we have seen, she came out publicly as a trans woman in an article published with the sensationalist headline, “I Was Born a Boy.” Why was it necessary for Mock and Jenner (both media savvy people) to make such a public disclosure and render themselves vulnerable to the manipulation of the media? For one, while exposure can be dangerous, it can also be financially profitable: both figures solidified their celebrity status and started their own TV shows.

But how realistic is what we see? What is shown is exceptional. By exceptional I am not referring to the dramatic, even spectacular results of current sex-change technologies that captivate audiences with “before” and “after” pictures and astound with how “real” the trans person looks in their gender. In fact, we should not be so surprised, or think that the technological transformation of the human body is something rare even when the results are fantastic: as Paul B. Preciado notes, someone like Caitlyn Jenner is simply using the same technologies “normal” (cis) women in the West have been regularly using since the 1950s—hormones (such as the pill for contraception or hormone replacement after menopause), plastic surgery, makeup.²¹ After a certain age, everyone with access to medical care might have artificial body parts—dental implants, hip or knee replacements, artificial lenses, pacemakers, plastic spinal discs, and so on. If we may all be becoming Freud’s “prosthetic God” or Donna Haraway’s cyborgs, why all this recent attention to the trans body, as if it were something new? Is it simply a search for trivial entertainment in a society of spectacle?

Transformations

Janet Mock and Laverne Cox are good examples of how the media tends to instrumentalize trans people and how difficult it is to shift a voyeuristic focus on aesthetics (how trans people look) to attention to trans experiences (how trans people live). As Mock writes: “My intent is that we truly transform the media’s framing of trans people’s lives and push producers of content to begin engaging in discourse not so much about what a trans body looks or feels like or how it’s transformed and evolved but rather why it’s unsafe to live in a body that is trans.”²² This confirms what I have called “the democratizing of transgenderism” in my previous book Please Select Your Gender. Transgenderism has indeed lost much of its stigma over the past decade or so, though perhaps little of its shock value. In spite of the increasing presence of transgender people in popular consciousness, transgender people still elicit a morbid fascination.

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The core of the distortion of the representation of the experiences of transgender individuals is the reduction of unique, singular stories to generalities, mere instances of a collective category. Working to transform the dehumanizing way trans people are presented in the media, as well as challenging the assumption that a universal trans experience exists, Mock is purposefully conscious of her public image, an image that combines intelligence with great looks. She is also “challenging our culture’s ideals of beauty” while revealing “how we devalue, dismiss, and demean people who are feminine on purpose.” Mock sees beauty and fashion as empowering tools: “For me, beauty culture and aesthetics is another avenue in which I can adorn my body and purposefully express myself.” Beauty affirms and expresses her identity as a trans woman. Mock asserts that “[m]y femininity was more than just adornments, they were extensions of me, enabling me to express myself and my identity. My body, my clothes, and my makeup are on purpose, just as I am on purpose.”²³ For Mock, fashion and beauty are not just aesthetic concerns but a creative activity with an ethical function; they are not simply an expression of identity but an affirmation of existence. This brings a different resonance to Caitlyn Jenner’s message to transgender youth: “We Are All Beautiful.” The most important word here is “are,” not “beautiful.” In Chapters 13 and 14 I will further develop the idea that beauty is more ethics than aesthetics; it is an affirmation of being.

Notes

  1    Jacques Lacan, “The Instance of the Letter in the Unconscious, or Reason Since Freud,” in Écrits: The First Complete Edition in English, trans. Bruce Fink (New York, London: Norton, 2006), 417.

  2    Ibid.

  3    Zackary Drucker and Rhys Ernst, Relationship (Munich, London, New York: Prestel, 2016), 11.

  4    Maggie Nelson, “Notes on a Visual Diary, Co-Authored,” in Relationship, 145, 146.

  5    Drucker and Ernst, Relationship, 10, 16.

  6    “Zachary Drucker and Rhys Ernst,” Whitney.org, accessed September 29, 2016, http://whitney.org/Exhibitions/2014Biennial/ZackaryDruckerAndRhysErnst.

  7    Jean Baudrillard, “We Are All Transsexuals Now,” in Screened Out, trans. Chris Turner (New York: Verso, 2002), 9.

  8    Ibid., 12.

  9    Ibid.

10    Jean Baudrillard, “Transsexuality,” in The Transparency of Evil: Essays on Extreme Phenomena, trans. James Benedict (New York: Verso, 1993), 20.

11    Baudrillard, “We Are All Transsexuals Now,” 13.

12    Janet Mock, Redefining Realness: My Path to Womanhood, Identity, Love, and So Much More (New York: Atria Books, 2014), xiv, xv.

13    Ibid., xv.

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14    Ibid.

15    Janet Mock, “‘More Than a Pretty Face’: Sharing My Journey to Womanhood,” Janet Mock (blog), May 7, 2011, http://janetmock.com/2011/05/17/janet-mock-comes-out-transgender-marie-claire/

16    Ibid.

17    Matthew Tharrett, “Why Is It So Offensive to Just Say That Transgender Women Grew Up as Boys?” Queerty.com, last modified February 6, 2014, https://www.queerty.com/why-is-it-so-offensive-to-just-say-that-transgender-women-grew-up-as-boys-20140206.

18    Ibid.

19    Fatima Bhojani, “Watch Katie Couric’s Offensive Attempt to Interview 2 Transgender TV Stars,” MotherJones.com, last modified January 7, 2014, http://www.motherjones.com/mixed-media/2014/01/katie-couric-transgender-laverne-cox.

20    Sunnivie Brydum, “Watch: Janet Mock Sounds Off on InTouch’s Bruce Jenner Cover,” Advocate.com, last modified January 16, 2015, http://www.advocate.com/politics/transgender/2015/01/16/watch-janet-mock-sounds-intouchs-bruce-jenner-cover.

21    Paul B. Preciado, “Pop Quiz: Paul B. Preciado on the Bruce Jenner Interview,” Artforum.com, last modified May 7, 2015, http://artforum.com/slant/id=52053.

22    Janet Mock, “Why I Asked Alicia Menendez About Her Vagina & Other Invasive Questions,” Janet Mock (blog), May 1, 2014, http://janetmock.com/2014/05/01/alicia-menendez-invasive-interview-demonstration/

23    Mock, Redefining Realness, 147.

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2

DEPATHOLOGIZING TRANS

While being relatable spokespersons, good-looking, wealthy celebrities like Caitlyn Jenner, Janet Mock, or Laverne Cox are far from representative. According to a widely quoted study, in 2011 there were 700,000 adults who identified as transgender in the United States.¹ By 2016, that number had doubled and the estimated size of the transgender adult community was assessed at 1.4 million, about 0.4 percent of the U.S. population, according to research of federal and state data out of the Williams Institute at the UCLA School of Law.² Current and precise demographic data on the transgender population could help expand formal recognition, legal protection, and access to health care, but this information is not available yet. Real figures might be difficult to access because many transgender individuals struggle in silence, secretly dealing with their gender trouble. Many suffer anonymously from discrimination and violence. Yet they do not seem as invisible as they were a decade ago. For those in the public eye, the spotlight seems more understanding and accepting than in any previous time. We may be more accepting today than ever before, but there is much that remains for us to learn.

There is no doubt that media exposure has positively impacted public opinion: we are not only becoming more accepting of trans people but we are learning about the fluidity and artificiality of gender (and race) while deconstructing identity as an immutable fact. However, this attention has not yet improved civil rights for all transgender individuals. One should not forget that the experiences of most transgender people are very different from those of Cox, Jenner, or even Mock who embody the fulfillment of the American Dream of self-improvement and class mobility. Many trans people are poor, some are homeless, and most suffer employment discrimination and continue to lead precarious lives, partly as the result of lagging legal protections. The rates of poverty, homelessness, unemployment, poor health, HIV infection, assault and incarceration are high for transgender people in general and exceptionally high for black transgender women.

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The published literature on transgender mental health suggests that transgender people experience a higher rate of mental disorder diagnoses than the rest of the population. Some have used these findings to contest medical transition. It is true that suicide rates for those who have identified as transgender are extremely high. A three-decade–long study in Sweden by the Karolinska Institute (from 1973 to 2003), one of the largest follow-up studies of transsexuals, has tracked trans people for an average of ten years after surgery and found that they were 19 times more likely to commit suicide and had three times the mortality rate than those in the cis (non-trans) population.³ In the United States, a 2010 study confirmed this pessimistic picture: 41 percent of those who identify as trans or gender non-conforming tried to commit suicide at least once—the percentage for the general population being 4.6 percent. Current care guidelines strongly advise those who want to transition to consult with a mental health professional in order to “ascertain the eligibility and readiness for hormone and surgical treatment.” This recommendation places at the center stage the professional in charge of the treatment, be it the psychoanalyst, psychiatrist or psychologist who will be called to play a complex and potentially controversial role as the specialist authorizing or vetoing the transition, an issue to which I will return, and also underscores the importance and urgency of providing better care for trans folk before and after reassignment.⁴

Another study of over a thousand male-to-female and female-to-male transgender persons (1,093 people, to be exact) found a high prevalence of clinical depression (44.1%), anxiety (33.2%), and somatization (27.5%). One of the main causes for their psychological distress was social stigma.⁵ This comprehensive study recommended an improved access to mental health and to social services.

“The only way I will rest in peace is if one day transgender people aren’t treated the way I was, they’re treated like humans,” wrote Leelah Alcorn, a 17-year-old from Ohio, before leaping to her death in front of a tractor-trailer.⁶ “Fix society. Please.”⁷ Until recently, no study had been able to identify the causes of such high rates of suicide among the trans community. Under the poignant title “Without This, I Would for Sure Already Be Dead,” a 2015 Canadian study from Western University in London, Ontario has identified social marginalization as a major risk factor.⁸ The study found that those with social support and access to personal identification documents, or who were completing a medical transition with hormones or surgeries, had marked reductions in suicide risk. Parental support for gender identity was also associated with markedly reduced suicidal ideation.

Not only is social support important to combat stigmatization; it is critical to keep in mind that being transgender is not a mental disorder or a psychiatric condition. According to a recent study, the main cause of distress and impairment among transgender people is precisely the classification of transgender identity as a mental disorder.⁹ The study, conducted in Mexico and currently being replicated in France, Brazil, India, Libya and South Africa, provides evidence that transgender identity is not a mental disorder and should not be classified as such. The presence of mental disorders among the trans population is not universal and mental distress is strongly related to experiences of stigmatization and violence rather than to gender incongruence. The study makes a convincing argument for the declassification of transgender identity as a mental disorder. In 2013, the American Psychiatric Association eliminated from its manual the diagnosis of “gender identity disorder” and replaced it with the less stigmatizing “gender dysphoria.”¹⁰ Nevertheless, the pathologization of non-normative expressions of gender and sexuality persists as a form of discrimination and violence. Since gender incongruence is not in itself a pathology, sex realignment should not be considered a cure or a treatment.

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Psychoanalysis is not a border patrol

For those who find that their birth certificate matches the gender that they identify with, now it is official. The word “cisgender” has made its formal entrance into several major English language dictionaries. Currently, the Merriam-Webster dictionary includes “cisgender” (“Someone whose internal sense of gender corresponds with the sex the person was identified as having at birth”) as also does the authoritative Oxford English Dictionary (“Designating a person whose sense of personal identity corresponds to the sex and gender assigned to him or her at birth”). While the word has been around in common parlance for almost two decades, the official inclusion of “cisgender” in the nomenclature is important in many ways.

Cisgender overcomes the trans/non-trans divide. It also questions the notion of what is normal in sexuality and sexual identity in a movement towards depathologizing gender variance and sexual non-conformity. For example, how universal is heterosexuality? How has it become the status quo? Not too long ago, homosexuality was considered an aberration, a deviation. As a result, nobody talked about “heterosexuals” because the assumption was that heterosexuality was the norm. Of course, this type of terminology is ideologically loaded, conveying culturally constructed ideas of norm and deviance. As Jonathan Ned Katz has shown in The Invention of Heterosexuality, until quite recently, 1923 to be exact, the term “heterosexuality” referred to a “morbid sexual passion”; its current usage was initially adapted to legitimate men and women having sex for pleasure.¹¹

Freud always questioned the idea of normalcy in human sexuality, highlighting a general erotic disposition towards perversion thus making deviance the norm. Similarly, cisgender acknowledges that gender is an internal sense for non-trans and trans people alike, and that like heterosexuality, cisgenderism is historically and culturally determined. It therefore should not be taken for granted as a natural destiny.

For those nostalgic for essentialist reassurances, cisgender might be as “natural” as a non-citizen becoming “naturalized.” The process of citizenship and the process of assuming a gender have parallels. Gender and nationality are declared at birth, without any effort or choice on the part of the individual. If one wishes to change either of them, the change involves a long and complex process dependent on approval by legal authorities. Both the rules of naturalization and for amending sexual designation in legal documents vary from country to country (for sex designation, the laws in the United States vary with each state’s jurisdiction, and at times each agency that issues identity documents has different requirements for changing name and gender markers, as well as a separate process for doing so.) “Naturalization” and “gender amendment” typically include specific requirements: a given time residing in the country or living in the gender of choice; demonstrable knowledge of the national dominant language or culture, or proof of having had sex reassignment surgery or clinically appropriate treatment for the purposes of gender transition. An oath or pledge of allegiance is also sometimes required. Often it is required to renounce any other citizenship that one currently holds, forbidding dual citizenship as well as gender indeterminacy.

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Lacan writes in the preface to the English translation of Seminar XI, The Four Fundamental Concepts of Psychoanalysis, “A certificate tells me that I was born. I repudiate this certificate: I am not a poet, but a poem. A poem that is being written, even if it looks like a subject.”¹² A birth certificate is an official document issued to record a person’s birth. It includes symbolic markers such as name, gender, date of birth, place of birth, and parentage; this vital data is determined in advance and we have little agency over it. A subject as a poem is another thing altogether. Since etymologically the word poem means “thing made or created,” Lacan’s remark makes us think of the subject as a creative invention, as a “making new.”

Indeed, a trans person requires a good dose of craft to successfully accomplish the transition. In the United States, most states allow name and sex changes on a birth certificate, either by amending the existing birth certificate or issuing a new one. But many U.S. states still require medical proof of “completed” sexual reassignment (surgery) in order to warrant a sex marker change. A name change used to be an almost impossible procedure in countries like France, whereas for those in the trans population, it entailed showing psychiatric evaluations, producing some proof of sex reassignment surgery, and undergoing forced sterilization. In a great victory for the rights of transgender people, in 2016 a bill was approved in France allowing anyone who demonstrates that their legal gender status does not match their lived gender to legally change their gender without surgery or forced sterilization, ending the long, uncertain, and humiliating procedures transgender people had to undergo in the past. In a pioneering gesture, already in 2012 Argentina became the world’s most trans-friendly legal environment. Under its pioneering gender identity law (Ley de identidad de género) trans people were permitted to change their legal gender and name in their documents without judicial permission or any requirement that they undergo surgeries.

There is a growing recognition of the fundamental rights of trans persons such that medicalization is no longer the gold standard in many countries. After Argentina, now countries such as Denmark, Malta, Colombia, France, Norway, and Ireland allow their citizens to determine their gender without medical certification or intervention. On the other end of the spectrum we might locate the paradoxical situation of Iran, an intriguing case in regards to transgender rights. The Islamic Republic of Iran, a country that criminalizes homosexuality and where women’s rights are severely restricted, has permitted and partially subsidized sex reassignment surgery since the mid-1980s; it also has the second highest number of gender reassignment surgeries worldwide, with only Thailand having more.¹³ This detour through the legal intricacies of naturalization and gender change of citizens can send us back to the old debate of nature versus nurture with a renewed perspective, as we see a promising trend towards giving priority to the lived experience of gender over medicalized body modifications.

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Psychoanalysis needs realignment

I write this book as a psychoanalyst aware that there may understandably be some reticence about psychoanalysis among the trans community. Psychoanalysis has a regrettable history of pathologizing non-normative genders and sexualities. I want to break away from this tradition. In my practice, I have not found evidence for the belief that all trans people are psychotic. I therefore argue for a depathologization of the trans experience and prefer to think of trans symptoms. Some people may ask why I call it a symptom. If we borrow from Lacan’s later theory of the sinthome, then a symptom is not seen the way the medical field thinks of symptoms, as a manifestation of disease that needs to be eliminated; rather, in using the archaic French spelling of the word symptom, the sinthome acquires a new meaning as it stands not for a pathology but for a sort of creative solution. For an analyst a symptom may be what you enjoy, as Slavoj Žižek argues, something that may allow you to exist in the world—in other words, your idiosyncratic, creative strategy of survival. In this sense, the journey between genders could be a creative symptom, a way of making life livable.

As practitioners, we have an ethical responsibility to take a more tolerant attitude to different, non-normative manifestations of sexuality, unconstrained by traditional gender roles. There is a lot we can learn about sex and gender from transgender that will help reorient the practice and improve it. As a clinician practicing in the United States, I distance myself from the stance historically taken by most Lacanian psychoanalysts of overlapping transgender with severe pathologies like psychosis. It also differs from usual Queer theory and doxa, and contravenes current popular ideas on sex and gender prevailing in American culture today.

Gender change is not a consumerist choice—you alter your diet, you stop smoking, or you change genders. This is an absurd media distortion, for as I learned in my practice, being trans is a consuming endeavor but not a consumer choice. It is all-consuming but not a commodity, even though, today, it is often presented as commodification. A gender is not a commodity, even though at times some people can afford a more successful embodiment due to their access to better medical care. The economic variable is there, the market rules apply, but, nevertheless, assuming a gendered body is not a consumer choice, but a pressing matter affecting the most intimate and private details of someone’s being.

What kind of choice are we talking about here? Lacan pushed Freud’s ideas further, positing that the assumption of human sexuality is a process in which each person makes a choice and adopts a sexual positioning that does not fully depend on anatomical differences (or even its psychic consequences) or on social conventions. Lacan invented the notion of “sexuation” to account for the unconscious sexual choice that this process entails. This is a choice which may or may not be constrained by the anatomical contours of our bodies that belong to a sex, and may or may not be determined by the way in which society inscribes each gender with rules, roles, and restrictions. The assumption of a sexual positioning is the result of dealing with sexual difference. This is a difference determined neither by sex (anatomy) nor by gender (social construction); it is a subjective, unconscious choice.

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Historically, the relationship of psychoanalysis and transsexuals has been a loaded one and trans people may have many reasons to continue distrusting psychoanalysis. If we consider that a great percentage of the trans population is actively involved in some form of talk therapy, the conflict with psychoanalysis is not for lack of interest in the process. According to a recent study, 75 percent of the transgender population is presently engaged in some form of talk therapy or has been in the past, with an additional 14 percent expressing the wish to seek talk therapy in the future. In comparison, only 3.18 percent of the general population in the United States participates in some form of psychotherapy.¹⁴

The access to treatment may be complicated by several factors. As we have seen, a mental health professional plays a central role in the process of gender realignment. Often in order to start receiving medical treatment for transition, a person might need one to two letters confirming that they are suitable candidates to be prescribed hormones or undergo surgery. The letters will attest that the medical transition would not adversely affect the mental health of the patient. This request interferes in the dynamic between analyst and analysand, potentially putting the psychoanalyst in the position of gate-keeper.

Even when this requirement might not be present, in both subtle and brutal ways, as we have seen, psychoanalysis has earned a bad reputation with its history of pathologization of non-normative sexualities and genders thus preventing the cure from proceeding in the most productive possible manner. Many analysts have been either threatened or puzzled by gender and sexuality variance and often have not managed to conceal their views, generating a regrettable homophobic and transphobic history. Tim Dean and Christopher Lane note that one of the greatest paradoxes in the annals of psychoanalysis is that, throughout the practice’s confrontation with gender variance, its institutions have in their development normalized moralistic and discriminatory practices that are antithetical to psychoanalytic concepts.¹⁵ This is unfortunate because psychoanalysis could make a valuable contribution to the field of transgender studies. The transphobic history of psychoanalysis is based on a selective reinterpretation of the Freudian texts or reductive distortions stemming from this homophobic and transphobic history. This is sad because psychoanalysis has much to offer, as long as it manages to divest itself of its normalizing and discriminatory history.

To listen to the unconscious truly is to deal with sex, sexual identity, and sexuality. Analytic work delves into the complex relationship between the body and the psyche, highlighting the precariousness of gender, the instability of the male-female opposition, and the fragility of sexual identification—the fissures of which reach back to Freudian psychoanalysis. As I discuss in Chapters 8 and 9, Freud observes in his account of the treatment of Dora, an 18-year-old hysteric, that the young woman adopted a peculiar attitude toward the married woman with whom her father was having an extramarital affair. Dora described her “‘adorable white body’ in accents more appropriate to a lover than to a defeated rival.”¹⁶ In fact, Dora’s interest in “the other woman” was sustained by the belief that her father’s mistress embodied the mystery of femininity—the kind of woman who could answer the question: “What is a woman?” In her unconscious, Dora was positioned as a man (like her father) and was trying to become a woman by loving a woman as a man would have. Dora’s predicament can be universalized, and psychoanalysts who follow Lacan’s insights often say that a hysteric is someone caught in a structure of indecision, someone who cannot know whether he or she is a man or woman.

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Provocative and counterintuitive as this theory sounds, nevertheless, I would be tempted to follow it, if only because in my practice, the hysterics whom I have treated found it exceedingly challenging to assume a position as man, woman, or anything else. The usual categories of sexual orientation make very little sense when we look at unconscious sexuality. Ultimately, analytic work compels us to confront the conundrum of sexual difference by calling attention to the uncertainties of sexuality and the challenges of making a sexual choice and assuming a sexual positioning. All these pivotal issues that analysts deal with on an everyday basis could have important implications for gender theorists and activists as well as transgender people, for they have the potential to enrich current debates about gender, sexuality, and identity.

Notes

  1    Gary G. Gates, “How Many People are Lesbian, Gay, Bisexual, and Transgender?”

UCLA School of Law, The Williams Institute, April 2011, http://williamsinstitute.law.ucla.edu/wp-content/uploads/Gates-How-Many-People-LGBT-Apr-2011.pdf.

  2    Jan Hoffman, “Estimate of U.S. Transgender Population Doubles to 1.4 Million Adults,” The New York Times, last modified June 30, 2016, http://www.nytimes.com/2016/07/01/health/transgender-population.html?_r=0.

  3    Cecilia Dhejne et al., “Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden,” PLoS ONE 6, no. 2 (February 22, 2011): e16885, doi:10.1371/journal.pone.0016885.

  4    See Ann P. Haas et al., “Suicide Attempts among Transgender and Gender Non-Conforming Adults,” UCLA School of Law, The Williams Institute, January 2014, http://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf.

  5    Walter O. Bockting et al. “Stigma, Mental Health, and Resilience in an Online Sample of the US Transgender Population,” American Journal of Public Health 103.5 (2013): 943–951. PMC. Web. 18 Oct. 2016.

  6    Ashley Fantz, “An Ohio Transgender Teen’s Suicide, A Mother’s Anguish,” CNN.com, last modified January 4, 2015, http://www.cnn.com/2014/12/31/us/ohio-transgender-teen-suicide/.

  7    J. Bryan Lowder, “Listen to Leelah Alcorn’s Final Words,” Slate, last modified December 31, 2014, http://www.slate.com/blogs/outward/2014/12/31/leelah_alcorn_transgender_teen_from_ohio_should_be_honored_in_death.html.

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  8    Greta R. Bauer et al., “Intervenable Factors Associated with Suicide Risk in Transgender Persons: A Respondent-Driven Sampling Study in Ontario, Canada,” BMC Public Health 15 (June 2, 2015): 525, doi: 10.1186/s12889-015-1867-2.

  9    See Rebeca Robles et al., “Removing Transgender Identity from the Classification of Mental Disorders: A Mexican Field Study for ICD-1,” The Lancet 3, no. 9 (September 2016): 850–859.

10    American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (Arlington: American Psychiatric Association, 2013), 451–459.

11    Jonathan N. Katz, The Invention of Heterosexuality (Chicago: Chicago University Press, 2007), 92.

12    Jacques Lacan, The Seminar of Jacques Lacan: The Four Fundamental Concepts of Psychoanalysis, ed. Jacques-Alain Miller and trans. Alan Sheridan (New York: Norton, 1981), viii.

13    For an authoritative, scholarly assessment of the complexity of transsexuality in Iran, see Afsaneh Najmabadi, Professing Selves: Transsexuality and Same-Sex Desire in Contemporary Iran (Durham: Duke University Press, 2014).

14    Jaime M. Grant et al., “Injustice at Every Turn: A Report of the National Transgender Discrimination Survey,” National Center for Transgender Equality and National Gay and Lesbian Task Force, Washington, DC, 2011, http://www.thetaskforce.org/static_html/downloads/reports/reports/ntds_full.pdf; Mark Olfson and Steven C. Marcus, “National Trends in Outpatient Psycho-therapy,” The American Journal of Psychiatry 167, no. 12 (December 2010): 1456–1463, http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2010.10040570.

15    See Tim Dean and Christopher Lane, eds, Homosexuality and Psychoanalysis (Chicago: University of Chicago Press, 2001).

16    Sigmund Freud, “Fragment of an Analysis of a Case of Hysteria (1905 [1901]),” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 7, ed. and trans. James Strachey (London: Hogarth Press, 1953), 61.

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3

GENDER IN THE BLENDER

“Why me? I’m not a woman. I wanted it to stop. It didn’t. I tried to live with it. I tried to forget. But I felt dead inside. I wanted out. You can’t change a man into a woman. You can’t hide who you really are. I tried to keep it down. I’m in my early 60s, I’ve got a wife, two grown kids, a good job. I should’ve been thinking about retirement.

I wanted to push it back. But I couldn’t.

I changed. Now, I live as me. Everything about me has changed and yet, I am more myself than I’ve ever been.”

This is what my analysand Jana shared during her initial session. She decided to consult a psychoanalyst while undergoing the first stages of transition from male to female. Jana was looking for a welcoming place where she could talk freely about her current situation, about her sexual identity—some “gender issues,” as she said. “I have never spoken to any professional about this, however I have become increasingly troubled by the prospect of not doing anything. I feel I have come to a point where I need to talk to someone.”

Abioye, a 19 year old who had been working with me for a while, opened his most recent session with a comment on how anatomy should not be destiny: “This is my bottom line—if someone says ‘I am a woman,’ or ‘I am a man,’ or simply ‘I am (whatever they think they are),’ please take that person seriously.” Abioye had made his first appointment a few months earlier because, as he explained, “I’ve been thinking about transitioning and wanted to first talk about it. I am ready to start hormone replacement therapy. I have always felt this way but had put it in the back of my head, thinking it was not normal. But I’ve made up my mind. Basically, I’ve come to accept myself. I was born a female but ever since I can remember I’ve always wanted to be a guy. I am ready to change.”

Both Jana and Abioye contacted me at a turning point in their lives. It was clear that something had radically changed for them. I realized that my position as a psychoanalyst had to change as well. We know that psychoanalysts and transgender people have a difficult history. Clinicians of the past have adopted condescending, moralistic attitudes and systematically relegated non-normative sexualities and gender variances to the terrain of stigma and pathology. Understandably, rejected and discriminated against, trans patients have maintained a very suspicious attitude toward psychoanalysis.

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“Why are you interested in transgender people?” I am often asked. The answer is simple: the analytic couch is a window. Through it we can see new things happening in society. If one maintains analytically alert ears, there is a lot to hear and discover. In my clinical practice as a psychoanalyst I let my patients guide me, and through them, I learn. I have been hearing the comments of my patients shift from an emphasis on questions of sexual choice (“Who do I like? Men or women?”) to questions of sexual identity (“Am I straight or bisexual?”). In contrast, I have noted that for patients whose bodies and beings did not align, the question was not about the certainty of their identity. Instead, they asked, “Why can’t I be loved for who I am?”

“So, are you a specialist in LGBTQ+ patients?” I have to confess that at times I am bothered by this question. As a psychoanalyst, one is never a specialist, in the sense that one should keep an open mind and refrain from limiting one’s scope. The key lies in analysis’s fundamental rule of free association. This refers to the invitation to say whatever comes to mind disregarding whether it is inconvenient, offensive, or inappropriate. It not only helps the analysand talk freely but also implies that the analyst is ready to listen without being judgmental or pushing a hidden agenda. One might say that the fundamental rule makes the analysand the only specialist in the consulting room. Expressing themselves unrestricted, analysands may say whatever they intend to say, but also more than they want to say, more than they think they know. In other words, this rule assumes that the analysands are the experts, possessing knowledge that is unknown to them because it lies in their unconscious, but can emerge during the cure. So, when I am asked whether I am an LGBTQ+ specialist, I answer, “I am not—my analysands are.” In spite of—or perhaps because of—that attitude, I see in my practice a great many gender non-conforming people.

Moving beyond the dichotomy of boy and girl

Rapid changes are taking place in the societal attitudes towards sex and gender, seen clearly on a consumerist level. Responding to the demands of a growing gender-fluid consumer base, major chain stores across the United States are getting rid of the boy/girl divide in their children’s sections. Gone is the pink and blue color partition in big-box store sections for toys, bedding, home decor, and entertainment. Gender neutrality is a selling point for Millennial parents now in their 20s and 30s and who are increasingly choosing unisex names like Hayden, Charlie, Emerson or River for their babies in an effort to raise their children with gender-neutral roles and identities, that is, blurring the traditional lines between boys and girls.

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For younger generations who have never known a life without the internet, like the cohort of 12- to 19 year olds of the Post-Millennial or Generation Z, the lines between male and female are becoming increasingly blurred. Boys can wear nail-polish; girls can ride skateboards. Gender is blended, no longer mandated by birth but rather by choice—or, to switch metaphors, I would say that the wall between the binary of the sexes has succumbed to the same fate as that of the Berlin Wall. We are still picking up its pieces and examining them. The transgender experience, which challenges traditional ways of thinking about sex and gender embodiment, is acquiring more and more visibility and losing its former exceptionality. There is an undeniable fascination in the media with daily stories about trans people. Is all this staging of a trans-presence making us more aware of the discrimination, inequality, and violence trans people continue to experience? Is the world changing? Or is it just an image?

As we have seen, gender mutability has entered the quotidian vernacular ever since the very public transition of Caitlyn Jenner. Reflecting this trend towards gender fluidity, the social networking website a while ago Facebook introduced an assortment of at least 56 gender options for its US users. Of course the selection moves away from the old-fashioned binary of male or female. Besides adding the option of keeping one’s gender private, the platform offers a very wide variety of gender identity choices. The complete list on Facebook’s gender tab is as follows: Agender, Androgyne, Androgynous, Bigender, Cis [shorthand for those whose birth sex and sense of gender cohere], Cisgender, Cis Female, Cis Male, Cis Man, Cis Woman, Cisgender Female, Cisgender Male, Cisgender Man, Cisgender Woman, Female to Male, FTM, Gender Fluid, Gender Nonconforming, Gender Questioning, Gender Variant, Genderqueer, Intersex, Male to Female, MTF, Neither, Neutrois, Non-binary, Other, Pangender, Trans, Trans*, Trans Female, Trans* Female, Trans Male, Trans* Male, Trans Man, Trans* Man, Trans Person, Trans* Person, Trans Woman, Trans* Woman, Transfeminine, Transgender, Transgender Female, Transgender Male, Transgender Man, Transgender Person, Transgender Woman, Transmasculine, Transsexual, Transsexual Female, Transsexual Male, Transsexual Man, Transsexual Person, Transsexual Woman, Two-Spirit.¹

Following the success of this customized gender feature, UK users were offered an even more inclusive list, covering 71 gender choices.² Despite their nuances, none of the options have to do with sexuality. The comprehensive list is, as writer and transgender activist Jennifer Finney Boylan once said, “not about who you want to go to bed with, it’s who you want to go to bed as.”³

For those who identify outside the gender binary, the wealth of options did not exhaust the current lexicon of gender expressions. This is why, more recently, Facebook added another feature for its US members: a free-form field where users can write in their own gender if they do not feel represented by the existing 56 options. This move follows the inclusion of three preferred pronoun choices for users: him, her or them, as well as non-gendered options to describe family members (for example, sibling-in-law, or child of sibling). This expanded gender nomenclature proves that at least for the over 1.5 billion Facebook users, gender is presented no longer as a binary but a spectrum. The menu of options in gender expression continues to be rewritten. Its semantic excess ventures in the direction of a surplus of being that defies categorization.

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For some people, their gender identity and sexual orientation are completely separated, but others experience that their gender determines their object choices, so let us note that for sexuality there is also an equally extensive glossary, another spectrum of labels that is continuously changing and growing. Alfred Kinsey’s mid-twentieth century idea, which caused such a scandal in his time, that in human sexuality orientation could be gauged on a scale of 0 to 6, with intermediary shades between heterosexual and homosexual, appears today a quaint oversimplification. For instance, the internet dating site OkCupid (3.5 million users) offers twelve categories for sexual orientation (besides gay, straight or bisexual, the list includes asexual, demisexual, heteroflexible, homoflexible, pansexual, queer, questioning, and sapiosexual for those who consider intelligence the most important sexual trait) but the feature is not as inclusive as Facebook’s when dealing with gender; OkCupid lists 22 options.⁴

Despite the proliferation and the atomization of choices, one has to restate that, at any rate, for psychoanalysis, “sexual difference” continues to exist, and resist. Psychoanalysis conceives the body not simply as an organism but as a libidinal entity reconfigured by language. Indeed, in psychoanalysis “sexual difference” is neither sex, defined by anatomical or hormonal determinations, nor gender or any socially constructed roles ascribed to men and women. Gender needs to be embodied, sex needs to be symbolized. “Sexual difference” may exceed the notion of sexuality since it has to do with issues of embodiment—the challenges of living in a body that is sexed and mortal.

I should add here that dealing with sexual difference, which also entails but is not limited to assuming one’s sexual and gender preferences, is a problem for everyone. Being a man, a woman, or anything else altogether is one of the many possibilities of misfire. In sexual matters of identity or object-choice, everyone fails. Lacan summed it up in the formula “There is not such a thing as a sexual relation.” Of course, he did not mean that people do not engage in sex, or fall in love, or assume more or a less precariously a sexual identity, but rather than there is something constitutively out-of-synch and inherently incommensurable, even incompatible, in human sexuality. Between man and woman, and between men and men, and between women and women, there is nothing but difference. All combinations are possible but there is no symmetry. We all remember Woody Allen’s Annie Hall (1977). In a scene, a split screen shows both protagonists, Alvyn and Annie, complaining about their sexual relationship to their respective therapists. Asked how often they have sex, she states that they have sex all the time, and specifies: three times a week. On the opposite frame of the screen, he says that they hardly ever have sex, adding that it is three times a week. He says, she says. They may agree on the number, but there is always a mismatch.

Lacan would say that this happens because, unlike Facebook with its array of gender categories and expanding options whose proliferation makes us suspect that their reach exceeds their grasp, the unconscious seems to know only one option—the phallus, which would have no feminine equivalent. Thus, a fundamental asymmetry emerges; whereas in Freud phallus and penis can at times be confused, for Lacan the phallus is not the anatomical organ but a symbol, a conceptual tool thanks to which sexual difference is introduced. While men can pretend to have it, and while women can act as if they are it, both sexes have only the phallus to define two different sexual identities. The phallus might exalt difference but it does not resolve it.

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Since we are discussing psychoanalysis’ sex problems, let us explore a little further one of its most controversial and contested notions. Lacan takes the phallus as a symbol of what compensates for a certain lack; it is an attribute that nobody can have, while everyone aspires to have it or embody it. At times, the phallus is not a body part, or an appendage to the body (as could be the case in the exhibitionistic pleasure of a man parading his pretty girlfriend as arm candy, or showing off the proverbial trophy-wife) but extends to the whole body. How does this happen? Only because the phallus functions as an exchange ratio; as a signifier it can be ascribed various meanings, as illustrated in a case of a cross-dresser discussed by the psychoanalyst Otto Fenichel.⁵ This analysand loved his penis so much that he had invented a pet name for it. When he cross-dressed, fantasizing that he was a girl, it happened that “the girl’s name which he wanted to have as a girl bore a striking resemblance to the pet name for his penis.”⁶ Fenichel observed that at play here was an equivalence derived from a “symbolic equation” that had been proposed very early by Freud, who had observed that a young girl’s desire for a penis would be replaced by a desire for a baby. Fenichel’s analysis of the case concluded that an unconscious series of substitutions was at work; the thought of “I am a girl” and “My whole body is a penis” would be condensed in one single idea: “I = my whole body = a girl = the little one = the penis.”⁷ Here Fenichel discussed not a physical organ but an imaginary one. He identified something that was more than the anatomical organ. This excess might be illustrated by the phallus as it was represented in ancient Greek comedy, mostly in Aristophanes. That impossibly gigantic prop was so huge and absurd that its mere appearance on stage would make the audience roar with laughter.

The same “phallus” is still present in contemporary life. If I walk in the street with a friend who owns an adorable little dog, everyone will turn and shriek in delight: “Oh my God, such a cutie!” They have recognized that my friend has her phallus with her and can take it for a walk; they are then seized by the wish to do the same. In another example, an analysand was describing how her new male lover had undressed for the first time in front of her; he displayed something that she was embarrassed to name because it was “so hard and so big.” It was not what you think: she expressed her awe at facing his toned six-pack abs.

The controversial phallus seems also to be at play in the statements of some trans people, like the protagonist of the film The Danish Girl (2015). In the movie, just before Lili Elbe is about to undergo a sex change surgery never attempted before, she responds to warnings about the dangers involved by telling the surgeon: “This is not my body. I have to let it go.” What Lili wants to let go of is her penis. She imagines that the removal of this organ will make her whole body go. Genitals and body appear conflated. Here, an “organ” becomes the organon, an instrument, a means of reasoning, a system of logic. This book will explore several instances of assumed sexual positions (man, woman, and anything else). Some of these might rely fully on the phallus (albeit imaginary) as in the example of Lili, while others might not.

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With the Oedipus complex, Freud introduced the notion of the phallus. Let us add only that the phallus is not the penis but a “universal premise”: it is the impossible infantile theory according to which sexual difference is denied under the absurd belief that everyone, and even everything, is equipped with a penis. The phallus, far from being an organ, is a theoretical speculation applied to both women and men. Moreover, the phallus, since no one can be or have it, most importantly introduces the dimension of the lack that defines human sexuality. This lack has a theoretical function in psychoanalysis.

In a 1971 seminar, Lacan remarked that transsexuals have trouble with the phallus because they dispense with lack and therefore confuse the actual organ with the signifier, a term that has to be understood as the material and linguistic side of language.⁸ I will return to this passage, and here simply note that Lacan was aware that the transsexual demand for the surgical removal of attributes like the breast or the penis might derive from an inability to use metaphors for those organs. A transsexual would literalize the old Freudian mechanism of castration. As a result, Lacanian psychoanalysts in France, led by the author of Horsexe (1983) Catherine Millot (to whom I will return in Chapters 11 and 12), started a tradition of pathologizing transgender manifestations.

Lacan retains the notion of castration (a notion I will revisit in Chapter 12) and makes an important move towards overcoming the limitations of the Oedipal model one year later, contradicting the previous assertion still founded on the central role of the phallic organ, when he proposes the sexuation formulae in which women are positioned outside the phallic realm as a “not-all,” which gives them a different relation to the phallus.⁹ This grid formalizes sexual realizations for men and women by using a model derived from logic. It is important to remember that the “male side” and “female side” are not determined by biology but by the logic of unconscious investments, to the point that, for instance, someone born biologically male can nevertheless inscribe himself on the female side. Lacan separates the positions according to modalities of enjoyment: he places a masculine modality of enjoyment, or phallic jouissance, on one side; and a feminine modality of enjoyment on the other, which he calls the Other jouissance. For the male side, we read, “All are subject to the law of castration.” On the female side, we read, “No X exists which is not determined by the phallic function.” In other words, castration is an absolute that functions for all—men and women. On the lower line, a negation bars the universal quantifier, to be read as “not-whole,” which entails that the woman’s side is not wholly subjected to the phallus.

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Lacan’s innovations from 1972 reopen the question of sexual difference as neither sex nor gender because difference is seen from the pole of jouissance. Whereas for Freud there is only one libido, Lacan proposed a division based on two modes of being, masculine and feminine, that correspond to two forms of jouissance: phallic and Other. Lacan located phallic jouissance on the male side and gave it the force of necessity (All men), which relies on the exclusion of one man, the unlawful or impossible jouissance of the primal father. In this model of sexual division, we encounter two positions: one, that of the phallic one (“man”) who is limited by the father exempted from castration (the exception to the phallic rule that provides its support), and on the other side the unlimited jouissance of a woman who is “not all” subjected to the phallic constraints. Femininity is where the Other jouissance comes into being. “Man” and “woman” are therefore signifiers of imprecise meaning and stand for sexed positions relative to a phallic premise.

Unlike the Lacanian unconscious, the Freudian unconscious is unable to recognize the elaborate system of difference that we call gender. From the point of view of the Freudian unconscious, there is an impasse on sexual difference; the sexual binary is the symptom of this impasse. As Ian Parker observes, what we call gender is “a signifier that operates as an imaginary effect of a real difference.”¹⁰ The “imaginary effect” that we call gender is also an attribution assigned from outside the subject and without the subject’s consent, as it is often inscribed in the birth certificate of the newborn long before the child acquires the ability to speak. The sexuation formulae offer a way of thinking about trans because they are free from the shackles of anatomical constraints. The model of sexual difference still recognizes that there is only one logical operator, which is the phallus, but acknowledges that some individuals are placed in a position in which the phallus is not operative. We are seeing more and more patients who do not think that they are in the wrong body but feel that the gender binary does not fit them. Their identity is “non-binary” or “agender”—they do not identify as either male or female. They are careful about using language: instead of the pronouns “he” and “she,” these analysands refer to themselves using the pronoun “they,” which already exists in the dictionary, or employ new gender-neutral pronouns like ze, hir, xe, ou, ey. And even when they may not want to change genders, they may take hormones to redistribute muscle and change how their voice sounds, precisely to inhabit the space between genders. Most importantly, they seem to be able to deal with sexual difference without fully relying on the phallus.

One of the truths the transgender phenomenon illustrates is that body and gender consistency is a fiction that is assumed through identification.¹¹ It is absurd to ascribe to anatomy the role of normalizer in a type of sexuality by focusing on the genitals or on a single prescribed act, as classical psychoanalysis has traditionally done. This normalizing role has been effectively challenged by transsexual discourse and practices.

Sexual identity issues all revolve around a particular body, a body one is not born into but one that one becomes. Today we see analysands in our practices who tell us that the sex they were assigned at birth does not align with the gender with which they identify. They prove that, in matters of gender, anatomy is not destiny. Some report that they have a peculiar experience of their body, a body that can fall from one’s self, like a wrapping that does not fully hold. In their testimonies we confirm that having a body entails a complex process of embodiment.

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Some of those analysands no longer talk about gender reassignment surgery but about gender realignment or gender confirmation surgery, as if the medical intervention would either change or restore to a different or former position or state, or corroborate a truth contradicted by the flesh. Some analysands who embarked on a journey of transformation between genders, however, expressed that the voyage does not end in the bodily transformation. Something else is needed for that process of embodiment to be successful.

Notes

  1    Will Oremus, “Here Are All the Different Genders You Can Be on Facebook,” Slate, last modified February 13, 2014, http://www.slate.com/blogs/future_tense/2014/02/13/facebook_custom_gender_options_here_are_all_56_custom_options.html.

  2    Rhiannon Williams, “Facebook’s 71 Gender Options Come to UK Users,” The Telegraph, last modified June 27, 2014, http://www.telegraph.co.uk/technology/facebook/10930654/Facebooks-71-gender-options-come-to-UK-users.html.

  3    Jennifer F. Boylan, “Loving Freely,” The New York Times, last modified October 23, 2015, http://www.nytimes.com/2015/10/24/opinion/loving-freely.html.

  4    “The Sexual Orientation Test,” OKCupid.com, accessed October 13, 2016, https://www.okcupid.com/tests/the-sexual-orientation-test-1; Emanuella Grinberg, “OKCupid Expands Options for Gender and Sexual Orientation,” CNN.com, January 2, 2015, http://www.cnn.com/2014/11/18/living/okcupid-expands-gender-orientation-options.

  5    See Otto Fenichel, “The Symbolic Equation: Girl = Phallus,” Psychoanalytic Quarterly 18 (1949): 303-324. See also Bertram D. Lewin, “The Body as Phallus,” Psychoanalytic Quarterly 2 (1933): 24-47.

  6    Fenichel, “The Symbolic Equation: Girl = Phallus,” 304.

  7    Ibid., 304.

  8    See Jacques Lacan, Le Séminaire XIX . . . ou pire. Le savoir du psychanalyste, session of December 8, 1971, unpublished papers, Gaogoa.free.fr, last accessed October 28, 2016, http://gaogoa.free.fr/Seminaires_HTML/19-OP/OP08121971.htm.

  9    Jacques Lacan, The Seminar of Jacques Lacan: On Feminine Sexuality, the Limits of Love and Knowledge, 1972–1973 (Encore), ed. Jacques-Alain Miller, trans. Bruce Fink (New York: Norton, 1998).

10    Ian Parker, “The Phallus is a Signifier,” The Symptom 8 (Winter 2007), http://www.lacan.com/symptom8_articles/parker8.html

11    See Gayle Salamon, Assuming a Body: Transgender and Rhetorics of Materiality (New York: Columbia University Press, 2010).

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4

BRING SEX BACK

Taking up recent theorizations in the transgender and transsexual fields, Gayle Salamon has eloquently called for a reappraisal of psychoanalytic discourse, putting forward a sophisticated amalgamation of psychoanalysis, phenomenology, and transgender studies.¹ Similarly, Shanna Carlson has proposed a collaboration between discourses, observing that Lacanian psychoanalysis can offer “a richly malleable framework for thinking through matters of sex, subjectivity, desire, and sexuality” and that “integration of the two domains can only ever be a scene of fruitful contestation.”² Already in 2001 Patricia Elliot had warned psychoanalysts against pathologizing the complex process of sexed embodiment, arguing that it was much more productive to analyze it, concluding that “psychoanalysis is a potentially useful tool for theorizing transsexual subjectivity when it manages to raise questions about processes of embodiment without normalizing or pathologizing.”³ I too have been arguing since 2010 for a productive confrontation between psychoanalysis and transgender discourses and have shown how transgender people are actually changing the clinical praxis, advancing new ideas for the clinic that can be expanded to social and intellectual contexts.⁴ Oren Gozlan takes this relationship to its extreme stating that “it could be argued that analytic discourse is inherently transsexual.”⁵

One wishes that psychoanalysts would have by now abandoned the moralistic and stigmatizing attitudes of previous generations of clinicians who, puzzled by the transgender phenomenon, could barely disguise in their disparaging comments their fear and contempt. Candidly, Leslie Lothstein in the 1970s wrote a paper advising analysts on how to manage the negative counter-transference he anticipated they would experience with transsexual patients.⁶ Lothstein’s assumptions were not incorrect—a great part of the sparse clinical literature published in recent years on psychoanalysis with transgender analysands deals with the analyst’s countertransference and reveals how often psychoanalysts feel tempted to carry out gender policing rather than actual psychoanalysis, confirming Lacan’s observation that “there is no other resistance to psychoanalysis than the analyst’s.”⁷

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It may thus be that psychoanalysis has a major sex problem, and in more than one sense. Gender and transgender activists and scholars have been wary of psychoanalysis, with good reason. It is of course true that many normative theories about sex and gender claim to derive from Freudian psychoanalysis and classify and adjudicate individuals according to sexual behavior. Freud’s Oedipal Complex, for example, it is said, starts with the recognition of anatomical sexual differences, before passing through “castration complexes” and “penis envy,” and culminating in the development of a mature, “normal” genital choice. In this reading, proper gender identification produces masculinity for males, femininity for women, and creates an adapted heterosexual desire that is purported to result in a satisfying sexual life. In fact, nothing could be farther from what Freud stated theoretically or observed in his practice.

However, the work with transgender patients of a few psychoanalysts, such as Collete Chiland, Danielle Quinodoz, Michael Eigen, and Ruth Stein, has raised interesting clinical questions.⁸ The number of colleagues raising such questions is rather small, which is remarkable given that a majority of the transgender community is engaged in some sort of talk therapy, as we have seen, so one imagines that the number of analysands presenting “gender trouble” might only be increasing. According to Stephen Whittle, “trans identities were one of the most written about subjects in the late twentieth century.”⁹ As a result, psychoanalysts have a lot of catching up to do. In 2005, Shari Thurer, a psychoanalytically trained psychologist practicing in Boston, tried to rouse her colleagues, whom she described as “arrested in moth-eaten bias—the conviction that there are two, and only two, normal versions of gender,” announcing that “sexuality has changed—all sorts of deviations have been ‘outed’—but theories haven’t caught up.”¹⁰ While she accuses psychological theorists and practitioners of displaying archaic prejudices, Thurer praises theorists of sexuality, especially French cultural theorists, “who leapfrog 180 degrees away from hierarchical thinking, who view sexuality as okay.”¹¹ (She does also suggest, however, that despite all their political correctness, these French cultural theorists seem to “lack common sense” and to be “insensitive to people in pain.”) Maybe an example of the cross-pollination she hopes for may come from the other side of the Atlantic, where Giovanna Ambrosio, an Italian classically trained psychoanalyst, assumes that analysts already work with gender nonconformist analysands but may not write about it.¹² She acknowledges that “we are behind the times compared with the growing amount of medical, political-sociological, cultural, and mass media attention paid to this theme” and invites her colleagues to pay more attention to the links between psychoanalytic theory and clinical experience, even when that implies looking at “shaded areas” of sexuality (by which she meant transgenderism). ¹³

Casting light into the dusty corners of our assumptions about sex, gender and identity, one would hope that psychoanalysts will increasingly refuse to buy into sweeping generalizations and negative stereotypes. Perhaps we can break out of pointless debate about the foundations of sex versus gender, nature versus nurture, biological essentialism versus social constructivism.

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Although psychoanalysis is unlikely to be the new hero of the gender and sex revolution, it is quite disconcerting that in a time and age when tolerance is growing and sexuality more openly expressed, psychoanalysis has grown increasingly “closeted,” systematically ignoring what Freud declared more than a century ago was the central issue in psychoanalysis: sexuality. The neglect of sexuality in both psychoanalytic theory and practice has been such that André Green posed the question “Has Sexuality Anything to Do with Psychoanalysis?”¹⁴ Green was provocatively pointing to the fact that sexuality is often misunderstood and rarely present in traditional psychoanalytic clinical work. Van Spruiell went as far as to accuse psychoanalysts of committing “an assault” against sexuality.¹⁵ Despite the occasional calls for a reintegration of sexuality within the last twenty years,¹⁶ most psychoanalysts continued rejecting sexuality in favor of an emphasis on early object relationships and attachment. Most recently, in the plenary address at the meeting of the American Psychoanalytic Association, Peter Fonagy urged his colleagues to bring sex back into psychoanalysis.¹⁷ Fonagy attempted to include psychosexuality in the discussion of a case, that of Dan, a 17-year-old male patient, who happened to talk about sex a great deal. His effort at finding a “genuinely developmental theory of sexual enjoyment” segued into a series of relational interpretations of affect that silenced his analysand. Not surprisingly, “Dan stopped talking about his sexual experiences,” and Fonagy at first, “did not notice the change, as we were engaged in complex discussions about his relation with his father. . .” As Jean Laplanche observed, like many relational psychoanalysts, Kleinian analysts regard sexuality as a defense against nonsexual, early and basic anxieties.¹⁸ Fonagy was brought back to task by the analysand, who at some point “referred back to a session some weeks earlier when he asked me about a fantasy he had had during intercourse of being a medieval knight in a complete suit of armor.” Fonagy’s interpretation encountered an objection: ‘‘You did not really know what I was talking about then, did you? You were talking about me wanting to protect myself from women who I feel might attack me. It is nothing to do with that. It is to do with being hard and rigid’ (and he held up his right arm clenching his fist).”¹⁹

Fonagy admitted that he was unable to engage with the phallic image of a “steely penis” and thus could not “resonate” his analysand’s emotions. Fonagy instead got lost in his own resistance, identified with “a woman whose body is asked to contain Dan’s metallic, cutting, painful excitement.”²⁰ Overwhelmed with what he saw as his patient’s sadism, Fonagy conceded that he had run into a “counter-transference block”—Dan’s wish for “steely stiffness in his penis” did not make “emotional sense” for Fonagy, who ended up feeling like “the subjugated woman” and thus “felt [him]self drifting back into the realm of defense.”²¹

There are plenty of assumptions at play here that are normative and politically suspect. Why should a woman receiving a steely organ be in a position of subjugation? Why is an image of eroticized domination antithetical to pleasure? Putting aside Fonagy’s masochistic identification and even his own disavowed jouissance, this is a good example of how today’s followers of attachment theory and relational psychoanalysis consider psychosexuality as a behavioral system concealing a more basic nonsexual object that represents self-related conflicts. Sexual material is reduced to underlying “primitive” relationship-based pathology. This shift desexualizes sex.

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Relational psychoanalytic theorist Steven Mitchell, for example, views sex as an expression of a wish to establish contact and intimacy. For Mitchell, sex is a manifestation of sociability.²² Such a sanitized notion of sex is a far cry from the notion of sex as an experience of the radical dissolution of the subject’s bodily boundaries that Leo Bersani calls “self-shattering.”²³ Following Freud’s observation that sexual pleasure occurs when a certain threshold of intensity is traversed, when the organization of the self is momentarily disturbed by sensation, Bersani argues that when we are having sex with another person we are no longer self-contained subjects; sexual enjoyment is “socially dysfunctional.”²⁴ Even when a partner is engaged, sex can be a solipsistic experience that undoes the notions of relationality dependent on selfhood.

If sex has left psychoanalysis (or shall we say, psychoanalysts have left sex), it is not just because psychoanalysis has not been able to provide a persuasive model of psychosexuality, as Fonagy argues. Indeed, there is a dramatic decline of psychoanalytic interest in the concept of psychosexuality, and even in the use of words concerning sexuality, amounting to a collective psychoanalytic rejection of sexuality. Fonagy states that the suppression of sexuality is psychoanalysis’ “open secret.”²⁵ What is this secret concealing?

Today, psychosexuality tends to be thought of as concealing nonsexual, object and self-related conflicts. Object-relations, self-psychology, and intersubjective relational approaches focus on affective developmental object-attachments; these approaches do not concern themselves with sexuality. Noting the reduced presence of sexuality in psychoanalytic publications, Fonagy offers as explanation a widening gap: Freud’s drive theory cannot be subsumed by a developmental theory. A “domesticated” version of psychosexuality reduces sexuality to early developmental libidinal stages because drive theory is incompatible with an object-relations theory based on mother-infant interaction.

In a comprehensive 2009 study, Ofra Shalev and Hanoch Yerushalmi assessed the status of sexuality in contemporary psychoanalysis and concluded that there is a “marginalization of sexuality in psychoanalytic theory and practice.”²⁶ Not only is there a disbelief in the centrality of sexuality in psychic life due to a “narrowing of the concept of sexuality,” a reductive confusion between sexuality and intimacy, but perhaps, most troublingly, the study concluded that the discussion of sexual issues was avoided because of the analysts’ uneasiness with the topic that the authors describe as a form of “new puritanism.” One therapist reported that his patients “rarely talk about sexual issues” because romantic relationships “never have sexual connotations.”²⁷ According to Shalev and Yerushalmi’s study, sexuality is seen as a “defense” against intimacy and self-identity and the discussion of sexual issues are viewed as an obstacle to achieving adaptation as the goal of the treatment.

So extreme is the repudiation of sexuality that two of the therapists interviewed stated that “sexual issues should be treated by sexologists and not by psychotherapists.”²⁸ For those therapists with whom there was discussion of sexual matters, it was described as a “form of hostility directed at them” and they said that they felt “abused by their patients.” One stated: “It was as if he was thinking, ‘this is therapy so I can talk about everything.’”²⁹ This prudish, repressive attitude goes against the grain of the psychoanalytic spirit and contradicts one of the fundamental rules of the analytic technique, the suspension of censorship and moral judgment, allowing analysands to engage wholeheartedly in the process of free association. Philip Rieff has praised this technique not only because it facilitates access to unconscious material but because it places psychoanalysis within an “ethic of honesty,” which relies on “a special capacity for candor.”³⁰ This promise of honesty and tolerance allows the uncovering of latent truths. By saying whatever comes to mind, disregarding whether it is inconvenient, offensive, irrelevant, unpleasant, or sexual, unconscious truth can be uncovered.

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Trying to reintroduce the psychoanalytic discussion of sexuality, Alenka Zupančič commented on the findings of the Shalev and Yerushalmi study by noting that if sexuality is reduced to sexual identity, to sexual practices, or even to “naughty things that one does or does not do and uses to harass one’s therapist,” then perhaps sexuality could be seen as a defense. She is right to note that the irony is that sexuality for Freud (sexual difference or “sexuation” for Lacan) is something that exceeds the different sexual practices; sexuality is “something inherently problematic and precisely disruptive of identity.”³¹ Furthermore, “sexuality is the very thing that disrupts all identity.” There is something uncertain about sexuality that escapes our attempts to grasp it. As Zupančič has put it more recently, elaborating on the concept of the sexual as an impasse: “To the Victorians screaming ‘sex is dirty,’ Freud did not answer something like ‘no, it is not dirty, it is only natural,’ but rather something like ‘What is this “sex” that you are talking about?’”³² Psychoanalysis’ sex problem has a history to which I now turn.

Notes

  1    See Gayle Salamon, Assuming a Body: Transgender and Rhetorics of Materiality (New York: Columbia University Press, 2010).

  2    Shana Carlson, “Transgender Subjectivity and the Logic of Sexual Difference,” differences 21, no. 2 (2010): 69.

  3    Patricia Elliot, “A Psychoanalytic Reading of Transsexual Embodiment,” Studies in Gender and Sexuality 2, no. 4 (2001): 321.

  4    See my book, Please Select Your Gender: From the Invention of Hysteria to the Democratizing of Transgenderism (New York: Routledge, 2010); and my “Psychoanalysis Needs a Sex Change,” Gay & Lesbian Issues and Psychology Review 7, no. 1 (2011): 3-18.

  5    Oren Gozlan, Transsexuality and the Art of Transitioning: A Lacanian Approach, New York: Routledge, 2015, p. 29.

  6    See Leslie Lothstein, “Countertransference Reactions to Gender Dysphoric Patients: Implications for Psychotherapy,” Psychotherapy: Theory, Research and Practice 14, no.1 (1977): 21–31.

  7    Jacques Lacan, Écrits: The First Complete Edition in English, trans. Bruce Fink (New York, London: Norton, 2006), 497.

  8    See Collete Chiland, Transsexualism: Illusion and Reality, trans. Philip Slotkin (Middletown, CT: Wesleyan University Press, 2003); Danielle Quinodoz, “A Fe/male Transsexual Patient in Psychoanalysis,” International Journal of Psychoanalysis 79 (February 1998): 95–111; Michael Eigen, Psychic Deadness (London, New York: Karnac, 1996); Ruth Stein, “Analysis of a Case of Transsexualism,” Psychoanalytic Dialogues 5 (1995): 257–289.

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  9    Stephen Whittle, “Foreword,” in The Transgender Studies Reader, ed. Susan Stryker and Stephen Whittle (New York: Routledge, 2006), xi.

10    Shari Thurer, The End of Gender: A Psychological Autopsy (New York: Routledge, 2005), xi.

11    Ibid., xi.

12    Giovanna Ambrosio, ed., Transvestism, Transsexualism in the Psychoanalytic Dimension (New York, London: Karnac, 2009).

13    Ibid., xvi, xiii.

14    André Green, “Has Sexuality Anything to Do with Psychoanalysis?” International Journal of Psychoanalysis 76 (1995): 871–883.

15    Van Spruiell, “Review of the Psychoanalytic Theory of Sexuality: Comments on the Assault against It,” International Journal of Psychoanalysis 78 (1997): 357–361.

16    Consider André Green’s “Has Sexuality Anything to Do with Psychoanalysis?”; John A. Friedman, The Origins of Self and Identity: Living and Dying in Freud’s Psychoanalysis (Northvale, NJ: Jason Aronson Inc., 1998); Otto F. Kernberg, “Aggression and Love in the Relationship of the Couple,” Journal of the American Psychoanalytic Association 39, no. 1 (1991): 45–70; Van Spruiell, “Review of the Psychoanalytic Theory of Sexuality: Comments on the Assault against It”; Ruth Stein, “The Enigmatic Dimension of Sexual Experience: The ‘Otherness’ of Sexuality and Primal Seduction,” Psychoanalytic Quarterly 67 (1998): 594–625; Mary Target, “Is Our Sexuality Our Own? A Developmental Model of Sexuality Based on Early Affect Mirroring,” British Journal of Psychotherapy 23 (2007): 517–530; Johanna K. Tabin, “Freud’s Shift from the Seduction Theory: Some Overlooked Reality Factors,” Psychoanalytic Psychology 10 (1993): 291–297; Lissa Weinstein, “When Sexuality Reaches Beyond the Pleasure Principle: Attachment, Repetition, and Infantile Sexuality,” in Attachment and Sexuality, ed. Diana Diamond, Sidney J. Blatt, and Joseph D. Lichtenberg, 107–136 (New York: Analytic Press, 2007).

17    Peter Fonagy, “A Genuinely Developmental Theory of Sexual Enjoyment and Its Implications for Psychoanalytic Technique,” Journal of the American Psychoanalytic Association 56 (2008): 11–36.

18    Jean Laplanche, “Panel on ‘Hysteria Today,’” International Journal of Psychoanalysis 55 (1974): 459–469.

19    Fonagy, “A Genuinely Developmental Theory of Sexual Enjoyment,” 30

20    Ibid.

21    Ibid., 30, 31.

22    See Stephen Mitchell, Can Love Last? The Fate of Romance Over Time (New York, London: Norton, 2002).

23    Leo Bersani, “Is the Rectum a Grave?” AIDS: Cultural Analysis/Cultural Activism 43 (Winter 1987): 217–218, 222.

24    Ibid., 222.

25    Peter Fonagy, Rainer Krause and Marianne Leuzinger-Bohleber, Identity, Gender, and Sexuality: 150 Years after Freud (London: International Psychoanalytic Association Press, 2006), 2.

26    Ofra Shalev and Hanoch Yemshalmi, “Status of Sexuality in Contemporary Psychoanalytic Psychotherapy as Reported by Therapists,” Psychoanalytic Psychology 26 (2009): 343.

27    Ibid., 350, 355, 353.

28    Ibid., 353.

29    Ibid., 354.

30    Philip Rieff, The Mind of a Moralist (New York: Viking Press, 1959), 315.

31    Alenka Zupančič and Randall Terada, “Sex, Ontology, Subjectivity: In Conversation with Alenka Zupančič,” Psychoanalysis, Culture & Society 20 (2015): 194.

32    Alenka Zupančič, “Sexual Is Political?” in Jacques Lacan: Between Psychoanalysis and Politics, ed. Samo Tomsic and Andreja Zevnik (London, New York: Routledge, 2016), 86.

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5

STRANGE BEDFELLOWS

Psychoanalysis and sexology

The story is well known. A young Sigmund Freud was in Paris interning at the famous neurologist Jean-Martin Charcot’s Salpêtrière hospital unit. The year was 1886. At a party at Charcot’s house Freud overheard his formidable host getting particularly animated while speaking to Paul Brouardel, a distinguished professor of forensic medicine. The great neurologist was sharing a story of a married couple he had seen earlier that day at the hospital: the husband was impotent or sexually awkward, and the wife severely hysteric. Charcot crossed his arms, hugging himself, and bounced up and down on his toes several times, as he said in his characteristically lively way: “Mais, dans des cas pareils c’est toujours la chose génitale . . . toujours . . .toujours . . . toujours [But in this sort of case, it’s always a matter of the genitals—always, always, always].” ¹ Freud recalled in 1914 that “I was almost paralyzed with amazement and said to myself: ‘Well, but if he [Charcot] knows that, why does he never say so?’ But the impression was soon forgotten; brain anatomy and the experimental induction of hysterical paralyses absorbed all my interest.”²

Freud might have gotten temporarily distracted by trying to locate the missing organic lesion of hysteria, but never completely forgot about Charcot’s observation. This was no doubt in part because of an incident that occurred before he went to Paris: Still an inexperienced young physician, Freud was walking across town with Joseph Breuer. A man approached to them to talk about an urgent request. When he left, Breuer told Freud that the gentleman was the husband of a patient of his who had been brought to treatment for a “nervous” problem. Breuer confided, “These things are always secrets d’alcôve!”³ Astonished, Freud asked what he meant, and Breuer explained the word alcove as marital bed. Breuer may have been entirely unaware of how extraordinary this moment of “enlightenment” was for Freud, making quite an impression on the young doctor.

Back in Vienna, in 1889, the gynecologist Rudolf Chrobak referred to Freud a patient suffering from anxiety attacks. In an uncharacteristically cynical tone, Chrobak assumed that the cause of the anxiety was that the woman, after eighteen years of marriage, was still a virgin. For her cure, Chrobak suggested a prescription: “Penis normalis, dosim repetatur.”⁴ Freud dismissed the offhand comment, but the idea that sexuality, “la chose génitale,” was at the root of hysteria—“a piece of knowledge which, strictly speaking, they [Breuer, Charcot, Chrobak] themselves did not possess”—stayed with Freud. Years later, Freud reminisced that this idea “had lain dormant in my mind for years, until one day [it] awoke in the form of an apparently original discovery.”⁵ This revelation would percolate, eventually becoming the key to the seduction theory and being integrated into his general theory of the neurosis.

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As he listened to patients who complained of mysterious ailments for which traditional medicine could not find a solution or even an explanation, Freud developed psychoanalysis. Body paralysis, blindness, mutism, seizures—the cause for these strange symptoms that defied scientific knowledge was revealed to be sexual in origin. Behind the hysterical, bodily symptom there was a repressed sexual content. Initially, Freud believed that, as a child, the hysterical patient had been the victim of a premature, traumatic and erotic experience, such as sexual seduction by an adult. Too immature to understand it, unable to represent it, the child was frightened and speechless, and the sexual excitation was excluded from the child’s awareness. The seduction was forgotten or repressed but would come back in the future, reawakened in hysteric symptoms, which meant the return of the repressed. The unbearable, sexually charged traumatic representation was an integral part of Freud’s seduction theory. He would eventually abandon this theory and come to believe in a principle of psychic reality, where the trauma would be inscribed in the unconscious, imprinted as fantasy.

Freud’s abandonment of the seduction theory induced the concept of fantasy—and the concept of fantasy led him to discover the existence of the drive (Trieb was never instinct). We can define sex for the speaking subject as the rapport between two fantasies, as the resulting interaction of two subjects through the lens of their fantasies. One classic trope is that of a heterosexual man having sex with a woman while thinking he is having sex with another woman; meanwhile, the woman is thinking that she is the other woman her partner is thinking about. Fantasies play a crucial role in our psychic life. Freud called what he recurrently heard in his patients’ discourse Urfantasie (protofantasy) to mark those fantasies that had a constitutive, founding function.⁶ Freud located only three protofantasies, all related to the Oedipal complex: seduction scene, castration, and primal scene. The seduction scene has to do with the parents as sexual objects; the fear of retaliation if the desire of sleeping with the mother is fulfilled constitutes the castration protofantasy; and the wish to separate the parents, breaking the unbearable union that threatens the importance of the child for the mother, forms the protofantasy of the primal scene.

Before and after the seduction theory, Freud continued granting great psychic importance to sexual experiences, and not limiting them to cases of hysteria but somehow generalizing sexual trauma as a main feature of human sexuality. For Freud, psychic reality was dominated by the primacy of sexuality. Since one of the vicissitudes of the drives is to fall to repression, if the repressed drive finds a substitute in a symptom, the satisfaction granted by the symptom is still sexual. Not only was sexuality the key for every single symptom and symptom manifestation, but the symptoms themselves could be so libidinally invested as to become “the patient’s sexual activity.”⁷

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What kind of norm reigns over sexuality if a symptom, supposedly the expression of pathological manifestation, could become a person’s sexual activity? What kind of satisfaction can be granted by a symptom? Did sexuality entail, inevitably, pains? Human sexuality was thus problematic. Freud noted that sexuality itself was symptomatic in the sense that there was something intrinsically amiss, lacking in sexuality that prevented the achievement of complete pleasure. Freud writes: “There is always something lacking for complete discharge and satisfaction—en attendant toujours quelque chose qui ne venait point [always waiting for something which never came]—and this missing part, the reaction of orgasm, manifests itself in equivalents in other spheres, in absences, outbreaks of laughing, weeping, and perhaps other ways.”⁸ Freud’s most groundbreaking disclosure was not only the omnipresence of sexuality, but rather, as Jean Laplanche noted, “the profoundly ambivalent nature of human sexuality.”⁹ We are quite aware of the “scandals” of the Freudian revelations: not only the existence of infantile sexuality but also the affirmation that infantile sexuality contains the structure of adult sexuality (polymorphous and perverse!). Freud’s discoveries were met with strong resistance because he uncovered important facts about sexuality and the unconscious that people preferred to ignore. The knowledge he disseminated touched upon something beyond morality. Freud’s findings forced a confrontation with a dark core in the subject that corresponds to an ethics of desire of which we want to remain ignorant. This is another scandal brought about by Freud’s discoveries. Freud’s notion of sexuality is so ample that it troubles the traditional boundaries of what is considered sexual. Zupančič considers this to be the real scandal of Freud.

The outrage of the Freudian revelations was not caused by his purported pansexualism but rather his exposing how uncertain human sexuality is. “What is most disturbing in the Freudian discovery is not the emphasis on sexuality, the emphasis on dirty matters; more disturbing was the ontologically uncertain character of sexuality itself. So when I say that sexuality is constitutively unconscious, I refer to some fundamental negativity implied in sexuality, yet which gives, as such, a structure to the unconscious.”¹⁰ Furthermore, “The cause of embarrassment in sexuality is not simply something which is there, on display, in it. But on the contrary, something that precisely is not there.”¹¹ The paradox here is that while Freud was accused of “pansexualism,” which means that he would find sex was everywhere, the Freudian discovery is that there is a recalcitrant negativity at the heart of sexuality.¹²

One example of this deficit in our relation to sex is that while animals seem to be able to rely successfully on the wisdom granted by instinct, humans need the pedagogical mediation of Sex-Ed to learn what we should know already. Not only are we at a loss facing sexuality, but our encounter with sex is disruptive: it happens too early or too late; it is too much or not enough; not good or too good; and so on and so forth.

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So it should not surprise us that in the early days of psychoanalysis, Freud worked very closely with the leading sexologists of his time, who became a source of great inspiration.¹³ Among them was Magnus Hirschfeld, the so-called Dr. Einstein of Sex, founder of the world’s first sexual research institute in Berlin and pioneering researcher, clinician, and advocate who did groundbreaking work on transgenderism, and published more than 2,000 articles on homosexuality and sexually variant behaviors. Hirschfeld, a passionate sex reformer and an activist, was also an occasional cross-dresser, and a central political figure in Germany’s incipient field of sexology. He published a number of early psychoanalytic papers, including Freud’s own article “Hysterical Fantasies and Their Relation to Bisexuality” (1908), which appeared in the very first issue of Hirschfeld’s new journal exclusively devoted to sexology as a science, Zeitschrift für Sexualwissenschaft (Journal of Sexual Science). Subsequent issues published original work by Alfred Adler, Karl Abraham, and Wilhem Stekel.¹⁴

Hirschfeld played a main role in the early days of psychoanalysis. Freud and Hirschfeld collaborated closely: Freud contributed articles to his journals while Hirschfeld took a serious interest in psychoanalysis. Furthermore, Hirschfeld co-founded the Berlin Psychoanalytic Society with Karl Abraham in August of 1908.¹⁵ In 1911, at the third international Weimar congress of psychoanalysts, Freud greeted Hirschfeld very warmly as an honored guest and publicly expressed his admiration for “the Berlin authority on homosexuality.”¹⁶ Yet even with this recognition, Hirschfeld left the Berlin Psychoanalytic Society shortly after the Weimar meeting, despite Abraham’s attempts to persuade him to stay.¹⁷

Hirschfeld’s departure had been precipitated by “an external cause” also described by Abraham as “a question of resistances.” It seemed that Jung had objected to his homosexuality.¹⁸ Unlike Jung, Freud did not seem to mind Hirschfeld’s political activism. He saw Hirschfeld’s advocacy of homosexual rights as a positive development and from the beginning he had encouraged Abraham to work with him.¹⁹ Hirschfeld’s departure deeply embittered Freud.

He hid his disappointment by commenting that this was not such a huge loss. However, not long before the split, following a visit from Hirschfeld that impressed Freud favorably, he wrote to Jung expressing his wish to include sexologists in the psychoanalytic movement, and insisted on the importance of such collaboration. After losing Hirschfeld, the Berlin Psychoanalytic Society decided, at Abraham’s instigation, to work collectively on Freud’s “Three Essays on the Theory of Sexuality.” The irony is that the “Three Essays” owe a great deal to Hirschfeld’s research (Freud, 1905, p. 1). In the opening page of the “Essays” Freud credits the “well-known writings” of Hirschfeld along with other eight authors, ranging from Krafft-Ebing to Havelock Ellis, all published in Jahrbuch für sexuelle Zwischenstufen (Journal of Intermediary Sexual Stages), a journal under Hirschfeld’s direction, showing how Freud’s sexual theory partially derived from the then emerging field of sexology.

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Ralf Dose writes that Hirschfeld’s departure from the Berlin Psychoanalytic Society was also caused by theoretical differences about the etiology of homosexuality.²⁰ While Freud and Hirschfeld both opposed the criminalization of same-sex desire and did not consider it an abnormality in the pathological sense, they had disagreements about what caused homosexuality. Hirschfeld believed in a biological, inborn homosexuality while Freud considered that childhood experiences determined unconscious libidinal tendencies and object-choice.

Rather than advocating against the punishment of non-normative sexual manifestations on the basis of the claim that biological variations determinate behavior, Freud’s originality was to separate sex from reproduction by highlighting the skewed character of human sexuality.

Equally innovative, but not as revolutionary, since he was navigating the treacherous waters of a political agenda while conducting innovative research, was Hirschfeld’s work exploring gender identity, in particular the desire to wear the clothing of the opposite sex. This was the first comprehensive, scientific study of cross-dressing. His rich empirical data collected from thousands of cases revealed that transvestites included both men and women who were homosexual or bisexual as well as, contrary to popular belief, heterosexual. Magnus Hirschfeld coined the term transvestite in 1910 to describe those who occasionally wear clothes of the “other” sex. He observed that some transvestites were asexual (automonosexual was his term); the asexual group eventually led to the 1950s classification of transsexual.

Hirschfeld’s classic book Die Transvestiten. Eine Untersuchung über den erotischen Verkleidungstrieb mit umfangreichem casuistischen und historischen material (1910) was translated into English eighty years after its initial publication. It was released in 1991 as Transvestites: The Erotic Drive to Cross-Dress. Notably; in both German and English its title contains a word that belongs to basic psychoanalytic nomenclature: Trieb or drive. The choice of term reveals an engagement with psychoanalysis, even if the sense is different.

Hirschfeld developed a theory of sexual intermediaries, contending that the existence of two opposite sexes was an oversimplification and that one could observe many varieties of intermediates. Hirschfeld broke new ground by proposing that transvestism was a separate sexual variation differing from fetishism and homosexuality. A pioneer advocate for transgender people, he argued that transgenderism could not be reduced to either homosexuality or fetishism, or any form of pathology.

Let us note, however, that as a clinician and researcher, Hirschfeld never wavered in his belief in a biological (endocrinological) basis for sexuality and thus was not opposed to Eugen Steinach’s experimental testicular transplants to “treat” male homosexuality. Both Steinach and Hirschfeld had speculated that the so-called “third sex” of homosexuals might be explained by the presence of both male and female sex hormones. Freud did not agree, because the idea of a third sex is predicated on a sexual binary made out of two discernable halves. Freud’s unanswered questions about feminine sexuality had revealed to him that there was not a symmetrical notion of sexual identity. In a more traditional or biological manner, Steinach believed that intersexuality and homosexuality were due to a lack of sexual differentiation in the gonads, which caused the production of both male and female secretions.

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This hypothesis emerged from exchanges with Hirschfeld, who had already placed a biological responsibility for homosexuality in the action of hormones that he named “andrin” and “gynacin.” Hirschfeld had suggested to Steinach that he experiment with the gonads of animals. This led to the highly debatable—and quickly abandoned—“cure” for masculine homosexuality in which one testicle was surgically removed and replaced with a testicle from a heterosexual donor. This approach was also indicative of the general drift of science at the time. Hirschfeld used Steinach’s research to scientifically validate the construction of homosexuality as a biomedical condition.

Hirschfeld followed the theories of Karl Heinrich Ulrichs, who advocated for the eradication of the association of homosexuality with pathology by arguing that these men had “a woman’s mind trapped in a man’s body” (anima muliebris corpore virili inclusa). This phrase reverberates in modern-day presentations of transgender identity, for instance during the transition of Caitlyn Jenner. We may also recall how Jenner’s argument of having a “female brain” dismayed certain feminists.

Ulrichs transposed new knowledge about embryology to sexual orientation in a strategy to decriminalize homosexuality and challenge sodomy laws. Magnus Hirschfeld, like Ulrichs, explained same-sex attraction in terms of the bisexuality of the developing human embryo. Where Ulrichs used the “mind,” Hirschfeld, taking a biological turn, spoke of the “brain.” Hirschfeld’s investigations about the neural centers for sexual attraction in fetuses destined to become homosexual demonstrate an ideological affinity to current controversial neuroanatomical research on homosexual, heterosexual, or in-between sexual orientation.

The philosopher Michel Foucault has made us aware that sexuality has a history, and that psychoanalysis has played a very important role in it as a theory of the intersections of law and desire. His History of Sexuality states that a history of the deployment of sexuality since the classical age “can serve as an archeology of psychoanalysis.”²¹ For Dean and Lane, this characterization, which makes it look “as if the book were really all about psychoanalysis,” also highlights the fact that today we cannot think of sexuality without using psychoanalytic categories.²² In the case of transsexuality, then, the interrelatedness with psychoanalysis is not just referential, it is foundational.

Notes

  1    Sigmund Freud, “On the History of the Psycho-Analytic Movement (1914),” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 14, ed. and trans. James Strachey (London: Hogarth Press, 1957), 14.

  2    Ibid.

  3    Ibid., 13.

  4    Ibid., 14.

  5    Ibid., 13.

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  6    See Sigmund Freud, “The History of an Infantile Neurosis,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 17, ed. and trans. James Strachey (London: Hogarth Press, 1957), 120.

  7    Sigmund Freud, “Fragment of an Analysis of a Case of Hysteria (1905 [1901]),” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 7, ed. and trans. James Strachey (London: Hogarth Press, 1953), 114–115.

  8    Sigmund Freud, “Findings, Ideas, Problems (1938),” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 23, ed. and trans. James Strachey (London: Hogarth Press, 1957), 300.

  9    Jean Laplanche, Life and Death in Psychoanalysis, trans. Jeffrey Mehlman (Baltimore: John Hopkins University Press, 1985), 27.

10    Alenka Zupančič and Randall Terada, “Sex, Ontology, Subjectivity: In Conversation with Alenka Zupančič,” Psychoanalysis, Culture & Society 20 (2015): 194.

11    Ibid.

12    See Joan Copjec, “Sex and the Euthanasia of Reason,” in Supposing the Subject, ed. Joan Copjec (New York: Verso, 1994), 16–43.

13    See Henri Ellenberger, The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry (New York: Basic Books, 1981), and Frank Salloway, Freud, Biologist of the Mind: Beyond the Psychoanalytic Legend (New York: Basic Books, 1979).

14    Vern Bullough, Science in the Bedroom: A History of Sex Research (New York: Basic Books, 1994), 68.

15    Peter Gay, Freud: A Life of Our Times (New York: Norton, 1998).

16    See Bullough, Science in the Bedroom, 64, and Elena Mancini, Magnus Hirschfeld and the Quest for Sexual Freedom (New York: Palgrave, 2010), 71.

17    Ernst Falzeder, ed., The Complete Correspondence of Sigmund Freud and Karl Abraham, 1907–1925 (London: Karnac Books, 2002), 139.

18    Ibid., 139, 140, 141.

19    Gay, Freud: A Life of Our Times, 181.

20    Ralf Dose, Magnus Hirschfeld: The Origins of the Gay Liberation Movement, New York: Monthly Review Press, 2014, 50.

21    Michel Foucault, The History of Sexuality. Volume I: An Introduction, trans. Robert Hurley (New York: Vintage Books, 1990), 130.

22    Tim Dean and Christopher Lane, eds, Homosexuality and Psychoanalysis (Chicago: University of Chicago Press, 2001), 8.

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6

CHANGING SEX, CHANGING PSYCHOANALYSIS

To further contextualize our discussion of the complex relation between psychoanalysis and transgenderism, let us take a rapid look at some canonical definitions of transsexualism as well as records of early treatments of transgender analysands, which are as revealing as they are exemplary. This brief history of the evolution of the nomenclature will be helpful in clarifying how the terminology has been linked to the domain of the pathological. It also shows the central and paradoxical role psychoanalysis has played in the history of transsexualism.

The best known early psychoanalytic theory about transgender phenomena was put forward by former close collaborator of Freud and early dissident, Wilhelm Stekel. Stekel often discussed cases of cross-dressing and systematized the use of the term paraphilia for unusual sexual behaviors (from the Greek para: beside, beyond, amiss, and philia: love). Stekel’s choice of this term places semantically sexual “deviations” on a par with other non-pathological formations of the unconscious such as parapraxis. Parapraxis refers to a psychic phenomenon introduced by Freud in Psychopathology of Everyday Life, a text whose title already normalizes pathology by presenting it as a quotidian event while exposing the pathologies of everyday normality. Parapraxis is James Strachey’s neologism that attempts to translate the German Fehlleistung: literally, Fehl, failure, falling or missing, and Leistung, work, performance. One might be tempted to translate paraphilia into the psychoanalytic jargon as a failed performance, a sort of slip of sexuality. As Freud says of everyday parapraxis, such as forgetting of words and names, paraphilias can occur in healthy and normal people.

Let us note that even though Stekel is often given credit for the invention of this term, paraphilia was coined in 1903 by ethnographer, sexologist, anthropologist, and Freud’s correspondent Friedrich S. Krauss, to whom I will return in Chapter 14. After the 1960s, paraphilia became widely used in the English-speaking world through the work of sexologist and sex-change pioneer John Money, who adopted it to establish some distance from the moral and religious implications of the legal notion of “perversion” as defined by Krafft-Ebing. In turn, in a clear depathologizing gesture, Money proposed “normophilia” for those “erotosexually in conformity with the standard as dictated by customary, religious, or legal authority.”¹ Paraphilia officially became part of the psychiatric jargon in 1980 with its inclusion in the Diagnostic and Statistic Manual (DSM) as a less loaded designation for non-normative sexual inclinations. As Glen Gabbard observes, despite Stekel’s efforts, the negative connotations of the term never disappeared.²

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“Not in the least pathological”

The title of Stekel’s major work Sexual Aberrations: The Phenomenon of Fetishism in Relation to Sex echoes that of section I of Freud’s 1905 text, Three Essays on the Theory of Sexuality, “The Sexual Aberrations.”³ Stekel’s subtitle, The Phenomenon of Fetishism in Relation to Sex, makes explicit a wish to systematize the structure of all sexual deviations as a single entity under the model of fetishism. He also attempted to move away from Hirschfeld’s biologically oriented model.

The second volume, however, included a chapter on a cross-dressing woman written by his disciple, Emil Gutheil, which moves slightly away from the model of fetishism. For Gutheil, even though transvestism was not fetishism, it was a compulsion to create a penile substitute. This clinical example of what is described as an example of transvestism and approached as a “parapathia” deserves a closer look. It is a very detailed case story documenting what was probably one of the first psychoanalytic treatments of a transgender patient, and it is also quite representative of future encounters between psychoanalysts and gender-variant analysands.

Sometime in the early 1920s, Elsa B., a 34-year-old government official, agreed to start an analysis with Gutheil, whose aid she enlisted in an effort to obtain from the police permission to wear male clothing in public, an authorization which she eventually secured.⁴ The analysis went on for 33 sessions. The work focused on extensive dream analyses. Let us note that Elsa engaged in the treatment not to get rid of a symptom but to gain the expert’s endorsement that would grant her safety in the public sphere. This is not too different from the limitations imposed on the therapeutic situation even today, when many transgender people are forced to consult with a mental health professional in order to obtain a letter confirming that they are good candidates to start the process of gender realignment.

Interestingly, Elsa asked that “under no circumstances” should Gutheil try to “destroy” her sexual inclinations.⁵ This requirement confirms that Elsa was already aware that her psychoanalyst could try to adopt a corrective direction in the treatment and attempt to interfere “with her particular sexual strivings.” Her request makes explicit that she did not want to renounce what gave her sexual enjoyment and that, for Elsa, her sexual inclinations were not a pathology but simply an erotic preference she did not wished questioned or modified. She just wanted to “live a more human and happy life” because, as she argued, her sartorial preferences actually did “not infringe upon the rights of anyone.”⁶

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Under “Case 70,” Gutheil gives a good description of Elsa B. She wore her hair short, had pale skin, a slender constitution, and “sexual characteristics of normal appearance.” She had experienced regular menses since age thirteen, and was able to “undertake the hardest of work even during her period.” Elsa appears self-possessed, a feature Gutheil describes in tandem with a “male type of walk with long steps.”⁷

The patient’s appearance is, indeed, striking. Upon a bobbed head with parted hair there sits a man’s soft felt hat. A raincoat reaches nearly to the ankles and makes it questionable as to whether trousers or skirt may be found beneath it. But she wears a skirt, the only female attribute on her person. Over a blouse of a shirt, she wears a man’s vest, a starched collar, tie, and starched cuffs. All the rest is male clothing: shoes, pocket knife, cigarette lighter, cigarette case, etc.⁸

Elsa also “urinates in a standing position.” Nevertheless, Gutheil adds that she “shows no signs of degeneration.”⁹ Elsa—who considered her “condition,” in her own words, “doubtless constitutional and perhaps abnormal, but not in the least pathological”—early on in the treatment shared her expectations about its outcome quite frankly: “I cannot imagine my condition being curable. If anyone came along now and told me that he could make me feel like a woman, I would reject this offer.”¹⁰

Elsa had introduced herself in a letter to Gutheil’s supervisor in the case, Wilhelm Stekel, trying to give an accurate description of her character. She tells the doctors that as far as she can recall she disliked girl’s toys and wished to “play only with boy’s things, e.g. sabers, guns, soldiers, etc.” As she grew up, her dislike of girls’ toys increased and soon “clothing became a serious dilemma.”¹¹ During her childhood she became so deeply attached to a dark blue winter coat resembling a military uniform coat that she wore it even in the spring and summer. Gradually, she developed a stronger dislike of female clothing. Going out dressed in skirts, hats, and ribbons made her “feel like a dressed up monkey.” The sartorial “bitter struggle” became shattering and led to a painful “estrangement between my family and myself.”¹² Since her early twenties, she had adopted outfits that often made people on the street take her for a man.

By the time Elsa started her analysis with Gutheil, she was living alone. Having suffered considerable economic hardship after leaving her family, she was now able to support herself financially. Elsa was born prematurely at seven months. Her father, a teacher, was 68 years old when she came to the world and died when she was only two. He was 38 when he married her mother, who was seventeen. The age difference caused many quarrels between the couple, because while he was a “serious minded and settled man,” her mother was “full of life and loved clothes.”¹³ Growing up, Elsa felt rejected and unloved by her mother who spoke about her deceased husband in derogatory terms. She also neglected Elsa, who was raised by her grandparents. It seemed that her mother never wanted to have a daughter. Mother “is supposed to have ‘worn the pants’ at home.”¹⁴

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Four or five years after the father’s passing, her mother remarried and bore two sons, the first, Edward, eight years younger than Elsa, the second, Otto, ten years younger. Elsa detested her stepfather, who appeared to reciprocate the sentiment: “My stepfather used to tell me as long as I knew him that I was ugly.” She believed him, “and was very much hurt”: thinking that she was “the apotheosis of ugliness,” she burnt all photographs of herself. At age twelve or thirteen, she tried on her grandfather’s suit, noticing that “it quite fitted me and make me look much better than in female attire. Then I desired to have such clothes.” When at age fifteen she tried her brother’s suit, she thought that she looked very handsome, and resembled her father. “I believe that vanity plays a large part in my life . . . I believe myself to be a rather handsome male.” Wearing male’s attire granted Elsa, in her words, a new freedom: “a great oppression leaves me and instead of feelings of inferiority, I feel free and easy.”¹⁵ For Elsa, as is the case with many analysands identifying as trans I worked with, beauty and aesthetics offer a pathway to freedom, appearing less a narcissistic striving than as an issue of existence.

In fact, Elsa never felt like a woman and in her fantasies sees herself as “the father of a family, caring for wife and children,” happy to be the husband accompanied by a motherly woman who “cooks, sews and tends to the other details of a wife’s duties.”¹⁶ Nevertheless, while growing up she rebelled against her stepfather’s attempts to teach her household duties to make her become “a good housewife,” because she “always looked upon a housewife as an unpaid working woman.”¹⁷

She also dreamed of being a husband having penetrative sex with his wife. “I am having intercourse with her and I am happy at the size of my penis and the male form of my chest. Then ejaculation and following, an orgasm which lasted for minutes.”¹⁸ Gutheil observes her wish for “the large phallus.”¹⁹ In fact, Elsa dreamed that orgasm follows ejaculation. What Gutheil takes for her ignorance about the usual mechanics of male orgasm points instead to the fact that even when Elsa was dreaming of a penis, for her, the phallus was not strictly an anatomical organ.

In her associations to this dream, Elsa shared that she discovered the existence of anatomical sexual differences when she saw her baby brother’s penis and “envied him because of this difference. I also had dreams at the time which showed me in possession of a penis.” In her masturbatory fantasies she imagined herself as a “a male in coitus.”²⁰

Until the age of eight or nine, Elsa thought that gender difference was determined by attire. Wearing the winter uniform coat as a younger child gave her self-confidence and a gratifying feeling of superiority, but when she cross-dressed in secret at age 14 or 15, trying on her brother’s suit, she would experience immediate sexual gratification. Gutheil then took this as a proof of her fetishistic disposition, which may appear too simple an explanation, a confusion between fetishistic condition and true fetishism. Elsa’s eroticism has features often associated with masculine sexuality, in which the object (partial, object a) could be taken for the whole (Other) and engender desire.

Elsa’s sexual pleasure appeared triggered by wearing male clothing, for “simply putting on a suit can provoke an orgasm.”²¹ She was not interested in sexual intercourse with men; however, cross-dressing was not her only source of sensual pleasure. Elsa was sexually attracted to women; in the case history there is ample material about her other sources of erotic fulfillment such as sucking nipples, cunnilingus, mutual masturbation, etc. Gutheil pushes forward a pseudo-Freudian concoction of mother fixation combined with a narcissistic injury along the lines of penis envy in the midst of an Electra complex combined with “feelings of ugliness” to explain Elsa’s fetishism as a deviation from a heterosexual, cis, “healthy psychic orientation.” Rejected by the mother, who would have preferred a son to a daughter, and observing that as a child Elsa had engaged in activities he judges to be feminine (she cooked and briefly fantasized about marrying a male older cousin) Gutheil speculates that her desire to not be a girl was a consequence of assuming that she did not have what would secure the mother’s affection.

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Gutheil’s explanation borders on misogyny. He writes:

She simply wanted to be pretty . . . the feeling of femininity and the sense of personal ugliness soon injured her infantile narcissism to such an extent that her healthy psychic orientation was repressed.

One day she recognized the real basis of sexual differences and then it dawned upon her why she could not achieve her mother’s love. Her infantile mind was then convinced that the only attribute which attracted her mother’s love was the possession of certain physical adnexa.²²

According to Gutheil, Elsa’s transvestism had identificatory and sexual functions. Mother preferred and favored her brother. Her first experience of orgasm during cross-dressing was caused by wearing her brother’s suit. Gutheil thinks that the climax betrays that Elsa had “finally achieved equality with her brother and [could] aspire to her mother’s true affections.”²³ Since Elsa could not have her brother’s penis, she moved on to the clothing as substitute. All this took place under the aegis of penis envy and the castration complex. Elsa had fantasies of attacking her brother Edward (she was jealous when he caught a nail in his foot and the whole house was in turmoil, when he had nasal surgery, and so on) and might even have had death wishes as castration retributions. While worrying about him dying, Elsa “accidentally saw his genitals as he lay sick in bed.” She adds, “I envied him.”²⁴ She consoled herself with the belief that her penis would grow.

As soon as she reached puberty, she was “forced to bury my original hope that my phallus would yet grow. It was at this time (about twelve years) that I began to strive to develop a male character of my clothing. My yearning for my father became distressing and I often thought that if he were only alive, things would not be so bad for me.”²⁵ Thus, the male attire satisfied a double attitude towards father and mother: “The transvesture affords her the sexual contact with her father (orgasm in putting on the clothing) and impels her in her male attire to seek a mother substitute as an object.”²⁶ This explanation, however, seems to assume that pretty girls love men and not their mothers, and ugly ones (as Elsa believed she was) pretend to be boys to continue loving their mothers, thus developing mother fixations. “This fixation is patent in the patient’s dreams and day-dreams. She calls her landlady ‘mother’ but their relationship is more like that of a man and his wife or a mother and her son. The patients’ hatred of the stepfather is easily traceable to her earliest childhood. She protested inwardly against her mother’s second marriage for the simple reason that she wanted to play the role of the husband.”²⁷ Gutheil also understands that the real cause of Elsa’s interest in male clothing (let us recall that mother loved clothes and “wore the pants at home”) was as a replacement for the incestuous object—the mother.

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In a surprising turn, Gutheil anchors Elsa’s transvestism in inhibited heterosexuality. Quoting Stekel, Gutheil concludes that Elsa’s “homosexuality is a flight from the opposite sex promoted by paraphilic and sadistic attitudes.”²⁸ He speculates that Elsa repressed her heterosexuality in order to protect a potential male partner from the sadistic impulses propelled by her penis envy and would thus avoid any direct contact with a phallus.

Gutheil follows his teacher Stekel, for whom perversions were not strategies to circumvent castration but defenses against desire and libidinal impulses, always seen as heterosexual. Thus, Stekel reaches the conclusion that paraphilias are not forms of satisfaction of the sexual drive but instances in which desire is held hostage by sexual dysfunction. As we can see, the normative slant prevails.

Stekel and Gutheil are good examples of how former devoted followers of psychoanalysis modified the Freudian theories while popularizing them, and in so doing went astray, erasing all nuances by bringing them closer to the dominating medical model. During the first half of the twentieth century, in order to solve the problem of the mind, most post-Freudians inevitably relied on the notion of the traumatic effect of childhood experiences while holding all along to a biological conception of the psyche. Castration anxiety accounted for a psychobiological etiology of transgenderism often confused with homosexuality.²⁹ Cross-dressing in males continued to be understood according to Gutheil’s theories as an attempt to overcome the fear of castration, creating a phallic woman and identifying with her.³⁰ As Bullough puts it, “Freud cannot be blamed for the excesses of his disciples.”³¹ One may wonder then, who is to blame?

Notes

  1    John Money, Gay, Straight, and In-Between: The Sexology of Erotic Orientation (Oxford: Oxford University Press, 1988), 214.

  2    Glen O. Gabbard, Gabbard’s Treatments of Psychiatric Disorders (Arlington, VA: American Psychiatric Press, 2007), 673.

  3    See Sigmund Freud, “Three Essays on the Theory of Sexuality (1905),” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 7, ed. and trans. James Strachey, 123–146 (London: Hogarth Press, 1953).

  4    Emil Gutheil, “An Analysis of a Case of Transvestism,” in Sexual Aberrations: The Phenomenon of Fetishism in Relation to Sex, ed. Wilheml Stekel, trans. S. Parker (New York: Liveright Publishing Co., 1971), 281–318, 354. See also Havelock Ellis, Studies in the Psychology of Sex, vol. 2 (London: William Heineman Medical Books, 1937).

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  5    Gutheil, “An Analysis of a Case of Transvestism,” 281.

  6    Ibid., 281, 283.

  7    Ibid., 281.

  8    Ibid., note 4, 354.

  9    Ibid., 281.

10    Ibid., 284, 288.

11    Ibid., 281, 282.

12    Ibid., 282.

13    Ibid., 283.

14    Ibid., 286.

15    Ibid., 302.

16    Ibid., 284

17    Ibid., 294.

18    Ibid., 286.

19    Ibid.

20    Ibid., 287.

21    Ibid., 289.

22    Ibid., 307.

23    Ibid., 308.

24    Ibid., 305.

25    Ibid., 303.

26    Ibid., 308.

27    Ibid., 309.

28    Ibid.

29    See Vern Bullough, “Transgenderism and the Concept of Gender,” The International Journal of Transgenderism 4, no. 3 (2000), https://www.atria.nl/ezines/web/IJT/97-03/numbers/symposion/bullough.htm.

30    See Nareyz Lukianowicz, “Survey of Various Aspects of Transvestism in Light of Our Present Knowledge,” Journal of Nervous and Mental Disease 128 (1959): 36–64.

31    Vern Bullough, Science in the Bedroom: A History of Sex Research (New York: Basic Books, 1994), 90.

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7

A NATURAL EXPERIMENT

Still trapped in the muddy waters of sexual aberrations, the word Transexualis was first used in the popular journal Sexology in a 1949 article by David Cauldwell titled, in Latin, Psychopathia Transexualis. Spelled with only one “s,” the term echoed Krafft-Ebing’s 1886 book Psychopathia Sexualis, the monumental catalog of the “aberrations” of sexual behavior.¹ Cauldwell, not so much a scientific writer as a hyperbolic popularizer and sex educator, believed in a biological etiology for transsexualism, which he considered pathological. He simply added the biological component to the old psychoanalytic formula of childhood trauma: when a genetic predisposition was combined with a dysfunctional childhood, the result was an immaturity that produced a “pathologic-morbid desire to be a full member of the opposite sex.”² It is often noted that in 1923, Hirschfield had used the German term seelischer Transsexualismus (psychological transsexualism), attributing transgenderism to the psyche. By 1949, Cauldwell described “transsexuals” as “individuals who wish to be members of the sex to which they do not properly belong.”³ Cauldwell also coined the term “sex transmutationist” and used both spellings “transsexual” and “transexual” interchangeably⁴ (1950).

Cauldwell’s initial position was, at best, problematic, since he described transsexualism as a hereditary condition for individuals whom he deemed to be “mentally unhealthy.”⁵ By 1950, Cauldwell had obviously turned a corner: “Are transsexuals crazy? One may as well ask whether heterosexuals are crazy. Some are and some are not. Some transsexuals are brilliant. Now and then one may be a borderline genius. Transsexuals are eccentric. Some of them are not of sound mind, but this is true of heterosexuals.”⁶ He still strongly advised against “sex change surgery” due to ethical and practical reasons, claiming that surgery could not make a “real” member of the opposite sex.⁷ Cauldwell is often mistakenly credited as the first person to use the word transsexual, but otherwise rarely quoted in the academic literature (except for Meyerowitz, 1998, p. 168–170, and Stryker & Whittle, 2006, p. 40–52, who nevertheless caution the reader against his excessive pathologizing, p. 40; see also Ekins & King, 2001).⁸

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Cauldwell’s role as tabloid sex-advice columnist warrants comment. As Stryker and Whittle (2006) observe, Cauldwell’s quasi-scientific work is worthy of note because it reflects the earlier positions of Krafft-Ebing, Hirschfeld, and Havelock Ellis while anticipating the contributions of future transsexualism experts such as Robert Stoller, Richard Green, John Money and Leslie Lothstein (p. 40). Most of Cauldwell’s popular booklets were published by E. Hadelman-Julius, an American publisher who reached a substantial readership with a sure formula: “sex, self-improvement, and attacks on respectability and religion” (Ekins & King, 2001). Cauldwell’s position as a popularizer serves also as a cultural barometer: as a medical practitioner, he developed a substantial second career explaining to the masses transgender phenomena, a prurient matter at the time, but also one that according to Hadelman-Julius’ winning recipe was seen as transgressing but also as self-improvement. Cauldwell’s post-Second World War switch to a somewhat more liberal attitude towards sexual matters, then, perhaps reflected a new climate of more honest public discussion of sex (as exemplified by the Kinsey studies).

The word transsexualism became a popular term in the 1950s thanks to sex-change pioneer Harry Benjamin. Benjamin was a Berlin endocrinologist who relocated to New York in 1915. He had worked closely with Eugen Steinach, whom we have encountered. Steinach was a gland specialist innovator who performed the first sex change surgeries by gland transplants in the late nineteenth century and isolated the “sex hormones.” He had known Hirschfeld from before the war. Benjamin relied on a biological concept to account for the etiology of transsexualism, despite the fact that he could not find any physical evidence for this claim. Notably, Benjamin advocated against psychotherapy. Benjamin borrowed Ulrich’s formula of a female soul trapped in a male body, all the while looking for answers in the body, not in the soul: “the soma, that is to say the genetic and/or endocrine constitution . . . has to provide a ‘fertile soil’ in which the ‘basic conflict’ must grow in order to become the respective neurosis.”⁹ Despite the use of the term neurosis, Benjamin discouraged any psychoanalytic or psychotherapeutic intervention, seeing these as “a waste of time.”¹⁰ Benjamin argued that psychoanalysis did not lessen the wish to change sex but rather forced patients to hide this desire and therefore live miserable lives. As his close collaborator Hamburger (1953) put it, “it is impossible to make a genuine transvestite [transsexual] wish to have his mentality altered by means of psychotherapy.”¹¹

Following the significant media impact of Christine Jorgensen’s 1952 successful sex change, Benjamin chose to publicly share his opposition to the psychoanalytic treatment of transsexuality at a symposium of the United States Association for the Advancement of Psychotherapy, a professional organization created for the development of psychotherapy in the medical field. This was a symposium that Benjamin himself organized, and which was attended mainly by professionals in the “psy” field.¹² The landmark 1954 paper that came from this and was published in the American Journal of Psychotherapy became one of transgender studies’ touchstones. It spelled out the distinction Benjamin was establishing between the transvestite (psycho-somatic) and transsexual (somato-psychic) phenomena. Physical bisexuality was the point of departure. Benjamin wrote: “Organically, sex is always a mixture of male and female components”, but he suggested that mild cases (transvestism) could be “principally psychogenic,” while for true “transsexualists” “a still greater degree of constitutional femininity, perhaps due to a chromosomal sex disturbance, must be assumed.”¹³

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British sexologist Havelock Ellis had renamed transvestism “eonism” after the Chevalier Charles d’Eon, a French adventurer and diplomat who was rumored to be anatomically male but lived and dressed as a woman. For Ellis, eonism was not an erotic impulse but an expression of the real self. Benjamin took inspiration from Ellis and proposed a continuum of transgender behavior, with cross-dressing on one end, and transsexualism on the other. For transsexuals, Benjamin reiterated, therapy was of no use. He was also not naïve, admitting that for a male-to-female transsexual, surgery “may not always solve [the transsexual’s] problem. His feminization craving may never end.”¹⁴ He also warned against performing sex reassignment on patients with psychosis or who were in danger of suicide or self-mutilation. The conclusion to this paper is quite revealing for its contradictions: “Transsexualism is inaccessible by any curative methods at present at our disposal. Nevertheless, the condition requires psychiatric help, reinforced by hormone treatment and, in some cases, by surgery. In this way a reasonably contented existence may be worked out for these patients.”¹⁵

According to Benjamin, then, transsexualism is both “inaccessible by any curative methods” and yet requires specific treatments such as psychiatry combined with hormone treatment and surgery. Did this mean that although incurable it was still considered a pathology? In any case, Benjamin considered that if psychoanalysis and psychotherapy could not cure transsexualism, they could not explain it either. Meyerowitz observes that Benjamin emphasized the biological aspect of transsexualism, which explained for him the failure of psychotherapy in treating the condition and justified a surgical intervention.¹⁶ Benjamin maintained a very negative bias against psychotherapy and psychoanalysis but created a protocol for sex change in which psychiatrists were given the power to determine who the potential candidates for surgery were; psychiatrists had the final word on the treatment decision, but no say on the diagnosis. As Bernice Hausman noted, “this illustrates the ambivalent relation between the mental health specialist and the clinical endocrinologist in the treatment of transsexualism.”¹⁷ The fact that Benjamin’s choice of treatments affected and transformed the body (surgery, hormones) foreclosed a consideration of what may not be fully anatomical, as if the seeming efficacy of the interventions on the organism would preclude any consideration of other issues involved in the transition of sex.

The American psychoanalyst Robert Stoller, who also collaborated with Benjamin, helped establish a pioneering sex change clinic in the early 1960s, the Gender Identity Center at UCLA. Stoller introduced the notion of gender into psychoanalytic jargon using notions derived from John Money’s 1950s new vocabulary of gender. It meant introducing the idea of an “environmental” psychological sex separated from the biological sex, and took pains to offer a distinct transsexual psychic structure.¹⁸ Money further developed Kinsey’s explanation of sexual behavior as the result of “learning and conditioning.”¹⁹ Money proposed a behaviorist model for what he called “gender roles.”²⁰ Stoller further refined the notion of a separation of sex and gender with the idea of “core gender identity” that corresponded to the internalized idea of the individual’s belonging to a particular gender.

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Stoller initially supported the idea of a biological force, a drive determining gender. “Gender identity” stressed more the subjective experience of gender and separated gender from sexuality. Based on the conviction of a distinct identity and the importance of the penis, Stoller systematized a distinction between the transsexual, the transvestite (cross-dresser), and the effeminate homosexual. He noted that in contrast to transsexuals, transvestites and male homosexuals identify as men; transsexuals abhor the penis, which for transvestites and homosexuals is an insignia of maleness and a source of pleasure.²¹ He also put forward the idea of “primary” transsexuals for those who felt they were born in the wrong body, were not homosexuals, did not derive erotic pleasure from cross-dressing, and were not psychotic. Stoller’s “primary” transsexuals align perfectly with Harry Benjamin’s description of a “true” transsexual in his protocol for sex reassignment. “Secondary” transsexuals for Stoller had occasional transsexual desires that arrived to them late in life, and derived fetishistic sexual gratification from cross-dressing; Stoller did not consider them good candidates for sex realignment, and they were seen as “wannabe” transsexuals.²²

Sexuality’s petri dish

By 1968, Stoller, always a believer in a constitutional bisexuality, had completely moved away from a biological model to a psychological one and emphasized the psychological forces that resulted in transsexualism. Stoller was mainly interested in male to female transsexualism, which he considered a “natural experiment” to measure variables in the development of masculinity and femininity, but also a pathology of psychosexual development caused in early childhood by “excess merging with the mother.”²³ He recommended “‘sex-change’ surgery” for patients properly diagnosed as transsexual, requesting from his colleagues that “everything should be done to assist them in passing.” He was however quite humble about the goals of his treatment: Stoller opposed any attempt at “converting” male transsexuals into masculine, heterosexual or even less feminine people, because “the treatment of the adult transsexual is palliative; we must bear this and not, in our frustration, impatience, or commitment to theoretical positions, fail even to provide that much comfort to our patients.”²⁴

Yet despite his open-mindedness, Stoller was rendering a general psychoanalytic theory of sexuality based on an Oedipal teleology; he believed that transsexualism was a petri dish for human sexuality—a “key test, in fact the paradigm for Freud’s theories of sexual development in both males and females.”²⁵ As for the etiology for trans women, Stoller developed a theory of excessive mother-son symbiosis qualitatively and quantitatively different from that of cis boys that he summed up in the formula: “dominant mother, father pushed to the side, infant cuddly and lovable, mother-son too close.”²⁶ In cases of male-to-female transsexualism, the key was an essential femininity passed from mother to son by way of imitative duplication: “What his mother feels is femininity; what he feels is femininity.”²⁷ He believed in mimetic reproduction: the son copied the mother; the mother’s excessive closeness to the son was considered to be a negative influence that prevented separation and differentiation. Stoller also talked about a bisexual mother, who might have had a period of extreme tomboyishness and devalued her own femininity, and of a distant father. These were factors contributing to the creation of transsexuality, especially in males to females. For female-to-male transsexuals, Stoller’s speculations can be rendered as an inverted version of that of trans women: “too much father and too little mother masculinizes girls.”²⁸ Importantly, Stoller stated explicitly that female transsexualism is not the same condition as male transsexualism, stressing that female and male transsexualism are clinically, dynamically, and etiologically different. Yet, his etiology seems to presuppose symmetry.

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After Stoller, many psychoanalytic theories of gender identity development blamed gender trouble on identifications with the “wrong” parent.²⁹ And most psychoanalysts proceeded to view transgender expressions as an indicator of underlying pathology—be it arrested development resulting from a failure of integration of lines of development (Kestemberg), a precursor of transvestism or homosexuality (Limentani), borderline disorders (Green), narcissistic disorders (Oppenheimer, Chiland) or psychosis (Socarides).³⁰

Understandably, feeling relegated to the realm of pathology and abjection, trans people rejected psychoanalysis. Ethel Spector Person & Lionel Oversey have discussed in their now classic text the reasons behind the unwillingness of transsexual patients to participate in treatment. They concluded that it was in great part created by the judgmental stance of those conducting the treatment. Nearly all of the patients they interviewed described their experiences of therapy in terms ranging “from useless to catastrophic.”³¹ In most cases, the intense negativism resulted from the clinician’s propensity to judge the patients as psychotic and to dismiss the transsexual wish as delusional.

Stekel and Gutheil tried to move away from the limitations imposed by Hirschfeld’s biological model in which transvestism is an organic disposition, which is nonetheless separate from homosexuality. While collapsing transvestism and homosexuality as forms of arrested development towards heterosexuality, Stekel and Gutheil do not pay any attention to the nuances of the elements in Elsa’s case. They force upon the case history self-fulfilling pseudo-psychoanalytic formulations of psychogenesis that rule out subjectivity and the unconscious, as we have seen. They move away from Hirschfeld’s medicalized mode and criticize him for not paying attention to the latent homosexuality in many of Hirschfeld’s clinical examples. Stekel and Gutheil, however, replace the constitutional hypothesis with a psychologization of the experience, which is simplistic, normative, and heterosexist.

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Despite its obvious limitations, the biological position on bisexuality held by Hirschfeld, Ulrich, Steinach or Benjamin appears closer to a queer notion of sexuality because it proposes that genders evolve as a continuum rather than being defined by a strict binary. Paradoxically, it is the liberal discourse of gender identity that supports a sort of essentialism about gender identification. A collaboration between psychoanalysis and transgender discourse should thus open the way for a different solution without jumping onto sweeping generalizations.

An epistemological model: Psychoanalytic revision of “homosexuality”

I am returning to the issue of homosexuality to suggest how our current psychoanalytic discourses about trans people could be inflected. We know that for many years homosexuality was considered by psychoanalysts to be a pathology. In fact, Freud never condemned it and even had a very tolerant attitude towards it. As Dean and Lane have shown, the founder of psychoanalysis never considered same-sex desire as pathological.³² For the founder of psychoanalysis homosexuality was a sexual orientation like any other, as contingent as heterosexuality. Freud observed “that all human beings are capable of making a homosexual object-choice and have in fact made one in their unconscious.”³³ Until the 1990s traditional psychoanalysts thought that homosexuality was deviant, whereas the American Psychiatric Association had decreed as early as 1973 that homosexuality was not a mental disorder. Psychoanalysts continued to consider homosexuality as a pathology for another 30 years. In 1991, psychoanalytic training institutes finally adopted a policy prohibiting discrimination on the basis of sexual orientation.

The normative tendency of psychoanalysis has distorted the Freudian spirit: Freud’s 1935 letter to the American mother of a gay man made it clear that there was nothing wrong with being homosexual: “I gather from your letter that your son is a homosexual. I am most impressed by the fact that you do not mention this term for yourself in your information about him. May I question you why you avoid it?” he wrote. “Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation; it cannot be classified as an illness; we consider it to be a variation of the sexual function. . . . Many highly respectable individuals of ancient and modern times have been homosexuals, several of the greatest men among them.”³⁴ Freud added that persecuting homosexuality constituted “a crime and cruelty too” thus reiterating the unequivocal opinion he had expressed three decades earlier in a 1903 an interview in the Viennese newspaper Die Zeit at the time when a prominent man was on trial for homosexuality: “Homosexual people are not sick, but they also do not belong in a court of law.”³⁵ Why penalize homosexuality since in terms of psychic unconscious dynamics this is just a variation of the sexual function as inexplicable as heterosexuality? On the whole, Freud acknowledged that the attraction between men and women is “a problem that needs elucidating and is not a self-evident fact.”³⁶ Homosexuality was as mysterious and problematic as heterosexuality. Nevertheless, post-Freudian psychoanalysts have talked about “normal” sexuality, assuming that it means heterosexual genital function.

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As Lacan said, Freud posited “sexuality as essentially polymorphous, aberrant.”³⁷ Freud created an outrage with his early sexual theories, not merely with the claim that children were sexual beings, but rather with his non-essentialism in the definition of sexuality, as we have seen. Freud’s later notion of the drive is also non–gender-specific. This revelation would clash with hetero-normative sensibilities and was thereafter repressed by post-Freudians. Indeed, Freud “perverted” sexuality when he separated the drive from any instinctual function and described its object as “indifferent,” that is, not determined by gender. Freud forces us to think differently. If then, and contrary to the standard view of traditional psychoanalysis, Freud had “queered” human sexuality, as Dean and Lean argue, and proposed a sexuality that operates in a mysterious, capricious way, contra naturam, veering off the reproductive aims, should we not take these views into account when considering transsexuality?³⁸

Notes

  1    Richard von Krafft-Ebing, Psychopathia Sexualis, trans. Harry E. Wedeck (New York: G. P. Putnam, 1965).

  2    David Cauldwell, “Psychopathia Transexualis,” in The Transgender Studies Reader, ed. Susan Stryker and Stephen Whittle (New York: Routledge, 2006), 40.

  3    Ibid., 275.

  4    David Cauldwell, Sex Transmutation—Can One’s Sex Be Changed? (Girard, KS: Haldeman-Julius, 1951), 12–16; and Questions and Answers on the Sex Life and Sexual Problems of Trans-sexuals (Girard, KS: Haldeman- Julius, 1950).

  5    Cauldwell, “Psychopathia Transexualis,” 275.

  6    Cauldwell, Questions and Answers on the Sex Life and Sexual Problems of Trans-sexuals, 4.

  7    David Cauldwell, “Is ‘Sex Change’ Ethical?” Sexology 22 (1955): 108–112.

  8    Joanne Meyerowitz, “Sex Change and the Popular Press: Historical Notes on Transsexuality in the United States, 1930–1955,” GLQ 4 (1998): 168–170; Susan Stryker and Stephen Whittle, eds, The Transgender Studies Reader (New York: Routledge, 2006), 40; Richard Ekins and Dave King, eds, “Special Issue on David O. Cauldwell,” The International Journal of Transgenderism 5, no. 2 (2001), https://www.atria.nl/ezines/web/IJT/97-03/numbers/symposion/cauldwell_01.htm.

  9    Bernice Hausman, Changing Sex: Transsexualism, Technology, and the Idea of Gender (Durham, NC: Duke University Press 1995), 122.

10    Harry Benjamin, “Transvestism and Transsexualism as Psycho-somatic and Somato-psychic Syndromes,” American Journal of Psychotherapy 8, no. 2 (1954): 228.

11    Christian Hamburger et al., “Transvestism: Hormonal Psychiatric and Surgical Treatment,” Journal of the American Medical Association 15 (1953): 392–393.

12    Joanne Meyerowitz, How Sex Changed: A History of Transsexuality in the United States (Cambridge, MA: Harvard University Press, 2004), 106–107.

13    Benjamin, “Transvestism and Transsexualism as Psycho-somatic and Somato-psychic Syndromes,” 228–229.

14    Ibid.

15    Ibid.

16    See Meyerowitz, How Sex Changed: A History of Transsexuality in the United States.

17    Bernice Hausman, Changing Sex: Transsexualism, Technology, and the Idea of Gender, 124.

18    See Meyerowitz, How Sex Changed: A History of Transsexuality in the United States, 114; Millot, 1990, 49–59.

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19    See Alfred Kinsey, Sexual Behavior in the Human Female (Philadelphia: Saunders, 1953), 643–644.

20    See John Money, “Hermaphroditism, Gender and Precocity in Hyperadrenocorticism: Psychologic Findings,” Bulletin of the Johns Hopkins Hospital 96 (1955): 253–254.

21    See Robert Stoller, “Bisexuality: The ‘Bedrock’ of Masculinity and Femininity,” in The Transsexual Experiment, vol. 2 of Sex and Gender (7–18) (London: Hogarth Press, 1975), 142–181.

22    Robert J. Stoller, Sex and Gender (London: Hogarth, 1968), and Robert J. Stoller, “Gender Identity Disorders,” in H. I. Kaplan, A. M. Freedman and B. J. Sadock, eds, Comprehensive Textbook of Psychiatry, vol. 2, 3rd ed. (Baltimore: Williams & Wilkins, 1980). For a psychoanalytic take on primary and secondary transsexuality, see E. Person and L. Ovesey, “The Transsexual Syndrome in Males: Primary Transsexualism” ([1974], pp. 110–126), and “The Transsexual Syndrome in Males: Secondary Transsexualism” ([1974], pp. 127–145), in E. Person and L. Ovesey, The Sexual Century (New Haven, London: Yale University, 1999).

23    Stoller, “Bisexuality: The ‘Bedrock’ of Masculinity and Femininity,” 281, 296.

24    Ibid., 279, 280.

25    Ibid., 297.

26    Ibid., 193.

27    Ibid., 204.

28    Ibid., 223–224.

29    S. Coates, R. C. Friedman and S. Wolfe, “The Etiology of Boyhood Gender Identity Disorder: A Model for Integrating Temperament, Development, and Psychodynamics,” Psychoanalytic Dialogues 1, no. 4 (1991): 481–523; Stoller, “Bisexuality: The ‘Bedrock’ of Masculinity and Femininity”; L. Lothstein, “Clinical Management of Gender Dysphoria in Young Boys: Genital Mutilation and DSM Implications,” in W. Bockting and E. Coleman, eds, Gender Dysphoria: Interdisciplinary Approaches in Clinical Management, pp. 87–106 (New York: Haworth Press, 1992).

30    See J. S. Kestenberg, “A Developmental Approach to Disturbances of Sex-Specific Identity,” International Journal of Psycho-Analysis 52 (1971): 99–102; A. Limentani, “The Significance of Transsexualism in Relation to Some Basic Psychoanalytic Concepts,” International Review of Psychoanalysis 6 (1979): 139–153; A. Green, On Private Madness (London: Hogarth, 1986); A. Oppenheimer, “The Wish for a Sex Change: A Challenge to Psychoanalysis?” International Journal of Psycho-Analysis 72 (1991): 221–231; C. Chiland, Transsexualism: Illusion and Reality, trans. P. Slotkin (Middletown CT: Wesleyan University Press, 2003); C. Socarides, “A Psychoanalytic Study of the Desire for Sexual Transformation (‘Transsexualism’): The Plaster-of-Paris Man,” International Journal of Psychoanalysis 51, no. 3 (1970): 341–349.

31    Person, E. and Ovesey, L. “Transvestism: New Perspectives,” Journal of the Academy of Psychoanalysis 6 (1978): 304–322.

32    Ibid.

33    Sigmund Freud, “Three Essays on the Theory of Sexuality (1905),” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 7, ed. and trans. James Strachey (London: Hogarth Press, 1960). Footnote added in 1915; 145n.

34    Sigmund Freud, “Anonymous (Letter to an American Mother),” in E. Freud, ed., The Letters of Sigmund Freud, pp. 423–424 (London: Hogarth Press, 1960).

35    Quoted by Henry Abelove, Deep Gossip (Minneapolis: University of Minnesota Press, 2003), 3.

36    Sigmund Freud, “Three Essays of the Theory of Sexuality,” footnote added in 1915, 146n.

37    Jacques Lacan, The Seminar of Jacques Lacan: The Four Fundamental Concepts of Psychoanalysis, ed. Jacques-Alain Miller, trans. Alan Sheridan (New York: Norton, 1981), 176.

38    On Freud “queering” sexuality, see Tim Dean and Christopher Lane, eds, Homosexuality and Psychoanalysis (Chicago: University of Chicago Press, 2001).

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8

FROM TRANCE TO TRANS IN LACAN’S REVISIONS OF HYSTERIA

As Lacan often suggested, psychoanalysis is a paradoxical science of the particular that follows a “logic of the singular.” It is only by sticking to the specific features and idiosyncrasies of each particular case history that one avoids the imposition of an obsolete vocabulary on slippery facts. In this spirit, let us explore another early case of a gender-variant patient in psychoanalysis. This case offers an opportunity to explore how jouissance emerges in the body; it also determines the subject’s sexual positioning in terms of allotment and modality of jouissance. Lacan maps sexual choices not according to the anatomy but according to forms of jouissance, as developed in the sexuation formulae that we discussed in Chapter 3.

Jouissance brings forth issues of embodiment because to experience jouissance one needs a body. The body represents descent to death because the body is mortal, therefore to talk about the jouissance of the body is to recognize the impact of the death drive on the living organism.¹ Let us remark that a problem stems from the fact that the term jouissance does not translate easily into English. Lacan himself suggested a combination of “enjoyment” and “lust.” The word connotes a form of enjoyment not necessarily accompanied by pleasure or joy (as in “it hurts so good”). Indeed, jouissance conveys enjoyment not just with a gratifying surplus benefit but a violent, climactic bliss closer to loss, death, fragmentation, and the disruptive rapture experienced when transgressing limits.

These two factors, excessive jouissance and baffling singularity, are present in a classical treatment of a patient who today would most likely identify as transgender. This comes from Karl Abraham, a pioneer psychoanalyst and co-founder with Hirschfeld of the Berlin Psychoanalytic Society. This case is the history of “E,” a biological male who desired to be a woman; in his daydreams, E would imagine himself changed into one and experience enthusiastic ecstasies. It is important to note that despite the fact that under the influence of Gutheil and Stekel, Abraham saw this case as one of repressed homosexuality, this clinical history was written up to illustrate hysteric day-dreaming. Abraham failed to see the transgender wish as a separate entity; he seems right, however, to approach the case as one of hysteria. Abraham refers to the patient as “he” but the gender variance is never pathologized. He instead pays attention to the peculiarities of the case and focuses on the psychic gains, we might say, on the surplus of jouissance produced by such intense dream-states that he called trance-like.

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Abraham speculates that an infantile sexual connection was combined with death wishes: the patient had been attached to both parents but not without some conflict. Having experienced unconsciously negative feelings towards his mother, those feelings turned against him when she died. The mother’s death made him feel that the whole world had lost meaning, that his own existence had become futile. Thus, the patient’s libido withdrew from the external world, and Abraham argues that “everything seemed strange to him now, as though he had not seen it before. People to whom he was actually speaking did not seem to exist at all.”²

“All the past acquired a dream-like quality, as if it had happened an eternity ago.”³ The analysand would enter dream-like states all the while remaining able to perform at a job requiring great intellectual concentration. If, at the beginning, the dream-states made him fantasize that he was reunited with his mother, later he would access those states whenever he had one of the chronic and severe headaches that caused him great pain. He had tried hypnotic treatment for the headaches. The hypnosis did not help with the headaches but taught him to access a highly pleasurable state that Abraham described as “auto hypnosis.” It was above all for the intractable pains caused by the headaches that he consulted Abraham. If the dream-states brought about a high degree of pleasure, they also satisfied his wish to be “thinking of nothing.” While his life in general demanded great intellectual effort, his desire was exactly for the opposite. At the height of the dream-state, he would reach a state of pure bliss that Abraham describes as “mental blankness.” Abraham writes that “Sexually he wished to be able to yield to sexual pleasure in a passive way like a woman.”⁴

Bringing about this dizzy passive state implied an active effort that was not deprived of erotic rewards. This is how the patient describes how he reached his trance-like state:

At first it is an effort, as in sexual intercourse. If I wanted to do it, I should have to lie down and work at it. I have to concentrate with all my might upon thinking of nothing. I close my eyes. Nothing must be allowed to reach me from the outer world. Then comes a short stage of bliss in which all my sensations are reversed. It is the greatest physical change that I know, and I cannot find words strong enough to describe it. That short stage of pleasure is nevertheless like an infinity. At the climax of the process of excitation for such we must term it his thoughts used to stop.⁵

The trance-like dream-state also yielded other benefits. The patient explains: “One has the idea that in life everything is moving forward; I mean, for example, the circulation of the blood. But suddenly everything is changed: everything ebbs away, as though it were no longer going forward but backwards. It is as though some magic had begun to work. While at other times everything tends to leave the body, now everything is driven back into it. I no longer radiate things out but absorb them.”⁶ This bliss is the sign of becoming or being a woman: suddenly, in the rapture of this trance, existence becomes peaceful, and life’s transience and mortality appear tolerable. As the patient states: “There is an absolute, harmonious peace about it, a comforting passivity, in contrast to my real life. Waves flow over me. Something is done to me. If the state did not pass I would not move till the end of time.”⁷ Abraham highlights the beneficial consequences—one may say, once more, the jouissance of this overwhelming trance—granted by the realization of the patient’s wish to become a woman through the dream-states: “These dream-states enabled the patient to obtain unlimited pleasure in imagination out of his sexual passivity. He wanted to be a woman, and in his dream-states he experienced the fulfillment of that wish. He was perfectly right when he spoke of the ‘greatest conceivable change,’ for a more radical alteration than a change of sex cannot be conceived. And to the patient it signified not only a change of sex, but a reversal of his whole mode of life.”⁸

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Abraham discusses the particular etiology of his headaches, which he interprets as an identification with the mother who suffered severe migraines during her periods. He notes that the patient’s headaches took place every four weeks and would last from three to four days each time. The patient himself seemed aware of this connection since he once jokingly referred to the monthly headaches as “periods” and said to Abraham: “I have got my period just now.”⁹ Abraham concludes that both the headaches and the trance-like dream-states served to transform him into a woman. Abraham perspicaciously notes that while the headaches “did not relieve him of his pain, they nevertheless offered him a compensatory pleasure which enabled him to put up with the pain he was obliged to endure.”¹⁰ At no point in the discussion of the case Abraham pathologizes the patient’s wish to become a woman. One only wishes that the psychoanalysts who followed Abraham had maintained the same ethical equanimity.

We do not have much more information on this case. Let us note that Abraham equates the trance-like dream-states with hysterical attacks and follows closely Freud’s analysis of hysteria. Freud noted that at times a dream could replace a hysterical attack. In this case, we can see that the dream-states not only grant and regulate jouissance (making the pain of life tolerable by preventing a hysterical attack), but also are, like most dreams, realizations of desire. The fact that the patient can even joke about his “period” when he has headaches confirms that he is not a psychotic. A psychotic would not have such distance from himself. At some point Abraham mentions masochistic fantasies that were part of the dream-states and equates these with the usual passivity that was then ascribed to femininity.

This is of course a simplistic conception of both femininity and masochism but at no point does Abraham think that the patient is a pervert. If it is productive to underline the emergence of hysteria in such a transparent case of transgender wish, this remark will force us to go deeper theoretically than Abraham did by assessing what the Lacanian theory of hysteria adds to the debate and how this can impact current discussions about trans people.

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Today, we know that the issue of what makes a man a man and a woman a woman is a question that came to psychoanalysis from hysteric patients. Hysteria, which guided Freud in the creation of psychoanalysis, officially ended in 1952 when the diagnosis was eliminated from the American psychiatric nomenclature. The word was deleted from the medical vocabulary: it ceased to be listed as a separate clinical entity in the first edition of the Diagnostic and Statistical Manual, Mental Disorders (DSM-I) (1952) and in The Standard Classified Nomenclature of Disease (SCND). Of course the termination of the entire disease was a semantic suppression that did not manage to bring about the elimination of the illness. It was not long before this official “repression” that we see a Freudian “return,” for, by a curious chronological coincidence, it was also in 1952 that Jacques Lacan published an article in the Revue française de psychanalyse that originated as a seminar he taught at the Société Psychanalytique de Paris. Lacan focuses on Freud’s detailed case study of a hysterical patient, the famous Dora case. “Presentation on Transference” is one of the few texts that Lacan devoted entirely to hysteria.¹¹ In addition to being an example of the proclaimed return to Freud that is so characteristic of Lacan’s work, it represents a decisive moment in French psychoanalytic history.

One year later, in 1953, a long-standing rift would develop into a split in the Société Psychanalytique de Paris. Lacan and others resigned to found the Société Française de Psychanalyse, under the direction of Daniel Lagache. The reasons behind the split were theoretical, directly affecting the practice of psychoanalysis. When Lacan had gone back to Dora’s case and the issue of hysteria, it had been with clinical and political motives. Lacan had supported liberal academics and intellectuals on the question of lay analysis; he opposed the authoritarianism of those who argued in favor of medical training for the practice of psychoanalysis. As the title of Lacan’s essay reveals, Dora’s case enabled him to underline the clinical importance of transference—the slippery terrain of mutual implication of analyst and patient in the treatment, the role of the “person” of the analyst, and the importance of the patient’s belief in the analyst. Lacan foregrounded the transference bond in the analytic cure, and above all, to the role of the analyst within the transference.

Lacan was also aware, following Freud’s example, that medical training was not in the least helpful to prepare an analyst to deal with the deceiving, non-empirical nature of transference. Precisely, a case of unanalyzed transference love, a love that had even “impregnated” Anna O. and terrified her doctor Joseph Breuer, was at play. Breuer “resisted” the sexual reality of the unconscious revealed by Anna’s imaginary pregnancy and parturition and abruptly terminated her treatment. Not wanting to know anything about it, he hastily declared her cured and ran away from the powerful force of transference.¹²

Freud, in contrast, did not vacillate: he not only admitted the existence of transference, but was also courageous enough to publish his first major case study on hysteria, although it would fail. Dora’s case is “fragmentary” (let us recall that it was published under the title “Fragment of an Analysis. . .”). It is an incomplete analysis because the defiant Dora had abruptly broken off the treatment. This unsuccessful case, however, taught him an important lesson on transference. Furthermore, it may suggest that psychoanalysis is best grasped through its own failure.

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Freud did not mind publishing “controversial” case studies; obstacles would turn into new clues. This becomes quite clear in the “Postscript” to Dora’s case, in which Freud learns from his mistakes and attributes his failure in the treatment to his being unaware that he had to interpret his own participation in the transference.¹³ We see here the limits imposed by Freud’s own resistances and prejudices, but also his unrelenting desire to further his theories. He offers this case as a testimony open to criticism, maybe even inciting it. In a footnote to the text, Freud admits that he was “in complete perplexity” facing the homosexual love of Dora for Frau K. In his “Presentation,” Lacan commented that only in 1923 could Freud reach an understanding of the meaning of this kind of love because this was the year when he started discussing feminine sexual development.¹⁴ In 1923, Freud observed that “the significance of the castration complex can only be rightly appreciated . . . in the phase of primacy of the phallus.”¹⁵ Let us note that “phase” refers to a stage that one undergoes and that one can eventually overcome. This leaves us with the problem of posing a sequence that suggests a development with an aim.

What was Dora searching for? Freud talks about a virile object, yet the blunt display of virility or the excesses of machismo also express femininity as a masquerade. Juliet Mitchell notes that Freud’s problem was to assume that, had Dora not been a hysteric, she would have accepted the advances of her suitor, Herr K., loving him as she had loved her father, thus following the expected Oedipal tendencies. Yet the footnotes reveal that the story was quite different. Juliet Mitchell puts it thus: “Dora’s relationship to her father had been not only one of attraction but also one of identification with him. In terms of her sexual desire, Dora is a man adoring a woman. To ascribe the situation to Dora’s hysteria would be to beg the whole founding question of psychoanalysis. Hysteria is not produced by any innate disposition. It follows that if Dora can have a masculine identification there can be no natural or automatic heterosexual drive.”¹⁶ Thus hysteria opens up the problem of the object of the drive and the problem of sexuality as an enigma to resolve.

Indeed, Dora’s interest in Frau K. exposes the indeterminacy of the object of human sexuality. Dora, a woman, can love another woman, like a man—or even not know whom she loves, a man or a woman. Hysteria is very much like psychoanalysis in that both demonstrate that there is no object for the drive, that there is no “normal” sexuality. The drive does not have any predetermined or inborn object besides satisfaction, which is why Freud insisted on the ubiquity of perversions. Furthermore, in 1905, Freud put forward a sexual theory in which “perversions” were not considered as deviations but a universal structure that is neither unnatural nor morbid. In fact, they are the foundation of “normal” sexuality. As Dany Nobus notes, “the real Freudian question would be ‘Why and how does anyone ever become sexually normal?’”¹⁷

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As we have seen, heterosexuality is an outcome of sexuality that is as arbitrary and labile as homosexuality. If an object appears, the relationship to this object is at least enigmatic. The drive’s aim is variable and its object uncertain. Hysteria and psychoanalysis bring forth the same issues: desire, jouissance, the drive, and the contingency of the sexual object. Not in vain did the one incite the invention of the other.

Lacan constructed his theory of the drive by highlighting the subversive, non-normative elements in Freud’s original theorization. The drive in its circuit swerves, it divides into partial drives. Like a surrealist collage, it atomizes in its pursuit of partial objects, working all along in a fragmentary manner, attaching to objects contingently, “it is a montage.”¹⁸ The image of the drive evoked by Lacan is quite illustrative: “the working of a dynamo connected up to a gas-tap, a peacock’s feather emerges, and tickles the belly of a pretty woman, who is just lying there looking beautiful.”¹⁹ We shall return to the concept of beauty in Chapter 13. Lacan further elaborates:

Who cannot see the difference that separates the unhappiness of consciousness . . . can still be said to be a suspension of knowing—from civilization’s discontents in Freud’s work, even if it is only in the inspiration of a sentence which, as it were, disavowed, that Freud marks for us what, if we read him well, cannot be articulated otherwise than the queer (in English, one would say: skewed) relation that separates the subject from sex?²⁰

Lacan’s quote refers to Freud’s reflections in Civilization and Its Discontents concerning the tremendous sacrifices that social life imposes on sexuality. Here, Freud is clearly non-normative when referring to the great loses civilized life imposes on our sexuality, forcing us to veer off from our sexual aims, renouncing pleasures and limiting our objects. Freud talks of a transformation of the drive into “an impulse with an inhibited aim.”²¹ Sensuality is renounced in social life; lust is let go of in a barter with culture, which defers satisfaction under the promise of love. Knowing is suspended, turning into a mere pursuit, and ignorance becomes our passion.

In the footnotes to his “Postscript” to the case, Freud discusses Dora’s sexual curiosity and mentions that her “knowing all about such things and, at the same time, her always pretending not to know where her knowledge came from was really too remarkable. I ought to have attacked this riddle.”²² It seems that the riddle of hysteria offers the chance for a great revelation in each failed attempt at resolution. The Sphinx knows the answer to her riddle but seems not to know from where her knowledge comes. Why is it that hysterics disown the knowledge they produce? How is it that they do not know what they know? While it is true that hysterical symptoms pointed to the sexual reality of the unconscious, what hysterics resist knowing is exactly that which their symptoms are unconsciously sustaining: they do not want to know that there is no knowledge about sexuality. Oscar Masotta conceives of the unconscious as what is “not working” between the knowledge of sexuality and sexuality itself.²³ As Maurice Blanchot has taught us, there is always a positive side to “unworking.”

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Notes

  1    See Jacques Lacan, Ou pire, séminaire 1971–72, Session of 4 November, 1971. Unpublished papers.

  2    Karl Abraham, Selected Papers, trans. Douglas Bryan and Alix Strachey (New York: Basic Books, 1954), 111.

  3    Ibid.

  4    Ibid., 112.

  5    Ibid., 113.

  6    Ibid.

  7    Ibid.

  8    Ibid.

  9    Ibid., 114.

10    Ibid., 115.

11    See Jacques Lacan, “Presentation on Transference,” in Écrits: The First Complete Edition in English, trans. Bruce Fink (New York: Norton, 2006), 176–185.

12    See Sigmund Freud and Josef Breuer, “Studies on Hysteria,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 2, ed. and trans. James Strachey (London: Hogarth Press, 1955).

13    See Freud, “Fragment of an Analysis of a Case of Hysteria (1905 [1901]),” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 7, ed. and trans. James Strachey (London: Hogarth Press, 1953), 118.

14    Lacan, “Presentation on Transference.”

15    Sigmund Freud, “The Infantile Genital Organization (An Interpolation into the Theory of Sexuality) (1923),” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 19, ed. and trans. James Strachey (London: Hogarth Press, 1961), 127.

16    Juliet Mitchell, “Introduction I,” in Juliet Mitchell and Jacqueline Rose, eds, Feminine Sexuality: Jacques Lacan and the École Freudienne (London: Macmillan, 1985), 11–12.

17    Dany Nobus, Perversion: Psychoanalytic Perspectives/Perspectives on Psychoanalysis, ed. Dany Nobus and Lisa Downing (London: Karnac, 2006), 9.

18    Jacques Lacan, The Seminar of Jacques Lacan: The Four Fundamental Concepts of Psychoanalysis, ed. Jacques-Alain Miller, trans. Alan Sheridan (New York: Norton, 1981), 169.

19    Ibid.

20    Jacques Lacan, Écrits, trans. Bruce Fink (New York: Norton, 2006), 676 (translation modified); [Qui ne voit la distance qui sépare le malheur de la conscience dont . . . on peut dire qu’il n’est encore que la suspension d’un savoir—du malaise de la civilisation dans Freud, même si ce n’est que dans le souffle d’une phrase comme désavouée qu’il nous marque ce qui, à le lire ne peut s’articuler autrement que le rapport de travers (en anglais on dirait : skew) qui sépare le sujet du sexe ?] Jacques Lacan, Écrits (Paris: Seuil, 1966), 799.

21    Sigmund Freud, Civilization and Its Discontents, in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 21, ed. and trans. James Strachey (London: Hogarth Press, 1961), 102.

22    Freud, “Fragment of an Analysis of a Case of Hysteria,” 120.

23    See Oscar Masotta, Lecciones de Introducción al Psicoanálisis (Mexico: Gedisa Editorial, 1991), 29.

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9

SIMULATION, EXPRESSION, AND TRUTH

In the 1950s, however, when Lacan announced his “return to Freud,” hysteria was quickly disappearing. Lacan’s rereading of Freud meant a return to the path of truth and knowledge, as opened up by hysteria. The return to Freud was in fact a return to hysteria. This meant for Lacan undoing his early training in clinical psychiatry for he, like most French neurologists and psychiatrists of his generation, had started his clinical career as a Babinskian.¹ Just eight years after his death, Charcot’s work on hysteria had been almost completely demolished in France. By 1901, Joseph Babinski, one of Charcot’s favorite disciples, had separated neurological organic diseases from hysteria. While this separation established the foundations for modern neurology, it was accompanied by the complete dismemberment of hysteria. Hysteria suffered a semantic suppression as Babinski replaced it with pithiatisme. Pithiatism was coined from the Greek words peithos (I persuade) and iatos (curable).² This new term conveyed that hysteria was a kind of simulation curable by suggestion.

During that time, the surrealists were flamboyantly celebrating hysteria. Above all, they opposed the eradication of the theory of hysteria, made invisible but no less powerful. The surrealists celebrated hysteria as a poetic creation and proposed a novel encounter between the Freudian unconscious and language. Their tribute appeared in a 1928 special issue of La révolution surréaliste. The manifesto-like tract, titled “The Fiftieth Anniversary of Hysteria,” was signed by Louis Aragon and André Breton. Printed in capitals, it began:

WE, SURREALISTS, WANT TO CELEBRATE HERE THE FIFTIETH ANNIVERSARY OF HYSTERIA, THE GREATEST POETIC DISCOVERY OF THE END OF THE NINETEENTH CENTURY, AND PRECISELY AT A TIME WHEN THE CONCEPT OF HYSTERIA APPEARS TO BE COMPLETELY DISMANTLED.³

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What followed was a rapid recapitulation of the history of hysteria from Charcot and Freud to Babinski, without forgetting Bernheim, quoted as saying that hysteria is a “complex and protean disease that escapes from any definition.”⁴ Reacting against Babinski, Breton and Aragon concluded their manifesto with a new definition of hysteria. “Hysteria,” they wrote, “is not a pathological condition and can be considered in every respect as a supreme vehicle of expression.”⁵ They paid homage not to Charcot but to Augustine, his famous, beautiful patient. They insisted on hysteria as an involuntary poetic trance that opens new vistas by abolishing the borders between dream and life—a true life, for the surrealists, was a constant day-dreaming state. The poetic and sexual metaphors created by the hysterics were to accomplish a “subversion of the subject” and usher in a new “dialectics of desire,” to quote a later text by Lacan.

Lacan discovered the far-reaching importance of Freudianism less through medical literature than through Surrealism. Lacan, like Breton and Aragon, had studied medicine. Lacan’s medical career followed the usual course. From 1927 to 1931, he was at the Saint Anne Hospital, one of the most prestigious mental hospitals, where he studied mental and cephalic disorders. As Roudinesco points out, of all of Lacan’s clinical cases of the period 1927–1932, one finds only one case of hysteria, but it is also the most interesting one.⁶ Co-authored with his friend Maurice Trénel, the article was presented at the Neurological Society on February 2, 1928 under the title of “Abasia in a War-traumatized Female Patient.” The language remains Babinskian: Lacan and Trénel write that the case was remarkable because of “the singularity of a motor problem of true pithiastic nature.”⁷ The word hysteria is not employed once in the five-page case study. At the time, Babinskian terminology had not fallen in disuse; Lacan and Trénel had to adopt the Babinskian vocabulary required by the dominant medical scientific discourse.

The subject of the study was a woman whose house had been destroyed by an artillery shell on June 22, 1915. She suffered superficial wounds: her leg had been trapped in the shattered floorboards when her house collapsed. After passing through various regional and Parisian hospitals, among them La Salpêtrière, her illness was marked by an eccentric style of walking. She walked as if performing a complex choreography of strange dance steps: she would take little steps on tiptoes, she would slide her feet on the ground, and cross her legs one in front of the other; she would walk backwards. The backward walk was the most complex one: she would advance by spinning on herself in reverse. As Lacan and Trénel report, however, a hospital security guard affirmed that once he saw this patient walking straight, completely normally, for a few yards when she was alone and unaware of being observed. In all her narratives she insisted upon what an army doctor at the Saint-Paul hospital had told her: “You will keep straight, you will stand straight, you are straight, you will remain straight.”⁸

Lacan and Trénel ironically point out that this early exposure to Babinskian therapy-by-repeated-suggestion not only proved ineffective but also gave her an early taste of iatrogenics; her illness was, if not produced, at least reinforced by the medical treatment. From then on, she walked with her body thrust forward, rocking from side to side and scuffing her feet. The patient explained that she needed to walk in this bizarre way, taking the very small steps that she called “on boat,” because otherwise she would fall. She reportedly claimed to feel that all was collapsing in her thorax.⁹ This case echoes the curious gait of Beckett’s characters whose exotic or mechanical ways of walking allegorize a sense of inner collapse. The patient was a relatively well-known case. She went from hospital to hospital where she received all sorts of treatments, including electric shocks, without any sign of improvement. The almost parodic aspect of her strange ambulatory antics not only betrays her personal disarray but also seems to mock institutional medical knowledge: she refused to “walk straight,” or within prescribed bounds.

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Lacan and Trénel’s case evinces a striking similarity to Freud’s clinical study of Elizabeth von R., also a case of analysis of hysterical abasia and Freud’s first full-length treatment of hysteria, published in the Studies. Freud successfully treated Elisabeth von R. just after having transformed his interpretation of hysteria, abandoning the “seduction theory.” Thus Freud wrote to Fliess: “The mechanism of poetic creation [Dichtung] is the same as that of hysterical fantasies.”¹⁰ Freud anticipated the surrealists’ idea of joining poets and hysterics. Both groups adopt a creative use of language that subverts commonsensical expressions and produces a new grammar of metaphor. Lacan would thus observe hysterics because of his fondness for poetry. He published one poem, “Hiatus Irrationalis,” and his poetic style has been one of the obstacles in the transmission of his work, especially in the United States.¹¹ Lacan’s progression towards a scientific study of the unconscious implied incorporating the teachings of poets who grasp something about the unconscious that remains inaccessible to others. Lacan’s work follows the rhetorical strategies of poets and hysterics, using language in innovative ways that are both challenging and enlightening.

For the young Lacan, the poetic creations of the surrealists would act as an antidote to the reductionism demonstrated by Babinski and his school. However, Lacan’s connection to Surrealism insofar as hysteria is concerned remains tentative. True, the young Doctor Lacan was known in surrealist circles as a brilliant specialist in psychosis. Lacan was learning more from psychosis than from any other psychic structure. He had not yet discovered the magnitude of Freud’s work on hysteria, which he was to use so fruitfully decades later, nor the extent of the originality of the psychoanalytic method. He would later consider the words of the hysterics as “presenting us with the birth of truth in speech.”¹² At the time, Lacan was elaborating a new conception of language. He analyzed the paranoid structure in its semantic, stylistic, and grammatical peculiarities. He noted that the extravagant language of paranoids resulted from a process tantamount to the one at work in the poetic experiments of the surrealists. His innovative view was expressed in its accomplished form in his doctoral thesis of 1932 on paranoid psychosis.

Even though his dissertation deals primarily with paranoia, the section devoted to the “Definition of Psychogenesis in Psychopathology” make reference to hysteria in a footnote that aspires “to contribute some order to the confusing debates about the pathogenesis of hysteria.”¹³ In the footnote, Lacan claims that even when hysteria results from an organic lesion or modifies a physical function, this fact does not preclude the possibility of a psychic organization at play. He argues that one can act upon the symptom by one causal chain or the other. Lacan recommends that one should not exclude either mechanism and refers the reader to the case of abasia that we have discussed. He concludes that this double perspective can clarify “difficult notions like over-simulation and pithiatism.”¹⁴

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We saw that in 1928 Lacan approached hysteria with the Babinskian terminology conforming to psychiatric orthodoxy. In 1932, his position was more complex. On the one hand, his loyalties were on the side of traditional psychiatry, and his main focus of interest was psychosis, supposedly a barren field for psychoanalysis. On the other hand, he implicitly criticized the psychiatric legacy by putting forward a new notion of psychosis. Lacan, at this point in his career, was a para-Surrealist who sought to identify a common poetic logic in psychosis and the experimental writing of the avant-garde. However, unlike the surrealists, he did not partake in their exuberant praise of madness, nor did he hold society responsible for mental illness. He was undergoing the transition from neurology to psychiatry in order to move into psychoanalysis. But when he referred his readers to his presentation on abasia, it is clear that he took his early case study seriously enough. The fact that he considers pithiatism and over-simulation to be “notions” that merit a clarification is symptomatic. The confusion that he perpetuates while trying to dispel it reveals that he was still bogged down by a French psychiatry in disarray after Babinski.

By contrast, in 1936, Lacan was already a Freudian who explicitly criticized the use of the term pithiatism, as one can see in his “Beyond the Reality Principle,” which appeared in a special “Freudian Studies” issue of Évolution Psychiatrique and was later included in Écrits. By then, in Lacan’s view, the notion of pithiatism represented a coalescence of the medical profession’s systematic disregard for psychic reality.¹⁵ In this piece, written just four years after his doctoral thesis, Lacan exorcised the demons of his psychiatric training in order to stress his psychoanalytic leanings. Finally, his substantial study on the family complexes, published in 1938 in the Encyclopédie Française, fully established his reputation. It also provided a very short summary of his early views on hysteria. In this piece, Lacan connects the “organ-morphic symbolism” of hysteric symptoms with the experience of the fragmented body of the mirror stage.¹⁶ In hysterical symptoms, a localized body-function is distraught: organs get paralyzed, lose sensation, and become painfully inhibited, expressing a fragmentation of the body that defies anatomical laws. Noting the similarities between the motor manifestations specific to the “mirror stage” and the motor symptoms specific to hysteria, he also locates the “mirror stage” at the origin of the constitutional hysteric somatic compliance. Lacan veered away from the Freudian schema when connecting the mirror stage and hysteria. For him, hysteria hypostatized at an organic level the notion of a fragmented body. The hysterical body confirmed his conception of the body as an image of the body. As he affirms in his piece on the mirror stage, when the symptoms of hysteria behave in a manner that shows that they ignore the physiology of bodily structures, they reveal how the body is divided according to the “the lines of ‘fragilization’ that define the hysteric’s fantasmatic anatomy.”¹⁷ Thus, Lacan is reformulating Freud’s early observations that “hysteria behaves as though anatomy did not exist,”¹⁸ because hysterical ailments are more faithful to language than to anatomy. For instance, a hysterical paralysis of the hand often takes the shape of a glove, following the meaning of the word “hand” rather than the physiology of the distribution of nerves, muscles, ligaments. In hysteria we see an imaginary body at work. Lacan concludes this brief section on hysteria by saying that in hysterical subjects one sees the pathetic images of humans’ existential drama. No other original contribution of Lacan’s can be found here, yet we can see that his perspective on hysteria is already Freudo-Lacanian.

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Between a short reference to hysteria in his 1938 article on the family for the Encyclopédie Française and his 1951 “Presentation on Transference,” not much was advanced by Lacan on hysteria. Lacan’s “Return to Freud” marked the beginning of a period of greatly expanded thinking and elaboration of psychoanalytic concepts. In his seminars, now open to the public, Lacan interacted with an audience who felt that they were rediscovering the unconscious and thus reinventing psychoanalysis. His view of psychoanalysis incorporated the teachings of philosophy, linguistics, mysticism and game theory. “Presentation on Transference” was dedicated to hysteria and could be the first “Lacanian” contribution to the topic. In this study of Freud’s case of Dora, Lacan showed that the analytic experience belongs to the order of speech as the realm in which truth can emerge. Clearly, he defined transference as the moments when analysts get lost and must take their bearings anew, and psychoanalysis as a dialectical experience in which the “ortho-dramatization” of the analysand’s subjectivity depends on the analyst’s response.

By 1951, if Lacan was clearly Freudian, the innovative thrust of his study of Dora’s case derived from his reliance on non-Freudian concepts such as the “beautiful soul” and “dialectic reversals.”¹⁹ Lacan was applying a terminology borrowed from Hegel to his understanding of the case. With the help of Hegel, Lacan rendered legible a new logic of hysteria. Lacan made use of Hegel in the 1950s in order to get a fresh perspective on this case of hysteria while addressing specific questions of psychoanalytic technique. The utilization of Hegel specifically on hysteria reached a zenith in his 1970 Seminar XVII L’envers de la psychanalyse, in which Lacan not only put forward the idea of the discourse of the hysteric but also declared the male philosopher Hegel to be “the most sublime of the hysterics.”²⁰

The hysteric’s discourse pertains not only to a subjective structure but also to the essence of the speaking being. Whenever we speak we necessarily assume a position, a relationship that establishes a social link. In his algebra of the four discourses, Lacan identified four such forms of social link or discourse: the discourse of the Master, the discourse of the University, the discourse of the Analyst, and the discourse of the Hysteric. His system combined the permutations of four symbols: S1 (the master signifier), S2 (knowledge, savoir), a (surplus enjoyment), $ (subject). The complex algebra of the theory of the four discourses proposed in L’envers de la psychanalyse demonstrates a forceful return of the hysteric into Lacanian theory. This idea of a discourse of the hysteric is an innovation that allows one to address the relationship between jouissance and desire; to conceive desire as a wish for an unsatisfied desire; to talk about the hysteric as the one who makes the man (or the Master); to see the hysteric as the one who manufactures the man animated by a desire for knowledge; and, ultimately, to think of the analytic cure as a hysterization of discourse.

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The question that remains to be answered is whether Lacan is really talking about hysteria when he talks about the discourse of the hysteric. To deal with this question, we need to explore the genesis of his reinterpretation of hysteria as a social link. Let us remember that Lacan did not produce a discourse of the obsessional neurotic, the psychotic, or the pervert. If there is a difference between hysteria as a psychic structure and hysteria as a form of discourse, why does he use in both cases the word “hysteria”? Could it be that with the invention of a discourse of hysteria, Lacan had gone back to his early Babinskian training, but with a different stress, replacing “simulation” as a structure of deceit with “stimulation” as a structure demanding truth?

We know that Lacan’s goal was to provide Freudian notions with a more rigorous formalization. This can be seen in Lacan’s theory of the four discourses, in which one finds Lacan’s most systematic development on hysteria. With the construction of his “discourse of the hysteric” he touches on the social conditions in order to integrate them into his notion of hysteria. Lacan calls attention to the importance of the Other in hysteria (often this Other is a woman—the Other woman), for the hysteric’s desire is the Other’s desire. However, as Lacan asserted in 1961, the hysterical relation is not with the small other, but the big Other, in which the hysteric devotedly believes. Following a later elaboration in which Lacan states that the Other does not exist, one could say that in fact the hysteric invents the Other. To this Other, the hysteric addresses the question: “What am I?” and identifies with whatever answer is provided by whoever occupies the position of the Other. “Whatever you say I’ll be”: a witch, a saint, a hysteric, a pithiatic simulator, a martyr.

The symbolic dimension of demand—as a demand for love—overshadows the fact that demand is the articulation of a need. Once again we find echoes of Kojève, who noted that the object of desire is “perfectly useless from a biological point of view.”²¹ This “biological uselessness” can be illustrated by anorexia. Lacan notes that in anorexia there is an anticipation of the Other to the articulation of the demand; the subject rejects the gift offered by the Other to have space to formulate a demand that will safeguard desire. A child will refuse to eat the food given before he has asked for it to preserve his appetite for nothing and desire nothing. The demand for love is both unconditional and unsatisfiable. Desire is the leftover that results from the subtraction of the appetite for satisfaction, from the demand for love. Desire results from the division of the subject caused by language; and demand, as Lacan poses in 1960, is addressed to the Other.

Dora, too, was asking for love in her demand: she wanted to be given what someone did not have, and like a “good hysteric” she not only sustained the Other’s desire but was also sustained by it. She played a key role in the intrigue of betrayals that captured her. She actually supported the relationship of her father and Frau K.: she did everything possible to help his father meet with his lover. One can explain Dora’s complicity in being used as an object of exchange by the men around her through her hysterical and virile identification with them. Her role as a “beautiful soul” can be understood as a paradoxical wanting-and-not-wanting to recognize her involvement in a double role as agent. Dora “accepts” the despicable exchange as if she were one of the primary beneficiaries in the bartering; she “agrees” to be the object exchanged. Her identification offers an alienating redoubling. On the one hand, she sees herself as the passive victim, and identifies with this role; this is how she presented herself to Freud, and this is how she consciously believed things were operating. On the other hand, her unconscious identification is with a structure that enables her to assume this role. As a “beautiful soul,” Dora does not take into account her responsibility in the mesh of intersubjective relations that she is exposing. However, the benefits of the farce evaporated when Herr K. interrupted the circuit of exchange, thus breaking the promise that Dora might access the mystery of femininity embodied in Frau K. He said the only thing he should have never said: confessing to Dora his lack of interest in his wife.

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In Dora, the assumption of sexuality is mediated by a man (Mr. K.) who is positioned as the other, who has a wife who provides access to the Other of sex. Concealed behind the position of the “beautiful soul,” Dora’s duplicity reminds us of Freud’s observations of the bisexual nature of hysterical fantasies. In “Hysterical Fantasies and their Relation to Bisexuality” (1908), Freud gives the famous example of one of his patients during a hysterical attack: she presses her dress to her body with one hand, as a woman, while trying to tear it off with the other, as a man. In this example we see both aspects—of symptom and fantasy—at play.

We can now reexamine Lacan’s and Trénel’s analysis of the patient who was trying not to walk straight as a defense against an Other prescribing a code of normativity—be it an orthopaedics of her body posture or the forceful imposition of sexual orientation. We can verify that her desire as a hysteric subject was caught up in the Other’s word. Recall that she was told to walk straight by an army doctor—“You will keep straight, you will stand straight, you are straight, you will remain straight”—and that she fully identified with those words.²² She already had difficulties walking; but from then on, through a strong identification with the Other’s signifiers, she enacted this fateful sentence in her strange body movements (she was irreversibly unable to keep straight, stand straight, or even walk straight). The manifestation of her symptoms, while replicating the underlying structure, also subvert it—her trance-like dances can call up Abraham’s case. Spinning on herself, she may have found a space of freedom, creativity and resistance. In this example, the hospital doctor occupied the position of the Other who represents the authority invested in medical knowledge. Her eccentric ambulatory antics betray the impact on her body image of what she interprets as being the Other’s desire. Her strange choreography exposed how she was at once accepting and refusing to become the object of the Other’s desire, which calls up Dora’s plight. Her walk reminiscent of a dancing dervish, her avoidance of going straight within the bounds prescribed by the Other reveal both her dependence on the Other and a new challenge. While she infuriated doctors who were frustrated in their attempts at curing her, her rebellion managed to create an in-between space.

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Lacan’s original contribution was to identify the place of hysterical desire in the economy of discourse. Hysterical desire is a central question with far-reaching implications, and it is one that requires interpretation. This is how Lacan discusses it in Seminar V:

What is the desire of my hysteric? It is what opens what I would not say is the universe, but a whole wide world of what we can call the vast dimension of the latent hysteria in every human being in the world. . . . Any hysteric echoes everything related to the question about desire as it appears in others, especially in the other hysteric, but also in someone that may not be hysteric, only occasionally, or even in a latent manner, insofar as he or she would manifest a hysteric modality of posing the question.²³

Here, already, Lacan deploys a definition of hysteria that exceeds the notion of neurosis. The hysteric echoes everything related to the question about desire as it appears in others, hysteric or not. “Hysteria” has already taken on an extended social sense and includes a dimension that is latent in all speaking beings, as long as they question their desire. That desire can be a source of perpetual questioning is the natural consequence of the alienation introduced by speech—the speech of hysterics and non-hysterics alike.

The cause of one’s own desire and enjoyment remains enigmatic. The fact that we may pose the question, “What am I?” or “What do I want?” should make a hysteric of all of us. As we have seen, this idea, just launched in Seminar V, is developed fully more than a decade later, in Seminar XVII, L’envers de la psychanalyse, where Lacan addresses the formal relationships that the very act of speaking establishes. We can understand then why he proposes to define hysteria as a mode of social bond that he calls the “discourse of the Hysteric.”

There is one important aspect in Lacan’s hysterization of psychoanalysis: for him, hysteria is not a pathology, because it defines the essence of the speaking being divided by and coming into being in language. Moreover, we can observe that Lacan was not above implicating himself in hysteria. Commenting on a grammatical mistake that he had made by referring to a young woman in the masculine, he observed: “All things considered, I am the perfect hysteric, that is, one without symptoms, aside from an occasional gender error.”²⁴

What can we make of Lacan’s occasional gender error, an error that, as we will see, proves that hysterics have trouble with sexual difference? Here is the section from the seminar of December 14, 1976:

This leads us to consider the hysteric, who everyone knows is as much a male as a female, the hystoric, if you allow me that slippage, basically consists only of the unconscious. She’s the radically other. She’s even nothing except as other. I feminize the other in this instance, but as you’ll see, I’m going to throw my weight on the other side.

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For this is my situation. I too am nothing but an unconscious. That’s even why I think about it all the time. It gets to the point that I even think the universe is toric. It means nothing else. I consist only of an unconscious, which I think about night and day, and this renders the une-bévue inexact—I make so few blunders! Of course, I make them from time to time. It happens that in a restaurant, I’ll say, “The lady is réduit to eating nothing but crayfish à la nage.” [Mademoiselle en est réduit à ne manger que des écrevisses à la nage]. [The correct expression should have been “en est réduite.”]

As long as we make an error of this kind, it doesn’t amount to very much. All things considered, I’m the perfect hysteric, that is, one without symptoms, except, from time to time, such errors of masculine and feminine.²⁵

Lacan’s gender error goes back to the bisexuality discovered by Freud at the root of hysteria. The fact that Lacan made a gender error in French grammar illustrates his definition of hysteria: it combines elements of topology and the idea of the unconscious as the une-bévue—a French transliteralization of Freud’s Unbewusst—a one-gaffe, a one-blunder. One might translate it, as Dan Collins wittily does, as “unbewoops.”²⁶

With the coining of the unconscious as “une-bévue” or “one-blunder,” Lacan distances himself from the Freudian idea that hysterics suffer from memories that need to be recovered and takes a direction that paradoxically brings him back to his Babinskian point of departure—however, with a difference. The unconscious as “une-bévue” introduces the dimension of the blunder, of the error, that we saw is so recurrent with transgender people who feel they are inhabiting the wrong body. Such an error can be traced back to Freud’s notion of hysteria as founded upon the hysterical prôton pseudos, a term which means both logical error and lie.²⁷

The notion of prôton pseudos is complex. In his early manuscript Project for a Scientific Psychology, Freud connected hysteria with logical theory in a passage entitled “The Hysterical πσωτον πσεδοs (prôton pseudos)” that condenses the case of young Emma who is unable to enter in a store alone. This phobia started when she was twelve. She entered a store and saw two salesmen laughing. She rushed out in panic, thinking that they were making fun of her, but felt guilty. Freud brought out an earlier memory from when she was eight. She had gone to a grocery store and the owner had molested her by touching her genitals through her clothes. She went back once more, as if to repeat the scene. Only at the age of twelve, when she was old enough to understand what had happened, did she experience disgust and panic, and the phobia started.

Emma’s associations run like parallel series of memories. The two series intersect: the laughter of the shopkeepers evokes the smile of the grocer five years earlier. When she was older, Emma had been attracted to one of the shopkeepers, which made her feel responsible for the first seduction scene. In her chains of images and memories, only “clothes” and “guilt” remained. There is no direct causal link here; the first scene of seduction could have turned into a scene of rape that would have constituted a trauma in the classical sense. Here, it brought an unknown pleasurable excitation to be reactivated later, triggering the panic. The memory of the first scene became pathological within the unconscious reconstruction operated by the second scene. This defines the hysteric’s prôton pseudos, an expression abridged as “Pp.” Freud borrowed the term from Aristotle’s Organon. This is a logical error about premises. For Aristotle, “falsity in an argument rests on the first false statement (prôton pseudos) which the argument contains.” Thus any error in the premises vitiates any subsequent reasoning.

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The translators themselves erred when they rendered Freud’s Greek phrase as “the first lie,” as it is in the Standard Edition. Leaving the expression in Greek, Freud played on the two meanings contained in pseudos. Pseudos means “lie” and “logical error,” and “fallacy” would be more accurate: it retains the undecidability of the original. In Freud’s earliest systematization of the mechanism underpinning hysteria, a margin of indecision is left between lie, error, and creativity. If hysterics suffer from reminiscences, as Freud always insisted, and memories are always screen memories, hysterics suffer from prôton pseudos.

Hysterics were thought of as being caught between deception and wayward thinking, between simulation and flawed logical reasoning. Lacan’s Babinskian past showed that hysterics were not sick because of their repressed memories, but were sustained by an “armor” that was founded upon a deceptive mistake. If they are simulators, even quite professional at it, they may be telling the truth with a lie.

Language cannot lie even if it never tells the whole truth. You need a hysteric to show you that perfection is never complete but needs a supplement, an excess of truth. I will assert that when an analyst receives into the office an analysand who might identify as transgender, the analyst has the opportunity to repeat Freud’s gesture when confronted with his first hysteric patients. While Charcot reduced them to objects of display in the Salpêtrière’s amphitheater, Freud restored their dignity by listening to them. Let us follow Freud and listen to trans patients in the plurality of their presentations. Their subjective truth will emerge. The analyst would err on the side of prejudice by not allowing the unconscious to show the way of the errancy of truth. At times, that truth can be observed today in the social discourse of the hysteric. This discourse has meshed in with renewed attempts at transcending social limitations and the ideology of subjective normativity. One of its most visible exemplifications is the rebellious, shocking but also poetic, often trance-like discourse of trans people.

Notes

  1    Earlier versions of this material were originally published as “Lacan’s Hysterization of Psychoanalysis: From Simulation to Stimulation,” Analysis 14 (2009): 113–126, and “Where Have the Hysterics Gone? Lacan’s Reinvention of Hysteria,” ESC English Studies in Canada 40, no. 1 (March 2014): 47–70.

  2    See Joseph Babinski, Démembrement de l’hystérie traditionnelle : Pithiatisme (Paris: Imprimerie de la Semaine Médicale, 1909).

  3    André Breton, “Le cinquantenaire de l’hystérie (1878–1928),” in Oeuvres complètes, vol. 1, ed. Marguerite Bonnet et al. (Paris: Gallimard, La Pleiade, 1988), 948.

  4    Ibid., 949.

  5    Ibid., 950.

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  6    Élisabeth Roudinesco, Jacques Lacan (New York: Columbia University Press, 1997), 19.

  7    Jacques Lacan and Maurice Trénel, “Abasie chez un traumatiseé de guerre,” Révue neurologique 2 (1928): 233.

  8    “Tenez vous bien droite, vous vous tiendrez droite, vous êtes droite, restez droite.” Ibid., 234.

  9    “Effondrement du thorax.” Ibid., 236.

10    Jeffrey Moussaieff Masson, The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887–1904 (Cambridge: Belknap Press of Harvard University, 1985), 251; translation slightly modified.

11    Jacques Lacan, “Hiatus Irrationalis,” Le Phare de Neuilly 3/4 (1933): 121. Reprinted in Magazine litteraire 2 (February 1977): 11.

12    Lacan, Écrits: The First Complete Edition in English, trans. Bruce Fink (New York, London: Norton, 2006), 212.

13    Jacques Lacan, De la psychose paranoïaque dans ses rapports avec la personnalité (Paris: Éditions du Seuil, 1975), 46, footnote 33.

14    Ibid.

15    See Lacan, Écrits, 64.

16    See Jacques Lacan, “Les complexes familiaux” in “La famille,” in Encyclopédie Française, ed. Henri Wallon, 8:40.3–16 and 42.1–8 (1938). Reprinted in Autres écrits (Paris: Seuil, 2001), 75.

17    Lacan, Écrits, 78.

18    Sigmund Freud, “Some Points for a Comparative Study of Organic and Hysterical Motor Paralyses,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 1, ed. and trans. James Strachey (London: Hogarth Press, 1966), 169.

19    Lacan, “Presentation on Transference,” 178–180.

20    Jacques Lacan, The Seminar of Jacques Lacan. Book XVII: The Other Side of Psychoanalysis, ed. Jacques-Alain Miller, trans. Russell Grigg (New York, London: Norton, 2007), 35.

21    Alexandre Kojève, Introduction to the Reading of Hegel, trans. James Nichols, Jr. (New York: Basic Books, 1980), 6.

22    Lacan and Trénel, “Abasie chez un traumatiseé de guerre,” 234.

23    Jacques Lacan, Le séminaire. Livre V: La relation d’Objet, 1956–1957, ed. Jacques-Alain Miller (Paris: Éditions du Seuil, 1998), 446–467.

24    My translation. Jacques Lacan, “Le séminaire XXIV: L’insu que sait de l’une bévue, s’aile a mourre,” December 14, 1976, unpublished papers.

25    Jacques Lacan, The Seminar. Book 24, trans. Dan Collins, private circulation, 11–12.

26    Ibid.

27    Jean-Michel Rabaté, The Ethics of the Lie (New York: Other Press, 2007), 280.

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10

THE SWEET SCIENCE OF TRANSITION

If we define the hysteric as someone who cannot determine his or her object of desire, as someone who is always questioning whom to love, we can say that hysteria unveils the very structure of human sexuality as described by Freud in The Three Essays, a skewed sexuality that has no specific object and operates in capricious ways, a sexuality dominated by the drive, a border concept between flesh and language.

Hysteria also challenges cultural conventions, preventing ossification of practices while exposing our fragility of being. I am currently working with several analysands who identify as trans men, who take “T” (testosterone), who look for love by dating cis women, cis men, trans men, trans women, gays, lesbians; their psychic structure is that of hysteria. This fact has both clinical and political implications. Meta-psychologically, Freud’s general thesis was that hysterics had bisexual tendencies that they could not reconcile. At the heart of hysteria, there was the irreducible presence of a bisexual fantasy. In Hysteria from Freud to Lacan, Juan-David Nasio took Lacan’s insight about the difficulties experienced by hysterics about being an object of desire trapped in eternal dissatisfaction as a point of departure. Nasio then pushed the analysis further by asserting that hysterics were not just bisexual but not sexual at all; for him, hysterics are “asexual, outside sex.”¹

This radical exteriority would derive from a structure of indecision. Fundamentally, a hysteric would be someone who cannot know whether he or she is a man or woman. For Nasio, the hysteric has not managed to “appropriate the sex of his body.”² This view makes Nasio diverge from the standard view proposed by Charcot and his followers, a view also shared by Freud: they all attempted to distinguish a masculine hysteria—which was the novelty at the end of the nineteenth century—from a traditionally feminine hysteria. To make his position clearer, Nasio adds: “The expression masculine hysteria is a contradiction in terms, since the noun hysteria means sexual uncertainty (neither man nor woman) while the adjective masculine, by way of contrast, makes a choice precisely where choice turns out to be impossible.”³

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Even if it is counterintuitive, there is an element of truth in this theory. Superficially, it resembles Catherine Millot’s theory of an “horsexe,” this “outside sexuality” that would define transsexuality and that I have discussed previously. My practice as a psychoanalyst in the United States has led me to deal mostly with hysteric analysands who find it exceedingly challenging to assume a sexual positioning, which seems to be what Nasio describes. While some are wondering “Am I a man or a woman? And what does that mean?” others may say: “I can’t believe I was born a female and now I am a trans man.” However, in this chapter, I will assert that being hors-sex, outside sex, is not necessarily a sign of psychosis, but rather one common feature of the most classical forms of neurosis—hysteria. Perhaps as Shanna Carlson writes, there is very little difference between transsexuals, hysterics, and cisgender subjects other than that the latter might enjoy a “false monopoly” on the “psychic experience of semblance of gender certainty.”⁴ Hysterics may be outside sex as undocumented immigrants are outside the national definitions of citizenship. Being outside sex does not cancel out sexuality; on the contrary, it makes it more of a point of reference.

For those who identify as trans men, taking “T” and binding their chest or undergoing “top surgery” (double mastectomy), growing facial hair, and wearing baggy clothing are ways of trying to embody a body that is hard to assume. The expression “to have a body,” as Lacan observed, shows that one “is not a body”: “having a body” while “being a body” requires a process of assuming the body one inhabits. With “T” the voice lowers, facial hair grows, and for some, like Paul (formerly Beatriz) Preciado, a self-declared “testo-junkie,” testosterone will induce what can be called “testo-mania.” Preciado waxes lyrical on the topic: “Power girls-orgasms-adrenaline-extravagance-social recognition-success-glucose-family acceptance-inclusion-strength-tension-camaraderie-financial ascent, these are the political surplus value obtained by a cis-female who ingests testosterone. Testosterone is immediate gratification, an abstract platform for the production of power, but without the comedown of coke, without the hole in your stomach that comes after the effects of crystal have worn off, without the grotesque self-satisfaction triggered by Prozac. There is only one drug like testosterone: heroin.”⁵

However, the best “T” cannot guarantee against the dissatisfaction that is inherent to hysterics’ desire, even when they are in love, for indeed satisfaction is elusive for hysterics. Paul Preciado writes: “Right where satisfaction is supposed to emerge, frustration emerges.”⁶ Strategies meant to avoid the realization that any satisfaction is limited are well in place:

When I am kissing her, I think I want to kiss her; when I am talking with her, I think I have an urgent need to talk with her . . . The present moment, the instant of assimilation, has no importance compared with the overwhelming necessity for what must come immediately after. More, more as quickly as possible. A moment later, desire will be still more intense, and on and on, more and more. Desire doesn’t destroy itself. It transforms itself, changing into an unconscious state during fatigue or sleep. I desire to continue desiring, without any possibility of satisfaction.⁷

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Psychoanalysis helps us understand that satisfaction is always obtained with limited means. Any other form of satisfaction beyond these constraints would fall within what Lacan calls the “Other’s jouissance” or the “jouissance of the Other,” which is a jouissance that cannot be properly qualified as sexual because it is not constrained by castration. It is also very different from the Other’s jouissance, which is found on the feminine side of the sexuation formulae. The Other’s jouissance is a form of satisfaction that, if realized, would put in danger the subject’s whole being.

If satisfaction is postponed, dissatisfaction, nevertheless, has its benefits. Let us recall Freud’s interpretation of the dream of smoked salmon. The hysteric creates an unfulfilled wish; her dream represented this renunciation put into effect. Although she craves for caviar, she does not want to be given any. In order to maintain her desire for caviar eternally alive, she limits her satisfaction and purposely avoids finding an object for her desire. The resulting dissatisfaction re-sends her desire in an aspiration toward a removed ideal of being. Lacan suggests that in the human economy of desire what lies behind the pursuit of a perpetually fleeting ideal object is, above all, the desire of an unsatisfied desire.

To be more precise, let us say that hysteria also entails a defensive strategy so as to avoid issues raised by castration. Hysterics delude the Master they invent by making him believe he is complete, all powerful; thus they avoid confronting their own castration. Here, castration should be understood as the impossibility of achieving a harmonious rapport between the sexes, because the realization of such Utopia of complementarity would require the denial of sexual difference. Even though hysterics try to fill the Other’s lack, they never fully succeed in doing so, which presents an important difference from perversion.

Let me give you other examples. Many of the trans men analysands arrive to analysis quite young, often sent by the parents, as with Dora or the so-called Young Homosexual Woman treated by Freud. Here is the case of a 14-year-old, whom I will call Leslie. Leslie changed his given female name for a gender-neutral name, prefers the use of male pronouns, and appears quite melancholic, spending long hours locked in his bedroom playing video games, smoking marijuana, and lagging behind in his school work.

Leslie tells me that he is often tired and sad; when he comes back from school he wants “to disconnect,” thus he goes to sleep and neglects his homework. The only thing that brings excitement to his life is boxing. At this point, an interesting issue emerges. Leslie has amazing knockout power, incredible balance, and swift footwork—for a female. Everyone admires his abilities that exceed those of any of the women boxing. But if Leslie were to compete as a man, his performance would be unremarkable. He is strong insofar as he is considered a female boxer, not as strong if he competes as a male. He is not sure what to do about this predicament. As if only in boxing, Leslie could ask, “What am I? A man or a woman?”

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Among causes for his sadness, both parents suffer from depression and both are currently taking antidepressants. Leslie’s father is from India, an engineer from a distinguished family of poets and scholars prone to nostalgic reminiscing. He is the only member of the family living in the United States. Leslie’s mother is fourth-generation American and has a big, close-knit family originally from the American mid-west. The mother is an only child; her birth was preceded by a series of miscarriages and followed by the premature death of a younger sibling, a baby born with a congenital disease that died as an infant when my analysand’s mother was five years old.

Besides her depression, her mother tells me that she agrees with “non-normative choices” since she herself had an important lesbian romantic liaison for several years before meeting and eventually marrying Leslie’s father. Since her college years, she has been active volunteering in several LGBTQ organizations, first during the 1980s AIDS epidemic, and now offering support for social justice initiatives.

While she seems very supportive of Leslie’s gender questions and explorations, intense conflict arises between Leslie’s preferences and the sartorial requirements demanded for formal family engagements. Leslie has been allowed to wear a suit for baptisms, weddings, and funerals. However, a great controversy was created when the family recently attended a funeral. Leslie was allowed to wear a suit, but not a tie, “because it is OK to look lesbian but not OK to look trans,” his mother said. Leslie can work well in the session, laughing at the polysemic implications of the “tie or not tie” discussions. Leslie’s trans identity appears “tied” to his mother’s lesbian past as well as his need to let that identificatory “tie” with mother become looser. For instance, both wear similar unisex hairstyles and wardrobes. Leslie tells me that his mother observed that simply wearing earrings could make everyone think that someone with short hair is a female; the manner in which Leslie reports this observation seems to imply that femininity is mostly a strategy of deceit.

Leslie appears to conform to Nasio’s diagnosis of an asexual hysteria. He has not managed to appropriate the sex of his body. This indecision reminds me of the recent comment of another analysand who also identifies as trans: “But I have to tell you, I have friends of friends who identify as women, who transitioned at 18, took T, had mastectomies, and now they are feminine, oh, very feminine, they say: ‘I had to become a man to know I wasn’t one.’” In this example, the itinerary goes from woman to man and then back to woman. The movement between gender seems to be done in order to reclaim an elusive femininity that could only be assumed once it was first erased and, then, retroactively, rewritten.

The question brought about by boxing tournaments, in which he still chooses to be paired with women, landed Leslie in several situations in which there was a “tie” and the judges were unable to decide who had landed more punches. Leslie would often win not through a knockout but because he showed more control, style, and technique—in fact, exhibiting more know-how or a superior knowledge about the sport. Hopefully, the analysis will produce another type of knowledge and know-how about subjective identity. So far, Leslie has changed pronouns and first name. There will be time to decide whether or not he is a man or a woman.

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All these worries took place during the Rio Olympics in August 2016, a time when many female athletes were confronted with the prospect of invasive and humiliating gender testing in order to ascertain whether they were actually female or male. Leslie had observed the case of Caster Semenya, a non–gender-conforming athlete married to another woman, and knew the entire process by which the effects of high testosterone are measured. The International Athletic Association’s protocol involves measuring and palpating the clitoris, vagina, and labia, as well as evaluating breast size and pubic hair scored on an illustrated five-grade scale. There was also a measure of testosterone and determination of chromosomes. This process upset Leslie, who followed the controversies closely. That entire discussion can be taken as a good example of a shift in social discourse: it moved from hormone levels to women’s rights, and from endocrinology to an ethics of difference.

Unlike Paul Preciado, Leslie rejected vehemently the idea of taking testosterone, precisely because this seemed to be an almost fetishistic object of gender testing in sports. Men and women generate testosterone in small quantities, greater of course for men. Some congenital disorders produce elevated levels of testosterone in women, but it is not clear that they offer a clear advantage in a competition. But if you take testosterone, it is considered a performance-enhancing substance.

In the New York Times article, “Runner’s Advantage Is Defensible; Scorn Is Not,” Jeré Longman quotes Dr. Eric Vilain, a medical geneticist from UCLA, who observes that “if we push this argument” entailed in the current questioning of the gender binary, “anyone declaring a female gender can compete as a woman.” In order to avoid humiliating sex-checks, some predict the impossibility of retaining a gender binary in sports. Vilain states: “We’re moving toward one big competition, and the very predictable result of that competition is that there will be no women winners”: if there is one single gender-blind competition for each discipline, it is quite likely that women, who score on an average at 10 percent less than men, could no longer win anything.⁸

This controversy fits with Lacan’s conception of hysteria understood not as a neurosis but as a collective structure, a whole “discourse” whose effect is to produce a social bond. In the case of the Olympics, the current discussion about male and female athletes corresponds to a slow shift in the social consensus about gender. This requires a certain type of knowledge about the competitions, their arcane rules, and the testing methods. Such knowledge will have to be sexualized. “Knowledge is perhaps eroticized to a greater extent in the hysteric’s discourse than elsewhere,” Bruce Fink asserts.⁹ Furthermore, the hysteric embodies a “unique configuration with respect to knowledge,” which Lacan will ultimately illustrate in Seminar XIV by a little apologue alluding to the art of the salesman, which is the art of making someone desire an object they have no need for, thereby pushing them to demand it. The hysteric works as a speaking riddle that poses a question that demands an answer. The hysteric’s commandment to say something about her symptoms produces a form of knowledge. This movement has inspired extensive knowledge—medical (from ancient wandering wombs to contemporary panic attacks), and religious knowledge (from demonic possession to miraculous sanctity) and even psychoanalysis (from a missing organic lesion to Freud’s discovery of the unconscious truth concealed in bodily symptoms). Thus the conditions under which the hysteric causes the production of such knowledge are the conditions for the production of knowledge in general. This is what I mean by learning from transgender.

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Notes

1    Juan-David Nasio, Hysteria from Freud to Lacan: The Splendid Child of Psychoanalysis (New York: Other Press, 1998), 56.

2    Ibid., 57.

3    Ibid., italics original.

4    Shanna T. Carlson, “Transgender Subjectivity and the Logic of Sexual Difference,” differences 21, no. 2 (2010): 65.

5    Paul B. Preciado, Testo Junkie: Sex, Drugs, and Biopolitics in the Pharmacopornographic Era, trans. Bruce Benderson (New York: The Feminist Press, 2008), 237.

6    Ibid., 251.

7    Ibid., 251–252.

8    Jeré Longman, “Runner’s Advantage Is Defensible; Scorn Is Not,” The New York Times, Aug. 20, 2016.

9    Bruce Fink, The Lacanian Subject: Between Language and Jouissance (Princeton, NJ: Princeton University Press, 1997), 133.

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11

THE SINGULAR UNIVERSALITY OF TRANS

Today’s practitioners may not know that Lacan was the first psychoanalyst in France to work with a gender-variant patient in a manner that expressed an ethics of sexual difference; Lacan’s intervention should have put an end to psychoanalytic gender identity narrow-mindedness. At the time when Christine Jorgensen was becoming an international media sensation and the first global trans woman celebrity, responsible for making the word transsexual a household term, every week between 1952 and 1954, Lacan treated a patient who was requesting “a castration with amputation of the penis, plastic surgery of the scrotum to make it into a vulva, creation of an artificial vagina, and treatment with feminizing hormones.”¹

Henri, as the patient was known, was hospitalized at the prestigious Sainte-Anne Psychiatric Hospital in Paris in the ward of eminent psychiatrist Jean Delay, who had been a pioneer in France in the psychiatric treatment of patients identified as transsexual. Henri, as it has been my experience with many analysands with this type of gender trouble, had tried to commit suicide, and was often navigating the treacherous liminal space between life and death. Lacan approached this case with great zeal.

Forgive me for returning to several relatively unknown transgender cases treated by Lacan I discussed in Please Select Your Gender. I will revisit Lacan’s treatment of gender-variant persons to highlight how his prudence hints at an ethics of sexual difference. Even though Lacan did not write about this case, Delay, who is also known for his excellent psychobiography of André Gide, published a detailed description of Henri’s case in which he drew general conclusions about the clinical management of transsexual patients. This text sums up Lacan’s work by saying that Henri “found in him [Lacan] an ‘unrivaled understanding.’”²

Henri/Anne-Henriette’s case is quite complex.³ Henri was 40 years old when he began a two-year hospitalization to determine whether he was a suitable candidate for gender realignment. Henri identified as a man and had been living as such since age 16. At birth, he had been declared a girl. Henri had been born with undescended testicles (cryptorchidism) and presented as a full-term newborn the characteristics of a premature baby. The family initially doubted the child’s survival. They named the baby Anne-Henriette, assigned her as female in the birth certificate, and raised her as a girl until her adolescence.

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Following the birth of a half-sister whose gender was also not easily determined, just when Anne-Henriette was entering a late puberty and started showing romantic interest in a man, all of a sudden, the father who had been distant and uninvolved made a sudden demand, the forceful injunction: “You can’t help but make a choice.”⁴

Thus Anne-Henriette was forced to give up dresses, cut her hair, and wear only male clothing to assume a male persona. The teenager acquiesced without any protestation. According to Delay, Henri “welcomed that transformation with obvious indifference and a lack of surprise that still astonishes him today. He was already aware that he was not like other people.”⁵ This change marked the beginning of a period of intense emotional suffering, which led to a suicide attempt by ingesting pills at age 31, and practical challenges since his legal gender was female. Henri concocted false documents and often impersonated his brother. This precarious arrangement put him in a danger when he attracted the attention of the Gestapo during France’s occupation. In terms of his gender identity, Henri said that he had “a feminine soul. I’m morally like a woman.” He dreamt of having a relationship as a woman with a heterosexual man. If we consider that Henri/Anne-Henriette was born with ambiguous genitalia, grew up as a girl and was forced to switch genders at age 16, one may ask, was this actually a strictly transgender case, or an intersex case?

Henri underwent an exhaustive multi-disciplinary assessment during his two-year stay at Saint Anne Hospital. Besides his two-year weekly treatment with Dr. Lacan, Henri went through numerous tests by a team of endocrinologists (before his hospitalization, Henri had taken both testosterone—which he abhorred—and estrogen—which created a welcomed breast tissue development.) He had multiple visits with surgeons, and underwent evaluations by both psychologists and psychiatrists.

This thorough examination process led the team to deny Henri’s request. What happened then? Henri and Lacan quickly “agreed on the uselessness of pursuing an attempt at changing his condition, a change to which the patient apparently never subscribed.”⁶ The use of the word “subscribe” is quite puzzling. One might speculate that it meant that despite the length of the hospital observation procedure, Henri accepted the refusal without much protestation, a fact quoted by Delay’s team to confirm that for Henri “the quest of his chimera was more important than its realization.”⁷ Did Henri feel not fully entitled to his own request? That Henri evinced no haste to realize his gender realignment is quite revealing; it teaches us something crucial about Lacan’s direction of this treatment. For Henri, gender appeared as an injunction that was imposed by others, and that had been done and undone in capricious and sudden ways. Sexual identity was a destiny in which one had no say and that had to be accepted without protestation. This dynamic was repeated during Henri’s stay at Saint Anne where he spent a long time waiting for the medical authorization and passively accepted a decision that perhaps contradicted his wishes. Did Lacan grant a little bit of freedom by sending the decision back to Henri?

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Henri was declared a girl at birth and raised as one as the consequence of a common “error,” the same error that the character of Lili Elbe makes in the film The Danish Girl, as we have seen, that of taking the presence or absence of a natural organ for an organon, a system of principles, an organizer that allows someone to assume a body. For those in charge of assigning Anne-Henriette’s sex, they took an actual organ as a signifier of sexual difference. An extreme example of this same error is still seen today in some intersex cases in which gender assignation on new-born babies with ambiguous genitalia is at times based on the size of the clitoris or penis, a controversial practice dubbed as “phallo-metrics” by Anne Fausto-Sterling, because of the use of the word “phallus” in current medical terminology.⁸ This shows that at times the pediatricians who decide on gender assignation for babies with an intersex condition seem to have their own infantile sexual theories, and these are not far from those of the children who attribute to everyone and everything the possession of a phallus.

This gender attribution predicated on a phallic premise was obviously a “mistake,” which in the case of Anne-Henriette was abruptly “corrected” during puberty. As her sexuality was awakening, the testicles descended into the scrotum, and she suddenly was mandated to became Henri. This mistake, based on wrongly perceived anatomical markers, shows that gender attribution is a construction, a fact that has been denounced by intersex and trans people: “If you think that because I have a penis I am a man, that is an error; I can be a woman who has a penis.” Or conversely, “If you think that not having a penis makes me a woman, this is an error because I am a man without a penis.” They are absolutely right, because for the unconscious somebody with a penis can be a woman or someone without a penis can be a man. Can sexual identity be based on organ attribution? This is a crucial issue if we want to think about the trans phenomenon structurally. Let me reiterate that during the evaluation process at the Saint Anne, Henri was all along expecting the medical team to decide for him while he never seem to have fully “subscribed” to the decision of a change in his condition. For Lacan, Henri needed to make a decision by subscribing to it. It would have to be Henri/Anne Henriette’s choice and not that of other people.

Organon

Lacan mentioned in a 1971 seminar that transsexuals “confuse the organ with the signifier,” and argued that the penis (an organ) can be confused with the phallus (an instrument), that is, as a signifying tool that is operative only as an effect of language.⁹ This is a common error that in some cases can lead to the surgical removal of physical attributes like the breasts or the penis. Those instances might derive from an inability to use metaphors for those organs, and castration is no longer symbolic but Real, literalized in a removal of an actual bodily organ. As a result, Lacanian psychoanalysts in France led by Catherine Millot, the author of Horsexe (1983, translated into English in 1991) dubbed by Kate Bornstein a “gender terrorist,” started a tradition of systematic pathologization of transgender manifestations.

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Millot’s position has not changed since 1983. In her recent memoir La vie avec Lacan (Life with Lacan, 2016),¹⁰ Millot uses the case of a transsexual seen at the Saint Anne Hospital as an example of Lacan’s ethical stance on clinical presentations. Millot praises Lacan because he does not capitulate to the delusional belief of a male patient who thinks that he is a woman, reminding him that he is a man and no operation will make him a woman. Millot observes that Lacan ends his interview calling the patient “mon pauvre vieux” (my poor old man), using an almost friendly manner that she does not consider condescending but rather as a gesture to remind the patient of his masculinity while pointing to the impossibilities and unhappiness marking the human condition.¹¹

A very different picture emerges of how Lacan conducts this interview at a psychiatric hospital before a group of psychoanalysts and psychiatrists from the transcription of “Lacanian Psychosis: Interview by Jacques Lacan” by Stuart Schneiderman, made available in an English translation in 1980.¹² Primeau puts in plain words: “Sexually, I am as much in love with a woman as I am with a man.”¹³ Indeed, Primeau had engaged in sex with both men and women. While relating the story of a woman he had loved because she had a beauty which radiated, Primeau suddenly turned his attention to one of the female clinicians in the audience. He mentioned that she had a luminous beauty despite the fact that she wore makeup.

Lacan immediately turned the question around and asked Primeau if ever wore makeup, and he explained that indeed, he would occasionally put on makeup: “It has happened to me, yes.” Smiling, he clarified that he would do this because he “had a lot of sexual complexes . . . because nature endowed me with a very small phallus.”¹⁴ Asked to elaborate further, Primeau continued: “I had the impression that my sex was shrinking, and I had the impression that I was going to become a woman. . . . I had the impression that I was going to become a transsexual” (p. 31). “A transsexual?” inquired Lacan. “That is to say, a sexual mutant,” responded Primeau. Lacan retorted: “That is what you mean. You had the feeling that you were going to become a woman.” “Yes,” confirmed Primeau, well aware that he still had a masculine organ and that he had never felt what it was to be a woman. Nevertheless, he had seen himself as a woman in a dream and thus hoped to become one. He experienced himself as a woman, “feeling it psychologically.”¹⁵

Lacan wanted Primeau to explain what he meant by being a transsexual; this referred to a transformation without any medical intervention—he was not changing sex, but rather undergoing a spontaneous change into a woman. He did not explicitly express a demand for a sex change. Lacan asks him to further explain what he means by the feeling that he was going to become a woman. Primeau elaborates, “Yes, I had certain habits, I used to put on make-up, I had this impression of shrinking of the sex and at the same time the will to know what a woman was, to try to enter the world of a woman, into the psychology of a woman, and into the psychological and intellectual formulation of a woman.”¹⁶ More exactly, Primeau had the impression that this spontaneous transformation into a woman resulted from the feeling of shrinkage of what was in place of the phallus.

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We can see that Lacan several times asked Mr. Primeau if he felt himself to be a woman. Lacan had a clear purpose in doing this. “Finally, you never felt yourself to be a woman?” Primeau answers: “No.” Lacan repeated: “Yes or not?” Primeau responded: “No. Can you repeat the question?” Lacan obliged: “I asked if you felt yourself to be a woman.”¹⁷ Again, Primeau talked about “feeling it psychologically” as an “intuition.” Lacan made Primeau clarify: “Yes, pardon me, of intuition. Since intuitions are images that pass through you. Did you ever see yourself as a woman?” To which Primeau answered: “No.”¹⁸

Lacan was carefully discerning a transsexual delusion from a demand for gender reassignment by testing Primeau’s position, but never adopted the moralistic position of asserting that surgery would never make him a woman. Whereas Catherine Millot tends to see this as a sign that Lacan rejects all transsexual desires as psychotic, in fact he is distinguishing the hopeless case of a man that he sees as psychotic from a more legitimate demand for sex change, which was not Primeau’s situation. In Schneiderman’s translation, Lacan ends the interview saying goodbye, shaking his hand and calling Primeau “my friend.” He also asks him to see samples of . . . Primeau interrupts him, “Of my writings [écrits]?” Lacan promises to see him again in a few days.¹⁹

After Primeau has left the room, Lacan briefly discusses the case with the audience. He shares his pessimism about the prognosis of this case, which he diagnoses as a marked instance of “‘Lacanian’ psychosis.” He recommends further study of this type of clinical picture, which he feels has not been properly described in the literature. Primeau’s presentation could be compared to Lacan’s original reading of Judge Daniel Paul Schreber’s case, a case of someone who cured himself with writing after he experienced what Lacan calls “transsexual jouissance.” Schreber, like Primeau, thought that he was becoming a woman rather than expressing a demand for a sex change.

We notice that Lacan asked Primeau if he saw himself as a woman; he was exploring here whether his “intuition” was a visual hallucination while probing the imaginary of the body, which in psychosis is often fallen or missing. Primeau and Lacan close the interview with an exchange about writings (écrits), which refers both to Primeau’s awareness about Lacan’s book (Écrits) and possibly indicates his transference to him, as well as revealing the function of writing in issues of embodiment, when the ego scriptor can make flesh and author become one.

Lacan’s intervention with Primeau was faithful to his clinical position facing psychosis. He never challenged a delusion. As we know, the delusion is for Lacan an attempt at self-cure. It is a metaphor that functions as a supplement (suppléance) so as to make sense of chaos and help frame jouissance. Lacan reminded Mr. Primeau “that nonetheless, you still have a masculine organ”²⁰ not to question the delusion as such but to loosen a conviction coming to the patient as the “imposed speech” and “imposed sentences” he experienced in what looked like a return of a foreclosed idea in the Real. Lacan’s strategy was not to dispute the feminization experienced by Primeau, which is a common feature of psychosis,²¹ but he was not complicit with a delusional conviction either. Lacan mentioned Primeau’s masculine organ in a skillful clinical maneuver that introduced something of the phallus so as to set a limit to the excessive jouissance that invaded Primeau.

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Primeau was not the only case of a trans patient approached by Lacan, as we have seen. Indeed, the same clinical finesse is visible in Lacan’s reading of the case of Schreber, whose memoirs had been commented on by Freud. Lacan’s theoretical elaboration about Schreber in his seminar differed markedly from that of Freud and was colored by what he had learned with his work with Henri / Anne-Henriette.

Freud’s study of Schreber can be considered the first psychoanalytic inquiry on transsexualism. Schreber had spent six years in a private psychiatric clinic and, feeling sufficiently recovered, wrote a thorough account of his illness to argue in court for his discharge from the asylum. It succeeded in securing Schreber his freedom, and Memoirs of My Nervous Illness may be the first-person account of psychosis most often discussed in all psychiatric literature, as well as one of the first sex-change memoirs.

The complex, delusional world of Schreber had a center: his body. Schreber’s body was a body without teeth, larynx, eyes, stomach, intestines, a body consuming itself, a body of miracles, a body of God’s divine rays, a body of sacred fertility, but above all it was the site of an astounding transformation:

The month of November, 1895, marks an important time in the history of my life and in particular in my own ideas of the possible shaping of my future. . . . During that time the signs of a transformation into a woman became so marked on my body, that I could no longer ignore the imminent goal at which the whole development was aiming. In the immediately preceding nights my male sexual organ might actually have been retracted had I not resolutely set my will against it, still following the stirring of my sense of manly honor; so near completion was the miracle. Soul voluptuousness had become so strong that I myself received the impression of a female body, first in my arms and hands, later on my legs, bosom, buttocks and other parts of my body.²²

Schreber was certain that he was becoming a woman. He would become God’s bride, a consenting prey to God’s voluptuous pleasures. Freud interprets Schreber’s paranoia as a defense against homosexuality while Lacan centers his analysis in what he calls Schreber’s transsexual drive and, most importantly, his transsexual enjoyment. This should not surprise us. As we have seen with Henri, Lacan conducted a psychotherapy with a transgender person and was well aware of the differences between transsexuality and homosexuality.²³

In Schreber’s delusional transformation into a woman, Lacan found new meaning to a recurring phenomenon in psychosis: feminization. This was the key element in Lacan’s original reading of the case—he took distance from Freud’s interpretation of Schreber’s paranoia as being determined by the patient’s rejection of homosexuality (for Freud, Schreber had to imagine that he was turning into a woman in order to accept the idea that he was going to have sex with a man or with a male father figure). In Schreber’s transsexualist delusion, in his conviction of being transformed into a woman, Lacan found the lineaments of a new theory of sexual identity.

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Notes

  1    J. M. Delay, P. Deniker, R. Volmat and J. M. Alby, “Une demande de changement de sexe: Le trans-sexualisme,” L’Encéphale: Journal de neurologie, de psychiatrie et de médicine psychosomatique 45, no. 1 (1956): 41–80, 52.

  2    Note that one of co-authors of this text, Jean-Marc Alby, had completed a groundbreaking thesis on transsexualism in 1956. This article was both a case study of Henri and a review of the existing literature on transsexualism at the time.

  3    For a more detailed analysis of Henri’s case, see my Please Select Your Gender (New York: Routledge, 2010), 154–166.

  4    Delay et al., “Une demande,” 45.

  5    Ibid.

  6    Ibid, 53.

  7    Ibid.

  8    See Anne Fausto Sterling, Sexing the Body: Gender Politics and the Construction of Sexuality (New York: Basic Books, 1999), 59.

  9    “le transsexuel souhaite réaliser La femme en tant que toute, et comme il veut se libérer de l’erreur commune qui est de confondre l’organe avec le signifiant, il s’adresse au chirurgien pour forcer le passage du Réel.” Jacques Lacan, Ou pire, séminaire 1971–72, Lesson of 8 December, 1971. Unpublished papers.

10    C. Millot, La vie avec Lacan (Paris: Editions Gallimard, 2006).

11    Ibid., 50–51.

12    S. Schneiderman, ed., Returning to Freud: Clinical Psychoanalysis in the School of Lacan (New Haven, CT: Yale University Press, 1980), pp. 19–41.

13    Ibid., 27.

14    Ibid., 30.

15    Ibid., 31.

16    Ibid.

17    Ibid.

18    Ibid.

19    Ibid., 41.

20    Ibid., 31.

21    To describe this phenomenon Lacan coined the term “push towards woman” (pousse-à-la-femme). This tricky phrase could be rendered in English as “driving one to become a woman,” if “drive” was not already a technical concept translating Freud’s Trieb. For more on “push towards woman” see my Please Select Your Gender, pp. 174–182.

22    D. P. Schreber, Memoirs of My Nervous Illness, ed. and trans. Ida Macalpine, Richard A. Hunter (New York: New York Review of Books, 2000 [1903]), 163.

23    See Pierre-Henri Castel, La métamorphose impensable: Essai sur le transsexualisme et l’identité personnelle (Paris: Gallimard, 2003), 351.

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12

PORTRAITS IN A TWO-WAY MIRROR

What is the common point between Elsa who wanted to wear male clothing in public, E who wished to be a woman, Primeau who called himself a sexual mutant, Henri who requested a medical intervention to be Anne-Henriette, and Judge Schreber who thought he was forced to become God’s wife? Today it is likely that they all would identify as trans persons. How should a psychoanalyst consider this uncanny convergence? First, today’s analyst would want to distinguish clinical structures that are different because they range from straightforward neurosis (hysteria) to severe psychosis (paranoia). Second, the clinician should acknowledge that patients’ symptoms evolve with historical contexts because they draw their material from what is provided by culture, high and low—religion, talk-shows, television programs, the internet. Such “openness to the Other” is observable whether analysands are neurotic or psychotic. What Schreber perceived at the end of the nineteenth century as rays that were sent by an evil God to traverse his body would have become by the 1920s a radio-like influencing machine as described by Victor Tausk, by the 1970s Primeau’s transmitter, and now turns into a computerized network of hackers crisscrossing lethal Wi-Fi waves.¹ But first and foremost, hysteria has functioned and still functions like a cultural barometer. The demonic possessions of the Middle Ages became the conversion attacks of Charcot’s times and they return in present times in medical mysteries blamed on obscure syndromes, undetected viruses, recalcitrant allergies, and the whole array of autoimmune disorders.

Let us be honest: Freudian psychoanalysis has been founded on two “mistakes”—but, as James Joyce wrote, a man of genius never makes mistakes, for his mistakes are the portals of discovery. The first “mistake” was Freud’s presentation of a case of male hysteria upon returning to Vienna after his stay in Paris at Charcot’s Salpêtrière. His Viennese medical colleagues were incensed by his blatant disregard for etymology; for all of them, it was obvious that “hysteria” derived from the Greek hystera, the lower organs of the female body, the proper etymology of uterus. How could Freud dare talk about a case of a man presenting symptoms connected with the uterus?² Freud’s correspondence with Fliess shows abundantly that he knew that men (including himself) could be hysteric. One could say that he was already queering the concept of hysteria and not making it gender-dependent.

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The second “mistake” came a little later and has been attacked by most feminists. It was Freud’s decision to talk about a “castration complex” that would preside over the sexual evolution of men and women. Freud, who had never visited a farm, did not seem to know the difference between the ablation of the testicles and the cutting of the penis, something that cattle breeders and veterinarians must pay heed to. This “mistake” shows that Freud’s very invention of the castration complex was marked by the child’s perception of the difference between the penis and the vagina, a difference hallucinated as the violent cutting on one side of what appears on the other—in short, his conceptual invention was deeply affected by the castration complex itself. In order to make better sense of the necessity of these two “mistakes,” one will need the more rigorous conceptual twist brought by Lacan. Castration in the simplest, schematic version of the Freudian Oedipal model was based on a binary of having or not having it, of presence or absence: boys have it, girls do not. While for Freud castration is a loss that women think they have suffered and that men fear to suffer, for Lacan indeed both sexes are castrated—the phallus is not an organ but rather something nobody has or can be.

In this perspective, desire is rooted in lack. How people relate to their sexual bodies is determined by the way they relate to lack: this is what Lacanian psychoanalysis calls castration. A relation to lack will be the foundation of structures of desire, whether neurotic or perverse. In what follows, I will elaborate on the benefits of holding to the concept of castration. This is key to the psychoanalytic treatment of trans-persons because of the role played by castration in the clinic of trans symptoms. In what follows, I will elaborate on the benefits of holding to the concept of castration, so as to argue—against Catherine Millot and classical Freudians—that the wish to change one’s gender by cutting either a penis or one’s breasts is not a strategy of eluding or negating sexual difference, but on the contrary usually entails a heightened concern for sexual difference. Understanding the prevalence of castration is crucial to the psychoanalytic treatment of trans-persons.

Narratives of how people grapple with identification beyond the metrics of straight, gay, bi are proper to psychoanalysis, and they should not be resisted in the field as they have been in the past. I will illustrate this with a brief clinical example. A woman in her fifties whom I will call Amanda consulted me because she was unhappy with her husband. She was surprised that he had not left her yet. As she acknowledged blandly, she was horrible to him, disrespecting, demeaning, and even abusing him. Amanda added with a smirk that “nothing happens in bed,” because “we are like brother and sister.” However, she admitted that when he made a sexual advance or even tried a tender gesture, she rejected him violently. Then Amanda told me an anecdote: in her twenties she was in love with a man. They met in a hotel and were to make love for the first time. When he embraced her, she became aware that he really loved her and she was scared by the intensity of his attraction to her. To find a way out, she blurted out a lie and said that she was pregnant. The encounter came to an abrupt end. He left, and their relationship ended. In spite of her desire for him, Amanda pushed him to reject her because she could not tolerate his love.

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For reasons unknown to her, Amanda could not put up with a man’s investment in her. Why did she stop the sexual encounter and force the relationship to end? It was by inventing a lie that inhibited the possibility of being this man’s desired object—his phallus. Her lie moved her from being a desired woman to pretending to be the impersonation of an untouchable mother-to-be. The lie about being pregnant enabled her to avoid her own desire for him. One may say that at the moment of the sexual act, the blade of castration suddenly appeared and with it, anxiety. Having sex with a man, Amanda would have to come to terms with her position not only as an object of desire—as her partner’s phallus, that is, as the representative of what a man is missing—but also as a desiring woman: she might have seen him as the holder of the phallus, of what she may be missing, thus potentially implying a threat of castration for both sexual partners. Amanda’s maneuver accomplished a transfer of her own anxiety to her boyfriend: with a ruse, the anxiety she experienced as a result of his palpable attraction to her became her boyfriend’s.

In psychoanalytic terms, her anxiety and its avoidance pose several problems. This analysand also asserted that whenever she liked a man she took extreme care of her appearance. Amanda would choose her clothes carefully, get her hair done at a beauty salon, and put on a lot of makeup. She said that when all her grooming was completed, she looked at herself in the mirror and thought that she looked like a man cross-dressing. As a result of this impression, Amanda kept adding layers of makeup, which exacerbated her feeling of looking like a man. Her comment calls up Lacan’s remark that the “virile display in human beings seem[s] feminine.”³ This means that even when the positions are not symmetric, there is an element of deception in both masculinity and femininity. One could even speak of imposture as Joan Copjec does when she describes “the fraudulence at the heart of every claim to positive identity.”⁴ In masquerade and imposture, the phallus plays a role. Masculinity implies the pretense of “having” the phallus and femininity the pretense of not having the phallus while “being” the phallus.

What happened when Amanda tried to become what she imagined made a woman desirable, like wearing fashionable clothes, an elaborate hairstyle, fancy makeup? In fact, Amanda felt that her feminine masquerade was a sham, and rather than feeling like a woman, she felt like a man with a mask. The more she wanted to look feminine, the less she felt like a woman. Amanda could only pretend to be a mother, otherwise she felt like a man in drag. It was as if Amanda could not be seen as a woman precisely because she tried so hard to look like a woman. Ultimately, the meaning of “woman” is sexual difference, upon which the castration complex is predicated. Hence, to avoid the threat of castration, Amanda avoided being “woman” insofar as she no longer tried to attract a man who liked them. She gave up the bluff, despite all her efforts at artifice (fake eyelashes, hair extensions, and so on); she needed an even stronger recourse than merely pretending, so she made up a big lie. Amanda moved from feminine masquerade as a strategy to embody the object of desire, to masculinity as a travesty. It seems difficult to make sense of this case without any reference to a problematic notion of sexual difference.

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For psychoanalysis, sexual difference is not a norm but a real impossibility, which is to say, it is a limit to the speakable and the thinkable. Sexual identity for both males and females is always precarious because the human infant becomes a sexed subject in a symbolic system of language in which there is no signifier of sexual difference. This unconscious sexual reality about which the subject has no knowledge (does not know what is to be a man or a woman) is one that psychoanalysis presupposes.

The speaking body loses flesh and gains physique in the symbolic; it is sexed through castration, which works at both a symbolic and imaginary level. As Lacan maintains, the body knots the elementary structures of social functioning, its sexual reality, and its imaginary aspects.⁵ From a psychoanalytic perspective, sexual identity is not determined by biology or any other innate factor but rather learned through language (symbolic) and identifications (imaginary). Identity is constructed around loss, a loss that dates to the inaugural moment when we were born and a sex was assigned to us. For psychoanalysis, unconscious choice has nothing to do with a voluntaristic free will. In this choice, the two alternatives available are not isomorphous; thus, discordances emerge between one’s erogenous sex and one’s declared sex. In the unconscious there is no representation or symbol of the opposition masculine–feminine. Sexual identity for both males and females is always precarious because the human infant becomes sexed without fully symbolizing unconsciously a normal, finished sexual positioning. Psychoanalysis attempts to clarify how not only sexuality fails to conform to the social norms that regulate it but also how the various fantasies are constructed to veil the structural failure.

Anxious? Castration is the solution!

The so-called Freudian wars have not ceased. They intensified at the end of the twentieth century. In the 1970s, they surged with the feminist critique of psychoanalysis associated with Betty Friedan, Kate Millett, and Germaine Greer. There were also the Freud doubters like Frederick Crews and Frank Sulloway. Then, there was Jeffrey Moussaieff Masson who denounced Freud for allegedly abandoning his early seduction theory as a cover up for perverted fathers, deliberately suppressing evidence of childhood sexual abuse. The casualties have been abundant and Freud’s death has been announced periodically. Year after year, on magazine covers and in monographs, Freud’s demise has been lurking ominously. Such tenacity makes one wonder: is Freud dead yet? Why this desire to declare him dead over and over again? For the critics, Freud’s theories have been derided as useless and unscientific and his contributions reduced to a cultural relic. And yet there is still the need to denounce and attack, a strategy that seems to suggest that he is more significant dead than alive.

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It is well known that the last two decades have been dominated by a preference for empirically demonstrable modalities of treatment. Recent studies, however, have shown that psychoanalysis has provided more lasting results over time than cognitive behavioral therapy. I, on the other hand, prefer to address the issue differently. Rather than insisting on how psychoanalysis compares to the various modalities of therapy available today, I want to focus on what is unique about psychoanalysis, to what no other form of “talking cure” can offer, as for example, a different kind of listening buttressed on the hypothesis of the unconscious. From behind the couch, a psychoanalyst has the opportunity to not only hear from the analysands testimonies about the effectiveness of psychoanalysis but also to experience how controversial Freudian ideas such as castration are surprisingly brought to the fore. This was shown by an analytic session with Melissa, as I call her, a 24-year-old female analysand. Melissa is tormented by the conflicted feelings she has about her boyfriend, Mike, who loves her devotedly and wants to marry her. She reciprocates his feelings but is tortured by her sexual attraction to other people, men and women, and feels unable to express any of her ambivalence. The more he shows his love, the more she feels guilty. Melissa reacts to her own uncertainties by increasing the show of love signs and by multiplying the compensatory gestures. Whenever she questions the relationship mentally, she becomes more attentive. Generous gifts, homemade meals, sweet words, a whole array of mindful gestures proliferate in direct proportion to her doubts about him. The result is that she experiences almost unbearable levels of anxiety. I paraphrase her account below:

I am feeling pretty stable and calmer than I thought I would feel. But at the end of the day, I am always feeling anxious. I would like to figure out what seems to trigger anxiety in me. Perhaps it’s this recurrent thinking, this unrelenting questioning . . . 

I want to figure out what the relationship with Mike means to me. I have conflicting feelings about him. Sometimes I experience a sense of happiness because I love him so much. Sometimes it can be really wonderful. But when he expresses how much he loves me I have only regret.

He seems to have a lot of admiration for me; he is loving and supportive. But sometimes his intensity is overwhelming. I am cut off from him or myself. Something keeps me from connecting with him.

Perhaps it’s the obligation attached to his love, as if he expected something in return. I have a kind of suspicion about what the problem is, and emotionally it’s my own. It is the issue of seeing other people. I have had a couple of dreams and I feel very confused. In the dreams I had sex with this guy. When I woke up, I felt as if I had betrayed Mike.

His feelings for me are so monogamous; he has not been interested in anyone else. There again, one can see in which ways we are so different. I have to accept the fact that I have desires; I may have dreamt about sex with a man, but in fact I have been wanting to be with a woman.

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It makes me feel bad.

What’s wrong with me? I do love Mike. I do value our relationship. I wish I didn’t fantasize about other people. . . 

I will have to make a choice about the relationship.

Mike talks in such an emotional tone. I really didn’t think he was capable of expressing himself that way. When I heard him talk like that I cried, and almost immediately, I felt distant. I just think that the feeling of being with another person is so scary to me. I think what I am scared of is that if I imagine being in a close relationship is maintaining aspects of myself, I get scared it will become the devouring love I have for my mother . . . 

I forged my own way outside my relationship with my mother but acquitting my own sexuality . . . 

It is scary for me to have sexual desire for Mike. He is the main focus of my sexual attention. I can’t do that. What feels really scary for me is that I haven’t had any real relationship with a woman but this is part of my sexuality. It is really confusing. I would not identify as lesbian but I do not really know if I am really myself with Mike.

. . . What’s the difference between men and women? My mother would say that gender is societal. How much do I disagree? Men and women are different. Yes, there are women who are masculine and men who have feminine sides. But still this is very confusing for me . . .

I feel attraction to both men and women. It is physical . . .

I think that’s how I know; this physical attraction to women is not going to go away. I also have emotional and intellectual attractions to women. Being around women feels right. What is the source of the attraction? It has to do with issues of gender and sexuality . . .

How can I accept Mike’s love? I enjoy sex with him but feel that a part of me is excluded. I feel dirty being sexualized by him. I backtracked. Actually being with him is strange for me. I did feel comfortable with my sexuality before him. My sexuality was not a source of shame or anxiety. Maybe the issue is: am I straight or bisexual?

Why was Melissa anxious? Were her words motivated by the desire to understand an issue about gender and sex, or did she confuse object-choice with identity politics? Was Melissa truly bisexual because she fantasized about having an affair with a woman? When she asks: “Am I straight or bisexual?” is she in fact asking: “Am I a man or a woman?” If that is the case, then the traditional question of sexual identity that we find at the core of hysteria is shifting from a question of gender identity (“Am I a man or a woman?”) to one of sexual orientation (“Am I straight or bisexual?”). Melissa’s comments remap the whole terrain of sexual politics, namely compulsory heterosexuality, sexual choices, monogamy, love, reciprocity in relationships, attachment, and sexuality. She became aware of her boyfriend’s love but while she admitted that she was happy with him, this realization made her experience regret. It was then that she questioned her sexuality while becoming distant, or, as she put it, “cut off from him or myself.” What kind of “cutting” was this? Did Melissa’s account replay the classic Oedipal familial scenario of identifications and rivalries? Did she question her sexual identity as a phobic reaction to intimacy? Was her sexual ambiguity a strategy defending her from desire while cancelling out the mother? As she said, she produced a way out of a “devouring” relationship with her mother, “acquitting my own sexuality.” Was her uncertainty about her sexuality a sort of father substitute (a stand in for a name or NO! which separates mother and child)? Which leads us to a theoretical issue: do contested notions such as “phallic attribution” and “castration” work in clinical practice?

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Melissa is not the only case of someone who seemingly breaks away from the paradigm of social conformity to “normal” sexual orientation or even of gender identification. But does it escape the traditional psychoanalytic paradigm of castration and the anxiety linked to it? Another analysand came to see me full of questions because, despite being a happily married woman, she became restless and had sex with a woman once. This was just because, as she said, she wanted to find out how a woman’s skin felt and how it smelled. Given that she admired and wanted to resemble the seductive, aggressive woman she had the sexual encounter with, was this also an issue of identification? Was she fascinated with an idealized femininity that would help her define her sexual identity on the basis of sexual practice? Or was she “done with men,” as she once blurted out exasperatedly and had, at last, followed her desire?

I could also reference the analysand who ran away from a marriage proposal from a man she said she was in love with only to rush into the arms of a lesbian friend, whom she claimed she did not find attractive. I remember a declared feminist analysand who defined herself as bisexual but never had a sexual encounter with a woman. She detested makeup and “girly” things and insisted that she wanted to be loved for who she really was, without being “objectified by a male,” but then appeared smitten by a boyfriend who told her almost offensively that she should wear sexy clothes and constantly compared her to other women he was ogling. Or the stay-home dad who doubts his masculinity and is torn by guilt, hoping to gather the courage to confess to his wife that he is convinced he is bisexual because he fantasizes that he is watching her have sex with another man.

All these cases offer variations on a universal theme: the inconsistency of the subject’s relation to sex. These cases seem to position themselves in a zone of sexual ambiguity, as Geneviève Morel calls it.⁶ This uncertainty should make us rethink how we define sex and sexuality, especially if we contrast the previous examples with other cases that hinge more explicitly around issues of sexual attributes, like that of a trans man who was deeply unhappy in his sexual life because, not having a penis, he was certain that he lacked the phallic attribute that he thought was desired by all women? Or the case of a patient explaining that in the past someone like her would have been thought of “as a man with a mental problem but that it’s just the opposite, I am a woman with a physical problem: the worst birth defect a woman can have, I was born with a penis and testicles”?

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These analysands who ask whether they are “straight or bisexual” seem lost in their sexuality: they fail to distinguish sexual orientation from gender, a reasoning that, as Stephen Frosch argues, results from an “obvious category confusion,” because “there is no necessary connection between object-choice and gender identity.”⁷ The normative slant in classical psychoanalysis, which has led to troubling standards of normalcy such as elevating the genitals to the status of fetish organs of a mature heterosexual genitality or to the pathologization of homosexuality, was indeed a post-Freudian deviation. It was based on what Lacan would consider as “delusional” notions of normalcy.

Perhaps those analysands who confuse object-choice with identity are searching for a totalizing answer that introduces a paradox: they ask whether they are straight or bisexual as if the simple fact of posing the question would mean that they are neither; but if they are neither, they feel obligated to choose what they are. Jacqueline Rose has observed that the unconscious always reveals the failure of identity. Rose goes as far as to say that there is no stability in sexual identity because “there is a resistance to identity at the very heart of psychic life.”⁸ For Rose, this “failure” is not a fact of individual pathology or a special case of deviance from the norm but rather a general psychic feature that appears in all forms of the unconscious (dreams, slips of the tongue, and jokes) as well as in “forms of sexual pleasure that are pushed to the sidelines of the norm.”⁹ From a psychoanalytic perspective, identity is an artificial construct that results from imaginary identifications with an “other” who grants a “sense of self.” Identity relies on the assumption of an image and is something that eventually may come to an end during a psychoanalysis because the subject emerges exactly there where identity fails.

Rose’s reading of identity’s “failure” is central because it contradicts the usual reading of “lack” as a loss or injury that women suffer and that men fear. Lack is neither a negative “wound” due to the loss of an object nor a deficiency. For Lacan, lack is a productive force: all subjects must confront and assume their lack. The Lacanian subject is subjectivized lack. Such a lack exerts several effects on the subject: it divides the subject, whose entry into the symbolic order is positivized into the being of desire as lack-of-being; in other words, desire is born through lack and can never be finally fulfilled. A relation to lack will be the foundation of structures of desire, whether neurotic or perverse. We note here that perversion is taken as a structure and not as sexual practice.

For those still skeptical about the benefits of castration anxiety, let us say that castration is a movement of separation imposed by the Oedipal law of the incest taboo. This law offers a limit to the fantasy of a hyperbolically phallic subject entailing an instinctual renunciation required by civilization. Psychically, castration anxiety can help formalize and contain other more primal, amorphous anxieties; as we have seen, the most anxiety-provoking situation is when lack is lacking. One might say that psychoanalysis is due to undergo its own castration, to experience a depletion of prejudice, ushering in new forms of desire. If heeded, this might radically transform the fraught relationship between psychoanalysis and transgender people.

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Notes

1    See V. Tausk, “On the Origin of the ‘Influencing Machine’ in Schizophrenia,” Psychoanalytic Quarterly 2 (1933): 519–556.

2    For more on Freud’s poorly received 1886 Vienna Imperial Society of Physicians lecture on male hysteria concerning the traumatic hysteria of a man who fell from a scaffold, see my Please Select Your Gender (New York: Routledge, 2010), 65.

3    Jacques Lacan, Écrits: The First Complete Edition in English, trans. B. Fink (New York: Norton, 2006), 584.

4    Joan Copjec, Supposing the Subject (Massachusetts: MIT Press, 1994), 41.

5    J. Lacan, The Seminar of Jacques Lacan. Book I: Freud’s Papers on Technique, 1953–1954, ed. Jacques-Alain Miller, trans. John Forrester (New York: Norton, 1991), 122–123.

6    See Geneviève Morel, Sexual Ambiguities (New York, London: Karnac Press, 2011).

7    Stephen Frosh, For and against Psychoanalysis (London, New York: Routledge, 2006[1997]), 236.

8    Jacqueline Rose, Sexuality in the Field of Vision (London: Verso, 1986), 91.

9    Ibid.

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13

PLASTIC SEX, THE BEAUTY OF IT

As the poet John Ashbery says, “Everybody has a body, that’s why they’re called everybody.”¹ I discovered something about the body in my psychoanalytic practice when working with some analysands who identify as trans. Often those analysands have a complex relation to their bodies, for many of them will say that they are in the wrong body, meaning the body of the wrong gender. However, other analysands refuse to align their bodies with the male/female binary and prefer to place themselves somewhere in-between. I am not saying that there is something specific in trans bodies as opposed to normative gendered bodies, but rather that the trans experience shows us that there is a disjunction between how subjects experience their bodies and the given corporeal contours of their flesh. Such a disjunction renders explicit the fact that we all need to establish some kind of relation to our bodies. One could argue that this disjunction is not pathological but universal, that there has to be a process of embodiment, that it will be at play for everyone who tries to bridge the gap and embody their carnal reality in order to flesh out subjectivity.

Adolescence is a good example of how the growing teenager devotes significant energy to imaginarization, in the Lacanian sense—to embodying the flesh. The time adolescents spend in front of mirrors or taking selfies exemplifies the importance of the libidinal investment in the specular identifications that support the body as a whole and let them be in their bodies, helping the image dress the flesh. Let us note that what is pursued in a gender reassignment or gender confirmation is not just an anatomical change but a different embodiment. This is why sex reassignment is now called “gender affirming surgery,” the official ratification of an experience.

This process has been described by Janet Mock, the journalist and trans activist discussed in Chapter 1, and she calls it “realness”: “To embody ‘realness’ enables trans women to enter spaces with a lower risk of being rebutted or questioned, policed or attacked. ‘Realness” is a pathway to survival . . . .” Mock explains further:

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I am aware that identifying with what people see versus what’s authentic, meaning who I actually am, involves erasure of parts of myself, my history, my people, my experiences. Living by other people’s definitions and perceptions shrinks us to shells of ourselves, rather than complex people embodying multiple identities. I am a trans woman of color, and that identity has enabled me to be truer to myself, offering me an anchor from which I can uplift my visible blackness, my often invisible trans womanhood, my little-talked-about native Hawaiian heritage, and the many iterations of womanhood they combine.²

Realness is not “passing,” neither is it “conforming.” Was that what took place in the very public gender transition of Caitlyn Jenner? Recall that when Jenner’s gender change became official on a Vanity Fair cover captioned “Call me Caitlyn,” Jenner tweeted, “I’m so happy after such a long struggle to be living my true self.”³ But what “truth” holds that self and body? What makes the body and the perception of the self cohere? What makes a body more or less authentic to the self it contains and expresses?

Central to Lacan’s theory of the origins of subjectivity was his invention of the mirror stage, the dialectical progression in which the child identifies with his or her mirror image. The child’s identification with the mirror image creates the “I” and the “me” while setting the blueprint for an “essential libidinal relationship with the body image.”⁴ This decisive turning point in the infant’s ego formation is a moment of triumphant, illusory mastery over the body, replayed in many memoirs of gender transition. Lacan’s mirror stage marks the beginning of subjective constitution, the birth of the ego. I would argue that the reiterated presence of a mirror scene in memoirs, selfies, and vlogs is more about the creation of an ego, as the projection of a surface, than about the fascination with a mirage. One important lesson I have learned from working with transgender analysands was that sexual identity issues revolve around a particular body, a body one is not born into, one that one becomes.

Having a relation to one’s own body as the wrong one is a possibility, which is included in what the verb “to have,” which we use for the body, entails: if one has one own’s body, one cannot be one’s body in any degree. That body can be foreign, fat, out of shape, imperfect, unlovable, wrongly gendered, for just some examples of the many manners in which the experience of the body and the person’s ideals may not align. Here, we should go beyond the model of imaginary identification, Lacan’s mirror stage, to understand the issues around embodiment in gender transition. Most commentators tend to stop at this point. This is the case of an author as gifted as Jay Prosser.⁵

The mirror stage, Lacan hypothesized, is a stage that infants pass through in which the external image of the body (reflected in a mirror or represented by the loving gaze of the main caregiver, often the mother) is internalized as a unified body. This image, which will become the “I,” is an idealized imago and will be the blueprint for emerging perceptions of selfhood. It anticipates a bodily perception of unity that does not correspond with the infant’s real neurological immaturity and vulnerability. It also creates an ideal of perfection that the subject will always strive to achieve. Here we can see how the ego is dependent on an external object with which the infant identifies, how it is produced in alienation, that is, as other, as an illusion of reciprocity and a promise of wholeness, when the real experience of the body is fragmented because at this early stage the infant cannot even control its bodily movements. In the mirror stage, the subject becomes an I in anticipation and alienated from itself. The dual relation of the body to the ego, which is at the basis of the body image, Lacan hypothesized, was quite different in the case of an artist such as James Joyce, involving identification not with an image but with writing. As Morel has it, his ego was supported by his art.⁶

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When Lacan turned his attention to Joyce’s art, he discovered a new relation to the body. He observed that Joyce had a peculiar body, one that could fall, slip away, like an open envelope letting go of its contents. Lacan focused on a passage of A Portrait of the Artist as a Young Man, when the hero Stephen Daedalus recalls a moment of rage at his schoolmates that suddenly falls from him “as easily as a fruit is divested of its soft ripe peel.”⁷ For Lacan, such a transformation of anger was revealing and could be generalized as defining a Joycean body, that is, a body that could fall from one’s self, like a wrapping that does not fully hold.⁸ Joyce’s solution would be to invent a writing that would “hold” the body. Taking into account the complex relationship that transsexuals have to their body—they often say that their souls are trapped in a body of the wrong (opposite) gender—I see that an art comparable to that of actual artists, if not necessarily with the genius of Joyce, can be found in transsexual artificiality. The image of the body as a vacant shell, as an enclosure oppressing the self, is a recurrent theme in autobiographical narratives of gender transition. Raymond Thompson, a female-to-male transsexual, poignantly describes this experience of the body as an ill-adjusted container:

I needed to be out of my body, to be free. It felt as if my “inner body” was forcing itself to the ends of my limbs. I was growing ever larger inside of me, making me feel I was bursting at the seams and wanting out . . . out . . . out!

Because this was impossible, this process would abruptly reverse and I would start to shrink inside myself. My whole inner body shrank until I became very small inside. It was as if I became so small I had to find some safe place to hide inside myself. My tiny inner body was in unfamiliar surroundings, in a place it didn’t belong and I felt utterly unsafe. I became like a little shadow inside my physical body, a shadow running around everywhere trying to find somewhere to hide. Inside I was screaming. “Get me out of here!”⁹

The body of these trans subjects appears as a container that cannot contain. Hence, gender transition appears as the only possible escape from the confines of a prison, the prison of an excessive jouissance. Frank Lewins explains: “In the case of transsexuals locked inside a prison of flesh and blood, there is a constant ache for emancipation.”¹⁰ The body is experienced as a burdensome envelop, an exterior layer worn like an ill-fitting piece of clothing one is impatient to shed. This is how Leslie Feinberg describes it: “I think how nice it would be to unzip my body from forehead to navel and go on vacation. But there is no escaping it, I would have to pack myself along.”¹¹ Jan Morris reiterates a similar wish when she writes: “All I wanted was liberation, or reconciliation—to live as myself, to clothe myself in a more proper body, and achieve Identity at last.”¹² Morris refers to her former body as an oppressive outer layer in which the real being, the true self, was locked; the urge to break free from it is pressing: “If I were trapped in that cage again nothing would keep me from my goal . . . not even the prospect of death itself.”¹³ One could generalize this experience since the body seems to be the only place one cannot leave. We are all trapped in our mortal bodies—embodiment incorporates death. This reminds us of Stephen’s paradoxical loss of anger, which he experiences in the same passage as a sort of subjective death—he even forgets his own name. One has to cross this death to oneself in order to be reborn differently and reclaim a changed body. Gender transition is more about mortality, the limit between life and death, than about sexuality, the border between male and female.

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The plasticity of gender

In my clinical experience, I have encountered people whose entire being is consumed by the question of a life or death metamorphosis. As we have seen, the rate of suicide attempts, currently at 41 percent in the trans population (versus 4.6 percent overall in the general U.S. population) is a stark reminder of this fact. Research supports my clinical observations. In his survey, Jay Prosser finds that across the transgender community, transitioning is not a minor pursuit, but an endeavor that takes over subjects’ entire lives. “As the insider joke goes, transitioning is what transsexuals do (our occupation, as consuming as a career).”¹⁴ One of my patients, a trans man I will call Maxwell, told me recently: “Transitioning is complicated. It is the most amazing and horrific experience one can go through. But I did not have a choice.” He added: “This chance of being who you are, of having your body match how you feel is amazing but can also be horrifying. You do not really know what is going to happen.” He paused, smiled, and nodding in astonishment, continued: “When I started my transition 10 years ago, I did not know what was going to happen. It was a harrowing experience. Now, it may be more common. There are kids who start transitioning at age 17, 18. I am 39. I do not know what it would have been if I had transitioned earlier, at age 18 or 20.”

I noticed surprise on his face:

“My process was so intense, so internal, so agonizing. I did not know how to think about it. I thought I was going mad, I felt sick, alone, isolated. It was a big deal. It was the transformation of the whole of adolescence in just a couple of months.”

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I have heard this kind of narrative frequently in my consultation room. It is a rather common account in our clinical practice, even if it seems exceptional to the public. Remember when, in 2014, Angelina Jolie candidly disclosed that she carried a rare genetic mutation, which predisposed her to reproductive cancers? The public was shocked. Facing the prospect of staring down cancer, haunted by the fear of death, she decided to have a preventive double mastectomy followed by the removal of the ovaries and Fallopian tubes.

Angelina Jolie made the choice to amputate healthy body parts with the hope that she would steer clear of her genetic destiny. She took control of her body. Jolie has undergone surgery to reconstruct her breasts with implants. Now she lacks hormone-producing ovaries. Will she not be the same as many transsexual women? Is Jolie’s sexual identity really the sum of her body parts? Are any of our sexual identities really the sum of our body parts?

Sexual identity cannot be determined by quantities of hormones or the artful work of a surgeon with a scalpel. There’s a lesson to be learned from Angelina Jolie’s story: sexual identity transcends anatomy while it remains a mystery. Can we understand the transformation of Angelina Jolie—her mastectomy and subsequent reconstructive surgery—and that of my analysand Maxwell in the same context? Are both transformations “plastic”?

“Plastic sexuality,” a concept developed in 1992 by sociologist Anthony Giddens, refers to the malleability of erotic expression in terms of both individual choice and social norms. Its opposite, “fixed sexuality,” on the other hand, stands in contrast with the binaries of heterosexual / homosexual, marital (legitimate) / extramarital (illegitimate), committed / promiscuous, and “normal” (coital) / “perverse” (anal, autoerotic, sadomasochistic). For Giddens, effective contraception in tandem with the social and economic independence achieved by women has “liberated” men from the constraints of traditional gender expectations; and “plastic sexuality” is a result of this shift. He writes: “Plastic sexuality is decentered sexuality, freed from the needs of reproduction. It has its origins in the tendency, initiated somewhere in the late eighteenth century, strictly to limit family size; but it becomes further developed as the result of the spread of modern contraception and new reproductive technologies. Plastic sexuality . . .frees sexuality from the rule of the phallus . . . .”¹⁵ Thus, Giddens claims that plastic sexuality represents a shift in value. Sex is no longer a means to an end—it involves more than reproduction, kinship, and generational continuity. Neither is sex still bound with death—today, women rarely die during childbirth.

Nevertheless, giving birth and the whole business of procreation are connected with mortality. While the U.S. may think of itself as a beauty-obsessed culture, Brazil, a country with much lower income per capita, is the number one consumer of plastic surgery. Brazilian women set out to erase any trace of childbirth and lactation altogether. Alexander Edmons has observed the cultural prevalence of plastic surgery in Brazil, where across social classes, in glitzy clinics and in free public hospitals, Brazilians are lining up to get surgery, or “plástica,” as it’s called there.¹⁶ Brazilian women want a body that looks young and toned, not a body that looks worn from sexual reproduction. As Maria da Gloria de Sousa, who is 46 years old and is described as looking barely 30 after six surgeries, candidly says, “You’re born perfect, but then you have children and you know what having children does. Then suddenly comes the rebirth: plastic surgery. You can be beautiful, even more beautiful than you were before.” She adds, “My bottom will never sag, my breasts will never sag. They will always be there, hard.”¹⁷ Fundamentally, these women want to deny their own mortality, as if they were saying, I know full well that I am mortal, but . . .

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AIDS, though, reintroduced the connection between sex and death, Giddens notes.¹⁸ Indeed, the AIDS epidemic forced us to rethink sexuality because, as Tim Dean has shown, it can lead to an exchange of life for sex—a dramatic, literal relationship between the two emerges.¹⁹ This relationship is a complex one. I will focus on the “return” of the death drive because I see such a drive as a limit to the plastic promise. One remembers Judith Butler’s conception of gender as performative, as a promise of endless plasticity. Isn’t the transsexual the most radical example of the “plastic” drive, or, as Hegel would suggest, our desire to work against nature?

Often, gender transformation aims to achieve the beautiful, stable form. The wonderfully tender and intimate documentary, Beautiful Darling: The Life and Times of Candy Darling, Andy Warhol Superstar, explores this ultimate aim. This 2010 feature-length film focuses on the life of Candy Darling, the moving transgender muse, who appeared in several of Andy Warhol’s films and inspired numerous Lou Reed songs. The documentary includes a clip from another documentary, Bailey on . . . Andy Warhol (1973), in which Warhol explains the difference between “drag queens” and his stars. Drag queens, Warhol says, “just dress up for eight hours a day. The people we use really think they are girls and stuff, and that’s really different.” Warhol may have even suggested to Candy that she have a sex-change operation. In the film, Candy demurred, “I’m not a genuine woman . . . but I’m not interested in genuineness. I’m interested in being the product of a woman.” Thus she dosed herself with the same female hormones that very likely caused her death from lymphoma in 1974. She was 29 years old. Candy is not preoccupied with her genitalia; she’s got a beautiful face—it’s “I, Candy” or, rather, “Eye Candy.” Her face is extraordinary; it’s spellbinding, pale and luminous, always impeccably made-up. Candy has the face Roland Barthes saw when he looked at Greta Garbo: a face “descended from a heaven where all things are formed and perfected in the clearest light.” To Barthes, Garbo’s beauty “represented a kind of absolute state of the flesh, which could be neither reached nor renounced.”²⁰

Candy was supremely beautiful. Her majestic face, though, did not allow her to reconcile the limits imposed on her by her corporeal, sexual being. “I feel like I’m living in a prison,” Candy wrote in her diary. She noted how she couldn’t do certain things—swimming, visiting relatives, getting a job, or having a boyfriend. Her sex life remains a matter of speculation. As she lay dying on her hospital bed, Candy posed for Peter Hujar, who snapped a black and white portrait, later entitled, “Candy Darling on her Deathbed.” Death was not far from the lens—Candy died soon after the picture was taken.

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She left a note:

To whom it may concern,

By the time you read this I will be gone. Unfortunately before my death I had no desire left for life. Even with all my friends and my career on the upswing I felt too empty to go on in this unreal existence. I am just so bored by everything. You might say bored to death. It may sound ridiculous but is true. I have arranged my own funeral arrangements with a guest list and it is paid for. . . . Goodbye for Now.

Love Always,

Candy Darling.²¹

As Susan Sontag wrote, “Peter Hujar knows that portraits in life are always, also, portraits in death.” Thinking of this last photograph, she added, in her introduction to Portraits in Life and Death, the only book Hujar published during his life, “Photography converts the whole world into a cemetery.”²²

It is the tension between beauty and death that I want to underline here. Perhaps more specifically, I want to explore beauty as a denial of death, which functions as a limit to plasticity’s promise of endless permutation. In the early 1900s, Bakelite, the first fully synthetic thermoset, was created. In 1933, polyethylene was discovered. In 1939, at the World’s Fair in New York City, the DuPont Corporation introduced nylon, the first purely synthetic fiber. In the 1940s and ’50s, mass production of plastics began. The 1950s, as Meyerowitz so compellingly tells us, marked the beginning of the mediatic popularization of transsexualism.²³

When Christine Jorgensen underwent surgery in Denmark, a press frenzy erupted. “Sex-change” became a household term.²⁴ “In 1952 the press discovered Christine Jorgensen and inaugurated an era of comprehensive, even obsessive, coverage. In the history of sex change in the United States, the reporting on Jorgensen was both a culminating episode and a starting point.”²⁵ In the United States, Jorgensen’s tremendous public presence was emblematic of a growing cultural preoccupation with the intertwining domains of science and sexuality. It was as if, all of a sudden, Jorgensen herself embodied the hysteric’s question: “What is a man, and what is a woman?”²⁶

The 1960s brought the contraceptive pill and a sexual revolution. The word “plastic” has roots in both Greek and German. In Greek, “plastic” derives from πλαστικός (plastikos) meaning “capable of being shaped or molded”; “plastikos” derives from πλαστός (plastos) meaning “molded,” in reference to the malleability of forms, allowing them to be cast, pressed, or extruded into a variety of shapes. In German, “plastic” derives from Plastik, meaning “classical sculpture,” an art presenting beautiful forms and harmonious arrangement of visual stimuli.

In her groundbreaking meditation The Future of Hegel, Catherine Malabou pivots from Hegel’s discussion, in Aesthetics, of Greek art and sculpture as “the plastic art par excellence.” Malabou writes:

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The sense for the perfect plasticity of gods and men was pre-eminently at home in Greece. In its poets and orators, historians and philosophers, Greece is not to be understood at its heart unless we bring with us a key to our comprehension an insight into the ideals of sculpture and unless we consider from the point of view of their plasticity not only the heroic figures in epic and drama but also actual statesmen and philosophers. After all, in the beautiful days of Greece, men of action, like poets and thinkers, had this same plastic and universal yet individual character both inwardly and outwardly.²⁷

Malabou understands “philosophical plasticity” as a philosophical attitude, the behavior of the philosopher; to her, “philosophical plasticity” applies to philosophy, to the rhythm with which the speculative content is unfolded and presented. In the Science of Logic, Hegel states:

A plastic discourse demands, too, a plastic sense of receptivity and understanding on the part of the listener; but youths and men of such a temper would calmly suppress their own reflections and opinions in which “the need to think for oneself” is so impatient to manifest itself, listeners such as Plato imagined, who would attend only to the matter at hand, could have no place in a modern dialogue; still less could one count on readers of such disposition.²⁸

I will not engage with the nuances of Malabou’s argument; I will just note that she has chosen to emphasize the idea of a continuous productivity of forms, namely “plasticity,” whereas “plastic” by itself hesitates awkwardly between a certain concept of beauty and the technical possibility of transforming matter according the canons of beauty. Hence “plastic surgery.”

Plastic surgery aims to reshape or move a tissue, fill a depression, cover a wound, or improve an appearance. Let us note that today, one of the most popular surgical interventions—along with the likes of tummy tucks, chin and breast implants—is vaginal plastic surgery. Labiaplasties and vaginoplasties are among the fastest growing cosmetic procedures as the quest for a “designer vagina” intensifies. Curiously enough, most vaginal reshaping aims to create the kind of symmetrical vagina produced by sexual reassignment surgery for male-to-female persons.

Giddens assumed that plastic sexuality is a sexuality unconstrained by “the rule of the phallus, from the overweening importance of the male experience.”²⁹ I was quite surprised by something I discovered in my research about intersex folks. “Androgen Insensitivity Syndrome” or Testicular Feminization Syndrome is a genetic condition suffered by male XY fetuses unresponsive to testosterone during gestation. It results in babies born looking like girls who have a standard looking vulva, a vagina shorter than usual, and no uterus, fallopian tubes, or ovaries. This syndrome is often detected during adolescence, when these girls do not start having menstrual periods.

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All medical descriptions converge on this observation: women with this syndrome tend to be exceptionally beautiful. They have wonderful skin complexion (the lack of androgen prevents the development of acne), are extremely tall, with lean bodies and long arms and legs (a possible effect of the masculinization of the skeleton), have generous breasts, and lack pubic hair. What is surprising is that they seem to embody the current ideal of female beauty in western society, and many women with this syndrome pursue careers, such as modeling or acting, in which beauty is prized. The irony here is that our contemporary ideals of women’s beauty are most perfectly embodied by persons who are chromosomal males.

Today, transgender top-models like Andreja Pejic, Geena Rocero, Hari Nef, or Lea T are regularly seen in major fashion shows and in high-profile publicity campaigns. Gender fluidity has been present on the runaway for some time, but recently the agency Apple Model Management opened in Los Angeles the world’s first modeling agency dedicated exclusively to representing transgender models.

For those who are not so familiar with the fashion world, since 2009 there has been a limited edition fashion magazine with a cult following. Candy, named after Candy Darling, is, according to its website, “the first transversal style magazine” dedicated to the celebration of “transvestism, transexuality, crossdressing and androgyny in all their glory.”

Taking inspiration from Vanity Fair’s Hollywood issue, for its fifth anniversary, Candy’s 2014–2015 “transversal issue” depicted on its gatefold cover fourteen of the most prominent and beautiful transgender women at the forefront of the battle for transgender rights today. It was the first time that so many transgender women had been portrayed together on a magazine cover. The caption read: “The Role Models.” The issue sold out quickly and a few months later Vanity Fair ended up emulating the style of Candy’s “transversal issue” when presenting Caitlyn Jenner on its cover. Indeed, the glossy role models offer more than imaginary projections: they provide guidelines for future transitions. This reversal of influences, together with the current media fascination with everything trans, corresponds less to a curiosity in a phenomenon that has been “outed,” with the attendant expectation of scandal and revelation, than to a deeper change in our aesthetics of everyday life.

Sex is a joke of nature

Perhaps nature has a sense of humor. Nature, Hegel tells us, “combines the organ of its highest fulfillment, the organ of generation, with the organ of urination.”³⁰ Žižek uses Hegel’s critique of phrenology in the Phenomenology of the Spirit as a point of departure. Žižek refers to what he calls Augustine’s theory of the phallus. For Augustine, sexuality is not the sin for which humans are punished, but rather a punishment for “man’s pride and his want of power.”³¹ The phallus embodies the punishment, “the point at which man’s own body takes revenge on him for his false pride.”³² Man can master movement of all parts of his body except one—the phallus acts on its own, having its own volition and will.

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Žižek reverses this paradox and entertains us with a vulgar joke: “What is the lightest object on Earth?—The phallus, because it is the only one that can be elevated by mere thought.”³³ In this divine levitation, any punishment can be dialectically overcome. The phallus is less the way in which the flesh is humbled than the signifier of the operation by which the power of thought over matter is made manifest. Thought, words, images can be mobilized and avoid the sad fate defined by anatomy.

Freud avoided the trap of having to choose between anatomy and social convention. For psychoanalysis, sex is never a natural event, nor can it be reduced to a discursive construction. The alternative of “sex or gender” is a false one. Sexual difference is neither sex nor gender because gender needs to be embodied while sex needs to be symbolized. There is a radical antagonism between sex and sense, as Joan Copjec persuasively contends. Sex is a failure of meaning, a barrier to sense. Is sexual difference a category comparable to other forms of difference at play in the construction of identity—social, racial, class? Or is sexual difference a different type of difference?

Let us return to the clinic. Stanley is a transsexual man in his early forties. He speaks easily of his mother and of her desire. He was raised by a grandmother who, he told me, was the only person who loved him. Stanley’s grandmother rejected her daughter—Stanley’s mother—because she “only loved boys.” Nevertheless, when, as a child, Stanley was sent to live with his grandmother, she warmly embraced the little girl.

Stanley’s mother, Marika, left home at fourteen to marry Robert, who was fifteen. Marika was already pregnant when she moved out. Stanley’s father was Polish-American; Robert was the sort of a muscular, fun-loving, heavy-drinking man Marika’s mother, Gilda—who was also of Polish descent—preferred. When Marika moved in with Robert’s family, she became very close with her new husband’s family.

They were all very poor. Some worked (the mother’s side) whereas others were continually unemployed (the father’s side). Both of Stanley’s parents died young. Robert died in a car crash, but Stanley suspects he committed suicide. Marika died of an accidental drug-overdose. In Marika’s teenage marriage, Stanley’s mother had refashioned Lévi-Strauss’s formula for exogamy: “I take a wife and give a daughter.” Marika gave herself as a daughter to her husband Robert’s family and gave in turn her own daughter to her mother. My analysand says he was a tomboy growing up. His grandmother would tell him, “Do not get pregnant.” Stanley would answer, “I will never be pregnant.”

Stanley admits that being a man today has a lot to do with not being pregnant; avoiding pregnancy as a teenager like his mother did has allowed him not to repeat a destiny that he claims most girls in his school followed. Today, Stanley is a married man, satisfied with his job as a medical assistant. His wife, a nurse, is a heterosexual woman who never dated anyone queer before meeting him. They have a daughter conceived by artificial insemination. They are a normal couple whose current problem is that Stanley’s wife wants a second child.

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My analysand fears that he will have a son and opposes the idea quietly, for he thinks that it would be difficult for him to be the “father of a boy.” As he says this, a revealing slip of the tongue follows: “I cannot be a trans father.” In fact, Stanley is already a trans father; he has a daughter. He thinks that raising a son will expose an insufficiency—his lack of knowledge about masculinity. Stanley regards himself as a “feminist man,” a label that has the other sex—difference—written in its identity. He’s not, he says, like a biological man. He feels at ease among men but also feels different (this is important, because he is not psychotic).

Recently Stanley mentioned a dream: “I was making love with a man. He does not know I am trans. I am anxious. I touch his penis but find a weird translucent plastic thing with a red rod in it.” He added, as if to explain: “A transparent plastic thing.” At this point, I stopped the session, repeating: “trans parent plastic thing.”

Ultimately, the most radical discovery of psychoanalysis is that sex is tied to the death drive. Stanley’s “castration” has to do with his acceptance of his own mortality, a fact not unrelated to his conflicted desire to become a parent. Reproduction proves the mortality of the individual. One does not “duplicate” in sexual reproduction, as we often think. We do not buy a share of immortality by having children; quite the contrary. As Lacan puts it, sexual reproduction means that “the living being, by being subject to sex, has fallen under the blow of individual death.”³⁴ Reproduction does not guarantee immortality through replication but rather shows the uniqueness (and death) of each individual. In Stanley’s case, this is made absolutely clear—his wife will get pregnant using sperm from an anonymous donor. And Stanley is aware of this fact. He is quite relieved that, thanks to the artificial insemination, his offspring will not carry the “defective, addition-prone” genes in his family. For Stanley, the cut of castration or mortality with which he is struggling to come to terms is also an expression of his singularity as a subject, as a feminist man, as a “trans parent.”

The bewilderingly varied aesthetics of trans people has been given a contemporary voice in the irreverent and innovative videos made by Ryan Trecartin, who has been presented as one of the major young American artists launched by the New Museum in the “Younger than Jesus” group show, and who recently showed Any-Ever and other videos to huge acclaim during the Venice Biennale of 2013. Trecartin’s zany video art is a hymn to plasticity playing on gender transformation and bodily modifications. In an interview for The New Yorker, Trecartin said: “What identifies people is not their bodies anymore.”³⁵ Flesh is post-production plastic in a vertiginously fast and mobile world. Patrick Langley has said of his art, “if Facebook had a nightmare, it would be like this”: the aim is to put the death drive at center stage in the place of the drive to be beautiful.³⁶ His work exceeds comparisons and defies linear narratives. The handheld camera shows us with chaotic speed a crescendo of disjointed scenes of cartoonish destruction (young men and women in a multiracial social bubble, all dressed up lounging in semi-abandoned and half-destroyed houses, drinking and passing out, setting fires, crashing mailboxes, throwing televisions from speeding cars). Young people breaking rules while trying out different identities. Trecartin’s videos are never static; there is a dynamic oversaturation of images, a text-talk vernacular mixed with corporate slogans, a mix of aphoristic inanities in “the unmediated muttering of a digital unconscious.”³⁷ General ugliness is flaunted as a comic mode of transgression. “Death will cure many of the desire for immortality,” as Beckett wrote about Proust, but Trecartin inoculates us with parody and raunchy laughter.³⁸ Trecartin rejects the binarism of real versus virtual, male and female, self and other, gay and straight, rationality and madness, surface and depth, style and content, time and space. He proposes a post-Joycean playfulness by re-scripting and re-editing our current constructions of identity, and does not shy away from death.

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For Freud and Lacan, sexual reproduction and death are two sides of the same coin. Sexual reproduction requires more than one individual; one person, or partner alone simply cannot produce a new being. In principle, the sexed living being implies the death of the immortal individual. Sexual difference and sexual reproduction account for the constitutive lack in the subject—a lack Lacan ascribes to “reproduction, through the sexual cycle.”³⁹ As we have seen, there is no pre-programmed “biological” dictate in the psyche that determines why somebody will situate herself or himself, independent of her or his body, as a man or woman; further, there is no “biological” dictate that seeks a “fitting” complement.

To occupy a sexual orientation is to accept a primal loss. Again, sex needs to be symbolized and gender needs to be embodied. The major signifiers at work in Stanley’s unconscious—“trans,” “parent,” “plastic”—may perhaps re-knot themselves in a sinthome. This feminist man is at ease in the world because he can pass in his masculine persona. His being a man is never questioned. He is tall, lean, muscular, and good-looking and has all the markers of what, in our society, is seen as virile masculinity. Once more, he is obviously not psychotic. Stanley often says in session that it is “weird” to be a trans-man, that his transition is hard to explain, even to himself, but that he needs to invent something to survive. In the years preceding his transition, he was drinking heavily, and ruminating about suicide.

I want to emphasize the strong drive to beauty within the transsexual transformation. We encounter many trans folk who hope to be seen or read in the gender with which they identify. These folk talk about passing or not passing. I cannot help but wonder: is this a purely imaginary beauty, or one like that of Antigone, in whom Lacan sees sheer radiance or “unbearable splendor” that is a beauty purified of the imaginary?⁴⁰ In his description of Antigone, Lacan regards her beauty as a protective “barrier” that “forbids access to a fundamental horror”; for Lacan, her beauty is a screen that protects us from the destructive power of the Impossible, which Lacan calls the Real. Beauty can be a limit to reckless jouissance and an intermediary site between two deaths. This may lead us to conclude that transgender individuals want to be recognized in their being. When they say “I am beautiful” the stress is more on “I am” than on “beautiful.” Theirs is more an ethical than an aesthetic concern.

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Notes

  1    John Ashbery, “Passive/Aggressive,” The London Review of Books 21 (January 2016): 20.

  2    Janet Mock, Redefining Realness, 249.

  3    Caitlyn Jenner, Twitter post, August 16 2016, 12:10 pm, http://twitter.com/Caitlyn_Jenner.

  4    Jacques Lacan, “Some Reflections on the Ego,” International Journal of Psychoanalysis 34, no. 1 (1953): 14.

  5    See Jay Prosser, Second Skins: The Body Narratives of Transsexuality (New York: Columbia University Press, 1998). For a discussion of Prosser’s “transsexual mirror stage,” see my Please Select Your Gender (New York: Routledge, 2010), 242–244.

  6    G. Morel, Ambigüedades sexuales: Sexuación y psicosis (Buenos Aires: Manantial, 2000), and “The Sexual Sinthome,” trans. Roland Végső, in Umbr(a): Incurable, no. 1 (2006): 65–83.

  7    James Joyce, A Portrait of the Artist as a Young Man (New York: Penguin, 1992), 87.

  8    Jacques Lacan, Le séminaire: Livre XXIII: Le sinthome 1975–1976, ed. Jacques-Alain Miller (Paris: Seuil, 2005), p. 149.

  9    Raymond Thompson, What Took You So Long?: A Girl’s Journey to Manhood (New York: Penguin, 1995), 200.

10    Frank Lewins, Transsexualism in Society: A Sociology of Male to Female Transsexuals (Melbourne: Macmillan, 1995), 14.

11    Diane Leslie Feinberg, Journal of a Transsexual (New York: World View Publishers, 1980), 20.

12    Jan Morris, Conundrum (New York: Holt, 1986[1974]), 104, 169.

13    Ibid., 104, 169.

14    Prosser, Second Skins, 4.

15    Anthony Giddens, The Transformation of Intimacy: Sexuality, Love and Eroticism in Modern Societies (Stanford: Stanford University Press, 1992), 2.

16    Alexander Edmonds, Pretty Modern: Beauty, Sex, and Plastic Surgery in Brazil (Durham, NC: Duke University Press, 2010), 10–15, 90.

17    Lulu Garcia-Navarro, “In Brazil, Nips and Tucks Don’t Raise an Eyebrow,” NPR.org, last modified October 7, 2014, http://www.npr.org/sections/parallels/2014/10/07/353270270/an-uplifting-story-brazils-obsession-with-plastic-surgery

18    Giddens, The Transformation of Intimacy, 27.

19    See Tim Dean, Beyond Sexuality (Chicago: University of Chicago Press, 2000), 20–21.

20    Roland Barthes, Mythologies (New York: Farrar, Straus, Giroux, 1972), 74, 73.

21    James Rasin, Beautiful Darling: A Documentary on Candy Darling, The Life and Times of the Andy Warhol Superstar (Corinth Films, 2010).

22    Susan Sontag, “Introduction,” to Peter Hujar, Portraits in Life and Death (New York: De Capo, 1976).

23    Meyerowitz, Joanne, How Sex Changed: A History of Transsexuality in the United States (Cambridge, MA: Harvard University Press, 2004).

24    Ibid., p. 51.

25    Ibid., p. 49.

26    Ibid., 51, 49.

27    Catherine Malabou, The Future of Hegel: Plasticity, Temporality, and Dialectic (New York: Routledge, 2005), 9–10.

28    Ibid., 10.

29    Anthony Giddens, The Transformation of Intimacy, 2.

30    G. W. F. Hegel, Phenomenology of Spirit, trans. A. V. Miller (Oxford: Oxford University Press, 1977), 210.

31    Slavoj Žižek, The Sublime Object of Ideology (New York: Verso, 1989), 222.

32    Ibid., 223.

33    Ibid.

34    Jacques Lacan, The Four Fundamental Concepts of Psychoanalysis: The Seminar of Jacques Lacan, Book 11, ed. J. A. Miller, trans. A. Sheridan (New York: Norton, 1981), 189.

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35    Calvin Tomkins, “Experimental People: The Exuberant World of a Video-Art Visionary,” The New Yorker, last modified March 24, 2014, http://www.newyorker.com/magazine/2014/03/24/experimental-people

36    Patrick Langley, “Ryan Trecartin, the Real Internet is Inside You” The White Review, last modified April 2012, http://www.thewhitereview.org/art/ryan-trecartin-the-real-internet-is-inside-you/

37    Ibid.

38    Samuel Beckett, Proust and Three Dialogues with Georges Duthuit (London: Calder, 1970), 26.

39    Lacan, The Four Fundamental Concepts of Psychoanalysis, 205.

40    Jacques Lacan, The Seminar of Jacques Lacan: Book VII. The Ethics of Psychoanalysis 1959–1960, ed. J. A. Miller, trans. D. Porter (New York: Norton, 1992), 247.

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14

THAT OBSCURE OBJECT

From beauty to excrement

Doch mildernd wirkt auch hier der Zeiten Lauf;

Er lässt, was schön war, immer schön erscheinen . . .

[Time in its steady course will temper and dull, allowing what was beautiful to appear always beautiful . . .].

Daniel Paul Schreber, from a poem to his mother Pauline on her ninetieth birthday, June 29, 1905.¹

President Daniel Paul Schreber wanted to become a woman for aesthetic reasons above all. As he explains, a dream brought him the revelation that it would be “rather beautiful” to be a woman, moreover a woman with whom God has sex: “It must be beautiful (recht schön) to be a woman succumbing to the act of copulation.”² The preoccupation with beauty had run deeply in Schreber’s family. His father, Dr. Daniel Gottlieb Moritz Schreber, who played a central role in his son’s paranoid universe, was a famous physician, athlete, prolific author, and pedagogue, who proselytized for the benefits of exercise and physical fitness. The elder Schreber made very popular the pursuit of a healthy body, achieved by a strict physical exercise program. He also launched a severe pedagogical regime based on stern discipline and orthopedic devices of his invention.³ The influential health and childbearing expert recommended that parents and educators apply “the maximum of pressure and coercion during the earliest years of the child’s life.”⁴ Dr. Schreber invented orthopedic restraining apparatus to ensure that children maintained “the straightest possible posture at all times—whether standing, sitting, walking, or lying.”⁵ His preoccupation with a perfectly erect posture, even during sleep, was combined with the use of constraining straps and belts as part of his crusade against children’s masturbation. Many psychoanalytically oriented critics have suspected a perverse penchant close to sadism in Dr. Schreber’s pursuit of sexual normativity.

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At the age of 50, Schreber’s father, also a body-builder and winner of several fitness contests, used his own body as the model for the illustrations in his book Pangymnasticom, for, as his biographer Alfons Ritter observes, “constant training had given his body perfect beauty.”⁶ Indeed, Dr. Schreber’s ideal body was not just healthy but also beautiful, as the title of one of his popular books shows: Kallipoedie oder Erziehung zur Schönheit durch naturgetreue und gleichmässige Förderung normaler Körperbildung (Callipedia or Education towards Beauty through the Natural and Progressive Production of a Normal Body), often referred to as Callipedia or Education towards Beauty, was a popular guidebook for parents and educators. This book not only condenses Schreber senior’s pedagogical method of body-building with vigorous and methodical physical exercises (daily gymnastics and calisthenics) aimed at physical fitness, good posture, and emotional restraint, but also exposes an aesthetic preoccupation based on the classical ideals of beauty condensed in the German word Plastik. For the Schrebers, beauty inscribes the norm.

Schreber fils, following his father’s ideal of beauty, would however add his own twist when he saw beauty not as a sign of health but as a source of pleasure. He found the feminine body to be the most beautiful body, a site of voluptuousness creating desire for both men and women: “female nudes stimulate both sexes equally.”⁷ The female body was a superior form of embodiment to which he aspired, a “miraculous” form that could be frightening. It appeared in moments of intense pleasure, for instance, when playing the piano and “feeling aroused by the beauty of the music” (224). Schreber writes in his memoirs:

I can also “picture” myself in a different place, for instance, while playing the piano. When I am lying in bed at night I can give myself and the rays the impression that my body has female breasts and a female sexual organ . . . The picturing of female buttocks on my body—honi soit qui mal y pense—has become such a habit that I do it almost automatically when I bend down. “Picturing” in this sense may therefore be called a reversed miracle. (211)

[. . .]

When the rays approach, my breast gives the impression of a pretty well-developed female bosom; the phenomenon can be seen by anybody who wants to observe me with his own eyes. I am therefore in a position to offer objective evidence by observation of my body. A brief glance however would not suffice, the observer would have to go through the trouble of spending 10 or 15 minutes near me. In that way anybody would notice the periodic swelling and diminution of my bosom. Natural hairs remain under my arms and on my chest; these are by the way sparse in my case; my nipples also remain small as in the male sex. Notwithstanding, I venture to assert flatly that anybody who sees me standing in front of a mirror with the upper part of my body naked would get the impression of a female trunk—especially when the illusion is strengthened by some feminine adornments. I will not hesitate to add, that once I am outside this Asylum, I would grant an opportunity for observing my body to any serious specialist whose motive is scientific interest and not mere curiosity, I myself would never instigate such an examination. (248)

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This passage and others have led Deleuze and Guattari to affirm that Schreber was Freud’s transsexual. In an important analysis, the French philosophers argue that Schreber was not bisexual or homosexual, as Freud thought, but fully transsexual. They write of Schreber as “not simply bisexual, or between the two, or intersexual. He is transsexual. He is trans-alivedead, trans-parent child.”⁸ Indeed, Schreber had himself mentioned that he was “trans-alivedead,” or a “trans-parent child.” He said that he felt his body hovering between life and death, but happily, for him, destined to be regenerated in a mystical transition from man to woman.⁹ He writes about his transformed body:

The only thing which could be counted as somewhat unreasonable in the eyes of other persons is, as mentioned by the medical expert, that at times I was seen standing in front of the mirror or elsewhere with some female adornments (ribbons, trumpery necklaces, and suchlike), with the upper half or my body exposed. This by the way happens only when I am alone, never as far as I can avoid it within the sight of other people. . . . I have very good and important reasons for this behavior, however stupid or even despicable it may appear to other people. (369)

This particular experience seems to replay the basic elements of Lacan’s mirror stage. Schreber composes a neat and total image of himself as a beautiful woman, with a suggestion of a pert soubrette ready to seduce the master. This Victorian cliché has a parodic function since the Father’s gaze is both omnipresent and cancelled. The Father’s hyper-male idealization has been inverted into a female mockery, in which however he finds a temporary reassurance. The rays embody pure jouissance and seem to come from the outside. The feminine embodiment offers a solution to make sense of the intense voluptuousness Schreber experiences: “I can produce a feeling of female sensuous pleasure, particularly if I think of something feminine. I do this, by the way, not for sensual lust, but I am absolutely compelled to do so if I want to achieve sleep or protect myself against otherwise almost unbearable pain” (246).

Schreber’s body, once thoroughly feminized, became a voluptuous machine of polymorphous jouissance. The heightened erotic sensitivity was not limited to the nipples or the breast but includes all the erogenous zones, and most specifically the orifices of evacuation. Because of the negative or “perfidious” influence of God’s rays, Schreber could never say at a normal speed the words: “Why do not then shit?” (202). Here is how he elaborates on the “miracles” that took place in his body:

Like everything else in my body, the need to empty myself is also called forth by miracles; this is done by forcing the feces in the bowel forwards (sometimes also backwards) and when owing to previous evacuation there is insufficient material present, the small remnants in my bowel are smeared on my backside. This miracle, initiated by the upper God, is repeated every day at least a dozen times. It is connected with the idea which is quite incomprehensible for human beings and can only be explained by God’s complete lack of knowledge of the living human as an organism, that “sh . . .” is to certain extent the final act, that is to say when the miracles produce the urge to sh . . . the goal of destroying my reason is reached, and so the possibility afforded for a final withdrawal of the rays. Trying to trace the origin of this idea one must assume some misunderstanding of the symbolic meaning of the act of defecation, namely that he who entered into a special relationship with the divine rays as I have is to a certain extent entitled to sh . . . on all the world. (205)

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In the following section of the Memoirs, Schreber notes that whenever he experiences the “miracle” of having the need to defecate, it happens that someone has been sent by God to the lavatory precisely to prevent him from relieving himself. Because this happens frequently, “thousands of times,” it cannot be due to a coincidence. Schreber concludes this section with a ready answer: “The question why do you then not sh..?” is followed by the capital answer ‘Because I am somehow stupid’” (205). From this chain of reasons, Schreber deduces not only that God is inconsiderate, but also that he has no understanding of human organisms: “When I do empty myself—usually in a bucket because I almost always find the lavatory occupied—this act is always combined with a very strong development of soul-voluptuousness. Liberation from the pressure of feces present in the guts creates an intense feeling of well-being, particularly for the nerves of voluptuousness; the same happens when I pass water.” (206).

For Lacan, there was no doubt that Freud’s short book on the Schreber case was the best essay he ever wrote—perhaps because Schreber triggered some psychotic element in Freud himself: “The best thing that Freud did was the case history of President Schreber. He took to it like a fish to water.”¹⁰ Praising Freud’s reading of the case, Lacan maintains that a psychoanalyst should never hesitate to be delusional; he quips, “If I were more psychotic, I would probably be a better analyst.”¹¹ Nevertheless, when Lacan explores Schreber’s transformation into a woman, he disagrees with Freud’s hypothesis of repressed homosexuality and points to the dimension of transsexual enjoyment (jouissance). Deleuze and Guattari echo Lacan in their similar assessment. What Lacan adds to this transsexual identification, paying attention to another source of jouissance, is Schreber’s apprehensive and yet simultaneously voluptuous approach to defecation. The obsession of Judge Schreber with this erogenous shit can be paralleled with the curious role played by beauty and aesthetics in his transsexual delusion.

In Schreber’s delusion, we find the most repulsive excrement co-existing with the most beautiful, which reminds us of Freud’s consistent equation in the unconscious of feces (replaced by money or gifts) and babies. Feces and babies also hide the penis, all three being impossible to distinguish from one another and being quite interchangeable. Freud added that “these elements in the unconscious are often treated as if they were equivalent and could replace one another freely.”¹² If the relation between “baby,” “penis” and “excrement” is at stake in the Schreber case, we need to link such a symbolic lability with the movement of the drive. Precisely because of this extreme mobility, Lacan extends the concept of the object of the drive with his notion of the object petit a. This special psychical object that commemorates loss is not the end point of desire but its primal mover. Lacan considers the object petit a, an object-cause of desire, a trigger for desire. Objects, on the other hand, represent this original object, and because they hold a representative function, they enter into a relationship of equivalence or interchangeability that promotes a movement from object to object.

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Very early on, Freud had detected three types of objects that are the prototypes for libidinal objects: the oral, anal, and genital objects. He was able to substantiate the exploration of the second type of object when he read a catalog of excremental rites, John Bourke’s Scatologic Rites of All Nations: A Dissertation upon the Employment of Excrementicious Remedial Agents in Religion, Therapeutics, Divination, Witch-Craft, Love-Philters, etc. in All Parts of the Globe. Freud was invited by the renowned folklorist Friedrich Krauss to write the foreword for its 1913 German edition. We have seen that in 1903, Krauss had coined the term paraphilia favored by Stekel, Gutheil, Money and others, introduced into English in 1913 by urologist William J. Robinson.

Krauss’s annual magazine Anthropophyteia condensed several of Freud’s interests—folklore, ethnography, and anthropology. Freud was one of its avid readers. In 1910, the magazine was the object of furious accusations. It was said that, under the pretext of anthropological divulgation, the magazine was distributing obscene, pornographic material. At that moment, Freud intervened, writing an open letter in support of the magazine (published in Anthropophyteia), and between 1910 and 1912 his name appeared as a member of the editorial board. In 1913, the year Totem and Taboo was published, Krauss’s revised version was issued with Freud’s foreword.

Bourke’s book was a pioneering anthropological text that was, as the subtitle states, “Based upon Original Notes and Personal Observation, and upon Compilation from Over One Thousand Authorities” and was deemed “Not for general perusal.” It is often referred to as Scatologic Rites of All Nations. Originally published in English in 1891, the book had been penned by John G. Bourke (1846–1886), a military man of Irish ancestry born in Philadelphia. Captain of the Third U.S. Cavalry, he studied the same Native Americans that his troops planned to exterminate. He was an amateur historian and ethnologist whose legacy includes hundreds of pages about life on the frontier after the American Civil War.

The subtitle explains that the topic may sound unpleasant and indelicate. Bourke had dared explore rites and customs that would have to be excluded from all polite conversation in educated company. The warning happened to be a major draw, and the book attracted huge interest. The warning disappeared when the 1913 German translation under the direction of Krauss was printed, accompanied by Freud’s prologue. The title changed and was condensed: Der Unrat in Sitte, Brauch, Glauben und Gewohnheitsrecht der Völker (literally, Filth in Customs, Uses, Beliefs, and Customary Laws of All Nations). Freud’s contribution to Bourke’s text was later reproduced in the German edition of Freud’s complete works under the title “The Excretory Functions in Psychoanalysis and Folklore.” It was included in the fifth volume of an anthology of texts written by Freud in English published in 1950.

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In 1994, Louis P. Kaplan re-edited an abridged version of Bourke’s book. It had only 30 chapters and 165 pages, instead of Bourke’s formidable 500 pages and 52 chapters. This new version was published in New York under the title The Portable Scatalog. It was promoted not as an anthropological text but as humorous toilet-reading material. Kaplan attributed the disappearance of the marks of censorship to Freud’s appearance in the volume. He considers, tongue in cheek, that a prologue written by “the master of the anal stage” has given the text “a direct stamp of approval.”¹³ Freud, for one, was sure to remain unfazed, for he knew that the unease generated by the book’s subject matter would only stem from the unavoidable conflicts that exist between the demands of instinct and the restrictions imposed by culture. In his Three Essays on the Theory of Sexuality, Freud had already alluded to how civilization cripples sexual impulses and breaks the body into parts, to which it grants the label of “normal” or “abnormal” in the context of sexual pursuits.

John Bourke was a prolific author who kept a meticulous diary throughout his adult life: this detailed personal record is a valuable ethnographic document that served as a basis for his books. Scatological Rites of All Nations was inspired by an exceptional event. In 1881 Bourke was invited to attend a covert religious ceremony of the Zuñí natives of New Mexico. There, he was able to observe that during the ecstasy of the ritual dance, the natives drank human urine. He later discovered that their rituals included not only urine but also the ingestion of human and animal excrement. The first report of this experience was published in 1885 in a 56-page monograph: Notes and Memoranda on Human Ordure and Human Urine in Rites of Religious or Semi-Religious Character in Various Nations.

Uncomfortable with the pioneering role of “participating observant” that Malinowski would have recommended, Bourke mentions that, fortunately, the rite that he attended did not include the usual ingestion of animal and human excrement. In spite of its unpleasantness, the amateur ethnologist provided an explanation as to the rationality of this ritual. He notes that, among the Zuñís, the Nehue were an order or a medical sect; their dances had the objective of strengthening the stomachs of the participants so that they would be able to tolerate any food, even the most repugnant. In that way, they not only developed a resistance that allowed them to survive in situations where food was scarce but also allowed them to combat digestive problems. Bourke underlines the fact that this was not an isolated rite but a known and sanctioned practice among all communities of the peoples native to the American Southwest. He adds that excrement and its attendant rituals should be the subject of studies and become a rich source of information on the life of primitive peoples and modern civilizations, and that scientists should not be squeamish about death and waste.

Bourke’s fascinating unabridged text is too extensive to be summarized here, but I will attempt to briefly outline it. This text inspired James Frazer, author of The Golden Bough, as well as Freud, and addresses the excremental diet of the native people of Florida, Texas, and California. It describes the outlandish modes of Siberian hospitality (let us not forget that hospitality originates from the Latin root hostis: stranger, enemy¹⁴), and customs where women are offered to strangers so that they may drink their urine. It describes how, in Africa, it is neither rice nor showers of petals but the urine of the bride that one throws onto the guests of the nuptial celebration. Bourke finds that urine appears in psychotropic rites in which drugs are combined with the shaman’s urine. Bourke does not omit mentioning aberrations, such as the use of human excrement by the mentally ill. Bourke recounts that, among the Arabs, the excrement of kings was used to produce sacred incense and that, for Tibetans, the Lamas’s bodily waste was used for amulets. He even mentions the feces of baby Jesus, presumed to have miraculous powers.

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Bourke studies the role of cow manure in religious rites, especially among the ancient Israelites and Assyrians (whose altars were filled with votive dung) and describes Egyptian and Roman excremental gods. He also mentions a little-known deity, the goddess Cloacina, Roman goddess of toilets, whose name was supposedly coined by Romulus himself, as the patron goddess of latrines, sewers, and toilets of the Eternal City.

Beside the detailed references to the use of feces in mortuary rituals, there are the expected uses of urine and fecal matter in medical diagnosis and also in cures, as well as the industrial utilization of urine and ordure in, for instance, tanning, bleaching, dyeing. Bourke discovers the employment of excrement in food, such as in cheese manufacturing, but also when it was revealed, under suspicion of the propagation of cholera, that toilet water was the secret ingredient for deliciously spongy bread, according to the shocking recipe of a distinguished boulangerie in Paris.

The repellent list is meticulous and extensive: excrement used as love potions, in medicinal cures, as an antidote for poison arrows or, in Ireland, to attenuate a child’s fever, to combat eye diseases and to neutralize witchcraft. Roman women urinated on statues of the goddess Berecynthia, great mother of gods, while the Canadian Hurons covered themselves in feces to ward off evil spirits. In this context, it should come as no surprise that magic spells and charms often contain bodily discharges: tears, sweat, excrement. Neither are references to flatulence missing, or to urine for ablutions or to change hair color or to preserve one’s teeth, along with multiple variants on beauty achieved “cum stercore humano.”

Bourke and Freud had a similar attitude, as one can see from the subtitle of Totem and Taboo: “Resemblances between the psychic lives of savages and neurotics.” Bourke builds upon the common ground between the Zuñís’s urine dance and the European medieval celebration called the “Feast of Fools” (festum fatuorum, festum stultorum, festum hypodiaconorum, or fête des fous). This tradition has been well studied. It was a festival in which the participants attended mass wearing masks, were allowed transgressions ranging from the vulgar to the obscene, including binges of blood sausages and lewd, blasphemous activities of “madness and passion” often leading to “the most indecent libertinage.”¹⁵ To highlight the similarities between the European saturnalia and the Zuñí urine dance, Bourke analyzes language. In the medieval Feast of Fools, revelers would eat blood sausages, in French, boudins, a word that also meant “excrement.” People would also throw manure on bystanders while singing impious and scatological songs. Bourke analyzes Thomas Fosbroke’s rendition of the feast and adds that the participants not only wore masks but that the men dressed as women and the women dressed as men. The sexual and the anal appeared intertwined: the obscene gestures and unseemly sexual activities were joined by carts full of excrement whose contents were hurled at the crowds. Bourke concludes that on both sides of the Atlantic the ritual has followed the same logic, and when the Zuñís eat actual feces, the medieval revelers who consumed boudin were ingesting a “sublimed” equivalent.¹⁶

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Bourke’s remark calls up the use of “sublimation” in psychoanalysis. The equivalence that Bourke proposes between excrement and its substitute appears explicitly in Freud’s prologue when he describes a child’s coprophilic interest that falls victim to the effects of repression, and as a result of education the interest will shift to other objects: for example, from fecal matter to money. Freud maintains that the separation between interest in excrement and sexual interest is only produced later in the life in children; such a passage is never absolute: “coprophilic inclinations continue to operate in later life and are expressed in the neuroses, perversions and bad habits of adults.”¹⁷

This lingering coprophiliac inclination was exemplified by Freud’s patient, the Rat-Man. At the beginning of his analysis, the patient saw a young woman on the stairs of Freud’s office and assumed it was the doctor’s daughter. That night, he dreamed that the woman had manure caked onto her eyes. For Lacan, this meant that the Rat-Man would imagine “that Freud wishes nothing less than to give him his own daughter who becomes in his fantasy a person laden with all earthy riches and whom he imagines in the rather peculiar form of a person with glasses of dung on her eyes.”¹⁸ Fearlessly reading this as a union of myth and fantasy, Freud’s interpretation is drastic: “You have fallen in love with my daughter not because of her beautiful eyes but because you are interested in her money.” In the dream of the Rat-Man, the gaze and excrement are linked: the glasses play an important role in his obsession with an unpayable debt and an anal torture, which may be paralleled in “glasses of dung” with manure filling the eye cavities.

In the Freudian interpretation, money is linked to an interested love in this dream that recreates his fundamental fantasy. The Rat-Man repeats in the dream the story of his father: marrying a rich woman out of convenience, but not out of love. Objects follow a circuit that is not fortuitous but trails the trajectory of the drive. This itinerary is not determined by a normative object, as could be assumed in the case of the function of the genitals, but by the personal drama of the neurotic, his private mythic structure that he follows to the letter.

Another connection between Bourke’s text on scatological rites and Freudian theory appears. He describes a custom of the inhabitants of Samoa in Polynesia whereby, when a woman is about to give birth, they pray to the god or protective spirit of paternal and maternal families. This god will be the protector of the infant that will be born. As a way of showing respect for this deity, the prayers offered by the family allude to the baby as the “excrement” of the god. This custom continues throughout childhood, with the child’s nickname becoming, affectionately, “Togo’s excrement” or “Satia’s excrement,” according to the protective god’s name. Bourke notes that this crude phrasing nevertheless expresses piety and respect towards the divinities.¹⁹ Here is anthropological proof of what Freud discovered in the clinic by following the path marked by the circuit of the objects of the drive. He developed this in “On Transformations of Instinct as Exemplified in Anal Erotism,” an article published in 1917, three years after the German version of Bourke’s text.²⁰ There, Freud proposes a series of equivalences between various objects of the drive: child = penis = feces = money = gift. Freud observes, “in the products of the unconscious—spontaneous ideas, fantasies and symptoms—the concepts feces (money, gift), baby and penis are ill-distinguished from one another and are easily interchangeable.” He adds, “these elements in the unconscious are often treated as if they were equivalent and could replace one another freely.”²¹ Thanks to this permutability, a child is considered a “lumpf” (little turd, as seen in the analysis of Little Hans), that is,

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as something which becomes detached from the body by passing through the bowel. A certain amount of libidinal cathexis, which originally attached to the contents of the bowel can thus be extended to the baby born through it. Linguistic evidence of this identity of baby and feces is contained in the expression “to give someone a baby.” For its feces are the infant’s first gift, a part of his body which he will give up only on persuasion by someone he loves, to whom indeed, he will make a spontaneous gift of it as a token of affection; for, as a rule, infants do not dirty strangers. (There are similar if less intense reactions with urine.) Defecation affords the first occasion on which the child must decide between a narcissistic and an object-loving attitude. He either parts obediently with his feces, “sacrifices” them to his love, or else retains them for purposes of auto-erotic satisfaction and later as a means of asserting his own will. If he makes the latter choice we are in the presence of defiance (obstinacy) which, accordingly, springs from a narcissistic clinging to anal erotism.²²

Feces are the baby’s “first gift” of love that later transfers its libidinal value to interest in money or in a wish for a baby, with, in the latter, the anal-erotic and genital drives overlapping. As for the penis, Freud ascribes its significance to anal eroticism. He speculates that the penis had already a prototype in the anal-sadistic phase when the fecal mass stimulated the mucous membrane of the rectum, which will later be replaced by the vagina.²³ Freud also indicates that a woman shifts her desire for a penis to a desire for a man, with the possibility of a passing regression from man to penis, as object of her desire. Freud’s theory makes several heterosexist assumptions but we should pay attention to the fact that, while he attributes to the male organ an important role, the penis is already functioning as a substitute. Both Freud and, even more systematically, Lacan speak of the phallus as a separable, transformable object (and, in this sense, a partial object) that is the last element in the series of interchangeable objects. Lacan adds two more objects to the Freudian list. When Lacan coins the concept of “object a” as an objectal remainder, he presents it as founded on four objects defining the partial drive: the breast as the lost object of suction (the oral drive); feces as the object of excretion (the anal drive); and objects causing desire, like the voice (the invoking drive) and the gaze (the scopic drive). For Lacan, when there is an object a, there is castration, because the object, as such, is always a lost object. While discussing the oral object, Lacan clarifies this point: “The object petit a is not the origin of the oral drive. It is not introduced as the original food, it is introduced from the fact that no food will ever satisfy the oral drive, except by circumventing the eternally lacking object.”²⁴

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We will now turn to the anal object; since the anal object is not gendered, it is a more universal model for subjective loss, applicable to cis and trans people alike. It is not only that as civilized beings the release of excrement falls under the impositions of culture. When “we go,” where “we go,” and what we do with what we produce will introduce a difference determined by imperatives that depend on signifiers such as Ladies and Gentlemen. The libidinal importance of the anal factor was perfectly condensed when one of my analysands unwittingly testified to the importance of our cloacal destiny: “I am an asshole letting my partner treat me like shit.”

Notes

  1    Daniel P. Schreber, Schreber inédit, ed. Daniel Devreese et al. (Paris: Seuil, 1986), 58.

  2    According to Freud, the first indication of a transsexual delusion in progress appeared in Schreber’s hypnopompic idea “that after all it really must be rather beautiful to be a woman submitting to the act of copulation” (my emphasis). This notion evolved and finally led to the voluptuous debauchery that he would not hesitate to attribute to God. Sigmund Freud, “Psychoanalytic Notes on an Autobiographical Account of a Case of Paranoia (Dementia Paranoides): The Case of Schreber,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 12, ed. James Strachey (London: Hogarth Press, 1958), 36.

  3    See William G. Niederland, “Schreber: Father and Son,” The Psychoanalytic Quarterly 28 (1959): 151–169.

  4    Ibid., 154.

  5    William G. Niederland, The Schreber Case: Psychoanalytic Profile of a Paranoid Personality (New York: Psychology Press, 2009), 51. See also 56, 70, 73, 74.

  6    Alfons Ritter quoted in Niederland, The Schreber Case, 64.

  7    Daniel P. Schreber, Memoirs of My Nervous Illness (New York: New York Review of Books, 2000), 155. All further citations will be in the text.

  8    Gilles Deleuze and Félix Guattari, Anti-Oedipus: Capitalism and Schizophrenia (London, New York: Continuum, 2004), 85.

  9    Deleuze and Guattari, Anti-Oedipus: Capitalism and Schizophrenia, 85.

10    Jacques Lacan, Seminar 24, 5 January 1977, Unpublished papers. I follow the translation of the transcription by Dan Collins, Q & A, p. 76.

11    Ibid.

12    Sigmund Freud, “On Transformations of Instinct as Exemplified in Anal Erotism,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 17, ed. and trans. James Strachey (London: Hogarth Press, 1958), 128.

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13    John G. Bourke, The Portable Scatalog: Excerpts from Scatological Rites of All Nations. A Dissertation upon the Employment of Excrementitious Remedial Agents in Religion, Therapeutics, Divination, Witchcraft, Love-Philters, etc., in All Parts of the Globe, ed. Louis P. Kaplan (New York: William Morrow and Co., 1994), 15.

14    On this issue, see Jacques Derrida and Anne Dufourmantelle, De l’hospitalité (Paris, Calmann-Lévy, 1997).

15    Bourke, The Portable Scatalog, 28.

16    Ibid., 29.

17    Sigmund Freud, “Preface to Bourke’s Scatalogic Rites of all Nations,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 12, ed. and trans. James Strachey (London: Hogarth Press, 1958), 337.

18    Jacques Lacan, “The Neurotic’s Individual Myth,” Psychoanalytic Quarterly 48 (1979): 416.

19    Bourke, The Portable Scatalog, 52.

20    Sigmund Freud, “On Transformations of Instinct as Exemplified in Anal Eroticism,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 12, ed. and trans. James Strachey (London: Hogarth Press, 1958).

21    Ibid., 128.

22    Freud, “On Transformations of Instinct as Exemplified in Anal Erotism,” 130.

23    Ibid., 131.

24    Jacques Lacan, The Seminar of Jacques Lacan: The Four Fundamental Concepts of Psychoanalysis, ed. Jacques-Alain Miller, trans. Alan Sheridan (New York: Norton, 1981), 179–180.

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15

FREUD’S SCATALOG

Scatology has an important contribution to offer to psychoanalysis because the anal object is the first object of loss and castration. Lacan takes excrement as the model of subjective loss, of primordial castration. He develops Freud’s observation that feces are the first part of our bodies that we had to give up as tokens of love. It is through them that we find the entryway into the castration complex. Tim Dean notes that this loss is universal: “Lacan’s model for subjective loss is not the phallus but feces, an ungendered object. In the face of this object-cause of desire, the controversy over the concept of the phallus pales into insignificance, since whether or not we’re all—men as well as women—missing the phallus, certainly we’ve all lost objects from the anus. And this distinction remains universally true—irrespective of gender, race, class, nation, culture, or history.”¹

Žižek observes that the anal object functions as a signifying element, highlighting the role that excrement plays in the economy between subjects as a proof to the Other of self-control and discipline in a child, or of obedience to the demands of the Other, or as a first gift to the Other.² Feces, before becoming a symbolic object, have been elevated to the status of gift; they are objects, parts of the body that fall and are lost to then acquire a symbolic role. This type of functioning denotes that the anal object has passed through the sieve of symbolic castration, which transforms it into what Lacan names as the object a, that is to say, the object that causes desire.

Developing this primordial function, in the seminar On Anxiety, Lacan wonders why excrement holds such a great importance in what he calls “an intra-living and inter-living economy.”³ Lacan suggests that the importance of excrement derives from its being the object of the demands of the Other represented on this occasion by the mother. Education teaches children to control their sphincters, which is not obvious. The ability to retain feces outlines the child’s dominion of something that is a part of the body and can be released upon request (à la demande). Education satisfies the demand of the Other and is accompanied by a series of well-known hygienic tactics called potty training. Bowel control produces indisputable erogenous effects, which “become that much more evident when it so happens that a mother goes on wiping her son’s bottom into his twelfth year,” comments Lacan (301). “Such things can be seen day in day out . . .we can see very well how poo easily assumed the function of what I have called . . . agalma. That this agalma should have passed over into the register of the foul-smelling is merely the effect of discipline itself, of which it is an integral part” (301). Shit is not only a gift but also the agalma, the sacred images contained in Socrates’s ugly body that, according to Alcibiades in The Symposium, account for Socrates’s charisma and asexual power of the mind.

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Demand elevates the turd to the level of a precious object, of a gift causing love. A specific agalmic relationship is established between the mother and her child’s feces, a connection that is not only conceivable in its relationship to the phallus, “to its absence and to phallic anxiety as such. In other terms, the excremental a has come within the scope of our attention inasmuch as it symbolizes castration” (301). The demands of the mother (or main care-taker) revolve around “Hold it!” or “Let it out,” upon request. Among the rituals of sniffing and wiping, there is approval and praise, “What a nice poop!” But then, the object switches and the child is taught not to get too attached to the smelly and disgusting poop, a condition for being properly “trained.” The feces are both the child (as a supreme gift) and not him (as abject dejection).

What stands out in the experience of defecation and toilet training is the fact that the child recognizes separation as a major principle. The role of excrement as mediator in the child’s relationship to the Other and the others proposes a model of otherness that, as Lacan indicates, establishes the basis for the constitution of another dimension: that of desire. Excrement, as object a, can be a part of the body that is released and given as a gift, or an object that is retained in rebellious disobedience, or a sexual activity given the pleasure produced by the stimulation of the fecal mass in its passage through the rectum and anus, as Freud details in an addition to the third edition of Three Essays.

We have seen Schreber caught up in the imposed copulation with an evil and stupid God, who knows nothing about the human body, and wants him to turn into a woman. His anal worries about feces generated enjoyment, reaching an economy of excrement comparable to that described by Bourke through which the lineaments of a whole social and psychic economy of the gift are discernible. Can we from these observations move on and push psychoanalysis beyond its limits? Although psychoanalysis seems to have been obsessed with sex or the lower functions of the human body, most psychoanalytic concepts are not sexed but contribute to an original definition of sexuality, like the unconscious, repetition, transference, symptom, and finally, the objet a.

We have discussed earlier the confusion between penis and phallus; this is implied by Freud’s statement that “anatomy is destiny.” Freud seemed to state that human subjects are defined by the genitals they were born with, but there has been a misunderstanding about the “anatomy is destiny” idea. If we look closely at its original formulation in Freud’s 1912 essay “On the Universal Tendency to Debasement in the Sphere of Love,” we realize that Freud is not discussing gender but presenting a thesis about unsatisfactory sexual relations, a precursor to Lacan’s “there is not such a thing as a sexual relation.” Freud writes, “It is my belief that, however strange it may sound, we must reckon with the possibility that something in the nature of the sexual instinct itself is unfavorable to the realization of complete satisfaction.”⁴ Freud lists two elements he thinks make dissatisfaction a universal feature of human sexuality. The first contributing factor is that any sexual object is nothing but a poor substitute for the first and forbidden object, the mother. The second factor is that there is a deep antagonism between our sexual drives and civilized life. Our drives—the coprophilic (excremental) and sadistic urges are Freud’s examples–-offend our standards of culture. Freud writes: “The excremental is all too intimately and inseparably bound up with the sexual; the position of the genitals—inter urinas et faeces—remains the decisive and unchangeable factor. One might say here, varying a well-known saying of the great Napoleon: ‘Anatomy is destiny.’ The genitals themselves have not taken part in the development of the human body in the direction of beauty: they have remained animal, and thus love, too, has remained in essence just as animal as it ever was.”⁵

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This observation about the “ugliness” of genitals reappears in a footnote added by Freud to his Three Essays in 1915. Freud observes a puzzling fact: we find beautiful what is sexually appealing, but the genitals, which are supposed to produce the strongest sexual excitation, are not beautiful. Finding something “beautiful’ or “ugly” is an aesthetic response of which love or disgust can be extreme forms. In order to understand why we might find the genitals ugly rather than beautiful (sexy) since they should produce the maximal attraction, let us take a look at disgust, the most acute response that ugly things like vomit, excrement, rot, and decay can elicit. For Freud, the genitals might be ugly because instead of evolving towards beauty they remained animal; as Paul Rozin claims, disgust is a human, cultural achievement.⁶ Lacan and Freud intimated that shame about excrement is what distinguishes humans from animals; the feces that initially the child values, turns into a problem only when it becomes part of a symbolic network that ascribes to it an abject value. Then the child learns to worry about how and when to dispose of it. In the larger context of society, this “civilized” concern reappears in the need to build sewers, better toilets, and perhaps in recent debates about public restroom access that have turned shared bathrooms into a battleground for transgender rights.

Beauty and the beast

Let us consider now an example, the movie The Crying Game (1993). In the film, a man, Fergus, is about to have sex with a beautiful woman, Dil. She undresses and reveals that she has a penis. Fergus first vomits and then physically attacks Dil. Fergus’s attraction to Dil unsettles his gender identity and causes him to question his sexual orientation. Fergus is shaken with disgust upon discovering his desire for Dil; his own attraction has taken a turn from the normative heterosexual aim. We know from hysteria that the other side of revulsion is desire, and that violence is often a reaction to the awareness of this disturbing reversibility.

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Freud also observes that disgust “interferes with the libidinal overvaluation of the sexual object but can in turn be overridden by libido. Disgust seems to be one of the forces that have led to a restriction of the sexual aim. These forces do not as a rule extend to the genitals themselves.”⁷ Disgust can deter from achieving satisfaction but it can also create an interdiction whose very transgression enhances pleasure: “The sexual instinct in its strength enjoys overriding this disgust.”⁸ In a later section of the Essays devoted to “Fixations of Preliminary Sexual Aims,” which introduces for the first time the notion of sublimation, Freud writes:

Visual impressions remain the most frequent pathway along which libidinal excitation is aroused; indeed, natural selection counts upon the accessibility of this pathway—if such a teleological form of statement is permissible—when it encourages the development of beauty in the sexual object. The progressive concealment of the body which goes along with civilization keeps sexual curiosity awake. This curiosity seeks to complete the sexual object by revealing its hidden parts. It can, however, be diverted (‘sublimated’) in the direction of art, if its interest can be shifted away from the genitals on to the shape of the body as a whole. It is usual for most normal people to linger to some extent over the intermediate.⁹

The beauty of the body is sexually arousing, but the most exciting zones, “the hidden parts,” are not beautiful. Let us take a closer look at the footnote added in 1915 where Freud introduces this paradox: “There is to my mind no doubt that the concept of ‘beautiful’ has its roots in sexual excitation and that its original meaning was ‘sexually stimulating.’ [There is an allusion in the original to the fact that the German word ‘Reiz’ is commonly used both as the technical term for ‘stimulus’ and, in ordinary language, as an equivalent to the English ‘charm’ or ‘attraction’.] This is related to the fact that we never regard the genitals themselves, which produce the strongest sexual excitation, as really ‘beautiful.’”¹⁰ Is sublimation and the interest in art a strategy to move away from the ugliness of genitals?

The presence of disgust in sexuality was a fact observed early on by Freud. In a letter to Fliess from January 1, 1896, Freud noted that the physical proximity of sexual and excretory organs “must inevitably arouse disgust along with sexual experiences.”¹¹ He remarks in Dora’s case that the “genitals can act as a reminder of the excretory function,” a fact made explicit in the male, since the same organ is used for micturition and sex. For both sexes, despite efforts at idealization, excrement is inseparable from sexuality ever since our birth, reiterating that this is due to the fact that “inter urinas et faeces nascimur.”¹²

Freud’s recurrent observations about the connection of sex and excretions remind us of the passage in the Phenomenology of Spirit in which Hegel remarks that nature combines “the organ of its highest fulfillment, the organ of generation, with the organ of urination.”¹³ It is worth considering the various implications of this urethral passage in Hegel’s philosophical masterpiece.

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When Hegel observed that man’s most perfect organ, the organ of procreation, is at the same time the organ of micturition, he did not use the German term Urinieren (urination) but the strong and vulgar word, Pissen (piss). The use of this rather crude term has surprised critics. Vincenzo Vitiello considers that this coarse word is chosen strategically.¹⁴ Hegel’s use of strong and bawdy language is interpreted by Donald Phillip Verene as a calculated attack against the pseudo-scientific claims of phrenology. Hegel refutes here the physiognomic proposition of phrenology and its speculations that cranial shape can predict and determine human behavior and character. All this boils down to stating that one can reduce the Spirit to a bone, which reveals a profound ignorance, Unwissenheit (a not knowing) disguised as Wissenschaft (science) or genuine Wissen (knowledge) of the Spirit. With this wordplay on Pissen and Wissen, Hegel exposes the oversimplification and utter nonsense of phrenology. Hegel uses this vulgar term to challenge the false science of phrenologists who reduce the mind to the skull (today it would be brain mapping). The extraordinary remark corresponds to his amused delight when observing that the same organ serves as the noble organ of generation and the base organ of urination. For Hegel, at least, anatomy is not destiny!

Hegel’s observation on the joke of nature anticipates the critique of what could pass as the psychoanalytic conflation of penis and phallus. Hegel refuted the claim of phrenology that the skull could be a map of the mind, by ironically affirming the opposite of what he thought—thus he writes: “the Spirit is a bone,” but then proceeds to debunk this thesis. If we consider the body as a map of circulating and accidental erogenous zones, can we say that Freud might be playing a similar game when he says, “Anatomy is destiny”? Can the phallus both pee and excite? Or is that supposed to be too disgusting a question?

Avital Ronell noted that Hegel’s perceived “contradiction” between the high and the low role played by the penis imposes a “re-zoning of phallo-central pleasure.” This shift of position reveals a “spreading network of erotic localities”¹⁵ that are progressively desexualized because, as Freud notes, initially, “[s]exual pleasure is not attached merely to the function of genitals.”¹⁶ This duality accounts for the fact that some organs have a double function. Ronell adds: “In the history of philosophy the dual-functioning organ was poignantly named by Hegel and later commented by Kierkegaard. The former understood the penis to be in ‘contradiction’ with the vagina, performing as it does the two essentially opposing tasks of producing semen and piss (Piß) generative substance and waste product.”¹⁷ Thus the penis would not “have a choice”; it is subjected to opposing and contradictory forces, while other organs appear more “volitionally oriented.”¹⁸ Ronell cites Freud’s example of the mouth as one such organ with “double function.” Freud elaborates, “The mouth serves for kissing as well as for eating and communication by speech; the eyes perceive not only alterations in the external world which are important for the preservation of life, but also characteristics of objects which lead to their being chosen as objects of love—their charms (Reize).”¹⁹ As we have seen, Freud thinks that Reiz is what makes us perceive something as attractive, sexy—in a word, beautiful.

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Freud uses the example of a “dual function” organ, the mouth, an organ meant to be used to eat and drink, but also to kiss. Even the most passionate lovers will hesitate before sharing a toothbrush, forgetting that kissing may entail a more extensive exchange of bacteria. Freud writes:

The use of the mouth as a sexual organ is regarded as a perversion if the lips (or tongue) of one person are brought into contact with the genitals of another, but not if the mucous membranes of the lips of both of them come together. This exception is the point of contact with what is normal. Those who condemn the other practices (which have no doubt been common among mankind from primeval times) as being perversions, are giving way to an unmistakable feeling of disgust, which protects them from accepting sexual aims of the kind. The limits of such disgust are, however, often purely conventional: a man who will kiss a pretty girl’s lips passionately, may perhaps be disgusted at the idea of using her toothbrush, though there are no grounds for supposing that his own oral cavity, for which he feels no disgust, is any cleaner than the girl’s. Here, then, our attention is drawn to the factor of disgust, which interferes with the libidinal overvaluation of the sexual object but can in turn be overridden by libido.²⁰

Is the kiss taking place because the girl is pretty, or does she appear pretty in order to override the disgust that her mouth might elicit? Neither one, nor the other. Freud concludes that, in human sexuality, the most sublime and most repugnant things appear in intimate dependency. As my argument about Schreber and Freud’s reading of Bourke’s book suggests, a better way to understand what can make an object appear attractive or repulsive, ugly or beautiful, or even indifferent, would be to situate it within Lacan’s concept of the object a. This object, to which sexual pleasure might be tied, and whose function is to trigger desire, is “a support of the subject and is in many cases a more abject thing that you care to consider.”²¹

We have seen that the child feels ashamed of excrement only after the feces have become an object that represents what the child believes he or she means for the Other. The child learns in relation to the Other to ascribe to an object a libidinal value. Feces offers the child an early experience in bodily loss and the baby’s bowel movements become precious as something to please others, for instance, the mother. This is how the anodyne poo goes from being raised to the level of treasured gift to become an abject refuse renounced with disgust. What if a penis appears as something not much better than a piece of excrement?

The child itself can be a gift—as in Freud’s economy summed up in the equation feces = penis = baby that we have discussed—or following the fate of exchanges, it can be a turd. But what happens when the whole body is experienced as abject? What is the role of the object when it goes beyond the wish to make the body whole? Why do some people experience their bodies as the wrong bodies? Is it that they feel that the organs they reject are organs without bodies? Are their bodies “bodies” only if they sense they can be bodies without organs? And what is the function of art in helping to embody a body that is at odds with the sense of self? We will see in the next chapters how art can offer a solution to all these queries.

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Notes

  1    Tim Dean, Beyond Sexuality (Chicago: University of Chicago Press, 2000), 264–265.

  2    Slavoj Žižek, The Metastases of Enjoyment: Six Essays on Women and Causality (New York: Verso, 1994), 179.

  3    Jacques Lacan, Le Séminaire. Livre X, L’angoisse (Paris: Seuil, 2004), 348; The Seminar of Jacques Lacan. Book X: Anxiety, ed. Jacques-Alain Miller, trans. A. R. Prince (Cambridge: Polity, 2014), 300. All further citations will be from the English 2014 translation, and presented in the text.

  4    Sigmund Freud, “On the Universal Tendency to Debasement in the Sphere of Love,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 11, ed. and trans. James Strachey (London: Hogarth Press, 1958), 188–189.

  5    Ibid., 189.

  6    See Paul Rozin et al. “Disgust,” in Michael Lewis and Jeannette Haviland, eds, Handbook of Emotions, (New York: Guilford, 1993), 637–653.

  7    Sigmund Freud, “Freud, S. (1905). Three Essays on the Theory of Sexuality (1905),” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 7, trans. and ed. James Strachey (London: Hogarth Press, 1953), 151.

  8    Ibid.

  9    Ibid., 155.

10    Ibid.

11    Sigmund Freud, “Draft K: The Neuroses of Defence from Extracts from the Flies Papers,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 1, ed. and trans. James Strachey (London: Hogarth Press, 1958), 221–222.

12    Sigmund Freud, “Dora’s Case History,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 7, ed. and trans. James Strachey (London: Hogarth Press, 1958), 31–32.

13    Georg W. F. Hegel, Phenomenology of Spirit, trans. A. V. Miller (Oxford: Oxford University Press, 1977), 210.

14    See Vincenzo Vitiello, “La religión revelada,” in Félix Duque, ed., Hegel: la odisea del espíritu (Madrid: Círculo de Bellas Artes, 2010), 276.

15    Avital Ronell, The Telephone Book: Technology, Schizophrenia, Electric Speech (Lincoln: University of Nebraska Press, 1989), 102.

16    Sigmund Freud, “The Psycho-Analytic View of Psychogenic Disturbance of Vision,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 11, ed. and trans. James Strachey, (London: Hogarth Press, 1958), 216.

17    Avital Ronell, The Telephone Book, 102–103.

18    Ibid., 103.

19    Freud, “The Psycho-Analytic View of Psychogenic Disturbance of Vision,” 216.

20    Sigmund Freud, “Three Essays on the Theory of Sexuality,” 150–151.

21    Jacques Lacan, “Of Structure as the Inmixing of an Otherness Prerequisite to Any Subject Whatever,” in Richard A. Macksey and Eugenio Donato, eds. The Structuralist Controversy: The Languages of Criticism and the Sciences of Man (Baltimore: Johns Hopkins Press, 1970), 189.

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16

THE ART OF ARTIFICE

This Damned Body: A Living Archive of Transformation is an intimate online document of Swift Shuker’s transition from a male body to an androgynous one. I was interested in the fact that for Shuker the process became an art form. This is why, on September 3, 2016, I went to Philadelphia’s Fringe Arts annual festival hoping to see a live performance, expecting the unexpected, since Shuker is co-artistic director of the [redacted] theater company, an innovative and daring theater collective based in Philadelphia.

Upon arrival at the festival’s main venue, I was told that This Dammed Body Is Carved Out of Meat was not going to be presented on stage, but would be live online as part of Digital Fringe, a platform for digital art in Fringe Arts’ annual Fringe Festival. Paradoxically, this story of the flesh was presented only virtually. On the website, I found the detailed description of a four-part “Epic Performance Series.” The videos are organized chronologically:

Part 1: THIS DAMNED BODY: A Living Archive of Transformation (December 1 2014–January 1 2017)

Part 2: This Damned Body Is Carved Out of Meat (August 28–30 2015)

Part 3: This Damned Body Is Going to Hell (August 2016)

Part 4: This Damned Body Is Coming Home (January 1 2017)

The description provided by the Fringe Arts program read like a manifesto: “Art is the link between your humanity, spirituality, and the people around you; art is a reprieve from loneliness. It is our job to restore this power to art, and to open the eyes of our audiences to art’s lost functions. Theater is not necessary anymore. It is an elitist diversion for the upper classes, not much more than entertainment. It is our job to use theater’s unique power of direct, living presence to make the audience think, live, feel, live, question, live, dismiss, live, discover, and live forever. You will live forever. . . . The greater the sacrifice, the greater the beauty.”¹

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Before attending the festival, I had watched a video from the “Living archives” posted during the fund-raising phase of the project.² The trailer for This Damned Body Is Carved Out of Meat opens with an off-camera voice saying: “Hello friends, we are making a play.” The use of the present tense brings to the project the immediacy and urgency of the “now.” It describes a project for a play, music recordings, and two-year performance series about “the difficulties, pleasure, and ugliness of living in a body,” words that refer to an impasse, to enjoyment, and to aesthetics. We see a person who we might assume is biologically male, long dark blond hair on one side, a shaved head on the other, pearls and hoops on the ears, nails painted bright red, writing words on their face with a black marker. “NO” appears with arrows pointing over the shade of a beard, “NOT IDEAL,” on the Adam’s apple, “HIGH,” on the forehead, “FINE,” with arrows pointing to the nose. While hearing of the need to help fund the project, we watch the video’s protagonist wearing a red padded bra, black marker in hand, continuing to write on their body.

We see the words “HAIR,” indicating chest and armpits, “FAKE” with arrows directed at the contents of the bra. The next scene shows the same person bare-chested, just wearing two pieces of underwear on top of each other—a black lace thong and over it, a striped black and white brief. The accelerated writing on the skin continues, and progressively reads “LARGE” on shoulders and hands, “FAKE” on the chest, “HAIR” towards chest and nipples, “LINT” and “UNDECIDED” pointing to the belly button, “FUCK IT SHAVE IT ALL” over the belly’s hair, and “ALIEN CREATURE UNDER MY SKIN” on the right thigh.

A longer version of this video was made available online during the Fringe Arts festival under the title “This Dammed Body Week 1: Year One.”³ It opens with the declaration: “I must start by telling you a lie.” The “lie” is the account of a suicide attempt—the protagonist is led by “marionette strings” to jump over a cliff, a potentially deadly fall, but from which they are miraculously saved. It is during this narration that we see alternating images of Shuker lying naked in bed and images of Shuker getting a tattoo on their back. The tattoo is elaborate—a tree with a rope tied to it, and holding onto the rope, suspended mid-air, a naked person. Then the video cuts back to scene of the writing on the body. This includes frontal nudity: on the penis, the writing says, “I AM FINE WITH IT.” The video closes with a cliffhanger: “and now I am going to tell you the truth.”

The story juxtaposes the statement “I am fine with it” written on the penis with the preceding account of a suicide attempt. This is a poignant section punctuated by the voice of Shuker saying: “This body isn’t mine, it isn’t right, it isn’t mine and I don’t like it.” We hear the voice breaking because Shuker is crying. “I know I don’t want to die. If I am gonna live I have to hang that life onto something, I have to hold onto something.”⁴ We now see rapid images of Shucker painting lines on their body with red lipstick superimposed with images of the tattoo in progress (another kind of writing on the body). “I know this body isn’t mine. This is wrong. I am living in the wrong thing.” The lines of lipstick get smeared, as if erasing the marks. Under the intense shadow of red color spreading all over the skin, the writing on the body becomes less legible, but still discernible. Shuker smiles to the camera in a disquieting manner.

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Here is a diary entry, an excerpt from Shuker’s moving account of gender transition. All diary entries follow the same grid: “Pronoun today; Changes noticed; Money Spent on Transition Expenses; Number of Times Correctly Gendered + Comments; Dream; People I Talked to Today; People I Actually Communicated with Today; What Have You Done to Become Better Today?; Other Comments; Have You Been Saved?”⁵

In the “March 31, 2016” entry, the dream was:

Me and N are in Boston, on a train. We’re going to a doctor to treat N’s foot, who is in the middle of a large park. We get off the train, and we’re in a large tunnel complex, with curved ceilings and walls all of a beige brick. There’s a person sitting at a table, and we go up to him to get directions, and he gives us a check for $100, made out to Pig Iron Theater, and tells us to give it to the doctor, who is to the left. We start walking down the tunnels, which become hallways, and become large rooms with many doors. We’re getting freaked out because we don’t want to get lost, and we run into another couple who’s been trying to get out for a while. Together we find a kitchen which has a window to the outside, so we decide to leave through that, but it’s locked, and when we try to break it, the glass isn’t glass, it’s a strange, incredibly strong material halfway between plastic and flesh. We get knives and slowly laboriously hack our way through this fake glass, and reach our hands outside to find that the outside world is a painted backdrop on this same kind of material, and there’s no way out. Me and Naia start running (them [sic] on a broken foot), trying to retrace our steps, frantic to get out of the maze. We eventually find our way back to the entrance, and the man at the table asks us if we enjoyed the play, and explains that the maze was an experimental performance piece (by Pig Iron), and if we’d given the check to the doctor, we could have seen the end. We yell at him about how frightening it was and how we were trying to see a real doctor for a real emergency, and demanding he send someone to get the bags we dropped when we were fleeing, because we’re sure as hell not going in there again.⁶

I want to explore how art helps inscribe the body, “the incredibly strong material halfway between plastic and flesh,” as in Shuker’s dream, which sends us back to my previous discussion of plasticity.⁷ This will lead me to argue that writing plays a crucial role in embodiment by making a body become something else that is beyond plastic and flesh.

Shuker chooses to be referred to as “they”; I will use this pronoun in my references to both the performer and to the character depicted. The description of the YEAR ONE video in Vimeo qualifies it as an “epic,” which suggests a heroic quest or the attainment of a great feat. One wonders if this grandiose depiction is ironical: “THIS DAMNED BODY: an epic, two-year, online performance art piece.”⁸ But let us note that what is most remarkable in this work is that Shuker’s bodily transformation is not so much about gender as it is a reconciliation with life:

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I, Swift Shuker, a real human person, have a real physical body. It sleeps and sweats and shits and bleeds. It is visible; other people can see it and smell it and notice it. After I die, people will look at my corpse and say, “That’s Swift.” They will be incorrect.

I, this human person, have the WRONG BODY. It is strange and hairy and breastless and I am not at home in it, and when people look at me, they see something which is not me.

In the absence of God, I take myself into my own hands. If I am to be seen, I will be seen on my own terms.

I, Swift Shuker, am becoming an androgyne. By medicine and by art and by sacrifice, I will make myself a body with an aesthetic, a gender, and a voice that I can live with. Because I do not wish to die.⁹

The project is a day-to-day, personal portrayal of the milestones and ups and downs of the process of gender transition from laser hair-removal to the transformative effect of hormones, to bouts of depression and sudden euphoria; it consists of audio files, videos, photographs, diary entries. It aligns itself with the exploding genre of trans people uploading selfies and videos to the internet, documenting their transition. If the mood might be glum and character’s anguish seemingly paralyzing, the purpose feels critical, pressing, necessary: “I am doing all this to keep myself alive,” Shuker says. “Art will keep us alive.”¹⁰ Taking my cue here, I can state that I am particularly interested in this project: it illustrates perfectly and accurately the function of art as a lifesaver. I am also intrigued by the body as written in Shuker’s video; the issue of body-writing and bodies-as-written is an issue I have often encountered in my practice while working with analysands who identify as trans.

In my reading of Shuker’s work, I will try to take some distance from the usual psychoanalytic interpretations of art that operate on fixed keys and are prone to bland generalizations. I prefer the approach recommended by Freud when interpreting dreams. Dreams, like Egyptian hieroglyphics, can be deciphered not as symbolic images but as phonetic writing, providing elusive yet readable texts. My method will not look for a translation of meaning but rather a literal exploration of the material. I take as my inspiration Freud’s description of his Leonardo essay as “partly a poetic novel” (“halb Romandichtung”¹¹). This does not imply that Freud downplays the quality of his research but rather that he acknowledges that writing psychoanalytically entails a creative way of writing that is never too far from fiction.

Lacan displaced the Freudian question of interpretation with a question of reading and writing—reading the symptom and writing the symptom. I will use the term he coined to describe this conjunction, that of “sinthome.” I will explain the logic of this coining in Lacan’s works and apply the concept to my own corpus: my clinical experience with analysands who identify as trans and for whom a process equivalent to writing takes center stage in their cure, including also other patients who have made use of a similar procedure. What I have learned in my clinic is that “trans patients” often applies to patients who are cis. This “curative” role of writing is more poignantly observed in the chronicles of people who changed sex, but it is universal. Their testimonies manifest most clearly that there is a new writing on the body, as a consequence of which an observation of the body can yield a productive understanding of art as such. Indeed, the transgender experience brings to the fore the challenge of assuming a different or transformed body. As many argue, this is similar to the experience of becoming a work of art. The body becomes an artistic endeavor, a body of work, a lifetime oeuvre, the final product. Thus, an art similar to that of actual artists is to be found in transsexual artificiality. On occasion, such art is tantamount to a “sinthome,” which means that it occupies a structural function analogous to the role Lacan ascribed to writing, particularly that of James Joyce, who, Lacan argued, was able to use art as a supplement, as an artifice.

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Notes

  1    “This Damned Body,” FringeArts, accessed September 12, 2016, http://fringearts.com/event/this-damned-body.

  2    See “This Damned Body Is Carved Out of Meat,” IndieGoGo, accessed September 12, 2016, https://www.indiegogo.com/projects/this-damned-body-is-carved-out-of-meat#.

  3    See Swift Shuker, “This Dammed Body Week 1: Year One,” [redacted] Theater Company, accessed September 11, 2016, https://vimeo.com/113248908.

  4    Ibid.

  5    Swift Shuker, “March 31, 2016,” This Damned Body (blog), March 31, 2016, http://thisdamnedbody.com/archive/

  6    Ibid.

  7    Ibid.

  8    Swift Shuker, “This Dammed Body Week 1: Year One.”

  9    Swift Shuker, “About,” This Damned Body (blog), http://thisdamnedbody.com/about.html, accessed October 7, 2016. Bold in original

10    Ibid.

11    In a letter to Hermann Struck of November 7, 1914, Freud writes that his Leonardo essay is “partly a poetic-novel,” adding, “I do not wish you to judge the validity of our other research according to the same pattern” (“Ich möchte nicht, daßsz Sie die Sicherheit unserer sonstigen Ermittlungen nach diesem Muster beurteilen”). This emphasizes again the essayistic quality of his theories but does not diminish their intellectually stimulating effect. Sigmund Freud, Briefe 1873–1939, ed. Ernst L. Freud and Lucie Freud (Frankfurt am Main: S. Fischer, 1960), 302.

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17

CLINIC OF THE CLINAMEN

Does our appreciation of Leonardo Da Vinci’s masterpiece change if we know that Mona Lisa’s enigmatic smile, which seems to promise “unbounded tenderness and at the same time sinister menace,” results from sublimated homosexual tendencies, incestuous wishes, and Leonardo’s phallicization of the mother?¹ Freud set a bad example when he interpreted Leonardo’s life and work and indulged in a practice that in another context he would have called “wild psychoanalysis,” an approach that he considered pseudo-scientific and “technically objectionable.”² To a certain extent, the creator of psychoanalysis was aware of the limitations of his method when it came to explaining the effect of an artwork on the spectator, as he made explicit in his analysis of the Moses of Michelangelo. Freud confessed that he was “no connoisseur in art, but simply a layman” and humbly admitted that he was “unable rightly to appreciate many of the methods used and the effects obtained in art.”³ Nonetheless, he pleaded guilty to experiencing the urge to interpret art in order to enjoy it:

Works of art do exercise a powerful effect on me, especially those of literature and sculpture, less often of painting. This has occasioned me, when I have been contemplating such things, to spend a long time before them trying to apprehend them in my own way, i.e. to explain to myself what their effect is due to. Wherever I cannot do this, as for instance with music, I am almost incapable of obtaining any pleasure. Some rationalistic, or perhaps analytic, turn of mind in me rebels against being moved by a thing without knowing why I am thus affected and what it is that affects me.⁴

Understanding for Freud did not decrease pleasure. On the contrary, he felt compelled to figure out the source of his enjoyment so as to enhance it. Nevertheless, all along Freud knew of the futility of this task, “the apparently paradoxical fact that precisely some of the grandest and most overwhelming creations of art are still unsolved riddles to our understanding. We admire them, we feel overawed by them, but we are unable to say what they represent to us.”⁵ For Freud, art is bewildering and inscrutable, yet we cannot help feeling compelled to come up with an interpretation, perhaps as a reaction to the opaque nature of the emotions art elicits or perhaps because once we experience strong feelings of pleasure, that pleasure can be paradoxical and accompanied by pain, boredom, or disruption. Thus, we start down the path of jouissance and we may no longer know or want to know where it will lead.

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While Freud was well aware of the potential pitfalls to the application of psychoanalytic concepts to the examination of works of art, he did not escape the temptation of “psychoanalyzing” not only art but also artists, connecting the life of the artist to the works. Ever since penis envy, Oedipal conflict, scopophilic drive, narcissism, and so on were “applied’ to biographical events, offering clues to several levels of pathology to explain the creative process, life and art illustrated theory. This is how psychoanalysis went “wild” and derailed into the slippery field of psychobiography. One could wonder whether this type of critical production is actually psychoanalytic at all, because, as Mijolla and Mijolla-Mellor observe, “there is no formulable psychoanalytical interpretation outside the psychoanalytical situation”; psychoanalytic interpretation would work only within the boundaries of the transference relationship established between analysand and analyst.⁶

Lacan preferred to keep both psychoanalysis and art closer to the couch, first by strongly rejecting the use of psychoanalysis outside the clinical field. He repeatedly attacked so-called “applied” psychoanalysis. He was vehemently opposed to it but had no qualms with using art and fiction in furthering psychoanalytic theory. It is enough to take a look at his texts on the works of authors such as Marguerite Duras or Edgar Allan Poe to see that he staunchly refused to psychoanalyze the author or the works and made fun of those who indulged in this practice.

With understandable trepidation, most psychoanalysts have relied on a timid proposition, the well-known Freudian formula that psychoanalysis has nothing to say about art but can learn a great deal from it. Lacan eventually contradicted his position when he worked on James Joyce, often conflating in his analysis Joyce, the author, with Stephen Daedalus, the character. Lacan’s reading of Joyce, however, is not an indulgent psychobiographical exercise. Like Sophocles’s Oedipus for Freud, Joyce’s fiction offered a new and revolutionary psychic paradigm. For Joyce, art played a central role, and his writings may have saved him from the psychosis that engulfed his daughter; he once blurted out that only a transparent sheet of paper separated Ulysses from madness.⁷

Lacan’s year-long seminar of 1975–6 focused on Joyce, offering an extensive exploration of artistic activity. As Lacan unambiguously stated in the opening session: “this year will be my interrogation of art.”⁸ When Lacan turned his attention to Joyce’s writings, he discovered a new understanding of art and creativity: from Joyce’s “art,” Lacan deduced an original definition of the symptom. Breaking away from the medical model by bringing the symptom closer to a mathematical function, Lacan developed a new theory of artistic creation from Joyce’s unique though not unprecedented situation, and found a new meaning for the term “symptom” that he rewrote as “sinthome.” This word, apparently an invention, is the ancient spelling of symptom in French; it is moreover pronounced identically to the contemporary word for symptom. This subtle difference, inaudible in speech but patent in orthography, is a deliberate gesture hinting at the importance of the dimension of writing.

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How productive was this neologism? The shift in terminology related the symptom to art, with sinthome defined as the creative knotting together of the registers of the Symbolic (language, speech), the Real (whose effect is the mixture of pain and pleasure Lacan calls jouissance, the distribution of pleasure in the body) and the Imaginary (images, meaning) whose interlocking sustain the subject’s reality.

By the time of the sinthome, Lacan was working on models that defied intuitive grasp taken from mathematics (set theory) and topology (knot theory), borrowing a different syntax and a new vocabulary in an effort to offer a formalization of what he observed in the analytic experience. This shift from linguistics to topology engendered major consequences. Lacan no longer thought of the symptom simply as something to decode, a carrier of a repressed message (a signifier) that can be deciphered by reference to the unconscious “structured like a language,” but as the trace of the unique way someone can come to be and enjoy one’s unconscious. The symptom as “sinthome” is an invention that allows someone to live by providing an organization of jouissance. Identification with the sinthome occurs when one identifies with the particular form of their enjoyment, thereby deriving their selfhood. For Lacan, the aim of the cure was no longer to remove the patient’s symptoms but to let the patient identify with her unique sinthome in order to enjoy it.

Enjoy your sinthome!

The sinthome is inscribed in Lacan’s theory of the Borromean knot, made out of three intertwined rings that correspond to the tripartite structure Lacan called the Real, the Imaginary, and the Symbolic orders. Although heterogeneous, these registers intersect and are held together. Lacan chose the Borromean knot because of its main characteristic—the rings are so interdependent that if one ring is unknotted, the other three come loose. A fourth term intervenes to repair the failure in the knotting, re-linking the rings and holding together again those that had disentangled. Lacan called “sinthome” this fourth ring capable of remedying the negative effects of the unraveling of the Borromean knot.

Inventing the sinthome, Lacan not only put forward a new technical term but also opened a revolutionary theoretical avenue. Let us not forget that the term was coined for a gifted artist like Joyce, whom Lacan claimed personified the sinthome. Lacan’s theory of the sinthome applied above all to the singularities of Joyce’s art but could be generalized. Joyce’s case constructed a clinical example explaining how the art of the sinthome worked.

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Lacan’s idea was that Joyce’s writing was a corrective device to repair a fault, a slip of the knot. According to Lacan, Joyce’s enigmatic writing in Finnegans Wake would undermine or undo language by creating a verbal stream of polyglot polysemy, saturated with multiplying meanings, a cosmos of indeterminacies; this revolutionary practice became his sinthome. Lacan then adds that Joyce wanted to make a name for himself, and produced a new ego through artifice. This turned into his signature, the mark of his singularity as an artist.

As I have argued in Please Select Your Gender, I connect the peculiar meaning given to the concept of “art” by Lacan in his interpretation of Joyce’s works with what I discovered in my clinical practice when treating patients who identified as trans. Joyce’s art compensated for a defect in its author’s subjective structure and saved Joyce from insanity. The sinthome-art granted him access to a new know-how that repaired a fault in the psyche; this produced a supplement that held together the registers of the Real, the Symbolic, and the Imaginary in such a way that it could fasten or re-knot the subject.

With the theory of the sinthome, Lacan reached a turning point. He created a new vocabulary in an effort to formalize what he observed in the analytic experience. This shift leads me to what I will call a clinic of the clinamen, a term that anticipates the new knotting produced by the sinthome. While Joyce was reknotting the three registers of the Real, the Symbolic and the Imaginary with a sinthome that reintroduced a certain order in his potentially chaotic psyche, for Lucretius and Democritus, the very existence of bodies in the world was due to an apparently random knotting of trajectories in the fall of atoms through the void. This swerve would account for the link between a singularity and the rule. This theory corresponds to the beliefs of the first atomist philosophers who held that atoms were falling in a void, and that bodies were created in that fall; these followed not a parallel streaming but were set off course by eddies or swerves introducing irregularity. Clinamen is the Latin name given by Lucretius to this infinitesimal, unpredictable swerve of atoms. Atoms fall following a slope, a deviation that operates in a void that by definition cannot be perceived.

The principle of the clinamen expresses “the irreducible plurality of causes or causal series, and the impossibility of bringing causes together into a whole,” writes Gilles Deleuze in Logic of Sense (270).⁹ The clinamen introduces chance and spontaneity. Its descendent movement produces turbulence, creating vortices and eddies. Such turbulence would account for the creation of new bodies; it is the spontaneous creativity of matter. This conceptualization, which has also been developed by Lacan, can be very useful if we bring it into contact with the notion of the material and embodied symptom. In the same manner that Marx became aware that ancient materialism implied an effect of structure, Lacan complicated the notion of matter and of materialism when he made of jouissance his only ontology.

Lucretius’s notion of the “clinamen” will allow me to explore trauma in a new light. To have a sexual body means reaching what we may call a second materiality. The materiality that is required to accomplish this is that of the letter (writing). For the body “to hold,” a second materialization needs to take place; this is accomplished by way of torsions knotted by writing. The letter gives a consistency to the knot that holds together the body on the three structural registers.

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In a discussion of how writing might be negatively affected by the use of computers, the writer Italo Calvino argued in favor of the creative potential of the clinamen as a catalyst for artistic creation. The computer, Calvino says, “far from intervening as a substitute for the creative act of the author,” liberates us from “the servitude of combinatory research,” giving the writer “the greatest possibility to concentrate on this ‘clinamen,’ which, alone, can make the text into a veritable work of art.” While for Calvino the clinamen can produce a real work of art, for the poet Jacques Roubou, the clinamen elicits originality. Roubou described the effect of the clinamen on the form of his poem “Air,” which he dedicated to Raymond Queneau, as follows: “An empty space—the length of syllables—in the table is filled minimally, by this sonnet written according to rules as well as with a little irony. A clinamen in the letter count by absence and excess, says the addressee. Like a parenthesis with an extra line, coda.”¹⁰ The clinamen deviates and thus unleashes a creative potential; it imposes an innovative pattern onto the constraint. According to Peter Consenstein, Calvino and Roubou are not the only Oulipians writers (who are known for using constrained writing techniques) to count on the clinamen as “an atom of freedom,” as Epicurus called it.

The clinamen operates as the source of creative deviations from the frame of the constraint. Paul Braffort in Atlas de littérature potentielle, for instance, calls for further research on the complex role of the clinamen: “we were proposing more and more to make explicit the constraining games than an author could not avoid, in order to make possible rigorous calculations and deductions (to the nearest clinamen).”¹¹ For Oulipian writers, the clinamen is “an obligatory stage in creating something ‘new’.”¹² Furthermore, the clinamen makes possible new forms. “The clinamen is an obligatory element in all Oulipian constraints, it participates in the evolution of genres, and formally reflects memory’s plasticity and often unknown reasons for igniting.”¹³ Consenstein sees the clinamen as an antidote to repetition: “if a constraint remembers or reflects the process of memory, the addition of a clinamen to it guarantees its continuity and plasticity . . . Without the deviation there is only a recursive and inescapable loop.” The clinamen functions as a constraint both flexible and rigorous and can inspire singular, original solutions for each writer. They are unique inventions outside the compulsion to repetition; when they amount to art, we might call them a sinthome.

I have suggested earlier that the experiences of trans people can allow us to see the function of art in ways that affect the life of everyone, men and women, transgender and cisgender alike. The trans person’s transformation brings us close to the etymological meaning of techné, which in Greek means both “technique” and “technology.” Techné is not exactly “art” in the sense of “fine arts,” as Heidegger has skillfully demonstrated. Other equivalents would be “expertise,” “technical knowledge,” and even “science.” The art of the sinthome is art but taken in an extended sense; it is more a know-how, a sort of singular knowledge that cannot be transferred to another person. In the case of sex-change memoirs that I have analyzed in Please Select Your Gender, writing a memoir gave the authors new bodies that could be named.¹⁴

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Before reaching my clinical example, I would like to rapidly sketch how Lacan arrived at the sinthome. He moved from a theory of the signifier to a theory of the symptom as developed by dialectical materialism. Lacan famously proposed that it was Marx and not Freud who had “invented” the notion of symptom,¹⁵ which led him to abandon the traditional Freudian notion of the symptom as message and as metaphor. The reasons were clinical. The language of symptoms may be metaphorical but in the sense of being carriers, it embodies jouissance. The completion of an analytic cure does not rely solely on decoding of symptoms; focusing on how the symptom gives a symbolic form to the Real of the drive implies also transforming the economy of jouissance. Only then might analysis reach an end.

Initially for psychoanalysis, the symptom was considered interpretable as a rebus, a decipherable configuration of symbols that went back to a repressed source. “It” spoke where “it” hurt, but, like a coded message, “it” could be undone by being translated. However, as Freud observed in Beyond the Pleasure Principle, after being interpreted, something remained unsolvable in the symptom, causing it to return. There was a beyond: even if the symptom caused suffering (that admission helps someone engage in analysis), the suffering also granted a painful form of satisfaction, one that “hurts so good”—jouissance—which one is compelled to repeat. In the words of Freud’s patient known as the Wolf-Man, the treatment’s success relied on a willingness to relinquish jouissance: “Freud said that one could get cured by analysis, on condition that one wanted to be cured. He compared it to a railway ticket. The ticket gives me the possibility to travel, but does not oblige me to. The decision is mine.”¹⁶ Then the cure depends on what Paul Verhaeghe and Frédéric Declercq call “a decision of the ego” overdetermined by the drive.¹⁷ They argue that the Real of the drive is the Real of the body that operates somehow “independent of the subject; it is an instance that judges and chooses independently.”¹⁸ In Lacan’s words, “it is a jouissance that thinks,” and yet the subject has to take a position vis-à-vis those bodily choices.¹⁹

How does the ego choose? Already in the 1950s Lacan noted that “the ego is structured exactly like a symptom. At the heart of the subject, it is only a privileged symptom, the human symptom par excellence, the mental illness of man.”²⁰ Lacan soon abandoned the idea of the ego as symptom, or more interestingly of the symptom as ego, something to which he only would return to in his seminar on Joyce, more than twenty years later.

For a decade or so, he presented the symptom as a metaphor that could be interpreted along the lines of his linguistics or rhetorics of the unconscious; thus in “The Instance of the Letter,” Lacan wrote: “Metaphor’s two-stage mechanism is the very mechanism by which symptoms, in the analytic sense, are determined. Between the enigmatic signifier of sexual trauma and the term it comes to replace in a current signifying chain, a spark flies that fixes in a symptom—a metaphor in which flesh or function is taken as a signifying element—the signification, that is inaccessible to the conscious subject, by which the symptom may dissolve.”²¹ If Lacan here sounds close to Jean Laplanche terminology, it is because he remains Freudian—the sexual trauma is repressed but its traces are encoded in the symptom.

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The problem of this position is that it does not take into account the important fact that symptoms can also be a source of satisfaction for the drive, and that they can embody and regulate jouissance. This observation led Lacan to the path of a realm beyond repression, representation, and knowledge, in other words, to what he called the Real. As Lacan proposed in this seminar Encore: “The real, I will say, is the mystery of the speaking body, the mystery of the unconscious.”²² No longer a message to decipher, the sinthome testified to a Real that emerged transformed, overdetermined by a surplus of jouissance.

The concept of the sinthome within the clinic of the clinamen provides a helpful clinical tool. I find it useful to distinguish between pathological structures and non-pathological ones. Such a concept implies that the materiality of the body is not defined by organs more or less visible; it is not a manifest destiny. Embodiment requires at times a creative sinthome. In my practice, I prefer to talk about transgender symptoms by situating them in neurosis, perversion, or psychosis. Hervé Hubert already proposed a differential clinical practice of the transsexual sinthome in 2006 in order to move away from the medicalized pathologizing notion of “transsexual syndrome.”²³ In Horsexe (1983) Catherine Millot was the first to observe that the transsexual transformation could have a function of sinthome. Millot sees in the transsexual transformation a function analogous the one that Lacan assigns to writing for Joyce. For many Lacanians, the name ‘Joyce’ is synonymous with psychosis. This was not Lacan’s position.

Millot’s claim also led many Lacanian and post-Lacanian psychoanalysts to assume that transgender manifestations where inevitably a sign of psychosis. Moving away from this position, Pierre-Henri Castel (2003) investigated transgender embodiment and considered Lacan’s notion of sinthome as a restorative construction when the Oedipal metaphor fails. Geneviève Morel discussed in 2008 what she called “the sexual sinthome,” a test to the limits of the phallic function. The notion was taken up systematically by Rafael Kalaf Kossi in 2011 to propose a “transsexual sinthome” that could be found in pathological and non-pathological psychic structures.²⁴ Oren Gozlan (2011, 2015) and Sheila Cavanagh (2016) have found the notion of sinthome to be useful in transgender embodiment to avoid the trap of pathologization.²⁵

As I proposed in 2010, I find that Jacques Lacan’s theory of the sinthome offers an original framework for rethinking sexual difference—trans and cis. Since a sinthome can be found in any structure (neurosis and psychosis), with the help of this theory, one can challenge the pathological approach too often adopted by psychoanalysis when confronted with non-normative expressions of sexuality and sexual identity.

Hubert, like Millot and Lacan, takes Joyce as a paradigm, though not of psychosis but rather for a particular body, a body that could fall from one’s self, like a wrapping that does not fully hold. Hubert’s analysis is nuanced and insists on the Real.²⁶ Joyce’s Stephen Daedalus offered something psychologically illuminating for Lacan—it exposed the “psychology” of the relation to the body. Lacan explains: “After all, psychology is nothing other than the confused image we have of our own body.” With Stephen, Lacan detects a type of body that “simply goes away, shed away like the skin of a fruit.” He adds, “Having a relation to one’s own body as foreign is a possibility, which is expressed by the verb ‘to have’ that we use for the body: one has one’s own body, one is not one’s body in any degree . . . the relation to one’s own body is entirely suspect for a psychoanalyst, since the idea of oneself as body has a certain weight. This is what is called the ego.”²⁷ The clinical practice has confirmed that in many cases it is not enough to undergo corporeal reconstruction, for an Ego scriptor needs to intervene in order to reclaim the body and craft a livable life. Only a concept like that of the “sinthome”—and we will understand better its devious logic in the next chapter—can therefore achieve this craft and make it enduring and endurable.

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Notes

  1    Sigmund Freud, “Leonardo Da Vinci and a Memory of His Childhood,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 11, ed. and trans. James Strachey (London: Hogarth Press, 1957), 115.

  2    Sigmund Freud, “‘Wild’ Psycho-Analysis,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 11, ed. and trans. James Strachey (London: Hogarth Press, 1957), 226.

  3    Ibid., 211.

  4    Sigmund Freud, “The Moses of Michelangelo,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 13, ed. and trans. James Strachey (London: Hogarth Press, 1955), 211.

  5    Ibid.

  6    Alain de Mijolla and Sophie de Mijolla-Mellor, Fundamentos del psicoanálisis (Madrid: Síntesis, 1996), 153.

  7    My italics. “In any event this book was terribly daring. A transparent sheet separates it from madness.” Quoted by Jacques Derrida, “Cogito and the History of Madness,” in Writing and Difference, trans. Alan Bass (London, New York: Routledge, 1978), 36.

  8    Jacques Lacan, Le séminaire de Jacques Lacan: Livre 23, Le sinthome, ed. Jacques-Alain Miller (Paris: Seuil, 2005), 22.

  9    Gilles Deleuze, Logic of Sense (New York: Columbia University Press, 1990).

10    Quoted in Peter Consenstein, Literary Memory, Consciousness, and the Group Oulipo (Amsterdam, New York: Rodopi, 2002), 68.

11    Ibid.

12    Ibid., 69.

13    Ibid., 67.

14    See my Please Select Your Gender (New York: Routledge, 2010), 215–244.

15    Jacques Lacan, Le Séminaire XXII RSI, session of December 10, 1974, unpublished papers, Gaogoa.free.fr, accessed December 15, 2016, http://gaogoa.free.fr/Seminaires_HTML/22-RSI/RSI10121974.htm.

16    Karin Obholzer, The Wolfman: Conversations with Freud’s Patient—Sixty Years Later, trans. Michael Shaw (New York: Continuum Books, 1982), 77.

17    Paul Verhaeghe and Frédéric Declercq, “Lacan’s Analytical Goal: ‘Le Sinthome’ or the Feminine Way,” in Re-inventing the Symptom, ed. Luke Thurston (New York: The Other Press, 2002), 63.

18    Ibid., 77.

19    “Ce qui pense, calcule et juge, c’est la jouissance,” Jacques Lacan, “. . .Ou pire,” Scilicet, nr. 5 (Paris: Du Seuil, 1979), 9.

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20    Jacques Lacan, The Seminar of Jacques Lacan. Book I: Freud’s Papers on Technique, 1953–1954, ed. Jacques-Alain Miller, trans. John Forrester (New York: Norton, 1991), 16.

21    Jacques Lacan, Écrits: The First Complete Edition in English, trans. Bruce Fink (New York: Norton, 2006), 431.

22    Jacques Lacan, The Seminar of Jacques Lacan: On Feminine Sexuality, the Limits of Love and Knowledge, 1972–1973 (Encore), ed. Jacques-Alain Miller, trans. Bruce Fink. (New York: Norton, 1998), 131.

23    Hervé Hubert, Transsexualisme : Du Syndrome au Sinthome, thesis, Université de Rennes 2, (Haute Bretagne, Lille : Atelier de Reproduction de Thèses, 2006).

24    See Pierre-Henri Castel, La métamorphose impensable: Essai sur le transsexualisme et

l’identité personnelle. Paris: Gallimard. 2003; Geneviève Morel, La Loi de la mère. Essai sur le sinthome sexuel (Paris : Anthropos Economica, 2008); Rafael Kalaf Kossi, Corpo en obra: Contribuições para a clínica psicanalítica do transexualismo (Sao Paulo: Enversos, 2011).

25    Sheila L. Cavanagh, “Transsexuality as Sinthome: Bracha L. Ettinger and the Other (Feminine) Sexual Difference,” Studies In Gender And Sexuality 17, iss. 1 (2016); Oren Gozlan, “Transsexual Surgery: A Novel Reminder and a Navel Remainder,” International Forum of Psychoanalysis 25, no. 1 (2011): 1–8.

26    Ibid., 596.

27    Lacan, Le séminaire de Jacques Lacan: Livre 23, Le sinthome, 149–150. Italics in the original French text.

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18

MAKING LIFE LIVABLE

Lacan’s later notion of the symptom led him to assert that normative heterosexuality was a sinthome and that sexual positioning also constitutes a symptom—sinthome-she or a sinthome-he, he called them. Being a “he” or a “she” would be seen as creations that attempt to “make up” for the disharmony between the sexes. As we have seen, Lacan’s dictum “there is not such a thing as a sexual rapport” was introduced to account for a sexual drive that is fragmented and finds its jouissance in partial objects that are not symmetrical, which ultimately creates a disjunction between sexual partners. A positioning such as male or female or anything else altogether can be seen as a creation to endure the non-rapport. Assuming a sexual body in some cases requires the know-how granted by a sinthome. For this reason, Paul Verhaeghe says that romantic relationships work when the emphasis is not placed on the chimera of overcoming the disharmony between the sexes but on the freedom granted by a creation built around differences. Thus, lovers often feel the need to invent their own language, giving each other a private name.¹ But let me first backtrack a little here.

For Lacan, one finds creativity in the symptom that could at times be tantamount to art. This insight already appeared in Lacan’s doctoral thesis, at a time when one can say that his encounter with the psychotic Aimée made him a psychoanalyst. Working closely and systematically on a single case of “paranoiac self-punishment” Lacan reached a sort of “paranoid knowledge” that allowed him to access a valuable insight on the role of art and creativity in the symptom. He discovered that “the symptom’s formal envelope, which is the true clinical trace for which I acquired a taste, led us to this limit which turns into pure creativity. In the case of our thesis (the Aimée’s case), these were literary effects, and with enough merit to have been quoted by Eluard under the (reverential) heading of involuntary poetry.”² If the symptom was, as Freud observed, a “compromise solution,” this solution had to be a creative one, and its singularity connoted artistry, on occasion, even “involuntary poetry.” Aimée’s writings gave Lacan a glimpse into how writing operates within the dimension of the Real. The symptom was thus not a disabling problem but a creative solution.

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After his seminar on The Four Fundamental Concepts of Psychoanalysis from 1964, the impact of the Real become more clear. A well-known passage of this seminar is devoted to the logic of trauma, and there Lacan evokes the Aristotelian couple tuché and automaton, the event or chance accident opposed to the issue of repetition. He then defines tuché as “the encounter with the real.”³ It is an “accident” that determines this encounter: “If the development is entirely animated by accident, by the obstacle of the tuché, it is in so far as the tuché brings us back to the same at which pre-Socratic philosophy sought to motivate the world itself. It required a clinamen, an inclination, at some point. When Democritus tried to designate it . . . he says . . . it is not a meden but a den, which in Greek is a coined word. . . . Nothing perhaps?—not perhaps nothing but not nothing.”⁴ The discussion that follows is complex, as Madlen Dolar has noticed, because it combines in one single paragraph key concepts of different philosophers, Aristotle (“tuché”), Epicurus and Lucretius (“clinamen”) and Democritus (“den”). Lacan seems to tackle all at once Being and non-Being, the One and the Void, negativity, contingency, repetition, and the entangled connections between materialism and idealism. Dolar comments that, from a traditional academic perspective, Lacan’s conceptual splicing could be seen as “unscrupulous” and even “sinful.”⁵ Lacan’s alleged transgression has a purpose: Democritus thinks the atom not as a body, not as an entity, not as a one, not as Being, but as non-Being. Dolar surmised that such a departure from all types of ontology was putting Lacan on the track to the object a, which is really the object of psychoanalysis. In that section of the seminar Lacan revisits Democritus’s physics of the nothing as a passage towards the mightily absent object of psychoanalysis, or object a.

Indeed, “Nothing is more real than nothing” or “Naught is more real than aught,” was one of the philosopher’s favorite maxims. A certain concept of negativity was introduced into the heart of the Greek cosmos by Democritus who, moreover, held that thought and soul were material. The Roman Lucretius, in “Book II: The Dance of Atoms” of his scientific poem De rerum natura (The Nature of Things), gives a clear and compelling account of classic Greek atomist theory:

Now by what motion atoms come together to create

Various things, or how these things once formed can dissipate,

And by what force they are compelled, and what freedom of motion,

They have to meander the vasty void . . .⁶

Lucretius observes that any material is subject to irreversible decay but can also recreate itself. How can the same materials, plants, animals, be recreated again and again? One obvious solution is to assume that there might be internal properties conveyed in a way not visible to the naked eye, thus the existence of “atoms,” something that stores and transmits inherent, indivisible properties.

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The classical “atoms” appear closer to our modern concept of “molecule” than to the atoms of modern science. The other big point of classical atomism is that there must be a great deal of open space between these “atoms”: the void. According to Lucretius, bodies fall in the void following the physic of creative chaos:

when bodies fall through empty space

Straight down, under their own weight, at a random time and place,

They swerve a little. Just enough of a swerve for you to call

It a change of course.⁷

Lucretius argues that the void is absolutely necessary to explain how gasses and fluids can change shape, flow, while metals can be molded, without changing the basic material properties. Democritus and other atomists thought that if atoms were indivisible, the shapes they took changed infinitely. These atoms existed in a void and moved about, combining and recombining. This movement required a void. Democritus said when naming the void a “nothing” that it was a “no-thing,” that the one (nothing) exists no more than the other (thing).⁸ Michel Serres insists on the drift in the movement through the void as shown in his illuminating reading of Lucretius. The clinamen, the atomic deviation or “swerve,” the minimum angle of divergence that created turbulence, functioned as a key, for “deviation is the birth of everything.” Serres’s terminology and Lacan’s present obvious parallels.

Lacan uses the Lucretian clinamen to rethink the logic of trauma. If Lacan had insisted in Seminar XI on the “nothing” (den) put forward by Democritus it is because he finds another point of analogy: atoms are like letters, which, combined into sentences, can be joined to form volumes. If we agree to take the deviation that upsets a preceding equilibrium as tuché or as an effect of the clinamen, this conception introduces turbulence into an unconscious “structured like a language.” By introducing chance, turbulence makes of the unconscious a less closed system. If we can speak at all, it is because of this deviation. The clinamen introduces a breakup of order, and thus is radically opposed to repetition. Michel Serres suggests that “meaning is a bifurcation of univocity.”⁹ Turbulence disturbs repetition by troubling the flow of the identical, and pulls and pushes in the same way as the sinthome does.

Psychoanalytic work will use turbulence in a deliberate practice of equivocation and verbal punning so as to undo the set of fixed and univocal meanings initially presented by the analysand.¹⁰ The practice of the “variable-length psychoanalytic session,” Lacan’s controversial technique of scansion, introduces a cut into a cycle of repetition. Above all, it interferes with the analysand’s jouissance by introducing an inclination in the void, a clinamen. Like a pun, the cut of the scansion reorganizes letters and sends the analysand towards an enigma whose resolution is not found in historical reconstruction but in the invention of new signifiers. The idea is to cause an effect of nomination and not of symbolic or metaphoric substitution. This is a movement that, unlike that of a metaphor, is not reversible. It is not moving down the chain as in the false knot that one finds in the Olympic rings, but a true Borromean knot in which all three rings are so interdependent that if we cut on one, the other three come loose. The issue here is not to replace one ring with another but to pull strings in a manner that will tighten a knot.

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Already in the session of Seminar RSI of December 19, 1974, Lacan talks about the limits of the metaphor, and proposes putting aside the search for meaning. I read this as proposing that the resolution of the symptom is no longer a deciphering of a hidden meaning but rather the creation of something new that appears in the void.

This main change in Lacan’s theorization of the symptom takes place in 1974, the year of seminar RSI. In fact just before the launching of the seminar, on October 31, 1974, in the “Discours de Rome—La troisième” Lacan declares: “I call symptom what comes from the Real.”¹¹ This idea is further developed in the opening session of RSI when Lacan comments on a labor strike: “as analyst, I can only take the strike to be a symptom, in the sense that this year perhaps, I will manage to convince you of it, that the symptom, to refer to one of my three categories, belongs to the Real.”¹² Lacan then adds: “it is in the symptom that we identify what is produced in the field of the Real. If the Real manifests itself in analysis and not only in analysis, if the notion of the symptom was introduced, well before Freud by Marx, so as to make it the sign of something which is what is not working out in the Real, if in other words, we are capable of operating on the symptom, it is in as far as the symptom is the effect of the Symbolic in the Real.”¹³

If the reference to Marx could lead us to think that the sinthome is purely a social-historical formation, Lacan completed this theoretical 180 degree turn when he gave a new clinical meaning to the notion of symptom by rewriting it as sinthome. This was in 1975–6 with Joyce’s sinthome. This new sinthome appears at the place where the knot fails, where there is a “lapsus” in the knot.¹⁴ The symptom, clearly located in the Real, is knotted, “considered like an equivalent of the real . . . the Imaginary, the body, what separates the body from the ensemble constituted by the knot of the symptom to the Symbolic.”¹⁵

Lacan illustrates here in an exemplary manner the clinical value of the symptom as a knot. This is an idea that I find extremely helpful in my work with the most varied analysands, but in particular with transsexual analysands. With them, one can observe the emergence of a new materiality in meaning, a language that seems to abandon the signifying chain. This chain will be replaced by the Borromean knot insofar as it pertains to writing.

The joy of music

Jay started his analysis by describing himself as someone with a “mild” addiction problem. Moreover, Jay identified as a trans man but this was not why he came to see me. He initially expressed no gender trouble. He “passed.” Socially accepted as a man, he was never in the uncomfortable situation of having to correct pronouns. As for the “addiction,” he would consider himself just a social “user”—he would drink and take drugs with friends and acquaintances, and felt all along that the addiction was under control. The motivation to search for an analyst came from his half-sister, who had sensed that Jay had become “hooked” on substance intake. Jay admitted that once in a while there were “crises,” moments during which he would binge-smoke marijuana every evening of the week and all weekend nonstop. He would also drink until he passed out but never missed work due to a hangover. Jay did not feel that there was any problem with being an “addict,” it was just an aspect of his social life.

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Jay was satisfied with his achievements. At the beginning of the treatment, he was the co-owner of a popular lifestyle shop and restaurant and was planning new commercial ventures that promised to be equally successful. Interestingly, for Jay being an “addict” initially functioned as a label that granted him a place in the group of other “addicts,” not just those friends who drank with him or provided drugs. Jay was an “addict,” but this label tied him to a group, therefore this was not a problem. In fact, thinking of himself as an addict offered an identification with a counter-culture model. “Addict” seemed to work for Jay as something outside of meaning, a master signifier (S1), a meaning pointing to itself that gave Jay an illusion of mastery and a semblance of a social connection.

Despite the fact that initially Jay did not identify any symptom besides a generalized malaise, in the early stages of the treatment he was enthusiastic about undergoing psychoanalysis. While he “loved” being in analysis, he found it, however, difficult to speak during the sessions. I took this resistance as a good indication—his fervent transference had found a good counterpoint. His words were often interspersed with long silences. Behind Jay’s apparent assurance and eagerness there was a sense of a great solitude and fragility.

He might occasionally ask for advice but in such a way that this request did not need to be satisfied; he was in search of a master who would provide a direction from which he could stray. There were moments when his enthusiasm bordered on impulsivity, a quasi-manic drive, which was in fact a request to make the Other complete. His quest was to create an omnipotent Other capable of managing, controlling, and supervising him.

Here was an interesting paradox: while his drug use could look like abandoning himself to the voracious pull of jouissance, the way Jay organized his drug intakes or his alcohol binges was not spontaneous but very calculated. Jay wanted to make himself hurt; he was a master at self-inflicting pain. “I make myself suffer” seemed to be his motto. It turned out that Jay consulted me because this pain calculation was getting out of hand.

Jay’s recent girlfriend (a cis woman who identified as queer) had moved in with him a month before he started treatment. Their relationship was becoming increasingly violent and volatile. Marty was younger (Jay was 37 when he met her and Marty had just turned 21). Marty had a 2-year old son from a previous relationship. Jay had accepted to live with Marty and her son knowing all along “that things would not work out.” Soon, however, he found himself attached to Marty’s son, Gary, and even seduced by the idea of family life. He described Marty as “smart,” “resourceful,” “fun.” She could also be called “very stupid”: she had “opinions about everything but knew nothing about life.” While Jay seemed quite happy in his role as Gary’s step-parent, his relationship with Marty was verbally and physically abusive. There were drunken fights usually leading to “full-on screaming matches,” which included mutual physical violence and often ended only when the neighbors called the police.

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Jay complained that his relationship with Marty was no longer sexual. The relationship had started passionately and made Jay feel “enthusiastic, reborn.” The honeymoon period was brief; it looked as if their libido had moved from the pleasures of sex to the thrills and tensions of their physical fights. As an explanation, Jay speculated that even though Marty said she was happy to be in a relationship with a trans man, she “was not so queer.” He believed that she missed having sex with a cis man. Jay was suspicious of her being “so turned on” by sex when he was wearing a strap-on, and was constantly tortured by the text-message flirtations of Marty with several ex-boyfriends. He concluded that as a trans man, he was a lesser lover than a cis man. While it seemed that Marty enjoyed sex with him, Jay was convinced that there was a problem she did not dare talk about.

Jay seemed to confuse the penis with the phallus. Deprived of the organ to which he ascribed such great value, he felt at a disadvantage when having sex with a cis woman like Marty. In fact, he admitted that he had been avoiding opportunities of having sex altogether, often by staying up late playing video games, or furtively masturbating while looking at gay porn, or searching online for graphic renditions of “bottom surgery” to confirm his suspicion that current surgical technology for phalloplasty could not build a reliable penis. He tended to “pass out,” sleeping almost every night on the living room’s couch rather than in the bedroom with Marty. It looked as if Jay was avoiding intimacy, unconsciously enjoying his construction of his role as the rejected partner, victimized by Marty’s seeming lack of interest. He also fantasized about having sex with gay cis men and said that, for him, reaching an orgasm had always implied imagining he had a penis. After the climax, he would often feel very sad.

In the middle of such a stormy relationship with Marty, the waters of the analysis became troubled. Jay started to question the impact of the treatment and complained about the uselessness of psychoanalysis. At the same time, some elements were changing in Jay’s presentation. Jay was not drinking as much or getting high so often; he was now constantly gaining weight, and his object a appeared stuck in the oral zone—it was food and screaming. Jay complained about not feeling attractive anymore; he admitted that his sister would call him “fatso.” Was his sister’s preoccupation just about “fat” or was she concerned about Jay’s body as something more than flesh? His older sister’s opinion mattered a lot; it had not only brought Jay to start a psychoanalysis, she had also played an important role in his life. They had the same father and she was clearly a link to the paternal lineage as well as a very supportive presence, especially when Jay was undergoing gender transition. With her, Jay related to something different from the father’s side; his sister was a reliable, constant presence that introduced another version of the father. She was a sort of ambassador of the father, and thanks to her Jay started to see his father not just as an uninvolved, neglecting parent but also as a man who nevertheless loved Jay and was conflicted about his role in his son’s life, remaining unable to find a way to connect to his child.

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At this very juncture, the nickname Jay had adopted for his girlfriend opened a way out of the cycle of repetitions. In the early days of their relationship, Jay would affectionately call Marty, “Ma.” In a session following a huge fight that ended with Marty and Gary moving out of the house for a few days, Jay reported the confrontation in a tone of voice in which I felt his characteristic mix of pain and pleasure, of enjoyment and despair. He then had a slip of the tongue; trying to say “Ma,” he stuttered and said “Ma . . . Ma.” I repeated back to him: “Mama?” He seemed annoyed and replied: “Not, Ma . . . not mama.” At this point, Jay appeared utterly confused. We ended the session there.

This lapsus was a welcome interruption; it brought about something new. At the next session, Jay acknowledged that the fights, in particular the physical violence with Marty, provided an exhilarating sensation similar to that of his drunken highs; this excitement related to the continuous disappointment he had experienced with his father, the parent who was “Not Mama.” His absences made him feel that nothing existed beyond his mother’s love. “Nothing” became an object he searched for in his alcohol and drug-induced highs. He would often say that while recovering from a hangover, he would “feel nothing.”

If, after the fights with Marty, he felt regret, there was also a sort of resignation to self-destruction that muted his guilt. He could not refuse the interpellation of the super-ego. However, it was as if the drugs, the drinks, even the fights functioned as stoppers in a void, while the void remained concealed, plugged, veiled by the actual object. It was the same void he experienced post coitum, causing his sadness. But he had said: “Not Ma . . . not mama.”

At the next session, Jay noticed that while his nickname for Marty was “Ma,” hers for Jay was “Dumpling.” Jay stopped himself mid-sentence and repeated to himself: “Dump.” “Dump?” I asked. He replied: “Yes, this is what Ma is doing, treating me like shit.” At stake in their interaction is the object a as feces. Shit was a substitute for Jay but also a memorial to early loss, the first gift the child relinquished, a prototype for an inscription of lack, the “sacrificed” object that separates jouissance from desire.

Tired of “being an asshole,” tired of this type of jouissance, Jay broke up with Marty soon after. He dated casually for two months and returned to his former daily gym routine, which granted him a narcissistic boost. Suddenly, he was excited to have met another “lovely” cis woman. This one was so “beautiful,” “perfect,” an “ideal femme—cute, thin.” The new girlfriend, Allyssa, was the opposite of Marty, a little older and never confrontational.

This relationship distracted Jay from the need to engage in drug use or heavy drinking. He no longer needed to carry the object in the pocket. Jay was able to feel depressed without falling into despair. He also felt more confident about sex with Allyssa. “I thought it was not a good idea to have sex right away,” but he did, and found with her “the sex I always wanted.” For once, Jay seemed to have found someone he knew really wanted him, “She is so into me. She has such energy, such desire for me. I can’t believe it. She was so aggressive, all over me.” Fear was not too far away, “I have to admit, if freaks me out a little.”

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Soon after, symptoms emerged. Again Jay was very jealous, secretly checking his partner’s cellphone; without any evidence, he was persuaded that Allyssa was going to betray him at any time. Jay developed panic attacks. He would become so anxious that he would feel as if he was going to die. This was accompanied by nervous eye twitching and bouts of insomnia. On top of that, his body was plagued by pains like neck contractures and sudden cramps and muscle spasms. The body that up to then had only been playing a role as a site of consumption took center stage as evidence of his suffering. He consulted doctors who reassured him that nothing was serious, and attributed the symptoms to stress. Jay was not convinced.

Perhaps Jay was trying to replace the illegal drugs he used to take with the legal drugs that a physician may prescribe, but above all, Jay wanted a nomination. He asked to be given a diagnosis mostly to find out what his “illness” would be called, because he needed a name to hold onto. He had already tried to achieve a first nomination by calling himself “Jay” when he transitioned. As for the analysis, despite his reluctance, he admitted that it was “what has kept me alive, even though it is not helping much lately.” This “negative” phase of the analysis was quite important for Jay in the movement away from the symptom to the creation of a reknotting, the invention of a sinthome. I maintained with my presence an Other, a failed Other, to be sure, but an Other that was there. Someone who was incomplete but would not “dump” him. If he wanted to leave the treatment, it was going to be Jay’s decision.

Separation and attachment for Jay were not simple issues. His mother had been perhaps too present in his life, possibly to compensate for a father who seemed to have intervened only as a genitor. Or maybe it was Jay who was too present for his mother, too fulfilling, her triumph. Jay was “a miracle baby,” a surprise pregnancy for a woman who became a mother in her early forties after having abandoned the hope of having a biological child. His father had been a man his mother was dating casually at the time; even though “he remained in the picture,” he intervened on and off in Jay’s life. The parents did not become a couple after Jay’s birth and his mother never established a long-lasting stable romantic relationship afterwards. Jay’s father was seen as an occasional visitor who would take Jay out for the day, once in a while and unexpectedly. At the time of the treatment, his position in Jay’s life was no longer a peripheral and unpredictable presence; they would see each other regularly; they had a good time sharing meals together, but Jay had “mixed feelings about him.”

As a child, Jay would long to spend time with his father and felt quite distraught when he would fail to show up to fetch him (which seemed to happen quite often), but felt that could never share those feelings with his mother. “I just waited. I feel like I’ve spent most of my life waiting.” Jay was aware that, “I never left anyone, always someone else left me.” He seemed unaware that at times passivity could be a passive form of activity.

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At this point in the treatment, Jay’s increasing panic attacks imposed a limitation on his life. He would be afraid of going out. Jay was staying indoors, protected by four walls, the space in which he could sustain his desire. The relation with Allyssa was a loving one, but plagued Jay with insecurities. He could not trust that he could be the love object for her. He was in constant fear. He had let go of substitute objects (alcohol, marihuana, fights) that so far had concealed lack, and now the nothing that makes desire possible and life livable, appeared exposed, threatening.

Jay was not only distrustful of Allyssa, but he also suspected doctors and even the psychoanalyst. He complained about the general inefficacy of those treating him—he berated the doctors because they failed to find the right prescription to medicate him (and he believed that the cause for his suffering was “something in my body”) and addressed a general complaint to me, his analyst, arguing that psychoanalysts “do not know about the body.” In fact, he had a point: I did not know much about his body, a site of intense suffering.

He had never felt he was a man trapped in a woman’s body. His body, however, was always at a disadvantage, always underperforming, somehow defective; it was a body that reminded him of having been born “a female.” Years of monthly injections of testosterone and a “top surgery” (double mastectomy) almost a decade earlier had more or less reconciled Jay with his body. My ignorance, however, turned out to be productive. If there was some knowledge to be gained, it had to come from him.

Jay never talked of transitioning as a destiny but rather as a survival strategy, as a necessary transformation that allowed him to live. “I had no choice. I would be dead if I didn’t transition—I would have killed myself.” He reflected on his mastectomy: “I had surgery, a serious surgery. It has been all worth it. It has had a kind of healing quality.” He said that he avoided looking at himself in the mirror for fear of finding traces of a female body. “Whenever I am about to take a shower—other than sex, the only time I am naked—I am reminded that I was born a with a female body. It doesn’t feel right, especially with all this body fat I have now. I do not hate my body; I just do not like it. I was born female but now I am male. It still puzzles me.”

Jay’s new somatic symptoms, the constantly evolving pains haunting his body, did not appear reachable by word association; they did not seem to operate as carriers of a repressed meaning. They represented an impasse for the effects of speech and metaphor. In fact, they were closer to the real of his body as flesh than to the body and its jouissance, out of reach of symbolic, metaphorical reverberations. The symptoms required the sinthome.

It is often said that, for some artists, their most perfect creation is their ego. As we saw, Lacan observed this when he turned his attention to Joyce, whom he described as someone without an ego. If the ego is above all a projection of an image that sustains a bodily ego, the creation is an ego that is also the creation of a body. Similarly, it was at this juncture in the treatment that Jay produced a series of changes that were resolved by way of artistry, by way of a sinthome.

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The object a (voice) opened a new way. There were no longer any substance related “crises,” which were “cry-ses,” cries for help that worked as an appeal to an absent Other that he longed to prop up but in order to see it fail. Now the invocatory drive was not emerging in terms of the cruel imperatives of the super-ego that his drug and alcohol intake would try to simultaneously appease and exacerbate. The internal “aphonic” voice of reproach moved to the register of sound, to an acoustic field he could share with others.

Jay had always loved music and collected many vintage vinyl records. In what looked like a sudden impulse, he sold his share in the restaurant he owned and paid back a loan from his mother that had allowed him to start that business. With the remainder, he started an online store for vintage records that developed into a very profitable site buying and selling, as well as sponsoring and producing experimental musical performances. Something that started as a hobby became a full-time job. The object a left the field of the Other and became an object that circulated and that he could reclaim with a specificity that was unique to him. The voice still addressed him, but now the register of sound and acoustic materiality prevailed in a different manner. “Not everyone listens to the music I like . . . but those who like it, love it.” He did not feel like a pioneer (as a trans man, as an entrepreneur) because the Other was castrated, but with those whose object a was similar to his, there was a connection, a link that granted several profits. “I care about this, in ways I could not imagine before.” He now wanted to leave a mark, to make a singular contribution using his unique know-how. In that sense, he wanted to leave an inscription, a signature.

With this new endeavor, Jay had to travel extensively and that forced him to overcome his panic attacks. “I was too afraid because I thought things over too much—it was just a matter of leaving.” What Jay left was the fusion with the mother that included the restaurant. The new business brought him closer to his father, who up to then had been absent somewhat. The father had for a while been a DJ. Jay then understood that the name he has chosen was a way of rewriting his father’s most treasured activity. In his new business persona, he was known as “J-J.” He even named the new company “J-Music,” with the slogan “the joys of J-Music.” He went from being called Jessica at birth to renaming himself Jay, and most lately to being known in the music business as J.J. Jay had never heard of James Joyce, but his sinthome curiously rewrote a Joycean solution. As with Swift Shuker’s, we see how a “damned body carved out of meat” could become flesh.

Notes

  1    See Paul Verhaeghe, New Studies of Old Villains: A Radical Consideration of the Oedipus Complex (New York: Other Press, 2009), 99.

  2    Translation slightly modified. Jacques Lacan, Écrits (Paris: Seuil, 1966), 52.

  3    Jacques Lacan, The Seminar of Jacques Lacan: The Four Fundamental Concepts of Psychoanalysis, ed. Jacques-Alain Miller, trans. Alan Sheridan (New York: Norton, 1981), 53.

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  4    Italics in the original. Ibid., 63–64.

  5    See Madlen Dolar, “Tuché, clinamen, den,” Savoirs et Clinique: Jacques Lacan, matérialiste: Le symptôme dans la psychanalyse, les lettres et la politique 16 (January 2013): 140–151. Unless otherwise indicated, all translations are the author’s.

  6    Lucretius, On the Nature of Things, trans. Alicia E. Stallings (New York: Penguin Books, 2007), 38. Italics original.

  7    Ibid., 42.

  8    Democritus used a neologism, “den.” As a negation of hen (one), “den” was part of the two words for nothing used by the Ancient Greeks: ouden, which refers to factual negation, something that could not have been, and meden, something that, in principle, cannot be. “Den” is a malapropism, a nothing without the “no.” See my discussion of Democritus’s “den” in “Laughing about Nothing: Democritus and Lacan,” in Patricia Gherovici and Manya Steinkoler, eds, Lacan, Psychoanalysis, and Comedy (New York: Cambridge University Press, 2016), 65–68.

  9    Michael Serres, La Naissance de la physique dans le texte de Lucrèce: Fleuves et turbulence (Paris: Minuit, 1977), 179. See also The Birth of Physics, ed. David Webb, trans. Jack Hawkes (Manchester: Clinamen Press, 2000), 145.

10    On the effect of turbulence in clinical work, see Roberto Harari, “The sinthome: Turbulence and Dissipation,” in Re-inventing the Symptom: Essays on the Final Lacan, ed. Luke Thurston (New York: Other Press, 2002), 45–57.

11    Jacques Lacan, “Jacques Lacan: La Troisième,” Lutecium.org, last modified June 22, 2014, http://www.lutecium.org/mirror/www.valas.fr/Jacques-Lacan-La-Troisieme,011.html.

12    Jacques Lacan, Seminar XXII, RSI 1974–1975, unpublished papers, 19 November 1974.

13    Jacques Lacan, Livre XXII. RSI, 1974–75, Ornicar? 2 (December 10, 1974): 96.

14    Jacques Lacan, Livre XXII. RSI, 1974–75, Ornicar? 8 (February 17, 1976): 19.

15    Jacques Lacan, Livre XXII. RSI, 1974–75, Ornicar? 10 (April 13, 1976): 12.

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19

BODY TROUBLE

Somebody who had chosen the pen name of N. O. Body wrote a beautiful, moving memoir originally published in 1907 under the title Memoirs of a Man’s Maiden Years.¹ Because the alias “N. O. Body” can be read alternatively as “No Body” or “Nobody,” the choice will be left to you. The nom de plume was inspired by Theodor Herzl’s then famous utopian novel Old New Land published five years earlier. The pseudonym is mentioned in the opening scene, which takes place in one of Vienna’s most charming cafes, not far from Freud’s house at Berggasse, 19. Herzl introduced two young men who were discussing an advertisement in a newspaper:

“Well, just look at this.” Schiffmann handed the paper to Friedrich, and pointed to a small notice. It read: “Wanted, an educated, desperate young man willing to make a last experiment with his life. Apply N. O. Body, this office.”

“You are right,” said Friedrich. “That is a remarkable advertisement. ‘An educated, desperate young man.’ Such a man might be found, of course, but the condition imposed is a very difficult one. A man must be desperate indeed to throwaway his life on a last experiment.”

“Well, Mr. Body seems not to have found him. He has been advertising for some time. But I should like to know who this Mr. Body is with his queer tastes.”

“It is no one.”

“No one?”

“N. O. Body—Nobody. Means no one in English.”

“Ah, yes. I had not thought of English. Know everything, need nothing . . .”²

If his pen name called up the desperate character who was shown ready to throw away his life on an experiment in the 1902 novel, the real N. O. Body published his memoirs because his life, he felt, had been an “experiment.” His life had been marked by the extreme pain caused by an erroneous gender assignment that had been covered over by secrecy and denial. The consequences were so dire that he reached a point at which he wanted to end his own life. N. O. Body’s memoir opens with the revelatory statement: “This book tells a true story. . . . I was born a boy, raised as a girl.” Indeed, N. O. Body was born in 1885, assigned a female identity and raised as a girl. During her childhood, she nevertheless engaged in what was considered stereotypical male behavior. She showed “no interest in girl’s toys and a distinct inclination for games for boys.”³ Her adolescence was dark and torturous as her body developed in a masculine manner and she developed a strong attraction for women. After two decades of feeling at odds in her body, passionately in love with a married woman and contemplating suicide, a doctor suggested “a minor operation,” declaring: “You are as much a man as I am!” That statement gave N. O. Body courage and hope. Moreover, the doctor added that for that kind of transformation, “the authorities could not deny permission.”⁴

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The memoir’s narrator was born twice—first as a baby girl named Nora, and then again as a 22-year-old man called Norbert. N. O. Body was in fact Karl M. Bauer, a person who would have been called intersex today. Bauer was born as Martha in 1884 and died as Karl in Israel in 1956. His flat gravestone in the Kiryat-Shaul cemetery of Tel Aviv carries the date of his death but no date for his birth.⁵ The memoir was an immediate success and went through at least six re-prints. It inspired two silent films and even a satire, confirming the popularity of the work.⁶

After his sex change, Bauer got married in October 10, 1907. His friends published this marriage announcement: “Norbert O. Body, the author of the book Memoirs of a Man’s Maiden Years, married Hanna Bernhardovna yesterday in Vienna, the same lady who plays such a prominent role in the last part of his book. Out of love for her, and with the help of excellent lawyers and medical doctors, he succeeded in persuading the Minister of the Interior to agree to change his personal registration to male gender. Body now lives as a civil servant in Berlin.”⁷

N. O. Body became just Body, a truly embodied body, and not just through the intervention of a scalpel and the rectification of his civil status but also by the reknotting his subjectify through writing.⁸ Body was able to complete and achieve a true transition—thus turning into an “Ego scriptor,” as Ezra Pound called himself in his Cantos.

It is often assumed that transsexuals are marginal, exceptional beings whose experiences cannot be shared by most of us. My contention is that their “gender trouble” and their foundational uncertainties about their gender are universal. They point to the impossibility of fully representing sex that troubles the fixity of any identitary claim. Intersex, transgender, and genderqueer subjects challenge biological determinism and gender essentialism. This is why an activist of the stature of Magnus Hirschfeld gave his endorsement to the publication of N. O. Body’s memoir by writing the Epilogue.

Hirschfeld published many cases of what was then called “hermaphroditism” as proof of the existence of a congenital bisexuality, and imagined that bisexuality would lead to a “third sex” he saw rooted in nature as an interior androgyny that made the body both male and female and thus neither fully male or female. In his Epilogue to N. O. Body’s memoir, Hirschfeld makes an interesting political statement that echoes our contemporary discussions: “The more we learn about transition between the sexes, the more we learn of the usefulness for man and woman of granting the greatest possible freedom to the play of forces. . . . The ancient demand of freedom, equal rights for all, has its roots far more in the differences between people than in their sameness. In order for every individual to develop freely and beautifully, everyone must be given the same opportunities.”⁹ Hirschfeld’s comment on the Epilogue revisits one of the main themes treated in this book: a freedom defined as the right to choose one’s gender, the respect for individual differences, and the pursuit of beauty.

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In 1907, Hirschfeld also makes a claim that remains close to Caitlyn Jenner’s declaration about her transition, when in 2015 she talked about having a “female brain.” Hirschfeld states: “The sex of a person lies more in his mind that in his body, or to express myself in more medical terms, it lies more in the brain than in the genitals.”¹⁰ As we have seen, according to this logic gender appears still coupled to the body, not between the legs but higher up, between the ears. Or is it perhaps under the logic of being “born this way” that gender identity gets disembodied and denaturalized to be then re-embodied and renaturalized?

Born This Way

Lady Gaga’s famous song “Born This Way” interests me not because I would be one of her fans but because I want to explore what J. Jack Halberstam has called “Gaga Feminism,” that is, a feminism favoring gender and sexual fluidity. For Halberstam, Lady Gaga “is a loud voice for different arrangements of gender, sexuality, visibility, and desire.”¹¹ Gaga’s “multiple” messages would be very wide ranging, as she is deploying “new matrices of race, class, gender, and sexuality,” and even questioning “the meaning of the human” (xii). Halberstam describes Lady Gaga’s fashionista feminism as one that “hints at emerging formulations of a gender politics,” a feminism “invested in innovative deployments of femininity . . . characterized by their excess, their ecstatic embrace of loss of control, in a maverick sense of bodily identity” (xiii).

While most gender transitions happen—as Stoller, quoting Winnicott, argues—to give expression to the subject’s “true self,” Gaga is placed at the opposite end of authenticity, celebrating the unreal, the unstable, and the artificial.¹² She is a “phony,” so much that Halberstam calls Gaga’s feminism a “pheminism” (xii). Indeed, Gaga would incarnate a new form of political engagement that is “a monstrous outgrowth of the unstable concept of ‘woman’” (xiii). Representing more than her person, Gaga deploys artificiality with such relentlessness that this makes an artist of her: “Gaga goes beyond the pop songs and becomes art” (139). Gaga takes her place in a prestigious genealogy along with Emma Goldman, Yoko Ono, Grace Jones, Shulamit Firestone, Marina Abramovic, musicians like Ari Up of the Slits or Poly Styrene of X-Ray Spex, and even the Invisible Committee. Gaga contains multitudes: both a media product and a media manipulator, she is a megabrand, a switch point for body futures. Gaga represents an erotics of the surface, of flaws and flows, because she situates herself at the heart of consumer capitalism. In sum, Lady Gaga would be a Karl Marx on sky-high platform shoes, someone ushering in a revolution not just in economics but also in the relations between the sexes.

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In her shows, Lady Gaga burns the usual divides imposed by gender norms; under the call sign “fashion is my freedom,” she once showed up in drag as her male alter-ego, Jo Calderone, upsetting some, delighting others, always surprising with her gender theatrics. Gaga challenges gender norms in her song “Born This Way.” She sings that we are all born superstars, adding the famous injunction not to be a “drag,” but to be a queen instead, meaning that celebrity trumps gender. To say that one has been born this way might suggest that Lady Gaga has embraced a certain essentialism, which has been seen by Halberstam who praises the “gaga spirit of anarchy” but adds a warning: “Forget about ‘Born this way’” (137). Nevertheless, I contend that it is precisely in Gaga’s contradictions that we can best ascertain “the spine of a liberatory anthem” (137). In the lyrics of “Born This Way,” we hear the famous refrain, “don’t be a drag just be a queen.” This phrase, repeated three times, contains implicitly the expression “drag queen,” with the admonition about not being “a drag,” opposed to being “a queen.” Art is the way to become a real queen, as the mother of the singer wished little Lady Gaga to become one day, which was just a matter of time since we are all “superstars.” All we need is a little lipstick and big hair to let the superstar shine through.

Gaga, whose birth name is Stefani Joanne Angelina Germanotta, started calling herself Lady Gaga after meeting a drag queen called Lady Starlight. Lady Starlight told her that she was doing much more than making music—she was doing art (139). Stephani followed suit, and rather than being a drag she became a queen in drag. Others claim that her name derives from the song from the group Queen called “Radio Ga-Ga” (139). In both versions of how Lady Gaga became her name, her self-nomination follows the path of the signifier “queen.” This reappears in the difference stressed in the song’s lyrics between “not a drag” and being “a queen.”

The rest of the song’s lyrics proclaim the foundational American doxa: a good dose of individualism will save you; it is enough to be proud of one’s identity to make it in America; we are all equal in our rights; and so on. This message is inclusive: let us “be brave” and accept difference as embodied by minorities discriminated against on the basis of ethnic, sexual, gender, and class disparities: one can just be a queen. Gaga invites us to a Utopia in which one can belong to any race, class, be able or disabled, bullied, teased or outcast, gay, straight, bi, transgender, for one can rejoice as long as one loves oneself.

Gaga’s message of inclusion and resilience inspired her to launch, with her mother, the “Born This Way Foundation,” which is a non-profit foundation established in 2012 at Harvard University. Its main mission is to foster a more accepting society, in which differences are embraced and individuality is celebrated.¹³ If there is a political program that would be heralded by the phrase “Born this way,” it cannot but evoke the expression that I often hear in my clinical practice. It is a phrase often brought up by patients whose whole existence seems devoured by the awareness that they were born with a gender at odds with their anatomy. That was, for example, what Jay was able to come to terms with. As we have seen, Jay was born with a female body but now lives a better life as a man. His was a process that I would describe as crafting a livable life, which entailed a gender transition.

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Jay’s transition was a long and complex process dealing with sexual difference at both the imaginary and symbolic levels while negotiating with ineffable leftovers of the Real that can be summed up as “gender needs to be embodied, sex needs to be symbolized.” By “symbolized,” I do not simply invoke the phallus, as I find it more productive to approach those cases using the logic of the sinthome. Let us add that Gaga’s song twists the essentialist formula of “Born this way” and actually makes it say exactly the reverse. Gaga pretended to impose a biological determinism but in order to accept a difference based on a paradigm of free choice. “Born this way” can then mean that I was born with a girl’s brain in a male body. Here is a contrarian essentialism.

What is revealed by Lady Gaga’s song can be better understood within the logic of the sinthome provided we give another meaning to the idea of being “born.” A sinthome is a plastic renaissance of a subject, a new birth in which art can grant a solution only when confronting its contradictions. Only art can allow someone to become the queen or the king of his or her new autobiography. The argument of an anatomical destiny proposed by Lady Gaga in “Born This Way” presents a reality in which race (in the sense that this term is usually employed by the authorities in the USA) or sexual orientation are seen as a “natural” attribute, which is at the same time a forced choice.

What choice are we talking about when the internal sense of gender appears to contradict the body, as if the body were an envelope that does not fit with the contents? Is this simply an image we use, or a metaphor most trans patients live by? Consider the position taken by Dr. Joanna Olson, a pediatric doctor featured during Caitlyn Jenner’s coming out television interview with Diana Sawyers, who affirms that a child of 18 months can declare a gender without hesitation simply by saying “I boy.” This assertion recalls John Money, a pioneer in U.S. transgender history, who recommended early surgeries because he assumed that gender was neutral for the child until the age of 18 months.¹⁴ The reference to 18 months calls up Lacan’s analysis of the mirror stage, the moment when children become aware that their image in a mirror defines their subjective identity. Is the sense of one’s body the result of introjections of an image in the mirror or an innate scheme in the brain?

What is the logic behind Caitlyn Jenner’s idea is that a person can develop a gender as if it were an “aspect” of the personality, a trait that was up to then hidden, dormant somewhere in the brain? Her body was masculine but her soul and her brain always had been feminine. Are we here returning to Freud’s thesis about the destiny (Schicksal) or vicissitude of sex? One cannot help but note the contradiction observed by Elinor Burkett: when Lawrence H. Summers, then president of Harvard University, declared that men outperform women in math and sciences because of sex differences in the brain, it created an uproar, and he was harshly attacked for his sexist essentialism. But when the idea of a sexed brain was put forward by Caitlyn Jenner to explain how she knew she was transgender, saying “My brain is much more female than it is male,” she was praised for her bravery and progressiveness.¹⁵

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Freud avoided the Scylla and Charybdis of anatomy as a “destiny” (sex) versus gender as a social convention. As we have seen, for psychoanalysis, sex is neither natural nor can it be reduced to a discursive construction. Let me insist: for psychoanalysis, sexual difference is neither sex nor gender because gender needs to be embodied and sex needs to be symbolized. This does not mean that gender is imaginary and that sex is symbolic. The problem that one finds in the clinical practice is always of the order of the Real, of the unassimilable aspect of sexuality that does not stop not writing itself. In a text of 1915, “Trieb und Triebschicksale” (literally, “Drive and the Fates of the Drive”), Freud separates sexuality from the destiny of genitality, from the destiny of gender, and even from the destiny of reproduction.¹⁶ The drive can be satisfied in one’s own body or in the body of another person. When the drive is satisfied in somebody’s body, this introduces a problem because if the drive is satisfied in the body of someone else, this exacerbates subjective division.

As we have seen, Freud had further elaborated on the sexual drive as not determined by gender. Above all, in Freud’s thinking the drive has only one object—the aim of the drive is satisfaction, a satisfaction that even when obtained is never complete. The drive, a tireless power, unlike other biological functions, knows no rhythm, or as Lacan put it, “has no day or night, no spring or autumn, no rise and fall. It is a constant force.”¹⁷ The drive carries along a non-representable sexuality in the unconscious. The drive is neither a biological force nor a purely cultural construction. As we saw about the excremental object, the drive involves an object that is not in the body but has fallen from it (the object a). At the same time, the drive demarcates a bodily zone from which it originates as a cause; it is placed in a liminal location, between the organic and the inorganic.

We are driven. Unlike the instinct, the drive is not functional; it will not work for the subject’s benefit. It may even work against the subject’s welfare; the drive might be destructive.¹⁸ Lacan connects the drive with death: “the drive, the partial drive, is profoundly a death drive and represents in itself the portion of death in the sexed living being.”¹⁹ Death is the motor of sexual life. The drive’s trajectory is skewed, its sequence features no end point other than death itself.

To cross the frontier between the sexes is often lived as traversing a mortal threshold, a passage from an impending doom towards a renaissance; what is at stake is precisely crossing an ultimate frontier. The drama of many analysands identified as transgender is often predicated around existential issues, for beyond the gender trouble, it is often a matter of life and death.

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Jay, whom we met earlier, assured me that had not transitioned, he would now be dead. This remark chimes in with the alarmingly high suicide rates in the transgender community. Even when Angelina Jolie chose to have prophylactic surgeries so as to avoid developing breast and ovarian cancer, hers was a decision of life and death. After her surgery, her then husband, Brad Pitt, shared a revealing comment with the journalists. Pitt almost denied her mortality by saying, “She will not die;” it was only after a pause that he added, “of this.” Even Caitlyn Jenner took the decision of coming out as a trans woman in relation to death: “If I was lying on my deathbed and I had kept this secret and never ever did anything about it, I would be lying there saying, ‘You just blew your entire life.’”²⁰ I see in this irruption of death on the one hand something that touches the Real, and on the other a limit imposed to the plasticity of the libido.

Several texts by Freud broach this same topic. One summary was offered by Jean Laplanche and Jean-Bertrand Pontalis in The Language of Psycho-Analysis.²¹ Freud talks of “Plastizität” or of “freie Beweglichkeit der Libido” to refer to a mobility that is confined to an interchangeability of objects and positions. In the entry for “Plasticity of the libido,” Laplanche and Pontalis show how this notion appears late in Freud and is opposed to that of “viscosity” of the libido. The viscosity of the libido makes the cure difficult because symptoms remain fixed; plasticity seems to help the progress of the psychoanalytic cure because it allows for change, which sends us back to what I described as the new plasticity of the body. Plastic is more than an aesthetic endeavor; if there is beauty, it is the radiance of desire becoming visible, the beauty of being.

As the poet Wallace Stevens famously wrote, “Death is the mother of beauty.”²² This oft-quoted sentence means that no perfect work of art can satisfy our wish for a reality untainted by mortality. This idea has functioned as the red thread of my book, which emerged when I realized that the true issue in transgender manifestations was more often than not an issue of life and death. This is an important point that I had not perceived fully when I published Please Select Your Gender. Like many Lacanian psychoanalysts, I had focused on the conundrum of sex and gender, not seeing with the required clarity that the transgender request was directly aimed at the border between life and death.²³

However, all the elements had been known to me. Both Eugen Steinach and Harry Benjamin developed an interest in sex hormones as part of their medical research to prolong human life. They performed great numbers of “rejuvenation” surgeries in a quest for immortality. When Freud had a “Steinach operation,” his immediate concern was to slow down the progress of his cancer of the jaw, but as he said in Beyond the Pleasure Principle, he was aware that cancers are caused by pesky cells that stubbornly refuse to die. This complex knotting of then recently discovered hormones, undying cells, and the ancient wish for an immortal life somehow reappears in the request of many of the analysands who identify as trans. The triumph experienced in numerous cases, following the at times grueling process of gender transition, can be condensed in a simple sentence: “I exist.” This “existence” seems to have been given to them as supernumerary, an excess beyond the dichotomy of life and death, and then this excess ends up embodying the truth of their desire. Let me quote again Wallace Stevens: “Death is the mother of beauty; hence for her, / Alone, shall come fulfillment to our dreams / And our desires.”²⁴ As we will see with the myth of Tiresias, trans desire is not a desire to go beyond the binaries of gender, but a desire to overcome the limits of mortal existence.

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Notes

  1    See N. O. Body, Memoirs of Man’s Maiden Years, trans. Deborah Simon (Philadelphia: University of Pennsylvania Press, 2006).

  2    Theodor Herzl, “Texts Concerning Zionism: ‘Altneuland’ (1902),” Jewish Virtual Library, accessed December 15, 2016, http://www.jewishvirtuallibrary.org/jsource/Zionism/altneulandtoc.html.

  3    N. O. Body, Memoirs of a Man’s Maiden Years, 7.

  4    Ibid., 99.

  5    Hermann Simon, Afterword to Memoirs of a Man’s Maiden Years, 113–136.

  6    Ibid., 134.

  7    Ibid., 130.

  8    See my Please Select Your Gender (New York: Routledge, 2010), 215–244.

  9    Magnus Hirschfeld, Epilogue to Memoirs of a Man’s Maiden Years, 111.

10    Ibid., 110. Italics original.

11    Jack Halberstam, Gaga Feminism: Sex, Gender, and the End of Normal (Boston: Beacon Press, 2012), xii. All future references can be found in the text.

12    Robert Stoller, Sex and Gender: The Transsexual Experiment, vol. 2 (London: The Hogarth Press, 1975), 2.

13    See more the Born This Way Foundation website: http://bornthisway.foundation/about-the-foundation#sthash.TOWumjF0.dpuf.

14    Money was in charge of the first clinic performing sex change surgery for intersex babies at the Johns Hopkins Hospital, Baltimore.

15    Elinor Burkett, “What Makes a Woman?” The New York Times, last modified June 6, 2015, http://www.nytimes.com/2015/06/07/opinion/sunday/what-makes-a-woman.html?_r=0.

16    See Sigmund Freud, “Instincts and Their Vicissitudes,” in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 14, ed. and trans. James Strachey (London: Hogarth Press, 1957), 109–140.

17    Jacques Lacan, The Seminar of Jacques Lacan: The Four Fundamental Concepts of Psychoanalysis, ed. Jacques-Alain Miller, trans. Alan Sheridan (New York: Norton, 1981), 165.

18    Jacques Lacan, The Seminar of Jacques Lacan. Book VII : The Ethics of Psychoanalysis, 1959–1960, ed. Jacques-Alain Miller, trans. Denis Porter (New York: Norton, 1992), 239.

19    Lacan, The Four Fundamental Concepts of Psychoanalysis, 205.

20    Buzz Bissinger, “Caitlyn Jenner: The Full Story,” Vanity Fair, last modified June 25, 2015, http://www.vanityfair.com/hollywood/2015/06/caitlyn-jenner-bruce-cover-annie-leibovitz.

21    See Jean Laplanche and Jean-Bertrand Pontalis, The Language of Psycho-Analysis (New York: Norton, 1973).

22    Wallace Stevens, “Sunday Morning,” Wallace Stevens: Collected Poetry and Prose (New York: The Library of America, 1997), 55.

23    I am indebted to Genèvieve Morel for highlighting this connection.

24    Ibid.

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CODA

Phallus interruptus, or the snakes’ lesson

Lacan once called up the figure of Tiresias, the mythical man-woman who was also a seer, as a role model for all psychoanalysts when he mentioned Tiresias as “the one who ought to be the patron saint of the psychoanalysts.”¹ This was in 1963. In his seminar on anxiety, Lacan once more turned his attention to this mythic figure, a character he had discovered when he started reading and then translating T. S. Eliot’s poetry during WWII.

The legend formalized by Ovid’s Metamorphoses book III has it that Tiresias became a prophet only after having changed sex twice. First, as a man, he came upon snakes who were copulating and separated them. The gods punished him for the interference with the natural process by transforming him into a woman. He remained a woman for seven years, which allowed him to experience several aspects of femininity, being for a while a prostitute, a married woman, and even a mother. Tiresias saw similarly entangled snakes seven years later: the spell could be undone by being repeated and Tiresias became a man again. We might wonder whether the discourse of science promising fast and easy sex changes for all is not imitating Tiresias’s hasty gesture—intervening in natural processes. But the pay-off of the myth is that we may have to repeat the intervention so as to understand it better. Then the snakes can appear entwined on a stick as in the caduceus, our usual allegory of medicine, healing beyond death and sexuality.

Tiresias was asked by Jupiter who derives more pleasure from sex, women or men. He was able to reveal to the gods the ultimate secret of sexuality: he reckoned that women enjoy sex nine times more than men. Spited because she had argued that men enjoyed more than women, Juno punished the indiscretion by blinding him. As a compensation, Jupiter gave him the gift of prophecy. What Lacan found in Tiresias was less a model of sexuation founded on the denaturalization of sexuality than the awareness that what matters fundamentally is jouissance.

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Before discovering in Joyce’s work the idea of a saintly man who would be a symptom and a sinthome, as we have seen, Lacan took from another famous modernist writer the figure of his patron saint for psychoanalysis, Tiresias. This Tiresias is telling us in no uncertain terms that psychoanalysis needs to learn more from the trans experience, and that this is the only way to progress toward a future marked by all sorts of gender trouble and body trouble. Indeed, if we play on the words, we may hear that for transference to take place, the analyst must embody the object a for the analysand: “analysts who are such only insofar as they are object—the object of the analysand.”² In another context, Lacan wrote: “It is not enough that the analyst should support the function of Tiresias. He must also, as Apollinaire tells us, have breasts.”³

Tiresias would thus represent for us the psychoanalyst as a seer who has been both man and woman, who has experienced what bisexuality really means. Here the psychoanalyst is a being moved by a desire for pure difference, ready to embody the semblance of the eternally missing object. Freud, we can argue, also referred to Tiresias when he foregrounded the myth of Oedipus as the cornerstone of psychoanalysis. We may remember that it was Tiresias who advised Oedipus after the latter discovered that something was amiss in Thebes. Freud also took on features of Tiresias. As we have seen, while fighting his cancer of the jaw, Freud underwent a “Steinach operation,” which in medical jargon is also referred to as “castration,” for it is a simple vasoligation that he hoped would help with his disease, increase energy and make him feel young again. Steinach’s cross-gender gonadal implants and his “rejuvenation” surgeries (or “reactivation,” as Steinach preferred to call them) were based on speculations about the aging process; here was the beginning of all the later sex reassignment practices and operations. During the 1920s the “Steinach operation” with its promise of eternal youth became extremely popular, and thousands of them were performed around the world. Freud had realized by then that psychoanalysis would have to push the sexual issue beyond the Darwinian concept of instincts and evolution; it would be forced to move in the direction of the death drive, in the hope of progressing even further, beyond death itself.

In the Odyssey, however, Tiresias is already dead. He is the blind prophet who lives among the shades of the underworld. If the rites are respected, if he is offered blood to wake him up, he will tell Odysseus how to go home. Tiresias incarnates truth beyond life and death. Joyce’s and Eliot’s friend Ezra Pound presented him in his re-translation of a later Latin translation of Homer:

A sheep to Tiresias only, black and a bell-sheep.

Dark blood flowed in the fosse . . .

I sat to keep off the impetuous impotent dead,

Till I should hear Tiresias.⁴

If it sounds strange today, in our disenchanted world, to speak of offering blood to the ghosts, this metaphor conveys to us that we need to make such ancient allegories come alive by offering them some of our living substance. It this allows us to go beyond the normative ideologies of sexuality and the fear of trespassing on the limits of life and death, the journey will have been worthwhile.

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Notes

1    Jacques Lacan, The Seminar of Jacques Lacan. Book X: Anxiety, ed. Jacques-Alain Miller, trans. A. R. Prince (Cambridge: Polity, 2014), 183.

2    Jacques Lacan, Television: A Challenge to the Psychoanalytic Establishment (New York: Norton, 1990), 4.

3    Jacques Lacan, The Seminar of Jacques Lacan: The Four Fundamental Concepts of Psychoanalysis, ed. Jacques-Alain Miller and trans. Alan Sheridan (New York: Norton, 1981), 270.

4    Ezra Pound, The Cantos of Ezra Pound (New York: New Directions, 1972), 4.

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p.183

INDEX

Abelove, H. 62n

Abraham, K. 7, 44, 63–6, 76

Abramovic, M. 162–3

Adler, A. 44

agalma 129

Aimée case (Lacan) 149

Alcibiades 129

Alcorn, L. 20

Allen, W. 30

Amanda case 95–7

Ambrosio, G. 36

American Psychiatric Association 21, 60

American Psychoanalytic Association 37

American Journal of Psychotherapy 56

Androgen Insensitivity Syndrome 110–11

anal object 119–20, 125–6, 128–30, 133, 155

Anna O. (Breuer’s case) 66

Anthropophyteia 121

Antigone 114

Apollinaire 169

Aragon, L. 70

Aristophanes 31

Aristotle 79, 150

Arthur Ashe Courage Award 1

Ashbery, J. 103

Augustine (Louise Augustine Gleizes) 71

Augustine of Hippo 111

Automaton 150

Babinski, J. 7, 70–3, 75, 78–9

Baldwin, J. 5

Barthes, R. 108

Baudrillard, J. 13

Bauer, G. 26n

Bauer, K. M. 161

beauty 17, 51, 90, 107–8, 110–11, 114, 117–18, 120, 123, 130–1, 136, 162, 166; and death 109, 113–4, 166–7 see also plasticity

Beckett, S. 72, 114

Benjamin, H. 7, 56–8, 60, 166

Berlin Psychoanalytic Society 44–5, 63

Bernhardovna, H. 161

Bernheim, H. 71

Bersani, L. 38

Bhojani, F. 18n

bisexuality 46, 57–8, 60, 76, 78, 81, 161–2, 169

Bissinger, B. 167n

Blanchot, M. 68

Blatt, S. 40n

Bockting, W. O. 25n, 62n

body: and art 105, 134-9; in hysteria 73–4, 76, 81–2; prosthetic body 13, 16; for psychoanalysis 24, 30–1, 33, 42–3, 63, 82, 89, 97, 103–4, 147; trans body 6, 9, 16, 33–4, 78, 82, 103–6; Schreber’s 92–4; and writing 91, 135–9, 143–4 see also embodiment, mirror stage, and sinthome

Body, N.O. 160–2

Bornstein, K. 90

Borromean knot 142–4, 152

Bourke, J. 8. 121–5, 129, 133

Boylan, J. F. 5, 294

Braffort, P. 144

p.184

Breton, A. 70

Breuer, J. 41–2, 66

Brydum, S. 18n

Brouardel, P. 41

Brubaker, R. 4–5

Bullough, V. 53

Burkett, E. 165

Butler, J. 108

Calderone, J. 163

Calvino, I. 144

Candy 111

Carlson, S. 35, 82

Castel, P. H. 93n, 146

castration 7, 32–3, 36, 42, 52–3, 67, 83, 90, 95–8, 100–1, 113, 126, 128–9, 169 see also Oedipus complex

Cauldwell, D. 7, 55–6

Cavanagh, S. 146

Charcot, J. M. 41–2, 70–2, 79, 81, 94

Chiland, C. 36, 59

Chrobak, R. 41–2

cisgender 6, 21–2, 29, 82, 144

clinamen 8–9, 143–4, 146, 150–1

CNN 1, 14, 15

Coates, S. 62n

Coleman, E. 62n

Collins, D. 78

Consenstein, P. 147n

Copjec, J. 96, 112

core gender identity (Stoller’s notion of) 58

counter-transference 35, 37

Couric, K. 16

Cox, L. 1, 12, 16, 19

Crews, F. 97

cross-dressing 31, 45, 48–53, 57–8, 96

Darling, C. 8, 108–9

Da Vinci, L. 139n, 140

Dean, T. 24, 46, 60–1, 108, 128

death drive see drive

Declercq, F. 145

Delay, J. 87–8

Deleuze, G. 119–20, 143

demand 75

Democritus 159n

den 159n

D’Eon, C. 57

desire 8, 31, 35–6, 42–3, 45–6, 51–3, 55–6, 58, 60, 63–65, 67–8, 71, 75–7, 81–3, 85, 91, 95–7, 99–101, 108–9, 112–14, 118, 121, 125–6, 128–9, 131, 133, 155–7, 162, 166–7, 169

Dhejne, C. 25n

Diagnostic and Statistical Manual (DSM) 49

Diagnostic and Statistical Manual, Mental Disorders (DSM-I) 66

Die Zeit newspaper 60

Diamond, D. 40n

Dolar, M. 150

Dolezal, R. 3–5

Dora case (Freud) 7, 25, 66–8, 74–6, 83, 131

Dose, R. 45

drive 8, 38, 42–3, 61, 66–7, 81, 121, 124–6, 130, 141, 145–6, 149, 158, 165; death drive 8, 63, 108, 113, 165, 169; transsexual drive 91

Drucker, Z. 12–13

dual-function organs 132–3

DuPont Corporation 109

Duras, M. 141

“E” case (Abraham) 7, 63–6, 94

Edmons, A. 107

Ego scriptor 91, 147, 161

Ekins, R. 53

Eigen, M. 36

Elbe, L. 23–31, 89

Eliot, T. S. 168, 169

Ellenberger, H. 47n

Elliot, P. 35

Elsa B. case (Gutheil) 7, 49–53, 59, 9

Eluard, P. 149

embodiment 28–31, 33–4,103–4; and death 106; feminine embodiment for Schreber 118–9; and gender 23, 28–31, 34–5, 103–4; and jouissance 63; and sinthome 146–7, 149; and writing 91, 137, 147, 161

Emma case (Freud) 78–9

eonism 57

Epicurus 144, 150

Facebook (and gender) 29–31

fantasy 42–3

Fausto-Sterling, A. 89

Feinberg, L. 106

Fenichel, O. 31

Fink, B. 85

Firestone, S. 162

Fliess, W. 72, 95, 131

Fonagy, P. 37–8

Fosbroke, T. 124

Foucault, M. 46

four discourses 74–5

Frazer, J. 122

Freud, S. 6, 7, 8, 16, 21, 23, 24, 31–3, 36–9, 41–5, 48–9, 52, 58, 60–1, 65–8, 71–2, 74, 76, 78–9, 81, 83, 86, 92–3, 94–5, 97, 112, 114, 119–25, 128–33, 138, 140–1, 145, 149, 152, 160, 164–6, 169

p.185

Friedan, B. 97

Friedman, C. 62n

Friedman, J. 40n

Frosch, S. 101

Gabbard, G. 49

Gaga, Lady (Stefani Joanne Angelina Germanotta) 9, 162–4,

Garbo, G. 108

Garcia-Navarro, L. 115n

Gates, G. 25n

Gay, P. 47n

gender: amendment 21–3; binary challenged: 30–4, 36, 45, 60, 85, 95, 103; construction of 2–6, 12-13, 89, 112; 165; gender identity 4, 11–12, 14, 20–1, 29–30, 45, 57–60, 99, 101, 130, 162; and sinthome 149–50 see also embodiment

Giddens, A. 8, 107–8, 110

Gide, A. 87

Goldman, E. 162

Gozlan, O. 35, 146

Grant, J. M. 26n

Green, A. 37, 59

Green, R. 56

Greer, G. 97

Guattari, F. 119–20

Gutheil, E. 7, 49–53, 59, 63, 121

Haas, A. 25n

Hadelman-Julius, E. 56

Halberstam, J. J. 162–3

Hamburger, C. 56

Harari, R. 159n

Haraways, D. 16

Havelock Ellis, H. 44, 56–7

Hegel, G.W. 7–8, 74, 108–11, 131–2

Heidegger, M. 144

Helmore, E. 2

Henri / Anne-Henriette case (Lacan) 87–9, 92, 94

hermaphroditism see intersexuality

Herzl, T. 160

heterosexuality 21

Hirschfeld, M. 6, 44–6, 49, 56, 59–60, 63,161–2; cross-dressing studies and theories 45–6

Hoffman, J. 25n

Homer 169

homosexuality: psychoanalytic revision 60–1

Hubert, H. 146

Hujar, P. 108–9

Human Rights Campaign 11

hysteria 102n, 131; disregard for anatomy 74; fragmented body 73; and gender 94–5; and Surrealism 70–3

identity 2–7, 9, 11–12, 14, 17, 19–22, 24–5, 27–30, 33, 36, 38–9, 45–6, 57–60, 84, 88–9, 93, 96–7, 99–101, 104, 106–7, 112–14, 125, 130, 146, 161–4

imposture of identity (Copjec’s notion of) 96

intersexuality 167n

Invisible Committee 163

Jay case 152–8, 164, 166

Jenner, C. 1, 2–4, 11, 16, 17, 19, 29, 46, 104, 111, 162, 164–6

Jenner, Kendall 2

Jenner, Kylie 2

Jennings, J. 1

Jolie, A. 107, 166

Jones, G. 162

Jorgensen, C. 56, 87, 109

jouissance 32–3, 37, 63–5, 68, 75, 83, 91–2, 106, 114, 119–20, 141–3, 145–6, 149, 151, 153, 155, 157, 168

Joyce, J. 9, 94, 105, 114, 139, 141–3, 145–6, 152, 157–8, 169

Jung, C. G. 6, 44

Juno 168

Jupiter 168

Kalaf Kossi, R. 146

Kaplan, L. 122

Kardashian, Kim 2

Kardashian, Kris 2

Karolinska Institute Study 20

Katz, J. N. 21

Kestenberg, J. S. 59

Kinsey, A. 30, 56, 58

Kierkegaard, S. 132

Kojève, A. 7, 75

Krauss, F. S. 48, 121

Lacan, J. 2, 7, 8, 9, 11, 22, 23, 25, 30, 31–3, 36, 39, 61, 63, 66–8 , 70–9, 81–3, 85, 87–91, 93, 95–7, 101, 103–5, 113–14, 119–21, 124, 126, 128–30, 133, 138–9, 141–3, 145–7, 149–52, 157, 164–5, 168–9; Lacan’s return to Freud, 70;

lack 31–2, 43, 83, 95, 101, 114, 126, 155, 157

Lagache, D. 66

p.186

Lane, C. 24, 46, 60–1

Langley, P. 113

Laplanche, J. 37, 43, 146, 166

La révolution surréaliste 70

Levinas, E. 6

Lévi-Strauss, C. 112

Leslie case, 83–5

Lewins, F. 106

Lichtenberg, J. 40n

Limentani, A. 59

Little Hans case (Freud) 125

Longman, J. 85

Lothstein, L. 35, 56

Lowder, J. B. 25n

Lucretius 9, 143, 150–1

Lukianowicz, N. 54n

Malabou, C. 8, 109–10

Malinowski, B. 122

Marie Claire 14

Marx, K. 143, 145, 152, 163

masquerade 96–7

Masotta, O. 68

Maxwell case, 106–7

Melendez, A. 15

Melissa case 98–100

Merriam-Webster Dictionary 21

Meyerowitz, J. 55, 57, 109

Michelangelo 140

Mijolla, A. 141

Mijolla-Mellor, S. de 141

Millet, K. 97

Millot, C. 13, 82, 90–1, 95, 146

Mirror stage 73–4, 103–5, 119, 164

Mitchell, J. 67

Mitchell, S. 38

Mock, J. 14–17, 19, 103–4

Money, J. 48–9, 56–8, 121, 164

Morel, G. 167n

Morgan, P. 14–15

Morris, J. 106

Moussaieff-Mason, J. 97

Najmabadi, A. 26n

Nasio, J. D. 81–2, 84

naturalization 21–3

Nef, H. 111

Nelson, M. 12–13

Netflix 1

New York Times 1, 14, 85

New Yorker 113

Niederland, W. 126n

Nobus, D. 67

not-all see sexuation

normophilia 49

Obama, B. 3, 11

Obholzer, K. 147n

object a 8, 51, 126, 128–29, 133, 150, 154–55, 158, 165, 169

Odysseus 169

Oedipus complex 7–8, 32, 36, 42, 67, 95, 100–1, 141, 146 see also castration

OkCupid (and sexual orientation) 30

Olson, J. 164

Ono, Y. 162

Oppenheimer, A. 59

Orange is the New Black 1

Oremus, W. 34n

Organon 32, 79, 89

Out 1

Oversey, L. 59

Ovid, 168

Oxford English Dictionary 21

pansexualism 43

paraphilia 48–9

Parker, I. 33

Pejic, A. 111

Person, E. 59

phallo-metrics 89

phallus 6, 8, 31–3, 51–2, 67, 89–92, 95–6, 111–12, 126, 128–9, 132, 154, 164, 168 see also Object a

Philadelphia Fringe Arts 135

plastic sexuality (Giddens’ concept of) 107, 110

plasticity 5, 8, 106–14, 137, 144, 166

pithiatism 70, 73

Pitt, B. 166

Poe, E. A. 141

Poly Styrene 163

Pontalis, J. B, 166

Pound, E. 161, 169

Preciado, P. 7, 16, 82, 85

Primeau case (Lacan) 90–2, 94

Prosser, J. 104, 106

prôton pseudos 78–9

Proust, M. 114

psychoanalysis: and art 140–2, and ethics of difference 2, 7, 39, 43, 87; feminist critique of 97; and hysteria 67–8; hysterization of 77; lasting results of 98; normative slant 101; sexual problems 2, 23, 31–9, 41–53, 55–61, 94–5, 129, 146; and transgender discourses 6, 24–5, 28, 35, 55–61, 101; wild psychoanalysis 140–1

Public Religion Research Institute 11

push-towards-Woman (pousse-à-la-femme) 93n, 117–20

p.187

Queneau, R. 144

Quinodoz, D. 36

Rabaté, J. M. 80n

Rasin, J. 115n

Rat-Man case (Freud) 124

Real, the 90, 97, 114, 142–3, 145–6, 150, 152, 157, 164–6; Real difference 33

realness (Mock’s concept of) 103–4

Reed, L. 108

Revue française de psychanalyse 66

Rhys, E. 12-13

Rieff, P. 39

Ritter, A. 118

Robinson, W. 121

Robles, R. 26n

Rocero, G. 111

Ronell, A. 132

Rose, J. 101

Roubou, J. 144

Roudinesco, E. 71

Row, J. 5

Rozin, P. 130

Salamon, G. 35

Salloway, F. 47n

Sawyers, D. 2, 164

scansion 151

scatology 128

Schneiderman, S. 90–1

Schreber case (Freud) 8, 91–4, 117–21, 129, 133

Schreber, D. G. M 118–9

seduction theory 42–3

Self 1

self-shattering (Bersani’s notion of) 38

Semenya, C. 85

Serres, M. 151

sex: and fantasy 42; and death 113, 165; for psychoanalysis 112–13, 129, 165 see also sexuation

sexology: and psychoanalysis 6, 41–53, 129

sexual difference 6–8, 11, 13, 24–5, 30–3, 36, 51–2, 77, 83, 87, 89, 95–7, 112, 114, 146, 164–5 see also sexuation

sexual non-rapport 30–1, 130, 149 see also sexual difference, sexuation

sexual trauma 42–3

sexuality: neglect of in psychoanalysis 37–9; and death 113–4, 165 see also sexual difference and sexuation

sexuation 6, 23–4, 32–3, 39, 63, 83, 168 see also sexual difference

Shalev, O. 38–9

Shuker, S. 9, 135–9, 158

Simon, H. 167n

sinthome 8–9, 23, 114, 138–9, 142–47, 149, 151–2, 156–8, 164, 169

Slits, the 163

Socarides, C. 59

Société Française de Psychanalyse 66

Société Psychanalytique de Paris 66

Socrates 129

Sontag, S. 109

Sophocles 141

Sousa de, M. G. 107

Spruiell, V. 37

Standard Classified Nomenclature of Disease (SCND) 66

Stanley case 112–14

Starlight, L. 163

Stein, R. 36

Steinach, E. 45–6, 56, 60, 166, 169

Steinach (rejuvenation) operation 166, 169

Stekel, D. 7, 44, 48–50, 53, 59, 63, 121

Stevens, W. 166–7

Stoller, R. 7, 56–9, 162

Stryker, S. 4, 56

Sulloway, F. 97

Summers, L. 165

symptom 9, 23, 41–3, 68, 73, 76–8, 85–6, 94–5, 125, 129, 138, 141–2, 152, 169; and art 149–50; and sinthome 141–3, 145–6, 149, 152, 169; and viscosity of the libido 166

T, L. 111

Tabin, J. 40n

Target, M. 40n

Tausk, V. 94

techné 144

Time 1, 12

Tiresias 9, 167–9

Tharrett, M. 18n

Thurer, S. 36

Tomkins, C. 116n

transference 66–7, 74, 91, 129, 141, 153, 169

transgender: beauty 8, 17, 51, 68; definition 3; “meteoric rise” 1; public perception 11–17; and psychoanalysis 23–5, 27–8, 35–6, 60, 101; suicide rates 20, 106; unraveling identity 4–6 see also transsexualism

transition: as reconciliation with life 5, 9, 12, 23, 87, 106–9, 119, 138, 164–167

Transparent (TV series) 1, 12

transsexual 29, 45; artificiality and art 9, 13, 105, 134, 135–139; beauty see transgender beauty; and plasticity see transgender plasticity; and psychoanalysis 46, 48–53, 55–66, 82, 87–93, 119–20; and sinthome 146, 152

p.188

transsexualism: history of the term 6, 55–8, 87; and psychoanalysis 23–5, 48–61, 92, 101; and sexual liberation 13 see also transgender

transvestism 45–6, 56–8 see also cross-dressing

trauma 7, 42, 53, 55, 71, 76, 78–9, 143, 145–6, 150–1

Trénel, M. 71–2, 76

Trecartin, R. 8, 113–14

Tuché 150–1

turbulence 159n

Ulrichs, K. H. 46, 56

unconscious 8–9, 23–5, 28, 31–3, 39, 42–3, 45, 48, 59, 60, 64, 66, 68, 70, 72, 74, 76–9, 83, 86, 89, 97–8, 101, 114, 120, 125, 129, 142, 145–6, 151, 154, 165

United States Association for the Advancement of Psychotherapy 56

Up, A. 163

Vanity Fair 104, 111

Verene, D. 132

Verhaeghe, P. 145, 149

Vilain, E. 85

Vitiello, V. 132

Von Krafft-Ebing, R. 44, 49, 55–6

Von R., E. case (Freud) 72

Warhol, A. 8, 108

Weinstein, L. 40n

Whitney Biennial 12

Whittle, S. 36, 56

Williams, R. 34

Williams Institute 19

Winnicott, D. 162

Wolf-Man case (Freud) 145

Wolfe, S. 62n

X-Ray Spex 163

Yerushalmi, H. 38–9

Žižek, S. 23, 111–12, 128

Zupančič, A. 39, 43