Transsexualism and psychosis

A discussion of "The Transsexual Wish in a Psychotic Character" by Katherine MacVicar, M.D. This paper reviews some of the major reports gradually emerging in the psychoanalytic literature which validate the belief that beneath the desire "to change sex" may lie serious, if not overwhelming, psychopathology-even of a psychotic nature. Transsexual wishes may arise from oedipal conflict, preoedipal fixation, or schizophrenic processes. This paper briefly describes the mechanisms involved in the development of psychotic reactions in those schizophrenics who desire and undergo sexual transformation surgery.