A childhood gender identity disorder. Analysis, preoedipal determinants, and therapy in adolescence

This paper is about a four-year-old boy's wish to be a girl. This wish was a compromise formation, the consequence of intrapsychic conflict. Using reconstructive inferences and research findings, I suggest a line of development in the boy's femininity, beginning with constitutional and maturational factors, with being shaped in a feminine direction by his environment, and with shaping himself internally in the form of a compromise formation in that direction by the time he was two to three years of age. The disorder began to acquire a persistence and stability during the preoedipal phase and, with minor changes in its components, remained operative during the oedipal phase, latency, and adolescence.