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This paper on the role of core gender identity in the genesis of perversion is an extension of a previous one titled “The Evolution of Gender Identity.”6 It is a reflection of my interest in this subject not only as a component of all emotional illnesses, but also because of its central significance in the understanding of the major sexual perversions.
During the past ten years I have been working at the Karen Horney Clinic with groups of people who manifested clinically different types of sexual perversions. This study is based on clinical therapy with about 80 people working in groups, as well as with an approximately equal number in individual therapy. Working with so large a number of patients has provided me with an excellent opportunity to consider the nature of transsexuality, transvestitism, homosexuality, nymphomania, satyriasis, exhibitionism and voyeurism. All of these clinical syndromes were represented among the patients under study. Although the vast majority were homosexual, there were enough of the other perversions represented to afford opportunity for deeper study.
The male-female identity is the most deeply ingrained or imprinted image of the various components that constitute one's global identity. It is closely related to body image. Uncertainty about the gender identity frequently generates great anxiety and often leads to panic, therefore defenses against such states are strongly preserved. This may account for the intransigence to change. Discoveries of behavior geneticists, learning theorists, and ethologists suggest that areas of learning are permanently imprinted during the earliest beginnings of the psyche. Disturbances in the body image and subjective feelings leave an imprint (Lorenz7) and affect the earliest basic gender identification.
Experiential events are crucial in the development of the gender image. Biological genetic forces undoubtedly augment this process. While the process of development in gender image continues until the end