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In opening the panel on overt female homosexuality, Herman M. Serota stated that this constituted the counterpart of the panel on overt male homosexuality (1959). Many of the general propositions then discussed would not be repeated here. However, all phases of the development of object relations from the state of undifferentiation to the most intricately sublimated ones so often characteristic of both apparent genitality and true genitality would be of relevance. It is obvious that the clinical presentation of an entity in which the regressive selection of an object by an adult for sexual gratification according to the narcissistic pattern brings into strong relief and reconsideration all developmental aspects of object and selection relations. For a variety of reasons, overt female homosexuality has been a relatively neglected clinical entity in contrast to that in the male. Analysts of long experience report having treated only a limited number of such patients. Female homosexual patients experience less superego anxiety and also less reality anxiety about their problem. Serota remarked on Freud's technical handling of his now famous patient in 1920 and the difficulties inherent in the management of the female homosexual who would willingly listen to a reconstruction of her dynamics, but was unable to endure her hostility to the therapist and fled transference feelings rather than relive them.
If one considers the problem from the adaptational viewpoint, the ego of the female homosexual is confronted with an exquisitely delicate attempt at resolving the multiple simultaneous problems posed to it by drives, structures, and functions, e.g., the need to reconcile drives toward gratification with limited representations of external reality, and to select objects with regard to past and present percepts (male and/or female characteristics), and toward whom both libidinal and aggressive expression may be directed in varying proportions. Instinct defusion is an e