Cryptorchism in childhood and fantasies about the testes contributed to body-image conflicts which played a central role in both the genesis and elaboration of a transvestite perversion. Impaired body-image formation stemming from faulty self differentiation in the earliest phases of ego development was reinforced in early childhood by awareness of the absence of testes. Repair of the defective body image necessiated total identification with the mother. However, castration anxiety which was equated with body-annihilation fears required phallicizing of the mother's body. Awareness of the mother's, as well as his own, lack of testes led to equating the mother's breasts with testes, while the body proper was equated with the phallus. He could then safely identify with the mother in his transvestite activities. A nonpervert who had

never been cryptorchid had experienced strong cremasteric contractions in childhood. Resultant anxieties concerning the testes stimulated fantasies which were strikingly similar to those of the transvestite.