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It is a brave thing these days for a psychotherapist to write about transgender issues. Serena Heller does something even more exceptional in devoting an entire PhD study to the subject—asking how psychoanalysis might genuinely contribute to a richer, more nuanced understanding of gender identity and focusing particularly on female-to-male transition. Her PhD thesis (Heller, 2022), which is publicly available, is itself an enriching and substantial piece of work. This book, published earlier this year, is both a distillation and a deepened extension of that original research. As someone who read the thesis alongside the book, I found that the two speak to one another in illuminating ways.
In her opening section, Heller acknowledges psychoanalysis as ‘an uninvited guest… in the highly charged, complex, sensitive subject of gender identity’. She notes that her focus on trans men occupies ‘a central, vexed and controversial aspect
of identity politics’, rendering her subject ‘topical and divisive culturally, socially, politically and academically’. She is not wrong. Reading her framing, I felt immediately the intellectual courage required to embark on such work—courage not only to stake a position in a fraught cultural field, but to scrutinise one's own psychoanalytic tools with honesty and humility.
Heller's project is situated within a broader movement in contemporary psychoanalysis—one that aims to rethink gender variance without pathologising it. Over recent years, scholars such as Avgi Saketopoulou, Ann Pellegrini, Patricia Gherovici, Alessandra Lemma, Leezah Hertzmann and Juliet Newbigin have advanced frameworks that honour psychic complexity while resisting outdated developmental assumptions or reductive clinical interpretations. Heller's work sits naturally within this evolving landscape: She contributes to these conversations in a way that feels both grounded in the tradition and is forward-looking, offering her own thoughtful exploration of female-to-male tr