A World that Insists We be One or the Other

I know I'm not a man—about that much I'm very clear, and I've come to the conclusion that I'm probably not a woman either, at least not according to a lot of people's rules on this sort of thing. The trouble is, we're living in a world that insists we be one or the other …

Lippe and Offner present a fascinating case of the client E, whom they view as having an identity disorder in general, and a gender identity disorder specifically. E is presented as someone who seems to lack a cohesive core, but rather is comprised of many part-object selves that are in conflict with each other. E's thinking is overly abstract, his speech is “dizzying” and “fragmented,” and he has intense confusion about his gender. This is manifested in E's fantasies of metamorphosing his body parts back and forth at will, and providing himself/herself with combinations of body parts that do not fit with the male/female dichotomy. Drawing from the literature, Lippe and Offner look at biopsychosocial and integrative theories that combine psychoanalytic and postmodern theories to frame the way in which they view E's struggle around his/her identity. One of the core ideas the authors work from is Sweetnam's model (1996), which integrates traditional psychoanalytic theory with postmodern theory, to understand a healthy gender identification as necessitating “both fixed, unitary aspects of gender identification” as well as more fluid aspects. The authors take the view that E is “a developmental work in progress”; that is, E's therapeutic work may be understood as a working