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An outwardly masculine man with a transvestite masturbation fantasy appeared to have suffered an early disturbance of body image formation. Then upon entering the phallic phase, the genital area of the body image, instead of differentiating out clearly from the rest of the body, remained fused with it, thus laying the basis for pervasive body-phallus identifications and for castration anxiety to become merged almost immediately with total body-disintegration anxiety.
The specific transvestite symptom derived from his older sister's long-continued use of him for sex play, in which she dressed him as a girl and as a long-tailed dog and beat down his erection painfully, leading him to push back his penis between his thighs and dress himself as a girl. By doing this, he became an appendage to his sister, her yearned-for penis, united to her (and through her to mother?) in intimate symbiotic object-relation. But that he could be used as a woman's phallus threatened again his insecure sense of self, so in his private transvestite fantasies he warded off this body fusion with women by becoming his own phallic 'beautiful girl', while in his daily life he tried to differentiate himself from women by excessive masculinity, behaving as though he were in toto a tall, erect phallus. Moreover, instead of being the woman's phallus, he tried to use attractive women as a phallus with which to demolish other men.