On Homosexuality and Gender Identity1

This contribution is based on the proposition that a study of gender identity will offer valuable insights into some of the special problems concerning the fate of the homosexuality in various types of patients. Gender identity refers to one's sense of being a member of a particular sex; it is expressed clinically in the awareness of being a man or a male in distinction to being a woman or a female. (The term was formulated in collaboration with Stoller, whose presentation deals with another aspect of this subject.) The startingpoint of this paper is the clinical finding that for most psychiatric patients in our society the appearance of homosexuality in their treatment stirs up a peculiar kind of dread (Freud, 1937), (1938). It is my contention that for these patients the awareness of homosexuality poses a threat to their gender identity. This seems to be true of neurotics, paranoid patients, and even some types of homosexuals, each of whom handle the problem differently. The only patients who seem to have no anxiety about their gender identity are the bisexuals and the typical overt homosexuals. I shall try to explain these differences.

The most obvious material comes from a curious finding in both male and female neurotics whenever homosexuality first enters the clinical picture. These patients react with a sense of dread and as a rule behave as though I had said: 'You are a homosexual'. Sometimes they actually misquote me as having said so, sometimes they express this statement as their own conclusion. At other times this is not verbally stated but can be reconstructed from their material. The notion 'I am a homosexual' is perceived as an oppressive, earth-shaking revelation and leads to a sense of impending panic. If we pursue the analysis of the idea 'I am a homosexual' the patient will describe his feeling of losing a component of his self, a cornerstone he had taken for granted, something central to his sense of 'Who am I', his identity in terms