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Dear Sir,
Dr Spritz wants to open a dialogue. Maybe I was not clear enough, but some of the difficulties seem to result from misunderstandings.
Dr Spritz writes that I am ‘conflating identity formation of transsexual and homosexual patients, as well as [the] possible treatment of the same’ (p. 390). However, on this point I was citing Elizabeth Moberly's view in her work
that draws of ‘attention to the deficiency felt by transsexual or homosexual subjects to have existed in their relationship (of attachment and identification) with the same-sex parent: this means not that this parent was absent or had shortcomings but that these subjects experienced him or her in that way’ (2000, p. 24). I confined my discussion to ‘The psychoanalyst and the transsexual patient’. I do not ‘treat’ homosexual patients.
Dr Spritz wrote: ‘the homosexual component is usually found in those who are young’ and that ‘The transvestite component occurs in older individuals’ (p. 390). One sees transsexual patients with a high homosexual component who are not young, and transsexual patients with a high transvestite component who are adolescents (see Zucker & Bradley, 1995).
It is not quite correct to state that I try ‘to elucidate the differences … between primary and secondary transsexuals, using the primal figure of Agnes in Stoller's work as an example of the former’ (p. 391). I wrote: ‘I have never been happy with this distinction, which is, I believe, valid only in extreme cases’. I made no reference to the case of Agnes. I said that colleagues, among them Professor Breton, used this distinction, ‘to distinguish primary transsexuals—in his opinion the only ones to whom sex reassignment by hormone and surgical treatment is relevant—from secondary transsexuals’ (p. 25). But in fact I have nothing to do with the prescription of sex surgical reassignment, I only help transsexuals to feel better, whether they are operated or not.
Dr Spritz writes that I state that is impossible to do psychoanalysi