Dr. Siomopoulos' reply

Dear Sir:

The objections raised by Dr. Meyer-Bahlburg show that he missed several points in my article. I maintained that the transsexual patient is a person who throughout his childhood felt and behaved as if he belonged to the opposite sex—a person who had difficulties with his gender identity early in his life. However, at a certain point later in his life, usually during puberty, he not only behaved—to limit the case to male transsexuals—in a feminine way, but he also developed the unshakable belief that he belonged to the opposite sex. At this point, I suggested, his difficulties ceased to be just those of a gender identity disorder, but they took dimensions of a psychotic process. The transition to psychosis was marked by the onset of the delusional—false, incorrigible, wish-fulfilling—belief “I am a female.” By analogy, a young person, confronted with a multitude of experiences which demand commitment to physical intimacy, occupational choice and competition, may have a lot of concerns about his intellectual, moral, social, and other resources and origins, and can be rightly described as having an identity problem. However, when he believes that he is Jesus Christ, he does not have an identity problem any longer—although he is obviously “confused” about his “identity”—he is simply psychotic.

I suggested that what makes the transsexual class reversal possible is the use by the patient of a particular type of thinking-paralogic thinking-which allows his inclusion into the class “females” on the basis of the single characteristic of feminine-sexual and other-interests. Dr. Meyer-Bahlburg objects that the “opposite-sex role behavior which pervades all areas of the child's life, including toy preferences, game preferences, sex roles in fantasy games, activity level, fighting behavior, sex preference in peer relationships, cross dressing, and so on,” cannot be described as “single characteristic.” I think his objection is one of semantics. The variety of behaviors de