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It is a privilege to review this extraordinary book. The authors, in my opinion, the two currently most distinguished psychoanalyst researchers/writers in the area of sexual orientation, continue their innovative, integrative, and theoretically and clinically brilliant studies in this area. Before considering the contents of this volume per se, I must comment on the authors’ attitudes and styles, which are, to me, extraordinarily laudable and, unfortunately, frequently lacking in psychoanalytic writing in a general sense. Downey's and Friedman's warmth, kindness, empathy, and caring for gay people, and for the suffering of individuals, are manifest. Their modesty pervades this volume, whereas narcissism seems to have been a hallmark of much (in my opinion) psychoanalytic writing on this point. The authors show flexibility. Downey and Friedman throughout, and with their vast knowledge of biology, medicine, sociology and culture, psychoanalytic theory, clinical issues, and political factors, have a wonderful and highly unusual (in psychoanalytic texts) way of evidencing marvelous tentativeness. They always leave room for exceptions and eschew the either/or, black/white, good/bad split that unfortunately characterized much psychoanalytic writing, in my opinion, until the 1970s or 1980s. Their work is both a masterful synthesis of their own and others’ contributions, and is also highly creative. Most importantly, it is written in such a way that clinical practicality is foremost. Sensitivity and thoughtfulness are two other adjectives that come to mind as I read this book. The authors’ modesty moved me away from the many other tributes that I could make, and on to this major work itself.
Because of considerations of length, I will focus only on part 1 of this volume, with only a few comments on part 2. Part 1 is devoted to theoretical and developmental issues.
Chapter 1, “Sexual Fantasies in Men and Women,” considers biological and developmental pathways, influences, and