American male patients who denied the existence of the bodily openings did so as a defense against desires of being penetrated. It was an attempt to deny their passive feminine receptivity. The author underscores the defensive denial in this mechanism by citing an example from an East Central African tribe, the Chagas. A boy about to be initiated into manhood is entrusted with a secret. The secret is that although adult men profess to women and uninitiated boys that they do not have anal openings and are unable to defecate, this is but a fiction. It is a conventionalized denial of their femininity.