In an interesting case presentation of a male transvestite the author points out how cryptorchidism in childhood and the patient's fantasies about his testes played a central role in the genesis of both body-image conflicts and the subsequent development of transvestitism. The impaired body-image formation was further re-enforced in this patient by faulty self-differentiation. In order to repair the defective body image, total identification with mother was necessary. Mother's breasts were equated with testes and her body proper with the phallus. This culminated in final identification with mother and was acted out in the patient's transvestitism. It is suggested that cryptorchidism may be a more frequent etiological factor in the genesis of transvestitism than has been realized heretofore.