Congenital absence of the vagina is a rare anomaly meriting psychoanalytic interest. It constitutes a severe narcissistic injury which compromises sexual identity. Marked disturbance

of body image and self-esteem, exacerbation of bisexual and exhibitionistic conflicts, pervasive denial and repression, reactive depression, and the psychology of the exception are characteristic features. CAV might serve psychoanalysis as an experiment of nature to test divergent hypotheses concerning the role of the premenarchal vagina in psychosexual development.