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The notion prevalent in some quarters regarding the nonconflictual origin of
transsexualism and its consequent resistance to psychotherapy is challenged. The author indicates that the cardinal historical (developmental) manifestations of this condition, i.e., early origin, blissful symbiosis, "imprinting" of the mother's own femininity and its apparent immutability, may be viewed in much the same fashion as other borderline or narcissistic psychopathology. This conceptualization fosters a psychotherapeutic approach to the patient's problem.