The author seeks to clarify the meaning of the concept of penis envy and its significance in clinical practice. He reviews the literature from Freud through Kohut on this topic, focusing in some detail on those theories that have relevance for his presentation of the case of a woman he treated for depression who manifested significant penis envy. She had been a tomboy and her "masculine protest" persisted beyond girlhood, to the detriment of her capacity for sexual pleasure. She secretly wished to be a man, or to gain possession of a penis from father or husband. Her mother had been overtly psychotic throughout the patient's childhood. Lengthy treatment suggested that the patient's phallic orientation was designed