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Many years ago, a woman came to my office for a consultation, ostensibly about a low dose of anti-anxiety medication that she used occasionally. She was meticulously dressed and gently mannered, and fairly soon after arriving she mentioned that three months prior she’d had sexual reassignment surgery and had been transitioning with hormones and feminizing her public presentation for two years. She was not yet divorced from her wife, and their three children ranging in age from fifteen to twenty years of age were responding reasonably well to the transition of their father to womanhood. Days before she consulted me, her estranged wife had been diagnosed with a cancer that would likely be fatal, which she saw as a tragedy that opened the opportunity for her to take a more actively nurturing role with her children. She described her desire to be more personally involved as a departure from her previous ways of relating to her children as a more distant father, and attributed the change to estrogen. She felt kinder, gentler, and stated plainly, “Estrogen is the source of all nurturing.”
When I quoted this patient’s statement about estrogen in a psychoanalytic classroom, one of the participants quickly implored, “Where can I get some of that stuff for my mother?” After a laugh, we tried to sort out which aspects of gender and sex could still be seen as biological or essential realities, and which former realities are upended by the lived experiences of patients in our offices and others in the world around us.
Psychoanalytic theory has undergone a dramatic evolution with regard to theories about gender and sexuality, while theories about
maternity, paternity, parenting, and child development have not kept pace. Psychoanalysts may therefore find that their training has left them alone at new frontiers when faced with dynamic relations in families that differ from the heterosexual model on which we were trained. Yifat Eitan-Persico deftly applies psychoanalytic thinking i