In my reply to Drescher’s focus on gender policing I clarify and elaborate on my ideas about colonization, intergenerational trauma, and the experience of intense shame and anxiety in the transference–countertransference relationship. I propose that Drescher’s emphasis on gender policing, while valuable in and of itself, comes at the expense of these and other themes that are central to my paper. I question whether Drescher’s lack of attention to this patient’s psychic life may indicate that Drescher does not consider a discussion of the relationship between gender and trauma as one that is useful for the patient but only as a search for causation. I clarify that in my work I am not looking for why Ava transitioned to David but for how his experience of gender emerged and developed, and what meaning that experience has had and can have for him.