In order to further our understanding of lesbianism the newer ideas of female development and of sexual object choice must be integrated into psychoanalytic theory. This includes such concepts as primary femininity, the girl's primary wish for a baby, and female genital sensations leading to a gradual understanding of female anatomy. Ties to each parent develop in tandem, not sequentially. Boys and girls have different attachment and separation experiences. Genital release, a major organizer of male psychological development, may not be as important as intimacy in the girl's development. Multitudes of environmental influences play a role in establishing gender identity, gender role and sexual object choice. Nature and nurture interact. Homosexuality and psychopathology are not connected and psychodynamics is not the same as etiology. A case presentation focuses on the role of aggression in female development. The importance of ambivalence is considered in its impact on maternal identification and sexual object choice.