This paper presents a six-year analytic treatment that began when Margo was five and a half years old. Unable to get the love and attention that her older brothers received, Margo sought repair by deciding to be both a boy and a girl. Before a solid gender identity could emerge, I needed to facilitate her development and help her obtain a cohesive sense of self that would include ego integration of feelings and object relationships. Margo's bi-gender solution crystallized a fundamental struggle and conflict with identity, and served to repair feelings of narcissistic injury, cope with extreme feelings of love and hate and good and bad objects, quell annihilation anxiety, and repair a sense of ego disintegration.