Theories of transsexuality developed by cultural theorists tend to ignore the psychic dimension of subjectivity. This article draws on Lacanian psychoanalytic theory, transsexual and transgender theory, and autobiographical narratives to reflect on what ought to be included in a psychoanalytically informed theory of transsexuality. Highlighting the work of Jay Prosser (1998), I discuss the importance of sexed embodiment, the problem of sociopolitical and biological reductionism, and the need to analyze, not to pathologize or to normalize, complex psychosexual processes. I suggest that the refusal to construct psychoanalysis and surgery as mutually exclusive constitutes the promise of recent clinical practice.