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The purpose of this paper is to give some account of a case which presents features of special interest, and which in one respect is perhaps unique in psychoanalytical practice; for, although the patient in question had always been presumed to be female, she had an organic genital defect such as to raise some doubt as to the sex to which she properly belonged. On this account alone the case appears to merit recording; for the question naturally arises how far the neurotic symptoms occurring in an individual with such an organic defect were found in the course of psychoanalytical treatment to follow the pattern of familiar psychopathological processes.
The patient was referred to me for psychoanalytical treatment by her family doctor on account of symptoms which will shortly be described. Meanwhile, it seems desirable to give some preliminary account of the nature of her physical abnormality so far as this could be determined. It was originally described by her family doctor as follows:
‘She appeared to be a perfectly normal child until she reached the age of puberty. She began then to grow unduly tall, did not menstruate, but kept perfectly well. When she was about twenty, I was consulted and made an examination. I found a complete absence of all genital organs with only a pin head opening as a vagina which led nowhere. As she felt perfectly well, nothing further was done.’
In accepting the patient for psychoanalytical treatment on account of her neurotic symptoms, I also accepted her doctor's account of her genital abnormality as substantially accurate; but, as treatment proceeded, I began to entertain some doubts regarding the complete