ABSTRACT
Looking back at the case of an anxious boy with a diagnosis of gender identity disorder, I still recall the unspoken Now what? feeling that hung over early sessions like a cloud. I had experienced it many times in the few months I had been seeing him – the feeling of not knowing what I was offering and what he was nding in our work. Despite many promising starts, sessions felt incomplete, as if something were missing, like when he brought and assembled his French horn and tried to blow some notes. It was a laborious, frustrating process that produced only a few not really melodious sounds that left both of us unsure as to what to say to each other. A few weeks later, he brought a stack of pictures from a recent family trip, but became disinterested after looking at a few. Invariably, when the time was up, I felt, as I watched him exit in a hurry, that I had expelled him, as if he had not performed to my expectations.
