chapter  6
Principles for Psychoanalytic work with trans clients
BySheila L. Cavanagh
Pages 13

This chapter establishes a distinction between transgender (trans) subjectivity and psychosis to support the move to de-pathologize gender variance. Despite sophisticated theorizing about subjectivity, psychoanalysts have been reluctant to view trans-subjectivity as a viable means to negotiate what Jacque Lacan calls the impasse of sexual difference. There has been an uncritical reliance on Catherine Millot’s (1990) early writing in Horesex along with a tendency to generalize the specifics of the Daniel Paul Schreiber (1903) case—a single instance of psychosis—to all trans patients.Moreover, few practitioners are knowledgeable about trans communities, trans life experiences and what it means to undergo a social or medically assisted transition. Based on Lacanian theory, recently published psychoanalytic literature in the North American context and a comprehensive review of online blogs, posts, and websites run by, for, and about trans people, I offer trans-positive therapeutic principles to support psychoanalysts working with trans clients.