ABSTRACT
This chapter traces the evolution of psychoanalytic concepts regarding disorders of gender and sexual identity in women. It covers gender-identity disorders, paraphiliac disorders (perversions), and ego-dystonic homosexualities. Gender-identity disorders and paraphilias are usually described as occurring less frequently in women than in men because of differing vicissitudes in separation-individuation. Recent hypotheses about etiologies for both gender-identity disorders and paraphilias in women stem from analysis of specific female developmental vicissitudes. Paraphilias have classically been viewed as related to oedipal castration anxiety, but recent writers have emphasized distortions of both gender and sexuality. The literature on female homosexualities encompasses many etiological explanations, among them oedipal issues; castration anxiety; excessive aggression; triumph over traumatic experiences or gender prejudices; disturbances in gender identity, feminine identification, or separate identity; ego adaptations to disturbed preoedipal maternal object relations; an adaptive search for greater intimacy; and normal biological variance.
