Killing off the good little boy: transition as a solution to the problems of separation from the primary object

This paper explores clinical work concerning a group of gender-questioning natal males who experienced physical difficulties in childhood. The author argues that these individuals develop a transgender (trans) identity as a defence mechanism against the psychological challenges associated with development, particularly the struggles of forming a distinct mind and identity. Anxieties related to physical health may have contributed to the formation of an anxious attachment to their primary caregiver, perceived as intrusive and demanding. Moreover, these individuals struggle to identify with their fathers, often experiencing them as distant, absent, or unsupportive of their relationship with the mother or other primary caregiver, thereby hindering separation from the primary attachment figure. These early experiences may lead to difficulties in acknowledging and owning their evolving sexuality and aggression, as well as in bearing the necessary guilt associated with separating from the primary caregiver. Consequently, the individual may fantasise about relinquishing identification with an idealised version of themselves and replacing it with a liberated version capable of living autonomously. Through a composite case, the paper illustrates how these conflicts manifest in the therapeutic setting through transference dynamics. Themes explored include gender dysphoria, confusion, adolescence, and transition.