This paper develops a neuropsychoanalytic account of masculinity that shifts the locus of gender identity from exteroceptive, anatomically-based criteria to interoceptive, internally felt experience. Masculinity is conceptualized not as a fixed property automatically derived from male anatomy, but as the outcome of a developmental process in which bodily predispositions, primary emotional systems, unconscious relational experience, and sociocultural meaning become progressively organized into a coherent sense of gendered selfhood. The paper reviews the genetic, hormonal, and neurodevelopmental foundations of somatic masculinization, showing that environmental social factors can shape the neurobiological maturation of sexually differentiated circuits, and ultimately gender identity. Lesion and neuroimaging studies show that gender identity consists of a distributed, mosaic-like construct consistent with predictive-processing models of mind. Two clinical vignettes illustrate how gender identity, sexual orientation, object choice, and caregiving function may develop along partially independent trajectories, with implications for a non-normalizing, individualized clinical approach to gender in psychotherapy. The perspective adopted here follows the universal proposition that everyone is a unique polymorphic mosaic of drives (including the sexual one) and of gender inclinations, some mutually harmonious, others potentially divergent, but all inevitably reflecting the richness and multi-faceted complexity.
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Clarici et al. (2026) studied this question.
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