Response to Juliet Mitchell's Reflections

Mitchell credits me with two important contributions, the first, that in theorizing the development of sex and gender I propose that it is “cognitive gender [that] controls/organizes libidinal sexuality” rather than “Freudian libido theory or some genealogical object relations theory.” This is correct insofar as cognition in this context is understood to mean a cognitive/affective constellation. Mitchell also credits Lionel Ovesey and me with suggesting that disidentification is another name for separation-individuation and with pointing out that both sexes need to separate and individuate from mother. Although the etiology of transsexualism is unknown, one significant factor in its genesis is separation anxiety, which gets bound in cross-gender fantasies. In transsexuals, safety takes priority over sexuality; this is the key finding that dictates a reevaluation of the absolute priority so often afforded sexuality in psychoanalytic theory. The way medical culture shaped the diagnosis of transsexualism and provided a surgical resolution is a premier example of what I call a shared cultural fantasy (Person, 1995). The medical endorsement of transsexualism as a biological disorder tilted the treatment toward a surgical resolution.