THE REMAINS OF THE DAY: TRANSSEXUALITY, PSYCHODYNAMICS AND THE MODERN NHS

Abstract

This paper describes a psychodynamic understanding of transsexualism and some related implications for NHS services. Following a brief literature review the author describes a series of clinical vignettes that tease out psychically important transsexual dilemmas. Specifically, themes of conflict with authority, idealization of destructive solutions and learning to live with regret are explored. Finally a psychological differentiation of transsexual issues is suggested as potentially helpful for future service development.

ACKNOWLEDGEMENTS

The author is grateful to Pip Garvey, Richard Mizen, Sue Mizen and Rachel Collingbourne for helpful ideas and encouraging comments.