Please Select Your Gender: From the Invention of Hysteria to the Democratizing of Transgenderism (Book Review)

Author:   Gherovici, Patricia
Publisher:  Philadelphia, PA: Routledge, 2010
Reviewed By:  Jeanne Wolff Bernstein, Fall 2011

A Matter of Choice

Please Select Your Gender (2010) stands out as a particularly well-researched book in the field of psychoanalysis. Although its focus is on the problematics of current transgender issues as a contemporary form of hysteria, the author leads her readers through a complex web of fascinating chapters on the history of hysteria, sex change operations, and Freud's famous cases of Schreber and "The Psychogenesis of a Case of Homosexuality in a Woman."

In order to construct her final synthesis that transgenderism should no longer be considered as evidence of severe psychopathology, but instead be viewed as an expression of freedom "to choose one's own gender while claiming ownership of one's own body" (p.246), Grievously places her argument in a far-reaching historical context. The chapters are not just useful preparatory steps toward a final synthesis of a democratization of transgenderism; they themselves are jewels of independent texts that familiarize the reader with many of Lacan's most controversial concepts, which include the "phallus," the "sinthome," Lacan's idea that "there is no sexual relationship between men and women," and the schema of sexuation.

Gherovici has a gift for translating difficult ideas into common language, and for making them clinically useful and intellectually available to psychoanalysts of all theoretical persuasions. Take, for instance, her chapter "Falling Into Sex Like Falling in Love," in which she elucidates Lacan's theories about Freud's treatment of the woman described in "The Psychogenesis of a Case of Homosexuality in a Woman." Freud's only nameless published case became one of Lacan's favorite Freudian texts, one in which Lacan illustrated, among other things, the difference between a "passage a l'acte" and acting out. Using the extensive literature that has been published posthumously about the case of the homosexual woman whose identity is now firmly established as that of Margarethe von Trautenegg, born Czonka (Rieder & Voigt, 2003), Gherovici zeroes in on the phallic position the girl assumes vis-a-vis her mother and father, and how that delicate position leads to her many suicide attempts that can be retroactively constructed as "passages a l'acte."

Citing Lacan's central idea that the "phallus is the signifier of the Other's desire," Gherovici explains that the imaginary phallus was thought to be initially

a detachable object that materialized the mother's desire. It circulated between mother and child in a dialectic that paved the way for the notion of the phallus as a signifier. The imaginary phallus is an object of a desire located beyond the child and with which the child tries to identify. The Oedipus complex entails renouncing the fantasy of becoming the imaginary phallus. For Freud, castration was not only the real "castration" but also the symbolic lack of an imaginary object. (p.98)

Citing the many obvious parallels between the heroine of all hysterical desire Dora and Sidonie/Margarethe von Trautenegg, Gherovici emphasizes that the homosexual woman identified with the mother's missing object:

[S]he became the baby she was denied. In her Niederkommen [German for coming down, descending, giving birth] she was at once having her child and destroying herself: a symbolic stillbirth. Whereas Dora remained within the metaphoric substitution, Sidonie's desperate act was the last element in a long metonymic chain of displaced objects. (p.107)

Gherovici is correct in repeatedly pointing out that Lacan is not placing the same emphasis on castration that Freud did, but that he focuses instead on the complex role of the phallus in both its symbolic and imaginary dimensions, and "the division that the primacy of the phallus creates for the girl" (p.105). From this renewed Lacanian oedipal triangle, the infant is seen as desiring to fill up something in the mother that has never existed, because the phallus is the maternal penis that is longed for; however, that has always been an imaginary construct, one through which mother and infant define their separate intertwined desires. In the end, "the mother is deprived of an object that she actually never had. If there is anything perceived as lacking, what is absent is already the symbolic phallus, and the agent of privation is the imaginary father" (p.105).

Having fallen out of her mother's desire, who resented her daughter for her beauty, and feeling betrayed by her father for the broken promise of having his child, the homosexual woman, Sidonie/Margarethe, stages a scene in which she creates herself to be the absolute phallus of "la cocotte," the scandalous lady in the gaze of her father. "Sidonie wanted to find in her father's gaze the love that would compensate for the privation of the phallus" (p.128). However, because the father did not see her, or only saw her briefly with great contempt (the accounts vary about this visual exchange, depending on Sidonie/Margarethe's own account or that of Freud in the narration of the case), and because she then also falls out of sight from her admired object, Sidonie/Margarethe rushes to throw herself down the subway station in a "passage a l'acte" where unlike in an acting-out process, she leaves the scene altogether and falls into the abyss of the Real.

In Please Select Your Gender, Gherovici keeps returning to Freud's case of the homosexual woman because Sidonie/Margarethe provides such a powerful example of the issues and questions contemporary transgendered people confront and for which they seek answers in their quest to transform their bodies into a different sexual identity. "Situating oneself as a man or a woman is a complex process, directly connected with the symbolization of the law and castration. The transgender phenomenon proves that there is nothing natural that would direct us to the opposite sex" (p.185). Because such a fundamental disharmony exists between the sexes, Lacan developed the idea of the "sinthome"/"saint homme," the holy man, the holy symptom through which every subject forms a construction that "makes up," as Gherovici writes, "for the disharmony between the sexes, it is a creation that 'makes do' around the disjunction" (p.185).

Because gender is fluid in contrast to the binary structure of sexuality, the human subject is constantly driven to resist the duality of this male-female division, opening up a realm for subjects to cross genders in that in-between space. The provocation that this binary structure usually poses for the hysteric, whose basic question is whether she is a male or female, becomes a question that is being concretely answered by the transgendered subject. "Hysteria," Gherovici writes, "is defined by a certain question about sexual positioning. By contrast the transsexual patients do not pose this question. They believe that they know what they are a man or a woman trapped in the wrong body and their main problem will be finding ways of rectifying that error." (p.211)

I believe that "knowing what they are" locates the transsexual solution more closely to the psychotic structure than the hysteric one. Unlike the hysteric who asks questions and constantly doubts, wavering between positions, the psychotic knows, and has a delusional system that substitutes for the foreclosed name-of-the father. Akin to the psychotic's delusional system, the transsexual tends to insist, as Gherovici's cases illustrate, that an error in nature has indeed occurred and that this error needs to be corrected by surgical and hormonal means.

Gherovici characterizes this "error in nature" as a "refusal to accept sexual discourse.""And when this sexual discourse is being foreclosed, the error is no longer symbolic, it becomes nature's error and has then to be repaired in the Real. Often the demand for a sex change is meant to rectify this error in the Symbolic register by correcting the error in the real of the body" (p.195). Gherovici disagrees with other Lacanians who have written on the subject of transsexualism, like Catherine Millot and Moustafa Saffouan, who argue that transsexuals opt for a psychotic solution, because the transsexual solution is structurally akin to the psychotic one.

Gherovici quotes Millot (1990):

The transsexual symptom appears to function as a substitution of the Name-of-the-Father inasmuch as the transsexual aims to incarnate the Woman. Not one woman in the sense of "not-all," implying that no one could claim to represent All women the transsexual position consists of wanting to be All, all woman, more woman than all woman and representing them all. (p.42)

Gherovici then suggests that some transsexuals' solution may be less pathologically structured than traditional Lacanians have previously suggested. Although she provides many fascinating case examples from her own clinical practice, I think there are moments in her own argument where her desire to depathologize transsexualism outweighs her clinical observations. To have a solid answer to a hysterical question and to decide for one gender over another seems to me to locate that transsexual solution in the sphere of a psychotic structure. The certainty and the omnipotent thinking that often accompanies the transsexuals' solutions like the man who has now borne two babies leads in my mind to a solution, more closely akin to a psychotic or perverse structure than a neurotic one, like hysteria. The wish to be it all, or to have it all to be a woman with a penis, or to be a man without a penis but with breasts speaks to an omnipotent solution that wants it all and cannot bear the experience of loss and mark of differentiation.

I do think that Gherovici ends up arguing very persuasively that a transsexual solution resembles a new reknotting of the symbolic, the imaginary, and the real, and constructs a new sinthome that holds these three registers together so that the transsexual subject does not descend into a psychosis. Akin to Lacan's theory that James Joyce's writing saved him from descending into a psychosis, and thus functioned like a patch covering up and over the foreclosed name-of-the-father, so the surgical operation into another gender can function in similar ways as an escape from a psychotic abyss. Unlike the bodily symptom, the sinthome, Gherovici writes, is a "purified symptom, it remains beyond symbolic representation and exists outside the unconscious structured as a language. In this sense, the sinthome is closer to the Real" (p.231). Likewise, the transsexuals, convinced that they live in the wrong body, are "trapped inside a living chamber of horrors," as one of Gherovici's patients says, and also exist outside the "normal dyadic structure, at which point their journey into the other gender is an attempt to reinsert themselves into a discourse that has left them outside, unspoken for and unsymbolized.I think the fact that Iran, under the leadership of Ayatollah Khomeini, has allowed sex change operations while still punishing homosexuals with the death penality says it all. Khomeini's statement that people "have a right to get rid of this body and transform it into the other sex" (p.3) points to the traditional values such an operation carries within itself. While a sex change operation still strikes many as a high tech, modern solution to an ancient problem, it echoes after all rather conservative values and attempts to erase, as Tim Dean writes, all sexual divisions (p.11). The man who feels he has lived in the wrong body often transforms himself into the hyperfeminine woman, embodying strikingly traditional ways of representing himself as a woman.

Transgendered people may thus become the select subjects who end up promoting and passing on the very models of hyperfeminitity that women who are content living inside their bodies often rebel against.

I think that Please Select Your Gender, in the end, provides a compassionate, inside account of the conflicts transgendered individuals are facing as they escape the body that is imprisoning them. The book provokes a great deal of thinking and does not lead in any wayto a set of easy conclusions. Whereas some readers may be inclined to depathologize the whole spectrum of transgender issues after reading Gherovici's book, others may be more disposed to view this modern-day struggle in increasingly complex and perplexing ways. Beyond a doubt, Gherovici has written a book that goes far beyond the scope of transgender ism, giving readers the rare chance of reading Lacanian thinking at its best and seeing it applied to clinical practice. Moreover, her book should be considered a textbook on the subject of hysteria and thus be added as a laudable addition to the psychoanalytic canon. ]


Gherovici, P.(2010). Please select your gender: from the invention of hysteria to the democratizing of transgenderism. New York: Routledge.

Rieder, I., & Voigt, D. (2003). Sidonie Csillag: Homosexuelle chez Freud, lesbienne dans le siècle. Paris, France: EPEL.

Reviewer Note

Jeanne Wolff Bernstein is a past president and faculty member at The Psychoanalytic Institute of Northern California (PINC) and currently a guest professor at The Sigmund Freud University in Vienna. She was the 2008 Fulbright Visiting scholar at the Freud Museum and Private Foundation in Vienna, Austria. She has published widely on psychoanalysis and the arts, and just wrote the entry on Lacan for the newly issued Textbook of Psychoanalysis.


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