Core Gender Identity: The Transgender Child and the Inversion of Freud

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At the Special Collections of the UCLA Charles E. Young Library I recently had the chance to examine the Robert J. Stoller collection, comprising the papers of the psychiatrist and psychoanalyst who helped steer the UCLA Gender Identity Research Clinic in the 1960s and 1970s. Although the interdisciplinary clinic that included psychiatrists, psychologists, psychoanalysts, endocrinologists, plastic surgeons, doctors, and neuroscientists, never oversaw Sex Reassignment Surgery (SRS), which was not available at UCLA, it did involve itself profoundly in the evolution of the diagnosis, etiology, and treatment for what was at the time usually termed “transsexualism.” The clinic also, crucially, involved itself in all manners of what it considered “gender identity disorders,” primarily visible forms of effeminacy in children assigned as male at birth. The centrality of childhood and the obsession over treating children at UCLA shaped the contours of the evolving distinctions between the gay and transgender child as they took shape in the post World War II era.

Stoller’s interest in transgender bodies took shape after he was referred several children for psychotherapy by his colleagues at UCLA in the late 1950s and early 1960s in which he diagnosed gender disorders. He became interested, from those first clinical experiences, with trying to fill in the missing psychic dynamics of transgender and other gender non-conforming medical labels. Following the work of John Money and his colleagues at Johns Hopkins, Stoller hypothesized that something like a “core gender identity” was established very early in life, possible by age one or two. However, where Money had come to this conclusion merely by observation of his many “hermaphroditic” patients seen for gender-normalizing surgeries at Johns Hopkins, Stoller felt he could use psychoanalytic theory to explain the actual process by which core gender identity was established. His resultant work effected a strange (because so rare) reversal of Freud’s theory of sexuality and consolidated the obsession with children in the medicalization of effeminacy and transgender embodiment and identity.

Stoller’s theory of core gender identity challenges the first assumption of Freud’s theory of sexuality: that the libido is primarily masculine. For Freud, both girls and boys, from birth, consider themselves little boys. In the oral, anal and phallic stages, children express an active libidinal position in taking the mother as the first love object. Only with the introduction of castration anxiety, in the case of the boy, and penis envy, in the case of the girl, is the a differentiation of the sexes registered psychically, resultant in the assumption of normative masculinity and femininity through the resolution of the Oedipus complex. Recall, then, that femininity is an incredibly difficult achievement under Freud’s developmental rubric, for the girl is not called upon merely to change her love object from mother to father (and then her future husband and baby), but she must also change her libidinal position from active to passive. Femininity is thus a derivative, a copy of a copy of masculinity, and an especially devalued psychic position vis-a-vis the “natural” phallic activity Freud assigns to masculinity.

For Stoller, any degree of femininity in children assigned as male at birth did not accord well with Freud’s phallocentric theory: why would some children declared boys (with all of the “natural” privileges of getting to keep an active position) spontaneously elect for femininity when femininity was such a difficult achievement even for children declared girls? Here he once again looked to his medical colleagues working on transsexual diagnosis and treatment in the 1960s. Money and his colleagues in Baltimore had become fascinated by a series of studies looking at the development of the mammalian fetus. They were surprised to find that all fetuses begin as “female.” Not only that, but they all will remain female but for the introduction, in utero, of androgens, in the correct dosage and at the correct moment of gestation. In what Money would come to call “the Eve principle,” the orginary state of mammals, including humans, was suddenly understood by medical science and biologists to be “female” (the originary assumption being that the distinction between female and male was always self-evident, of course). In experiments on animals, principally rats, the artificial introduction of androgens to the uterine environment of a “female” fetus resulted in the birth of “masculinized” and “virilized” animals, chromosomally “female” but with masculine genitals and aggressive personalities. Money did not conclude from this that either sex or gender (which in his mind were distinct) were established or at least encouraged by uterine hormonal exposure, but he felt it was a possibility.

Stoller was greatly impressed by the Eve principle and founded his theory of core gender identity on a psychic analogy to it. For Stoller, the originary state of infancy is not active masculinity. Prior to any of the pre-oedipal stages, he theorized (although he admits simultaneously that he could never prove its existence) a stage of primary symbiosis between infant and mother, a period during which the infant is unable to distinguish itself from the body of the mother. Unsurprisingly, this state of merger is described as blissful, an originary jouissance from which the infant must be weaned in just the right way in order to establish an ego.

Primary symbiosis entailed that all infants are first feminine, according to Stoller, completely inverting Freud. For girls, he happily remarked that this posed no problem, since girls were supposed to identify with their mothers anyways. But for boys, the primary femininity they were at risk of introjecting from birth could lead to all manner of pathological outcomes if not cut off in the right way and at the right time. In transgender children, Stoller argued that a pathological mother who had extreme penis envy and masculine qualities literally kept the infant too close, too merged, too involved in her femininity, and thus encouraged the assumption of a feminine identification by at least age two but especially age five. In effeminate gay boys, he felt the same process was at fault, but merely in a lesser degree of intensity (this theory cannot account for gender-normative gay boys). In this way, the longstanding confusion of homosexuality and gender through the nineteenth century trope of inversion was re-actualized through the concept of core gender identity. The misogynist blaming of the mother was complemented by the archetypal, pathologically distant, uninterested father, who failed to intervene in the closeness of child to mother to create a stable superego that would pre-empt feminine identification.

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The results of Stoller’s theory are bizarrely bipolar. On the one hand, it is profoundly homophobic and transphobic, for where Money and his colleagues at the bare minimum felt transgender patients had the right to pursue SRS in the absence of any other effective psychotherapeutic treatment, Stoller hoped that early enough behavioral therapy of children could literally eradicate both future effeminate gay men and transgender women. In this way, his work is complicit with a genocidal impulse so well diagnosed by Eve Sedgwick’s reading of Stoller’s colleague, Richard Green, in the infamous essay “How to Bring Your Kids Up Gay.” (Although Stoller did not practice it, I found manuscripts in his papers sent from colleagues in Mississippi who practiced electro-shock aversion therapy on a transgender teenager.)

Yet, Stoller also by accident lay the foundation for the eventual reversal of his position in the consensus of the treatment of transgender children in the twenty-first century. Stoller was very clear that he felt that femininity in children assigned at birth as males was not a result of trauma or any conflict whatsoever. So, although he did not approve of it, he did not technically see it as a psychotic pathology. “I see male transsexualism [his term] as an identity per se,” he writes in Sex and Gender, Vol II, “not primarily as the surface manifestation of a never-ending unconscious struggle to preserve identity. To me, transsexualism is the expression of the subject’s ‘true self’ (Winnicott’s term)” (2). The concept of core gender identity was invested, from the 1960s to present, with the force of the truth of the self for the medical necessity of transition in individuals who desired it. And although none of the clinics offering SRS and transition support when first developed in the United States in the 1960s would admit patients under 21, the obsession with childhood in the etiology of gender laid the genealogical groundwork for the later consolidation of transgender childhood as a recognizable identity. For that reason, long-existing hormonal therapies for precocious puberty developed in clinics like that at Hopkins could be adapted to to the relatively new “puberty suppression therapy” currently offered as the cutting edge option to transgender children to begin transition in childhood.

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Amidst the genocidal impulse to hunt down femininity and eradicate it in childhood, then, are other traces in the archive of the transgender child. Lawrence Newman, one of Stoller’s colleagues in the Gender Identity Research Clinic, writes in an unpublished manuscript from the 1960s I found, of a 15 year old patient who transitioned while in high school. Changing her name and switching schools (with the new principal’s understanding), she successfully attended her new school and obtained a legal name change. Later, after reaching the legal age of majority, she was able to obtain SRS.

In revision to the generally rehearsed narrative of the post-war era, which posits that the de-medicalization of homosexuality by the American Psychiatric Association in 1973 led to the pathologization of childhood femininity through the creation of Gender Identity Disorder in the subsequent DSM in order to treat homosexuality by proxy, the genealogy of the transgender child stretches back to the 1950s in clinical institutions like UCLA. Stoller stands out in this genealogy as one of the only attempts at the psychoanalysis of transgender identity. Although Stoller himself eventually came to argue against transition in all forms, his conceptual attempts at eradicating childhood femininity psychically now serve rather different, if still normalizing, ends, in therapies for childhood transition.

What has remained stubbornly consistent since the invention of gender by Money in the 1950s, however, is the grounding assumption that masculinity and femininity are discrete, separable, and opposable. The invention of the concept of the transgender child did very little to upset that consensus.

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