The Sexual Politics of Clinical Psychoanalysis and Transgender Mental Health

Perversion is derived from the Latin pervertere which means to turn around and has been broadly conceptualized as that which deviates or wavers from an original course. One could argue that the perverse is fundamentally constructed through difference; its existence is predicated upon being set up against some norm and its eccentricity is maintained through a continued refusal to adhere to the rule. This dissertation explores questions of gender difference and sexual deviance as they relate to the clinical pathologization of transgender peoples mental health. In particular, it considers how psychoanalytic theories of perversion – in their multifaceted definitions and various clinical applications – can be usefully employed to understand transphobia as it emerges throughout psychiatric institutions. In borrowing from Freuds polymorphous perversity, fetishism, perverse defense, and Lacans perverse structure, this study both contributes to and moves beyond a genealogical account of transgender peoples relationship to psychoanalysis. It uniquely considers the psychical provocations behind clinicians anxious descriptions and treatments of gender variance, as they have emerged since transsexuals nosological coinage in the early 20th century. By combining two disparate contemporary fields of study – psychoanalysis and transgender studies – this project also asks how transgender people may re-narrate their relationship to the perverse. To do so, this research investigates many under-considered objects of study, including surrealist transsexual drawings from the mid 1900s, lineages of psychiatric taxonomies, science fiction literature, contemporary transgender art installations, autoethno-pornographic transition narratives, and transgender accounts of undergoing psychoanalytic psychotherapy. Through a combination of critical historiographies, discourse analysis, content analysis, and narrative research, this dissertation contributes to a rapidly emerging non-pathological conversation about the psychic life of gender variance, both for transgender people themselves and the mental health institutions that serve them. Ultimately, it finds perversion to be quite useful as a floating signifier, as its various theoretical containers and clinical meanings are employed to deconstruct institutionalized transphobias tenacity. Furthermore, this research centers an archive of historically neglected transgender narratives on mental health as they emerge in the clinic, through case study, and in art or aesthetics.

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