Fantasy and Feminity—a Pattern in Sex Deviation

This paper deals with unmual set of psychiatric patients who basically sought help for depression. The cases were gathered from Community Mental Health Centre, Hyderabad (2 cases) and from Government Hospital for mental care, Vishakhapatnam (2 cases). All four patients were males who were basically diagnosed as transexuals. Their age range was between 18 and 25. Clinically, associated with depressive symptomatology they also had varying degrees of sleep disturbances, dreams of sex change and sexual involvement , nocturnal emission, masturbation and homosexuality along with somatic and hypo-chondriacal preoccupation. Also these cases weie reported to have enjoyed cross dressing even in social gatherings. Following clinical assessment all the four patients were given a set of psychological tests to assess their intelligence and personality structure. Most of the patients were found to be average in intelligence while one showed slightly below average I.Q_. and another had superior intelligence (Benders and Ravens). Personality tests (MMPI, T.A:T., Rorschach) uniformly revealed social isolation, parent child discord , inadequate and emotionally deprived families, overt homosexuality, transvestic activily, fantasy of flight into feminity and autoerotic activity along with predominant heterosexual panic. Two of the patients had attempted heterosexual coitus and had psychogenic impotency. Detailed inquiry into sex activity revealed all were homosexuals, they being the passive partners during the act. All were enjoying the fantasy of feminity and being with attractive handsome males while engaged in masturbation. One of these patients had an excessive desire for cunni-lingus and his heterosexual contact ended in fellatio and disruption of marriage. One of the patients was of the opinion that he would be satisfied if he could be transformed into a "female" by surgical intervention. CASE ILLUSTRATIONS Case-I : A 25 years old, married but separated biological male from a middle class Hindu family and photographer by occupation had presented with acute depression and one suicidal attempt. He was stout, stalky and walked with feminine gait. He was shy, aloof, preferred to be left alone and cried easily. As a youngster he had masturbated. He played many feminine roles in the school and enjoyed dressing like females. He had homosexual involvement as a passive partner with his brother and had developed depression and despondency following the separation from his homosexual partner which had ultimately led to his leaving the job. After persuation for a period of one year l.e got married to a girl. He obtained a firm promise from …