Table Of Content‘The clinical and ethical reflections contained in this book, the outcome
of over ten years of clinical work with transgender individuals, invite
us to think about the body and its unconscious identifications. One of
Alessandra Lemma’s fundamental premises is that the understanding of
the internal world of transgender individuals casts light on the subjective
experience of embodiment. Psychoanalysis, in the words of Winnicott,
does not “. . . take for granted the lodgment of the psyche in the body”: it
sees it, instead, as “. . . an achievement”. In this profound book Alessandra
Lemma underlines the relevance of the heterogeneity of pathways to
the understanding of transgender as it encompasses a range of lived
experiences. This deeply sensitive book, which also displays examples
of her clinical work, will be a valuable resource for all those interested in
exploring this complex area.’
Rosine Perelberg, President of the British Psychoanalytical
Society, author of Sexuality, Excess and Representation
and editor of Psychic Bisexuality
‘There could not be a more appropriate, indeed urgently needed, time for a
serious, empathic consideration of transgender identity. As cultural norms
are dramatically shifting and identity politics are often highly polarized, it
is both an act of courage and clinical sophistication for Professor Lemma
to ask simply and directly how individuals find a “hospitable home” in
their bodies. From that simple but profound question comes a call for
a respectfully challenging consideration of how we can clinically do
better for those individuals with transgender identity and at the same
time, encourage a more tolerant, accepting society for all. This is a book
clinicians working with adolescents and young adults in our contemporary
culture cannot afford to pass by for it necessarily challenges day to day
practice around transgender identity.’
Professor Linda Mayes, Arnold Gesell Professor, Yale Child Study
Center, Yale School of Medicine
Transgender Identities
This important new book by Alessandra Lemma provides a succinct
overview of psychoanalytic understandings, approaches and controversies
around transgender identifications.
Illustrated with case vignettes, Lemma provides an up-to-date
synthesis of current research and a critical overview of psychoanalytic
approaches to transgender identities, distilling some of the contemporary
controversies about how to approach the topic in the consulting room.
Lemma also outlines a psychoanalytically informed ethical framework
to support clinicians working with individuals who request medical
transitioning and distils the ethical challenges faced by clinicians in light
of the current emphasis on gender affirmative care.
Part of the Routledge Introductions to Contemporary Psychoanalysis
series, this book is of great importance for psychoanalysts in practice,
academics and all those with an interest in transgender identities and
mental health.
Alessandra Lemma is Fellow of the British Psychoanalytical Society
and Consultant Clinical Psychologist at the Anna Freud National Centre
for Children and Families. She is Visiting Professor, Psychoanalysis Unit,
University College London. For many years she worked at the Tavistock
Clinic where she was, at different points, Head of Psychology and Professor
of Psychological Therapies (in conjunction with Essex University). Until
2020, she was Editor of the New Library of Psychoanalysis book series
(Routledge) and was one of the regional editors for the International
Journal of Psychoanalysis until 2018. She has published extensively on
psychoanalysis, the body and trauma.
Routledge Introductions to
Contemporary Psychoanalysis
Aner Govrin
Series Editor
Tair Caspi
Associate Editor
Books in the Routledge Introductions to Contemporary Psychoanalysis
will serve as concise introductions dedicated to influential concepts,
theories, leading figures, and techniques in psychoanalysis.
The length of each book is fixed at 40,000 words.
The series’ books are designed to be easily accessible so as to provide
informative answers in various areas of psychoanalytic thought. Each book will
provide updated ideas on topics relevant to contemporary psychoanalysis – from
the unconscious and dreams, projective identification and eating disorders, through
neuropsychoanalysis, colonialism and spiritual-sensitive psychoanalysis. Books
will also be dedicated to prominent figures in the field, such as Melanie Klein,
Jaque Lacan, Sandor Ferenczi, Otto Kernberg and Michael Eigen.
Not serving solely as an introduction for beginners, the purpose of the
series is to offer compendiums of information on particular topics within
different psychoanalytic schools. We ask authors to review a topic but
also address the readers with their own personal views and contribution to
the specific chosen field. Books will make intricate ideas comprehensible
without compromising their complexity.
We aim to make contemporary psychoanalysis more accessible to both
clinicians and the general educated public.
Published Titles
Projective Identification
A Contemporary Introduction
Robert Waska
Donald Meltzer
A Contemporary Introduction
Meg Harris Williams
Transgender Identities
A Contemporary Introduction
Alessandra Lemma
Cover Image: © Michal Heiman, Asylum 1855-2020,
The Sleeper (video, psychoanalytic sofa and Plate 34),
exhibition view, Herzliya Museum of Contemporary
Art, 2017
First published 2022
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
605 Third Avenue, New York, NY 10158
Routledge is an imprint of the Taylor & Francis Group, an informa
business
© 2022 Alessandra Lemma
The right of Alessandra Lemma to be identified as author of
this work has been asserted in accordance with sections 77
and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted
or reproduced or utilised in any form or by any electronic,
mechanical, or other means, now known or hereafter
invented, including photocopying and recording, or in any
information storage or retrieval system, without permission
in writing from the publishers.
Trademark notice: Product or corporate names may be
trademarks or registered trademarks, and are used only for
identification and explanation without intent to infringe.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British
Library
Library of Congress Cataloging-in-Publication Data
A catalog record for this book has been requested
ISBN: 978-0-367-54822-3 (hbk)
ISBN: 978-0-367-54824-7 (pbk)
ISBN: 978-1-003-09072-4 (ebk)
DOI: 10.4324/9781003090724
Typeset in Times New Roman
by Apex CoVantage, LLC
To Andy
Contents
Acknowledgments x
Introduction: identity in modern times 1
1 Research perspectives on transgender 14
2 Understanding transgender: controversies
and challenges 25
3 Arriving at the body 36
4 Trans-itory identities? Adolescent
development, gender and identity 61
5 Towards a psychoanalytic ethics-based
practice with transgender individuals 89
Conclusion: keeping the body in mind 107
Bibliography 114
Index 132
