{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T06:49:50Z","timestamp":1782802190382,"version":"3.54.5"},"reference-count":101,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T00:00:00Z","timestamp":1412121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Am Psychoanal Assoc"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:p>This paper introduces the concept of massive gender trauma, a clinical syndrome arising at the onerous intersection of the misgendering of transgender patients and the subjective, anguished experience of the natal body. Analysts have become increasingly aware in recent years of the complex interactions between psyche, soma, and culture. Consequently, the field is increasingly hospitable to considering the psychic risks inherent in misgendering. However, patients\u2019 body dysphoria is often left unaddressed even by analysts who seek to work within their analysands\u2019 gendered experience. Through a detailed, in-depth account of work with a five-year-old trans girl (female-identified, male-bodied), the developmental implications of the natal body\u2019s not becoming sufficiently mentalized in the course of treatment are tracked and explored. Attention to unconscious fantasy and its transformations shows the importance of helping transgender patients whose bodies are a source of suffering to be able to psychically represent their pain as a critical step in the process of a psychologically healthy transition.<\/jats:p>","DOI":"10.1177\/0003065114553102","type":"journal-article","created":{"date-parts":[[2014,10,2]],"date-time":"2014-10-02T22:01:18Z","timestamp":1412287278000},"page":"773-806","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":107,"title":["Mourning the Body as Bedrock"],"prefix":"10.1177","volume":"62","author":[{"given":"Avgi","family":"Saketopoulou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,10,2]]},"reference":[{"key":"bibr1-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1177\/1359104508096773"},{"key":"bibr2-0003065114553102","first-page":"1","volume-title":"Transvestism, Transsexualism in the Psychoanalytic Dimension","author":"Argentieri S.","year":"2009"},{"key":"bibr3-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1177\/1359104512460621"},{"key":"bibr4-0003065114553102","volume-title":"The Transsexual Phenomenon","author":"Benjamin H.","year":"1977"},{"key":"bibr5-0003065114553102","volume-title":"Second Thoughts: Selected Papers on Psychoanalysis","author":"Bion W.R.","year":"1967"},{"key":"bibr6-0003065114553102","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301241"},{"key":"bibr7-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/15532739.2011.623652"},{"key":"bibr8-0003065114553102","volume-title":"The Transgender Child: A Handbook for Families and Professionals","author":"Brill S.","year":"2008"},{"key":"bibr9-0003065114553102","volume-title":"Bodies That Matter: On the Discursive Limits of \u201cSex.\u201d","author":"Butler J.","year":"1993"},{"key":"bibr10-0003065114553102","volume-title":"Creativity and Perversion","author":"Chasseguet-Smirgel J.","year":"1985"},{"key":"bibr11-0003065114553102","volume-title":"The Melancholy of Race: Psychoanalysis, Assimilation, and Hidden Grief","author":"Cheng A.A.","year":"2001"},{"key":"bibr12-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1516\/0020757001599483"},{"key":"bibr13-0003065114553102","first-page":"41","volume-title":"Transvestism, Transsexualism in the Psychoanalytic Dimension","author":"Chiland C.","year":"2009"},{"key":"bibr14-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/10481889509539066"},{"key":"bibr15-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1521\/jaap.1.1990.18.3.414"},{"key":"bibr16-0003065114553102","first-page":"103","volume-title":"Identity, Gender, and Sexuality: 150 Years after Freud","author":"Coates S.","year":"2006"},{"key":"bibr17-0003065114553102","first-page":"39","volume-title":"A Stranger in My Own Body: Atypical Gender Identity Development and Mental Health","author":"Coates S.","year":"1998"},{"key":"bibr18-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1023\/A:1021769215342"},{"key":"bibr19-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-011-9758-9"},{"key":"bibr20-0003065114553102","first-page":"429","volume":"1","author":"Corbett K.","year":"1996","journal-title":"Gender & Psychoanalysis"},{"key":"bibr21-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/10481880802473381"},{"key":"bibr22-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/10481880903088484"},{"key":"bibr23-0003065114553102","volume-title":"Boyhoods: Rethinking Masculinities","author":"Corbett K.","year":"2011"},{"key":"bibr24-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1002\/j.2167-4086.2011.tb00092.x"},{"key":"bibr25-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1007\/BF01542316"},{"key":"bibr26-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/15532739.2011.675233"},{"key":"bibr27-0003065114553102","first-page":"7","volume-title":"Treating Transgender Children and Adolescents: An Interdisciplinary Discussion","author":"de Vries A.L.C.","year":"2013"},{"key":"bibr28-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-2958"},{"key":"bibr29-0003065114553102","first-page":"55","volume-title":"Transvestism, Transsexualism in the Psychoanalytic Dimension","author":"di Ceglie D.","year":"2009"},{"key":"bibr30-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/02668734.2012.743226"},{"key":"bibr31-0003065114553102","first-page":"93","volume-title":"The American Psychiatric Association Publishing Textbook of Psychoanalysis","author":"Dimen M.","year":"2005"},{"key":"bibr32-0003065114553102","first-page":"1","volume-title":"Treating Transgender Children and Adolescents: An Interdisciplinary Discussion","author":"Drescher J.","year":"2013"},{"key":"bibr33-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1037\/0012-1649.44.1.34"},{"key":"bibr34-0003065114553102","first-page":"27","volume-title":"Treating Transgender Children and Adolescents: An Interdisciplinary Discussion","author":"Edwards-Lepper L.","year":"2013"},{"key":"bibr35-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1002\/aps.185"},{"key":"bibr36-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1037\/a0023828"},{"key":"bibr37-0003065114553102","volume-title":"Gender Born, Gender Made","author":"Ehrensaft D.","year":"2011"},{"key":"bibr38-0003065114553102","unstructured":"Ehrensaft D. (2012). When talking about children\u2019s gender, words matter. Retrieved March 1, 2012, from: http:\/\/www.huffingtonpost.com\/diane-Ehrensaft-phd\/gender-nonconforming-kids_b_1311204.html?view=print&comm_ref=false"},{"key":"bibr39-0003065114553102","first-page":"43","volume-title":"Treating Transgender Children and Adolescents: An Interdisciplinary Discussion","author":"Ehrensaft D.","year":"2013"},{"key":"bibr40-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/19361653.2012.717474"},{"key":"bibr41-0003065114553102","doi-asserted-by":"publisher","DOI":"10.4324\/9780203822579"},{"key":"bibr42-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1177\/0003065112459956"},{"key":"bibr43-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/10481885.2011.562833"},{"key":"bibr44-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/00223890802108022"},{"key":"bibr45-0003065114553102","doi-asserted-by":"publisher","DOI":"10.2307\/j.ctt1ww3v4c"},{"key":"bibr46-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/10481885.2010.502501"},{"key":"bibr47-0003065114553102","volume-title":"In a Queer Time and Place: Transgender Bodies, Subcultural Lives","author":"Halberstam J.","year":"2005"},{"key":"bibr48-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1300\/J032v12n01_03"},{"key":"bibr49-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/10481885.2011.562846"},{"key":"bibr50-0003065114553102","volume-title":"Paper presented at annual colloquium, Manhattan Institute for Psychoanalysis","author":"Hansbury G.","year":"2013"},{"key":"bibr51-0003065114553102","volume-title":"Gender as Soft Assembly","author":"Harris A.","year":"2005"},{"key":"bibr52-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1177\/000306510505300401"},{"key":"bibr53-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-0345"},{"key":"bibr54-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/19361650903013527"},{"key":"bibr55-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/00797308.1978.11822973"},{"key":"bibr56-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/07351698509533579"},{"key":"bibr57-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/21674086.1974.11926677"},{"key":"bibr58-0003065114553102","volume-title":"Paper presented at the Third Annual Trans Symposium, Institute for Contemporary Psychoanalysis","author":"Langer S.J.","year":"2012"},{"key":"bibr59-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/02668734.2012.732104"},{"key":"bibr60-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-8315.2012.00663.x"},{"key":"bibr61-0003065114553102","volume-title":"Transgender Emergence: Therapeutic Guidelines for Working with Gender-Variant People and Their Families","author":"Lev A.I.","year":"2004"},{"key":"bibr62-0003065114553102","first-page":"139","volume":"6","author":"Limentani A.","year":"1979","journal-title":"International Review of Psychoanalysis"},{"key":"bibr63-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1177\/0003065112468489"},{"key":"bibr64-0003065114553102","unstructured":"Meadow T. (2014). Being a gender: A new conceptual framework. Lecture given at Princeton University, April 2."},{"key":"bibr65-0003065114553102","first-page":"63","volume-title":"Treating Transgender Children and Adolescents: An Interdisciplinary Discussion","author":"Menvielle E.","year":"2013"},{"key":"bibr66-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-3696"},{"key":"bibr67-0003065114553102","first-page":"221","volume":"72","author":"Oppenheimer A.","year":"1991","journal-title":"International Journal of Psychoanalysis"},{"key":"bibr68-0003065114553102","first-page":"582","volume":"73","author":"Oppenheimer A.","year":"1992","journal-title":"International Journal of Psychoanalysis"},{"key":"bibr69-0003065114553102","volume-title":"Facial Feminization Surgery: A Guide for the Transgendered Woman","author":"Ousterhout D.K.","year":"2009"},{"key":"bibr70-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1521\/jaap.1.1978.6.3.301"},{"key":"bibr71-0003065114553102","first-page":"139","volume-title":"Identity, Gender, and Sexuality: 150 Years after Freud","author":"Pf\u00e4fflin F.","year":"2006"},{"key":"bibr72-0003065114553102","volume-title":"Paper presented to the American Psychoanalytic Association","author":"Pula J.","year":"2011"},{"key":"bibr73-0003065114553102","volume-title":"Paper presented at the William Alanson White Institute","author":"Pula J.","year":"2013"},{"key":"bibr74-0003065114553102","first-page":"95","volume":"79","author":"Quinodoz D.","year":"1998","journal-title":"International Journal of Psychoanalysis"},{"key":"bibr75-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1516\/7ULG-83LG-PC08-DNTX"},{"key":"bibr76-0003065114553102","first-page":"5","volume":"15","author":"Ramachandran V.S.","year":"2008","journal-title":"Journal of Consciousness Studies"},{"key":"bibr77-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/15532739.2011.622121"},{"key":"bibr78-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/19317611.2011.593932"},{"key":"bibr79-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-1804"},{"key":"bibr80-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/10481885.2011.562845"},{"key":"bibr81-0003065114553102","author":"Saketopoulou A.","year":"2011","journal-title":"DIVISION\/Review"},{"key":"bibr82-0003065114553102","volume-title":"Assuming a Body: Transgender and Rhetorics of Materiality","author":"Salamon G.","year":"2010"},{"key":"bibr83-0003065114553102","volume-title":"Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Femininity","author":"Serano J.","year":"2007"},{"key":"bibr84-0003065114553102","volume-title":"Excluded: Making Feminist and Queer Movements Inclusive","author":"Serano J.","year":"2013"},{"key":"bibr85-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291704002776"},{"key":"bibr86-0003065114553102","first-page":"341","volume":"51","author":"Socarides C.W.","year":"1970","journal-title":"International Journal of Psychoanalysis"},{"key":"bibr87-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-0907"},{"key":"bibr88-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-011-9752-2"},{"key":"bibr89-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1177\/1359104510378303"},{"key":"bibr90-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/10481889509539065"},{"key":"bibr91-0003065114553102","first-page":"46","volume-title":"Clinical Lectures on Klein and Bion","author":"Steiner J.","year":"1992"},{"key":"bibr92-0003065114553102","volume-title":"Presentations of Gender","author":"Stoller R.J.","year":"1985"},{"key":"bibr93-0003065114553102","volume-title":"Splitting: A Case of Female Masculinity","author":"Stoller R.J.","year":"1997"},{"key":"bibr94-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1080\/10481885.2011.562842"},{"key":"bibr95-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1097\/CHI.0b013e31818956b9"},{"key":"bibr96-0003065114553102","first-page":"89","volume":"34","author":"Winnicott D.W.","year":"1953","journal-title":"International Journal of Psychoanalysis"},{"key":"bibr97-0003065114553102","first-page":"16","volume":"36","author":"Winnicott D.W.","year":"1955","journal-title":"International Journal of Psychoanalysis"},{"key":"bibr98-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1177\/1359104500005002007"},{"key":"bibr99-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1037\/a0016125"},{"key":"bibr100-0003065114553102","doi-asserted-by":"publisher","DOI":"10.1177\/1359104502007003007"},{"key":"bibr101-0003065114553102","first-page":"75","volume-title":"Treating Transgender Children and Adolescents: An Interdisciplinary Discussion","author":"Zucker K.J.","year":"2013"}],"container-title":["Journal of the American Psychoanalytic Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0003065114553102","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0003065114553102","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0003065114553102","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:37:34Z","timestamp":1777376254000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0003065114553102"}},"subtitle":["Developmental Considerations in Treating Transsexual Patients Analytically"],"short-title":[],"issued":{"date-parts":[[2014,10]]},"references-count":101,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["10.1177\/0003065114553102"],"URL":"https:\/\/doi.org\/10.1177\/0003065114553102","relation":{},"ISSN":["0003-0651","1941-2460"],"issn-type":[{"value":"0003-0651","type":"print"},{"value":"1941-2460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10]]}}}