All proponents of multi-causal explanations of transsexuality developed their concepts by taking into consideration theories and findings in US-American research on transsexuality.4 Schorsch (1974), Sigusch, Meyenburg and Reiche (1979) and Kockott (1978) for instance discussed Stoller’s assumption that par-ticular family constellations induce transsexuality. However, they arrived at dif-ferent conclusions.
According to Stoller, family dynamics that trigger a transsexual identity are different for male and female children (Stoller 1972: 62; cf. Sigusch/Mey-enburg/Reiche 1979: 256). The male child is believed to grow up in a setting that is shaped by a symbiotic mother/son-relationship and a psychologically ab-sent father (Stoller 1968: 125). Driven by »penis envy«, the mother encourages feminine traits in her child and the father »does not interrupt the process of the son’s feminization« (Stoller 1968: 138; cf. Sigusch/Meyenburg/Reiche 1979:
255).
With regard to the female transsexual-to-be, Stoller observed that the moth-er is in poor health, depressed and barely attends to hmoth-er child. The masculine father distances himself from the mother and the family. The daughter has to stand in for the father at a very early age in life and is not encouraged to develop a female mode of behaviour (Stoller 1972: 50; cf. Sigusch/Meyenburg/Reiche 1979: 256; Schorsch 1974: 198; Eicher 1976: 42).
While Schorsch relied on Stoller’s concept (Schorsch 1974: 197), Sigusch, Meyenburg and Reiche (1979), and Kockott (1978) refuted Stoller’s notion of a particular family constellation that pertains to a transsexual development.
While the former did not doubt that certain family constellations are found more frequently among transsexual individuals, they questioned that there was a typical mother-child or parent-child constellation (Sigusch/Meyenburg/Re-4 | For a comprehensive account of US-American approaches see Meyerowitz 200(Sigusch/Meyenburg/Re-4: 98-129 and Weiß 2009: 266-305.
iche 1979: 274). Kockott did not detect any particular family structure among his patients (Kockott 1978: 48).
Several authors discussed Money’s findings. Eicher e. g. referred to Money, Hampson and Hampson’s assumptions on gender role development in intersex individuals (Money/Hampson/Hampson 1957) to underline the importance of socialisation for the development of a gender identity, regardless of the indi-vidual’s chromosomal, hormonal and phenotypical status (Eicher 1976: 42).
Schorsch’s concept was influenced by Money and Ehrhardt (1972), Green (1969) and Pauly (1969; 1969a), among others. The latter suggested that transsexual individuals’ gender identity is fixed in early childhood (Money/Ehrhardt 1972:
16 f.; Green 1969: 34; Pauly 1969: 57; 1969a: 86). By that time, the child behaves according to the ›other‹ sex/gender (Schorsch 1974: 197).
The psychoanalysts Socarides, Person and Ovesey inspired Sigusch, Mey-enburg and Reiche’s concept of transsexuality. The latter developed their con-cept of transsexuality by discussing and comparing the psychoanalysts’ per-spectives with their clinical observations.
Socarides considered transsexuality a perversion, which develops because transsexual individuals are unable to pass the symbiotic and individuation phase of early childhood successfully (Socarides 1970: 348; cf. Sigusch/Meyen-burg/Reiche 1979: 253). While Sigusch, Meyenburg and Reiche disagreed with Socarides’ therapeutic approach,5 they picked up the notion of transsexuality as a perversion. According to this concept, transsexuality features as a particularly early and with that complete attempt at restitution which, unlike other perver-sions, is assumed to occur at such an early stage of a child’s development that sexualisation is precluded. The authors used this assumption to explain their clinical observation that transsexual individuals were asexual (Sigusch/Meyen-burg/Reiche 1979: 270).
While Person and Ovesey suggested that transsexuality is caused by similar factors, they classified transsexuality as a borderline pathology (Person/Ove-sey 1974: 19; cf. Sigusch/Meyenburg/Reiche 1979: 254). Sigusch, Meyenburg and Reiche considered this classification convincing, because it was congruent with their clinical observation that splitting mechanisms, which are typical of borderline pathologies, occur in transsexual individuals, too: The »desire for a sex change [is] in a way the sum of manoeuvres that are organised around split-ting« (Sigusch/Meyenburg/Reiche 1979: 269).
5 | Socarides disapproved of hormonal and surgical treatment of transsexual indivi-duals. To him, such measures sanction the »transsexual’s pathological view of reality and cannot solve the underlying conflict« (Socarides 1969: 1419; cf. Sigusch/Meyenburg/
Reiche 1979: 254).
However, Sigusch, Meyenburg and Reiche disagreed with Person and Ove-sey’s distinction between primary and secondary transsexuality.6 According to Person and Ovesey, primary transsexuality is caused by a severe disorder of the core gender identity in early childhood (Person/Ovesey 1974: 5; cf. Sigusch/
Meyenburg/Reiche 1979: 257). The category of secondary transsexuality is com-prised of formerly effeminate homosexual individuals and transvestites. The latter are assumed to desire a medical transition after experiencing extremely stressful situations. These situations spark a psychodynamic process that pre-vents the respective person from maintaining his or her emotional equilib-rium. As a result, the individual is believed to fall back upon an early childhood fantasy (Person/Ovesey 1974a: 192; cf. Sigusch/Meyenburg/Reiche 1979: 258).
At this point Sigusch, Meyenburg and Reiche abandoned the psychoanalyti-cal framework and turned to a historipsychoanalyti-cal perspective. They argued that social and cultural factors shape the formation of symptoms. Hence, the point in time when an individual wishes to transition depends on aspects such as the de-velopment of medical technology, sex morals and the media. They supported this argument with their clinical observation that transvestites have become increasingly rare in sexual medical offices and so-called secondary transsexu-als visit sexologists’ offices more frequently (Sigusch/Meyenburg/Reiche 1979:
272).
2.1.2 Developments in the treatment of transsexual individuals
Just as US approaches to transsexuality left a deep imprint on the West German sexological debate of the 1970s, so did US developments in the management and therapy of the subjects.7 US influence figured strongly in surgery as the therapeutic route, the interdisciplinary organisation of the treatment oftrans-6 | However, other authors, such as e. g. Spengler, categorised transsexual individuals according to Person and Ovesey’s distinction between the two types of transsexuals (Spengler 1980: 102).
7 | In June 1969, the German Association on Sex Research invited Money and Ehrhardt to give a paper at the 10th scientific congress featuring their experiences with the diagnostic and surgical programme at Johns Hopkins Hospital in Baltimore. Money and Ehrhardt’s report was published in the association’s conference proceedings (Money/Ehrhardt 1970). West German sexologists continued to refer to the findings in this publication throughout the 1970s. In addition, Benjamin’s commitment to transsexual patients and sex reassignment surgery deeply impressed sexologists in the Federal Republic of Germany (Sigusch 1991a: 227 f.). Several sexologists relied on his observations. On one occasion, Eicher e. g. stated that, »[t]he surgical method is undisputed nowadays. Benjamin (1954) is unaware of any case where an intensive and long psychoanalysis would have been successful and considers the attempt a waste of time« (Eicher 1976: 44).
sexual individuals, extensive diagnostic measures and strict guidelines for an indication for surgery. These trends are mirrored in Sigusch, Meyenburg and Reiche’s comprehensive and influential programme of treatment that appeared in 1979 as well as in several other programmes of the time.