Julie was afraid to be a woman. She dressed in shapeless, mannish
clothing to conceal her body. She had started doing this when she
was a teenager. Although her adult sexual history included genital
encounters with both men and women, her arousal response was
definitely heterosexual. Her discomfort with her genitals was predi-
cated on the fear that as a female she was vulnerable, not only to
sexual assault, but to ridicule and abuse as well.

Her psychosexual disorder had its roots in confused childish per-
ceptions of what men and women are supposed to be. Her father
was an abusive alcoholic; her mother was a stereotypic ineffectual
woman, who took refuge in female role behavior to protect herself
from her husband. Neither were acceptable role models for Julie.

As a child, Julie had witnessed repeated situations in which her
father berated her mother for not cleaning the house or not prepar-
ing food appropriately. He would ridicule her mother's efforts to
"do it right" or to please him, and he would curse, push, and slap
her. These incidents usually ended with him leaving the house and
being gone for several hours, frequently all night. Julie remem-
bered hearing her mother pleading with him not to go.

Recalling one time when her parents were naked, she witnessed
an argument and subsequent struggle in the hallway outside their
bedroom. It was the first time Julie had seen the contrast in male
and female genitalia. She reported taking off her clothing also and

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