Eroticisation as a defence against separation

This article is a description of a three-year psychotherapy treatment of John, a seventeen-year-old boy, who presented with gender dysphoric feelings. I discuss his erotised use of dressing up in female clothes and his wish to provoke me into criticising him and link this to my countertransference experiences in order to identify the predominant defensive manoeuvres employed by my patient to distance himself from feelings of disappointment and loss.