In defense of Other psychoanalysis: on the real in at issue in transsexual solutions¹

Abstract

The logic of sexuation, by Jacques Lacan, is presented in opposition to the notion of gender, constructed as the matrix for transsexuality intelligibility. The Lacanian approach of sinthome is developed as an alternative to think on singular solutions for sexual impasses, through the depathologization bias. It is concluded that transsexuality, instead of an inescapable psychotic forcing, may be an inventive solution coordinated to the clinic of the sinthome.

Keywords:
transsexualism; psychoanalysis; Jacques Lacan

Resumo

Apresenta-se a lógica da sexuação, de Jacques Lacan, em contraposição à noção de gênero, construída como matriz de inteligibilidade da transexualidade. Desenvolve-se a abordagem lacaniana do sinthome como alternativa para se pensar soluções singulares aos impasses sexuais pelo viés da despatologização. Conclui-se que a transexualidade, em vez de inelutável forçamento psicótico, pode ser uma solução inventiva articulada à clínica do sinthome.

Palavras-chave:
transexualismo; psicanálise; Jacques Lacan

Résumé

On présente la logique de la sexuation de Jacques Lacan en opposition à la notion de genre, érigée en matrice de l’intelligibilité de la transsexualité. L’approche lacanienne du sinthome est développée comme une alternative afin de penser à des solutions uniques aux impasses sexuelles, a travers le biais de la dépatologisation. On conclut que la transsexualité, au lieu du forçage psychotique inéluctable, peut être une solution inventive articulée à la clinique du sinthome.

Mots-clès:
transsexualisme; psychanalyse; Jacques Lacan

Resumen

Se presenta la lógica de la sexuación de Jacques Lacan en contraposición a la noción de género, construida como matriz de inteligibilidad de la transexualidad. Se desarrolla el abordaje lacaniano del sinthome como una alternativa para pensar soluciones singulares a los impasses sexuales, por el sesgo de la despatologización. Se concluye que la transexualidad, en vez de ineluctable forzamiento psicótico, puede ser una solución inventiva articulada a la clínica del sinthome.

Palabras clave:
transexualismo; psicoanálisis; Jacques Lacan

Western thinking is impregnated by a certain scientific realism that understands the categories men and women as “natural kinds”, substantialized by their own intrinsic biological characteristics. Drying out this fateful bias (the idea of biology as destiny) corresponded to the invention, in 1957, and dissemination, in 1968, of the notion of gender, respectively by John Money and Robert Stoller. This allowed for a plural interpretation of sex. There is a discontinuity between the body’s sex and the culturally constructed genders, so that men and women ceased to be determined by nature to become human artifices; that is, men and women became social constructions of gender over the biological sex. On the one hand, there is the natural impression of sex, biologically inherited (innate), on the other, the artificial expression of gender, socially inherited (acquired). Sex and gender may converge or not. In case of mismatching, the gender will prevail - the intimate feeling of identitarian belonging - over the biological sex, as it happens, for example, in transsexuality. For Stoller, who, besides being a psychiatric, was also a psychoanalyst with a culturalist bias, nurture prevails over nature, and constructivism triumphs over essentialism. Consolidating the disjunction between sex and gender, Stoller disseminates the later as an unstable object, an “artificial kind”, with a pluralization² that has been studied by the so-called “gender studies”. These studies are inserted in the tradition of feminist and post-colonial studies in English, according to an epistemological perspective that understands gender as a mechanism of social oppression from which it is necessary to emancipate oneself. For that, a political project is constructed with a device composed, as a general rule, by militant activism (feminist, queer, etc.), focused on deconstructing the instituted genders, which mirrors the U.S. triumphant reception to French theory - specially Foucault, Derrida, and Deleuze. Its main representants are Gayle Rubin, Monique Wittig, Judith Butler, and Eve Kossofsky Sedwick in the United States; Luce Irigaray, Didier Eribon, Éric Fassin, and Marie-Hélène Bourcier, in France (Fajnwaks, 2015, pp. 20, 24). Berger (2013) indicates that the current French reception to gender studies receives novelty colors, being just as or more triumphant that the former U.S. reception to French theory that originated it, a phenomenon described by her as a massive intellectual countertransference on an American ideal-self (p. 113). In Brazil, theoreticians such as Berenice Bento and Guacira Lopes Louro, among others, are highlighted.

According to Leguil (2015), what characterizes the singularity of Lacanian psychoanalysis is that its position is neither favorable nor opposed to gender (p. 52); this notion simply does not address the point of the real (out of the norm: injunction of jouissance) that is of interest to Lacan and, thus, is not clinically useful, although its importance and legitimacy as a political strategy are recognized. According to the Lacanian approach used in this work, directed towards the real, the jouissance expressed through the logic of sexuation is more important than the semblants of gender, guided by the imaginary and symbolical dimensions, attached to the social Other. Therefore, we will deal with sexuation, since an analysis compels the subject to take on the singularity of their own jouissance beings, the node of their sinthome. Psychoanalysis, as a real science, is connected to what, in each subject and each case, regardless of their orientation [semblants of gender], remains impossible to utter, resisting all formulations (Bourlez, 2015, pp. 102-103). Here, transsexuality will be focused by this point of view.

Stoller’s critique to gender in light of Lacanian sexuation

It is important to highlight that the disjunction disseminated by Stoller between sex and gender prevails up to today, being used as guideline for the practices of medicalization and judicialization transsexuality. Therefore, such disjunction is reproduced by the Resolution 1.955/10 of the Brazilian Federal Medicine Council, which disposes about the sex reassignment surgery (SRS), just as by the Law operators in Brazil when dealing with the demands for register rectification by transsexual people (Moura, 2016, p. 39). Besides that, when reviewing the literature of the IPA’s psychoanalytical orthodoxy, Bulamah and Kupermann (2016) indicate that all psychoanalysts who published reports of analyses with trans patients have positioned themselves regarding Robert Stoller’s ideas (p. 75). This means taking Stoller initially as a privileged interlocutor, given that, even though Lacan (1970-1971/2009, p. 30), in his Seminars, book XVIII, recommends reading Sex and gender (Stoller, 1968), which was then recently published, his theoretical perspectives are not to be mistaken. Let us see.

Stoller’s gender identity, as indicated by Morel (2012), is the intimate conviction of a subject regarding their sex (p. 46). It is a kind of ontology, the search for a nucleus of the being, strong than anything, that the subject receives from the Other (p. 177). Gender is thus a kind of true sexual soul of the subject (p. 186). According to Stoller, when developing sexuality, there would be an almost unmistakable individual subjection to the determinations by the social Other, indicative of the gender binarism: whatever the biological determinants of sex are, we have converted ourselves into members of the sex we have been designated to (Morel, 2012, p. 76).

This Stollerian perspective considers, in the process of sexuation, only its two first moments, namely, the time one of anatomy and time two of the sexual discourse, but not the third one, which corresponds to the unconscious election of sex by the subject during childhood. These three times correspond to conceptual phases (and logics) of the sexuation process, and not to a temporal evolution. Time one is the time of natural anatomy, which is a real one. The second time, of the sexual discourse, is the one in which the first is interpreted by the surrounding discourse. Which makes it so in two phallic categories, and the subject then takes a position regarding the phallic function (inscription or forclusive rejection). When one rejects the phallic function, the subject is psychotic; their election of sex, in a third time, may or may not be in accordance with the sex designated to them by the surrounding discourse in the second time. For a subject who has inscribed themselves in the phallic function in this second time, the third one is the moment for electing the sex, all phallic male or not-all phallic female. Such election implies on their jouissance modalities and on their relationship with the other sex. It does not necessarily match the anatomy (time one) nor the sex designated by the surrounding discourse (time two) (Morel, 2012, p. 162).

In the sexuation process, besides the anatomy (time 1) and the semblant of gender (time 2), there are the jouissance modality (time 3), which is the last subjective criteria of truth in Lacanian psychoanalysis. The modalities of jouissance phallic and not-all phallic are articulated to the structures of fantasy, on the sexuation formulas proposed by Lacan in his Seminars, book XX (Lacan, 1972-73/2008).

The jouissance of the man side is inscribed in the universal whole of the phallic function as sexual. It is a language jouissance, which implies on the drive renunciation (castration) on behalf of the social bonds and that is articulated to the matheme of fantasy ($ <> a). “Each subject must confront themselves to a lack of jouissance, understood as the impossibility of full drive satisfaction. It is not recovered except through the language fictions that enable them to find on the sexed other the jouissance [object a] they lack. For that, there are semblants . . . .” (Miller, 2011, p. 145). On its turn, the jouissance from the woman side is not completely inscribed in the phallic function as sexual, in this sense, it is called not-all phallic. It is “Other jouissance” (or jouissance of the Other), in alterity with the phallic jouissance, which is not reduced to any identifiable trait that could be universalized: it is singular. “What characterizes it is that it is supported by an edgeless set; it is not constructed over a limitation” (Melman, 2000, p. 129). It is a jouissance that is not restricted by the significant, expressed by the infinitude and impossibility to put it down in words. Morel (2012, pp. 156-157), given a literary example of such jouissance, extracted from Jorge Amado’s novel Dona Flor e seus dois maridos (Dona Flor and Her Two Husbands): Dona Flor enjoys, at the same time, the peaceful phallic happiness of her current marriage and of her deceased husband, who appears to her as an incubus, with whom she shares a jouissance that is incomparable to the marital relations with her living husband. This dead, spectral lover is the metaphor of an absence. This imaginary and fantastic figure is Dona Flor’s partner for the Other jouissance.

When describing these two modalities of jouissance, both neurotic ways of inscribing oneself in relation to the phallus, Lacan signs that there is no relation. Hence the Lacanian axiom: there is no sexual relation (Il n’y a pas de rapport sexuel) - as there is no complementarity neither an effective encounter between the sexes. It seems that it is the encounter between a man and a woman, but in truth it is the encounter between a subject and an object a of the fantasy; it seems to be an encounter with a man, but it is the encounter of a not-all woman with the phallus (Brodsky, 2013, p. 37). A woman wants to enjoy her partner’s body recovering the phallic organ as the significant she extracts from it. But the phallus, far from copulating, is an obstacle (Laurent, 2015, p. 148); if she experiences a female orgasm, this jouissance is not placed in an organ, neither can it be shared, being a body happening (événement de corps) that overflows the woman’s body. The sexual partnership is determined by the fundamental fantasy, which makes each person able to extract from another body - or its own body - a modality of jouissance that makes social bonds. The impossibility of sexual relations is the paradigm of Lacan’s later teaching (Gerbase, 2008).

The main Lacanian idea comprised in the sexuation is that identifications - coming from the imaginary or the symbolic - are not enough to cover the real in the subject’s relation to sex, which is only apprehended through jouissance and fantasy. Hence the fact that Lacan resorted to the modern Logic, not without subverting it, as it was his habit when appropriating from other sets of knowledge, exactly to surpass the Aristotelian class and attribute Logic, which substantializes identities into fixed categories³. Therefore, it is a crass error to read the sexuation formulas as if Lacan were substantializing the categories men and women and naturalizing the gender binarism around male and female. Men and women in psychoanalysis have nothing to do with the anatomic sex nor with gender roles. As indicated by Soler (2005),

a man is a subject entirely submitted to the phallic function. Due to that, castration is his destiny, just as the phallic jouissance, which he access through the fantasy. A woman, on the contrary, is the Other, a subject that is not completely submitted to the regime of phallic jouissance and who has a supplementary jouissance, without the support of any object or semblant (p. 138).

Moreover, the “not-all” quantifier itself, present on the female side of the formulas of sexuation, incarnates the anti-identification essentially as there is not the “at least one” necessary to found an identification through a significant trait. In this sense, “The woman” does not exist (written as a crossed The, to mark that the negation falls upon the definite article and not on the substantive woman), given that there is no exception to the phallic function that fuses the women set as a whole and “The woman” as an universal concept. This happens due to the inexistence of a significant of woman in the unconscious, which confer to femininity an Unheimliche character, of absolute alterity as Other sex.

When re-reading two clinical cases of intersexuality - described by Fairbairn and Stoller - only discovered during puberty, Morel (2012, pp. 165-179) highlights that new gender designations imputed to both by the social Other (actualization of the time 2 of sexuation) did not change, as expected, the previous sex election referring to the modalities of jouissance taken on by the subjects during childhood (time 3 of sexuation). The biological ‘anomaly’ does not seem to have affected decisively the sexuation, and the announcement done to the subjects regarding their anomaly has reinforced the directions previously taken (Morel, 2012, p. 178). These two clinical frames relativize the suppositions on the inevitable inculcation of the sexual discourse on pacified subjects, as insinuated by Stoller.

In sum, the identification, despite being important, are not enough to stablish the sexuation of a subject, who taken on an active role on this process.

In the complex process of sexuation, there is room for unconscious decisions in times two and three. Without this responsibility quota, as subtle it may be in comparison to the real and symbolic restrictions over the subject, psychoanalysis would be the adaptation to the worse. (Morel, 2012, p. 266)

There is a real at stake in psychoanalysis, which, despite being accessed only through the utterances of a subject, does not coincide to them. One must face a work of decantation, deduction and demonstration before affirming which is the sexual position of a subject (Morel, 2012, p. 143).

the psychoanalysis of neurotic subjects, when taken sufficiently far, shows that the subject makes jouissance options very early, which then denotate a sex election. For example, in the case of girls, the adoption of a position of father’s object, sometimes close to incest, be it in fantasy or reality as the response of a trauma, may be much more potent and determining for the subject’s femininity than hystericizing virile identifications that may contradict this position. (Morel 2012, p. 200)

Morel’s affirmation shows that, in psychoanalysis, it is more important the jouissance being of the girl than the feminine masquerade performed by her through virilizing identification, which serve to “conceal its lack” (Lacan, 1958/1998, p. 701). Although the masquerade is not an attribute exclusive to women, Lacan (1970-71/2009) affirms that women have a great freedom with the semblant. They can even confer weight to a man that has none (p. 34). Thus, the masquerade characteristic to the comedy of the sexes (Lacan 1958/1998), in the current context of pluralization of gender semblants, is much more important for the militant activism than to the Lacanian psychoanalytical clinic⁴.

Berger (2015) indicates that in the Anglophone and Francophone worlds - just as in Brazil, which is strongly influenced by both, we add -, there is a tendency to separate both epistemological traditions, which cause political divergences: a thinking tradition that takes as its object or starting point the sexual difference, and a thinking tradition that is interested not on sexual difference but on gender (p. 129). This author also affirms that this epistemological separation between two paradigms (of sexual difference and gender) is less characteristic in the German-speaking world, due to particularities of the German language.

In the Lacanian psychoanalytical clinic, beyond gender semblants (LGBTTQI… ∞), what is at stake is the singular encounter of each person with the sexual enigma: there is something that does not fit, that does not work, that fails… Sex is then understood not as referring to an ideality, but in its a-sexuality, that is, “around the chiasma of the singular encounter with object a, extracted from the body” (Laurent, 2015, p. 154). To consider the impossibility of the sexual relation - avoiding applying a previous epistemology to the field of drive (Trieb) - is what characterizes the psychoanalytical ethics. According to it, there is no good sexual identification, neither ideal sexual partnership, that is, there is no comfort when dealing with the sexual.

As pointed out by Fajnwaks (2015), “the subversive capacity of psychoanalysis lies mainly on the fact that Lacan has not theorized psychoanalysis in terms of genders, but in terms of jouissance” (p. 26). To the point that Lacan (1960-70/19992) has called his perspective “field of jouissance” - which is equivalent to the field of the real, of the lawless, of the non-sense. It corresponds to the economic (quantitative) dimension of the psychic life, approached by Freud through thermodynamics, in which the drive and libido are highlighted. The subject, “even in the best of worlds, will have to face the repetition of an element refusing all positivity, an excessive shadow refusing the ideality of beauty, good, and truth” (Bourlez, 2015, p. 105). The subject will be submitted to this hole in the universality of the sexual sense they want to live, and which will not cease to cause them anguish (Laurent, 2015, p. 157).

If, even so, one insists on objecting that the framework of Lacanian sexuation formulas remains characterized by the heteronormative matrix - given that it deals with two positions in face of the phallus, male and female, given the dissymmetry of jouissance⁵ -, that will not be a question when dealing with the Borromean approach to the sinthome, which will be seen next. We believe that the articulation of the sinthome by Lacan, in his very later teaching, transcends the epistemological partition, pointed out by Berger (2015) among the paradigms of sexual difference and gender.

The sinthome (Σ)

In his Seminars, book XXIII, Lacan (1975-76/2007) deals with the sinthome (with “th”, as in the ancient spelling of the expression: le sinthome). It is a neologism that is opposed to what is conventionally designated in psychoanalysis by symptom (symptôme).

The symptom, as it appears in Seminars, book V (Lacan 1957-58/1999), is a creation of the unconscious and, as such, it is a part of the Other’s discourse, articulated as language, fractured between significant and significance, which may affect both the body and thoughts. The symptom, just as the symbolic unconscious, is a generality.

Whereas the sinthome is not a creation of the symbolic unconscious, but, on the contrary, it is the name of what is incurable, connected to the real. The sinthome is what is singular in each individual and thus belongs to the register of the One, that is, the jouissance. The sinthome is a singularity, the way through each One domesticates their jouissance. There is a logical anteriority of the register of the One in relation to the register of the Other, and, in all of Lacan’s later teaching, there is this movement of going back, beyond the Other.

However, how to approach the sinthome, in psychoanalysis, without referring to the unconscious and the Other? This is when the Irish writer James Joyce comes to play. Lacan refers to Joyce’s writing practice, as the artifice of a text that, many times, communicated nothing, of a sense breaking literature, pure progressive construction over the language culminating on his last work, Finnegans wake. Thus, Lacan affirms that Joyce is unregistered to the Unconscious (désabonné à l’inconscient), which means he is the incarnation of sinthome; he incarnates what is singular in each individual. His writing mirror his singular handling of the text, out of meaning effects, with the aim of pure jouissance - a emblem of what Lacan calls savoir-y-faire with his sinthome, which is equal to knowing how to handle it, to make some use of it. Lacan has shown that the art of Joyce has constituted his sinthome, his modality of jouissance, and has served as his ego. Such is the maximum emblem one can do without the Name-of-the-Father⁶, with the condition of being served by it, in its sinthome function, that is the interlacing function.

In the perspective of the supplementation or suppletion clinic, opened by the node topology, the function of the sinthome consists on keeping the real, symbolic, and imaginary together. According to Schejtman (2015), the sinthome would be the pinnacle of the nominations as possibilities for psychic knots, due to repairing the Borromean knot lapse where it happens and having a privileged relation to the symbolic. There is a generalized solution, prêt-à-porter, represented by the repression of the Name-of-the-Father and by the inscription in castration under the aegis of the phallic function (equivalent to the Borromean knots), however, there are also countless possible singular solutions, among them the Joycean one, sinthomatic, which Lacan brings to light and evinces in his later teaching moment. The Lacanian sinthome clinic opens up promising future perspectives, allowing for overcoming the complaints over the decline of the father in culture⁷, supporting the ethical position of not drawing back in face of the contemporary challenges. As Sophocles’ Oedipus for Freud, Joyce’s fiction has provided a new and revolutionary psychic paradigm (Gherovici, 2017, p. 141).

Transsexuality psychoanalysis: the sinthome approach

Much like Lacan’s reading of Joyce’s sinthome, researchers in the Lacanian field (Hubert, 2007; Morel, 2012; Teixeira, 2012; Gherovici, 2017) have been thinking on singular solutions for transsexual jouissance - which can also include the SRS, without, however, being reduced to it. Those are original perspectives, given that, traditionally, authors in this field - such as Marcel Czermak, Catherine Millot, and Charles Melman, registered by Perelson (2011) - approach transsexuality in its psychotic forclusive aspect (Lacan, 1970-71/2009, p. 30), with emphasis on the mortal transsexual jouissance, with an “common mistake”⁸ associated to the demand of body mutilation (Lacan, 1971-72/2012, p. 17). This psychotic aspect would end up being called “push-towards-woman”: an specific sexuation form of the psychosis, introduced by Lacan in “L’Etourdit” (Lacan, 1973/2003). It is a psychotic process of forced feminization, due to the delirious interpretation that the subject has on the jouissance that invades them. The idea of “the” woman is imposed to a subject that must interpret their jouissance. This interpretation leads to the effect of push-towards-woman, experienced as a forcing (Morel, 2012, p. 229). It is located in the formulas of sexuation in the lower right side in crossed A→ S (crossed A): and there is the push-towards-woman, the dialogue to God, the ecstasy. It is Schreber, very macho, saying he feels like a woman who copulates with God (Brodsky, 2013, p. 28). If the father does not exist, if he is forclused in the psychosis, “The woman” and the sexual relation come to existence: Schreber in his divine coupling.

The phenomenological manifestations of the push-towards-woman are multifaced - as shown by Morel (2012) -, covering since the great paranoid delusions in which “The woman” is effectively incarnated; through more discrete clinical manifestations, as someone who is forced to write a long university thesis on the female condition (p. 226); up to the case of an analyzed subject who, incarnating the not-being, under transference, places “The woman” in the image of the analyst (pp. 231-232); here, the cases described as “primary transsexualism” by Stoller⁹, in Sex and gender, could also be included. It is important to highlight that not always is the push-towards-woman installed in the psychosis, with the sexuation being able to be subordinated to the sinthome - to the detriment of the sexual life (p. 217). And, even in the psychosis cases in which the push-towards-woman is manifested, beyond its prevailing damaging effects, it is possible to use it positively, making it a sinthome (pp. 238, 250).

The perspectives endorsed in this work follow carefully the sinthome reading of Joyce done by Lacan, who, instead of approaching the psychotic aspect of the Irish writer in his mortal jouissance¹⁰, has chosen to highlight the inventive dimension of his writing practice, making a turn in his teachings. Where the incorrigible deficit used to prevail, Lacan emphasized the invention by supplementation. The psychosis approach would never be the same after that, given its depathologization, read in Joyce through the singularity that allowed him to live. However, there are many Lacanian psychoanalysts who still pull back in face of the Joycean sinthome.

We suspect that Lacan himself would have deconstructed in the diachrony of his teaching, resorting to Joyce, his slandered synchronically located “phallocentrism”. In this later teachings, focusing on the relation between the significant and the jouissance, Lacan articulates a continuity clinic, in which there would not be a radical discontinuity between neurosis and psychosis in the sense of not having a big structural difference: a neurotic would be a speech being (parlêtre) with a very well succeeded supplementation, with a sinthome that would tie all three registers (RSI), which would be the Name-of-the-Father. On its turn, there would be a countless number of psychosis that would have been supplemented, but not in the neurotic way - with the Name-of-the-Father as the agent of castration and with the phallic function placing the jouissance as sexual -, but in another singular and original manner, as in the transsexual sinthomatic identification. Thus, it becomes important the singular modalities of jouissance in the condition of being articulated or not to the discourses promoting social bonds. “Both the frankly psychotic subject and the normal one are variations of the human condition, of our position as speech beings, of the existence of the parlêtre” (De Georges, Henry, Jolibois & Miller, 2009, p. 202). The Borromean knot clinic through sinthome thus promotes a kind of equality for each one both regarding the jouissance and death, diluting the frontiers between normal and pathological - hence the affirmation that the non-inscription to the phallic function (Φ0) and the forclusion of the Name-of-the-Father (P0) are the edges of the Gauss curve, which presents the real of human things (De Georges et al., 2009, p. 216). When finishing his teaching, with the return of Lacan to Lacan, he affirms “that everyone is mad, that is, delusional” (Lacan, 1978/2010). It is up to each speech being to deal with it.

It is important to highlight that, strictly speaking, the psychosis in Lacan was never deliberately considered a pathology to be cured with a view to reestablish a previously lost norm, in the psychiatric way, but a “subject position” which “we are always responsible” for (Lacan, 1965/1998, p. 873), With Marguerite Anzieu (Aimée), Lacan was limited to actively witness the spontaneous drop of her delusions after she passing to the act - the knife attack to the life of the actress Hughete ex-Duflos -, which resulted on her imprisonment in a judiciary asylum and assistance by Dr. Lacan (Lacan 1932/1987). While with Schreber, faithful to the Freudian proposition of delusions as an attempt of cure (Freud, 1911/2010; Freud, 1924/2011), Lacan affirmed that it was the psychoanalyst’s function - who should not pull back in face of psychosis - only to act as secretary of the insane in their work for stabilization, in the sense conferred by Hegel to the philosopher as the secretary of History, promoving it scansion and extracting from it a logic (Lacan, 1955-56/2002). Finally, with Joyce, the supposed unanalyzable structural psychosis of the Irish writer - his subject position as “unregistered to the Unconscious” according to Lacan - gathers an inventive dimension, which avoids its unleash and the correlated mortal jouissance (Lacan, 1975-76/2007).

To Lacan, the psychosis is conceived peculiarly as a structural position of the subject in the psychic topology, and it may be manifested as a psychiatric syndrome, depending on the outcome, or not. If, in relation to the unleashed psychosis, Lacan has, in a way, revealed to be pessimistic, pointing out imaginary crutches compensating the psychotic devastation that made it difficult for him to advance at the time in relation to his preliminary issue regarding the forclusion of the Name-of-the-Father (Lacan, 1959/1998), with Joyce’s hypothetical structural psychosis, he becomes more optimistic, given his demonstration that it would be possible to suppress the psychotic flaw in the psychic knot through the sinthome, changing the subject’s position and thus avoiding the psychotic outcome and correlated mortal jouissance. This implies on other clinic outcomes.

In each case, what one must ask is not if the Name-of-the-Father is forclusive or not. I believe that what guides the clinic and interventions is to always ask: what domesticates the jouissance? And when the jouissance is not domesticated, asking: what can we do, as analysts, for a subject to invent this function of jouissance domestication, that, in neurosis, is exerted by the Name-of-the-Father?¹¹ (Brodsky, 2013, p. 29)

Cases of the transsexual sinthome

Using as background the question brought forth by Fajnwaks (2015) - would Lacanian psychoanalysts be sufficiently queer to dispense with the diagnosis (an, thus, with the pathologization), matching the real at stake? (p. 44). We presented a brief overview of four psychoanalytical proposals applied to transsexuality: the sinthome clinic by Morel (2012) and Teixeira (2012), the retrenchment clinic by Huber (2007) and Gherovici’s clinamen clinic (2017).

Despite inserting transsexuality in the field of psychosis, Morel (2012) does not fit into the caricature of Lacanian psychoanalysts as guardians of the sexual order, being sensitive to the effects of a clinic practice beyond the phallus and castration incarnated in the sinthome. In the description of the “Ven case”¹², a designated woman that went to her with the intention of having a psychological approval for the transition to the male sex, Morel (2012) indicates that, accepting the transvestism, she kept on addressing the patient as a male, which, on the other hand, she had spontaneously done since the first moment (p. 188). Morel adds that the transvestism, an unsettling first step towards the surgery may otherwise appear as a barrier that allows one to avoid it (p. 197). She concludes the Ven’s transvestism knots the imaginary (the clothing is a second skin), the real (to look like is to be), and the symbolic (the true value). Therefore, transvestism is a symptom that here follows the function of a sinthome (p. 200).

Morel (2012) also describes the “Hélène case”, a long analysis that produced a resolution of the push-towards-woman due to its transformation into a sinthome that would be written in a phrase: being a woman of letters (pp. 251-256); and the “Serge case”, whose commitment solution found, the modelling of his push-towards-woman to socially accepted homosexual practices, has provided him with a sexual identity, constituting a kind of sinthome (pp. 257-260). Both cases portray the transformation into sinthome of the push-towards-woman, with neither of them having undergone through SRS. However, even this radical intervention does not necessarily represent anymore, in the Lacanian field, the transgression of a taboo, as the following cases will show.

Teixeira (2012), at the same time she keeps the formal correlation between psychosis and transsexuality, indicating that it results from the forclusion of the Name-of-the-Father as correlated non-inscription in the phallic function, highlights the insufficiency of this explanation as a clinical guideline for transsexuality. Therefore, Teixeira (2012) portrays the identification intervention of three transsexual subjects - through the analysis of the autobiographies of Christine Jorgensen, Amanda Lear, and João Nery -, who would have been capable of locating the sex change as a sinthome that allowed them to make “bodies that matter” and to reach the remarkable effect of a nomination. Teixeira sees, thus, a possible positivity in the SRS, conceived out of the psychosis/push-towards-woman/mutilation spectrum, shaking the strong resistance to such technical body transformation procedure that still exists in the Lacanian field. Teixeira (2012) defends the clinical position attentive to inventive solutions that each subject was capable of forging compelled by the transsexualist jouissance, and that somehow led them to hormones and to the surgery (p. 7), which would allow for reaching a subjective position that is expressed in an ethics, which consists on overcoming the lack by the jouissance, and in an aesthetic that gives rise to the masquerade game (p. 7).

In his turn, Hubert (2007) relativizes the association between psychosis and transsexuality: classifying transsexualism in the psychotic nosography encases transsexual people in a judgement that rejects and condemns it (p. 268) and pinpoints the effects of localized forclusion, supposedly present in transsexuals, which differs from the forclusion of the Name-of-the-Father in psychoses: it is a localized forclusion, a saying that does not echoes in the body, the author proposes using the term retrenchment to name the clinical phenomenon localized in the union between significant and the body (p. 268). Consequently, in his analysis of the case of the Hungarian doctor reported in Psychopathia sexualis (Krafft-Ebing, 2000, pp. 143-161), Hubert (2007) proposes a clinical guideline for the psychoanalysis of transsexuality, which includes body transformation:

It is with the sexual retrenchment clinic that one finds the specificity of the sinthome: a singular way of dealing with the drive. The hormone-clinical reassignment touches the body in its real. It removes from the body the original erotic drive through hormone-therapy and then through the surgical act, of changing the appearance of the body in its plastics (skin, scalp, hairiness) and its feelings (skin) through hormone-therapy. This concerns both the visual drive (the gaze jouissance) and the skin’s erotism. This body reassignment is knotted with the significant reassignment, the one concerning the marital status, the fact of being signified as “mister” or “madam”. Therefore, the name and significant mister or madam, which signed the origin sex, will be removed from identity documents. It is immediately highlighted a treatment orientation for the transsexual subject that knotted the gaze, the skin, the significant of the other sex, the removal of the origin sex linked to drive, just as the removal of the significant of the origin sex (p. 260).

Lastly, Gherovici (2017) indicates that the redefinition of the symptom as sinthome has important consequences for a positive end of the analysis, in the case of analyzed patients that identified themselves as transsexual. In her practice, Gherovici takes the sinthome as a variation over the clinamen, the “deviation” of atoms described by Lucretius and by the first materialists. She thus makes an effort to develop a “clinamen clinic”, which will function as the extension of the Lacanian sinthome theory. The practical advantages of this clinical proposition are highlighted with a case example of Jay’s analysis. This case of her clinical practice is compared to the work by the transgender artist Swift Shuker, to whom the body transformation is a reconciliation to life. It is explored how the practices of trans people may remind us of the “body writing” that corresponds to Lacan’s elaboration - thanks to James Joyce - of his notion of sinthome, a new kind of symptom that does not need to be removed or cured. It is concluded, in light of her analytical clinical experience, that the gender transition, more frequently than ever, is actually a matter of life or death.

Concluding remarks

Based on these Lacanian authors (Hubert, 2007; Morel, 2012; Teixeira, 2012; Gherovici, 2017), the feared psychotic aspect of transsexuality, connected to the mortal jouissance of the push-towards-woman, takes on a much lighter aspect, with new clinical implication, after the sinthome approach in Joyce, articulated by Lacan (1975-76/2007). The intention is not anymore to brake the transsexual jouissance at any costs, but to rig it with a view to the sinthomatic formation. This implies on the construction of a body for the speech being, including the SRS or not, given that the dimension of the singularity is considered, unattached from the biomedical protocol and the pathologization through “gender dysphoria/incongruency”. The body transformation is no longer necessarily seen as something of the psychotic forcing, but also as a legitimate demand that can be articulate to the sinthome clinic.

It seems that it was not by chance that Lacan, in his later teaching, enunciated his aspiration to rise psychoanalysis to the dignity of surgery, which would imply on rising the psychoanalytical debility to the sovereign safety of the surgical gesture of cutting, this would be the safeguard of psychoanalysis (Miller, 2009, pp. 198-199). In this late analogy, the Lacanian sublimation syntax is updated as “escabeau” (footstool or stepladder), covering that which the speech being rises over to become beautiful, from this pedestal that allows them to rise themselves to the dignity of the Thing (Laurent, 2016, p. 85).

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• 1
  This article is the result of a postdoctoral research made by Rogério Paes Henriques at the Fluminense Federal University under the supervision of Paulo Vidal, financed by the National Council for Scientific and Technological Development (CNPq).
• 2
  It is observed the current gender explosion both in Facebook, which allows one to invent exclusive genders for each user, making them infinite, and in the diagnose manual of the American Psychiatric Association (2014), which, through its cultural bias, recognizes the existence of alternative genders in the definition of transsexuality as gender dysphoria (pp. 452-453).
• 3
  This Logic supports the current official psychiatric classifications.
• 4
  It is important to highlight that cultural psychoanalytical perspectives (Porchat & Ayouch, 2016), giving consistency to the social Other, tend to celebrate the pluralization of gender semblants and the knowledge arising from it - (trans)gender studies - as an indispensable tension for the subversion of psychoanalysis.
• 5
  With focus on transsexuality, Lattanzio & Ribeiro (2017) denounce Lacan’s phallic moralism, on behalf of an original femininity. They thus parody Butler’s proposal (2000) for psychoanalysis, guided towards the pre-Oedipal polymorphism.
• 6
  The Name-of-the-Father articulates the desire and the law, its function brakes the jouissance. This function does not inscribe simply something of interdiction. Breaking the jouissance is also opening a path to the subject that drives them away from a mortal “push-towards-jouissance” (Laurent, 2012, p. 184). Besides the interdicting paternal metaphor, Lacan recalls the Name-of-the-Father as the entrance for the desire metonymy, since Seminars, book VI (Lacan, 1958-59/2016), up to the point that from Seminars, book XXII (Lacan 1976-1975) on, the Name-of-the-Father, effectively pluralized, becomes the nomination function connected to the Borromean knot as the fourth ring. The Name-of-the-Father is thus widened, from a repressive instance to a node production device.
• 7
  In this sense, Jacques-Alain Miller has launched a petition against the instrumentalization of psychoanalysis, in the occasion of the marriage pour tous, in January 2013, in which he reminded that the Oedipal structure described by Freud is not an anthropological invariant (Miller, 2013). Miller thus takes up about five decades later Lacan's conception (1960/1998, p. 827), according to which Oedipus cannot perpetuate itself indefinitely, given its dependence on sociocultural configurations.
• 8
  The common mistake would be rejecting the significant of the sexual jouissance (phallic forclusion), which would return in the real of the body. With the impossibility of interpreting the invasive jouissance of the sexual organ, the subject demands intervention on this erogenous zone, an anguishing source of drive. The mistake effectively consists on pointing the organ, instead of the significant, as source of jouissance.
• 9
  Out of that field are: the hysterical aspect of transsexuality nowadays (Jorge & Travassos, 2017); the “transsexualists” (Frignet, 2002); those who have the mere desire to obtain any cultural advantages given to the fact of belonging to the opposite sex (American Psychiatric Association, 2002, p. 552); that is, transsexuality as a social phenomenon.
• 10
  It is presumed that Joyce would have died due to consequences of a duodenal ulcer neglected by him. It is important to highlight that the psychosis in Joyce is a supposition based on two possible accesses: on the one hand, the literary symptom, a methodical sense forclusion, and on the other the abandonment of his own body, which indicates an imaginary lapse and error in the psychic knot, compensated by his sinthome-ego. Recently, it has been questioned the presumption of psychosis in Joyce, specially by Soler (2018).
• 11
  Indeed, according to Lacan, the domestication of jouissance is always partial, being in charge of the Borromean function exerted by the sinthome (which lato sensu includes the Name-of-the-Father) in both neurosis and psychosis.
• 12
  This case was previously described in the Champ Freudien’s compilation on ordinary psychoses (de Georges et al., 2009, pp. 67-69).

Publication Dates

• Publication in this collection
  17 Oct 2019
• Date of issue
  2019

History

• Received
  04 July 2018
• Accepted
  25 Aug 2019