Identity and the Foundational Myth: Psychoanalytic Insights into Gender Distress

Author(s) : Marcus Evans

Identity and the Foundational Myth: Psychoanalytic Insights into Gender Distress

Book Details

  • Publisher : Karnac Books
  • Published : November 2025
  • Cover : Paperback
  • Pages : 240
  • Category :
    Forthcoming
  • Category 2 :
    Child and Adolescent Studies
  • Catalogue No : 98273
  • ISBN 13 : 9781800133884
  • ISBN 10 : 180013388X
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There are increasing numbers of young adults presenting with symptoms of gender distress. Marcus Evans suggests that this focus on gender funnels feelings of distress into a narrow domain of mental life, whereas the problems being faced relate to the perennial struggle to establish an identity and mind of one’s own, particularly in adolescence.

The concept of identity is complex and affected by personal and cultural pressures. No more so than during adolescence, a time when we endeavour to find out who we truly are as our minds and bodies go through many changes, we start to disidentify with our families, and we are exposed to group attitudes and pressures. For many adolescents, puberty can feel like an unwanted betrayal by their own bodies. Their changing physicality seems to pull them further away from the self they imagine or wish to be and they struggle to reconcile their physical form with their sense of self.

This book explores gender distress through the lens of early childhood development with a focus on and elaboration of developmental interpretations and corresponding psychotherapeutic approaches. It builds on the work of Evans’ previous book, co-authored with Susan Evans, Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults (2021). As with his first book, it is based on continuous learning gained through clinical work with different patient groups. The analyst’s role is to remain curious and help patients explore and understand themselves in every aspect of their lives. Evans uses composite cases to chart the progression of therapy and show how psychological support can help individuals. The book includes a Preface from R. D. Hinshelwood and Foreword from Ron Britton. It is essential reading for all clinicians, practising therapists and trainees, as well as any other professionals who work with adolescents and young people.

Table of Contents


Acknowledgements
About the author
Preface by R. D. Hinshelwood
Foreword by Ron Britton
Introduction

Part I. Overview and background
1. Introduction
2. Introduction to early childhood development
3. Some observed aspects of trans-identifying individuals
4. Aspects of psychoanalytic assessment and treatment of gender dysphoric young people

Part II: Case studies
Introduction to Part II
5. Difficulty taking ownership of the body and the adult sexual body
6. Fragile ego prone to fragmentation and concrete thinking
7. Exploring identity and transference: A psychoanalytic journey through early trauma and gender dysphoria
8. Eroticised as a defence against separation
9. Killing off the good little boy: Illness in childhood
10. Mourning the loss of the ideal self: Short-term work with a trans patient post-transition
11. Conclusion

References
Index

About the Author(s)

Marcus Evans is a psychoanalyst and fellow of the British Psychoanalytical Society. He was a consultant psychotherapist and mental health nurse with forty years of experience in mental health. He was head of the nursing discipline at the Tavistock & Portman NHS Trust between 1998 and 2018. He was also the lead clinician in the adult and adolescent service and one of the founding members of Fitzjohn’s Service for the treatment of patients with severe and enduring mental health conditions and/or personality disorders. He has written and taught extensively on applying psychoanalytic thinking in mental health settings. Karnac published the first, Making Room for Madness in Mental Health: The Psychoanalytic Understanding of Psychotic Communications, in 2016. His second book, Psychoanalytic Thinking in Mental Health Settings, introduces front-line mental health professionals to psychoanalytic thinking and was published by Routledge in 2020. The following year, his third book, Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents, and Young Adults, written with his wife, Susan, was published by Phoenix.

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