SUMMARY :
In this article, the author studies the clinical status of Pascal (or Pascale), a young man of about thirty, presenting a narcissistic psychopathology with transsexual symptoms, and the original encounter which progressively took place with narcissistic "mirrored" transfer, working with his therapist.
The clinical material provided by the patient contained sketches and extracts from his psychotherapy diary, illustrating his extremely narcissistic fantasies and the gender dysphoria of which he was suffering at the time, plus his pathogenic erotic imagination which not only gave him the illusion of being a girl and a sexual woman unconsciously, but also defined him as a "high level" anal passive transvestite in his sexuality.
Adopting an increasingly deep sexoanalytical approach, we shall see how Pascal was progressively able to decode his initial vaginal erotic fantasies, associated with a non-intrusive penile sexual disorder, and how he was able to clarify more specifically his fantasy of penile mutilation.
Finally, we will observe the positive therapeutic outcome, where Pascal, by working on correcting his imagination, was able to accept himself with an active male penile sexuality, and finally attained his own masculinity in terms of his sexual identity.