As a young boy, Rob was dressed as a girl one Halloween by his older sister, and as he made his door-to-door trick-or-treat journey, he was praised by his mother and neighbors for “what a good girl he would have made.” The initial Halloween cross-dressing was not sexually exciting but it was ego-gratifying. Subsequently, as a young boy, Rob cross-dressed in order to repeat the ego gratification. He would admire himself in the mirror. When he became pubescent, the crossdressing became eroticized and he would become sexually aroused and masturbate.
Now in his early thirties, Rob reported cross-dressing both for sexual excitement and release as well as for relaxation. His wife had discovered the behavior and was afraid for the sexual safety of their children, and she had threatened to leave the marriage. This threat brought Rob into treatment with an ambivalent request to help hi stop the behavior.
Rob’s antecedents were any set of circumstances that challenged his sense of worth. His supervisor putting pressure on him at work, the children disobeying him, but especially his wife criticizing or disagreeing with him caused him to feel both demoralized and anxious.
He had the assumptive belief that his cross-dressing in secret was his “little island of repose,” and he would strategize about how to arrange for the necessary privacy. When his wife left the house for an extended period of time with the children, the “trigger” was there.
Rob would unpack his hidden stash of female clothing and engage in the cross-dressing behavior. Except for the last incident, he was able to return the clothing and, with some shame, resume his day “as if nothing happened.”
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