Du corps sexué incomplet (agénésie utéro-vaginale) au ressaisissement identitaire du féminin dans la rencontre sexuelle : une étude de cas

Context

This article proposes a psychodynamic approach to MRKH syndrome, designating an absence of uterus and vagina, a rare congenital malformation which concerns one in 4000 female births. It proposes to identify, from a qualitative perspective, some of the issues raised by the nature of this medical pathology and the specificity of its treatment, as well as their repercussions on sexuality in connection with the adjustments of sexual identity, based on a case study.

Objectives

The aim is to show how the bodily obstacle to penetrative sexuality, caused by the nature of the syndrome, will be treated on a somatic level and in what way these protocols, associated with the issues raised by the pathology, will impact the way to live sexuality.

Method

Data collection is based on individual clinical research interviews between the young woman concerned by the case and the clinical psychologist. The article occasionally refers to the author's work on the same theme, especially a previous article dealing with the subject in a both qualitative and quantitative approach.

Results

This study makes it possible to identify in this case the recourse to sexuality with an addictive tendency which would reinforce the status of a “complete” woman with a strong reparative value for injured feminine identity. The over-investment of the “erotic pole” of the female personality attempts to rehabilitate the libidinal dimension of the genital area affected by the issues of lack, incompleteness and overwhelming pain, with benefits on the experience of the gender identity.

Interpretations

This study allows us, beyond the specific context of the syndrome, to consider the importance of intersubjectivity in the capacity of transforming the traumatic bodily experience. It also poses new ways to think about the appropriation of the sexual body in and beyond the logic of repetition, and to consider the question of the investment (potentially fetishized) of a transplanted organ and its appropriation on a psychological level. It would therefore be interesting to treat these themes in the context of other somatic clinics.