People sometimes seek sex reassignment because of advantages and opportunities which, they believe, are enjoyed by other sex. This rather unrealistic (fantastic) view of other is faintly narcissistic. It includes elements of idealised over-valuation, of self-preoccupation, and of objectification of one's self. It demonstrates a deficient ability to empathise and some grandiose sense of entitlement ("I deserve to have best opportunities/advantages") and omnipotence ("I can be whatever I want to be – despite nature/God").

This feeling of entitlement is especially manifest in some gender dysphoric individuals who aggressively pursue hormonal or surgical treatment. They feel that it is their inalienable right to receive it on demand and without any strictures or restrictions. For instance, they oftentimes refuse to undergo psychological evaluation or treatment as a condition for hormonal or surgical treatment.

It is interesting to note that both narcissism and gender dysphoria are early childhood phenomena. This could be explained by problematic Primary Objects, dysfunctional families, or a common genetic or biochemical problem. It is too early to say which. As yet, there isn't even an agreed typology of gender identity disorders – let alone an in-depth comprehension of their sources.

There are mental disorders, which afflict a specific sex more often. This has to do with hormonal or other physiological dispositions, with social and cultural conditioning through socialisation process, and with role assignment through gender differentiation process. None of these seem to be strongly correlated to formation of malignant narcissism. The Narcissistic Personality Disorder (as opposed, for instance, to Borderline or Histrionic Personality Disorders, which afflict women more than men) seems to conform to social mores and to prevailing ethos of capitalism. Social thinkers like Lasch speculated that modern American culture – a narcissistic, self-centred one – increases rate of incidence of Narcissistic Personality Disorder. As Kernberg observed:

"The most I would be willing to say is that society can make serious psychological abnormalities, which already exist in some percentage of population, seem to be at least superficially appropriate."

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Quotes from Literature

"Specifically, past research suggests that exploitive tendencies and open displays of feelings of entitlement will be less integral to narcissism for females than for males. For females such displays may carry a greater possibility of negative social sanctions because they would violate stereotypical gender-role expectancies for women, who are expected to engage in such positive social behavior as being tender, compassionate, warm, sympathetic, sensitive, and understanding.

In females, Exploitiveness/Entitlement is less well-integrated with other components of narcissism as measured by Narcissistic Personality Inventory (NPI) - Leadership/Authority, Self-absorption/Self-admiration, and Superiority/Arrogance- than in males - though 'male and female narcissists in general showed striking similarities in manner in which most of facets of narcissism were integrated with each other'."

Gender differences in structure of narcissism: a multi-sample analysis of narcissistic personality inventory - Brian T. Tschanz, Carolyn C. Morf, Charles W. Turner - Sex Roles: A Journal of Research - Issue: May, 1998

"Women leaders are evaluated negatively if they exercise their authority and are perceived as autocratic."

Eagly, A. H., Makhijani, M. G., & Klonsky, B. G. (1992). Gender and evaluation of leaders: A meta-analysis. Psychological Bulletin, 111, 3-22, and ...

Butler, D., & Gels, F. L. (1990). Nonverbal affect responses to male and female leaders: Implications for leadership evaluations. Journal of Personality and Social Psychology, 58, 48-59.

"Competent women must also appear to be sociable and likable in order to influence men - men must only appear to be competent to achieve same results with both genders."

Carli, L. L., Lafleur, S. J., & Loeber, C. C. (1995). Nonverbal behavior, gender, and influence. Journal of Personality and Social Psychology, 68, 1030-1041.

Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He is a columnist for Central Europe Review, PopMatters, and eBookWeb , a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory Bellaonline, and Suite101 .

Visit Sam's Web site at http://samvak.tripod.com

But Internet may also be closest many narcissists get to psychodynamic therapy. Because it is still largely text-based, Web is populated by disembodied entities. By interacting with these intermittent, unpredictable, ultimately unknowable, ephemeral, and ethereal voices – narcissist is compelled to project unto them his own experiences, fears, hopes, and prejudices.

Transference (and counter-transference) are quite common on Net and narcissist's defence mechanisms – notably projection and projective identification – are frequently aroused. The therapeutic process is set in motion by – unbridled, uncensored, and brutally honest - reactions to narcissist's repertory of antics, pretensions, delusions, and fantasies.

The narcissist – ever intimidating bully – is not accustomed to such resistance. Initially, it may heighten and sharpen his paranoia and lead him to compensate by extending and deepening his grandiosity. Some narcissists withdraw altogether, reverting to schizoid posture. Others become openly antisocial and seek to subvert, sabotage, and destroy online sources of their frustration. A few retreat and confine themselves to company of adoring sycophants and unquestioning groupies.

But a long exposure to culture of Net – irreverent, skeptical, and populist – usually exerts a beneficial effect even on staunchest and most rigid narcissist. Far less convinced of his own superiority and infallibility, online narcissist mellows and begins – hesitantly – to listen to others and to collaborate with them.

First published in my "Narcissistic Personality Disorder" Topic Page on Suite 101

Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He is a columnist for Central Europe Review, PopMatters, and eBookWeb , a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory Bellaonline, and Suite101 .

Visit Sam's Web site at http://samvak.tripod.com