This work attempts to illustrate and explain through case examples the clinical phenomenon of men who require transsexual images in order to engage in sexual activity. The analytic concept of the phallic woman was used to both understand and treat the phenomenon. The work attempts to go beyond the more classical explanations of the phenomenon with its emphasis on castration anxiety and develop an understanding different from the Freudian conception of fetishism. The findings indicated that an earlier and perhaps universal experience of a fantasy of a detachable penis is more basic to the understanding of the phenomena and its integration would seem to be an essential step in the development of an individual's gender identity. (Daniel Aaron)