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As transsexual and transgender identity and experience have emerged from the outer boundaries of sexual identity and have become part of mainstream awareness of the full potential for sexual self-definition, cultural response has ranged widely. Responses include acceptance and approval; moderate levels of anxiety concerning perceptions of gender, sexual identity, and sex; obsessive fascination with the "otherness," the "not-me-ness" of those identifying as transsexual or transgender; the desire of non-trans-people to co-opt the experience of trans-people without personal risk; alarm at the reification of gender roles in what some people hoped would be a non-gender-defined, gender-neutral future. And more.

Elia Kazan's 1963 film, America America is a tribute to the immigrant experience of his own forebears, and has relevance to the refugee crisis of today. In stark black and white cinematography, the film provides insight into the refugee-immigrant experience, personified in Stavros, a young man longing for freedom, obsessed with an idealized America. His hope and innocence cannot safeguard him. His memories of his happy childhood and loving family create idealizing transferences to a world of others who manipulate and betray him as he undertakes his quest. Eventually he too learns to manipulate and betray, unconsciously identifying with the aggressor. History will offer ethical challenges, the black and white cinematography mirroring the black and white perception of good and bad, the shades of grey evoking a maturation of understanding.

Teaching professional ethics in psychoanalytic institutes begins with two assumptions: (1) Students learn not only a code of ethics, they learn to develop their inner ethicist. (2) Institutes do not "train" students to become versed in a professional discipline, institutes educate, so students acquire a complex range of knowledge, developing intellectually and emotionally. Studying professional ethics begins with questions concerning freedom, free will, and responsibility, allowing students to contemplate emotionally charged topics: power politics, collegial relationships, organizational malfeasance, and boundary violations. Another area of concern involves the ability to observe and manage countertransference. Another related theme is trust: trust in supervisors, training analysts, instructors, and one's own ability to process countertransference. Processing countertransference is a necessary ethical obligation. Instructors need to be aware of the emotional stresses involved in studying professional ethics, particularly in discussions of sexual boundary violations. Students developing an ethical stance can enhance creativity in psychoanalytic work.

Developmental issues arising from the dilemma of the protogay male child (as defined by Blum and Pfetzing in 1997) and the assaults to his sense of self are discussed in the context of the impact of the analytic attitude. Clinical material is offered as a 50-year-old gay man, troubled by his inability to form a lasting loving relationship with a man, experiences integration in the analytic relationship, stemming from what he describes as the "Yes" offered by his female analyst.