A literature review of Lacanian approaches to “transsexualism” shows that female-to-male (FtM) transition is significantly overlooked and that psychoanalysis seems to be persistently and almost exclusively interested in male-to-female (MtF) transition—to the extent that the latter can be said to have become the very epitome of transsexualism. How can the lack of psychoanalytical interest in FtM transition be addressed? To what extent is this structured around the Freudian theories, in particular those on femininity? The study of the place given to the differential between FtM/MtF in the psychoanalytic literature will also show that the questions surrounding transsexualism seem impossible to distinguish from diagnostic considerations, which will lead to the question of how psychoanalysis tends to think of “transsexualism” as one structural entity.