In the 1950s, homosexuals in the United States were routinely arrested; today, homosexual activity between consenting adults is legal in every state, with same-sex marriage legal in Massachusetts and Connecticut.

In the 1950s, ambitious women were often seen as psychopathological and were told by psychoanalysts that they had penis envy that needed treatment; today, a woman has campaigned for President of the United States. Mark Blechner has lived and worked through these startling changes in society, and Sex Changes collects papers he has written over the last 45 years on sex, gender, and sexuality.

Interspersed with these papers are reflections on the changes that have occurred during that time period, both within the scope of society at large as well as in his personal experiences inside and outside of the therapeutic setting.

He shows how changes in society, changes in his life, and changes in his writing on sexuality - as well as changes within psychoanalysis itself - have affected one another. One hundred years ago, psychoanalysis was at the cutting edge of new ideas about sex and gender, but in the latter half of the 20th Century, psychoanalysts were often seen as reactionary upholders of society's prejudices.

Sex Changes seeks to restore the place of psychoanalysis as the "once and future queer science," and aims for a radical shift in psychoanalytic thinking about sexuality, gender, normalcy, prejudice, and the relationship of therapeutic aims and values.