This paper seeks to provide an alternative reading of Re Alex: Hormonal Treatment for Gender Identity Dysphoria [2004] FamCA 297 ( 13 April 2004 ) from a psychoanalytic perspective. The claim of this paper is that psychoanalytic theory can provide an alternative reading of Alex's case that emphasises the social and cultural construction of gender. The implications of such an alternative reading are both particular and more general: the particular implications for this case are that gender reassignment may not free Alex from the web of parental desire and narcissism, and therefore it is difficult to say with any confidence that the decision was in the best interests of the child; and the more general implications of the reading are that gender is largely the product of convention and should not be viewed as inherently natural, inevitable and dichotomous.