All these males and females who offer their bodies to homosexual inverts for hire, are seldom inverts themselves. With them it is only a vice or a perversity.

Homosexual perversion.—The perversion of homosexuality has, as a rule, the force of a congenital phenomenon and is characterized by precocity. In normal individuals the sexual instinct, except induced by seduction, does not manifest itself before puberty. The sexual life of the individuals afflicted with homosexual perversion, on the other hand, appears abnormally early in life. The impulse appears at the tender age of five to eight years, and ab initio in a perverted form, without having been brought about from the outside by bad examples or other influences.

The child shows its anomaly in its tastes, sentiments, and occupations. The boy avoids the company of other boys. He shuns their games and plays. He is found playing with dolls, ribbons, miniature housekeeping, etc., in company with girls. He is more particular about his dress, in fact, he loves to be dressed like a girl as long as possible. He likes to occupy himself with girls’ work, such as knitting, sewing or crochet-work. The homosexual girl is found in the haunts of boys and competes with them in their games. She neglects her dress and assumes and affects boyish manners. She is in pursuit of boys' sports. She plays with horses, balls and arms. She gives manifestations of courage and bravado, is noisy and loves vagabondage.

Toward puberty the boy finds his sexual inclinations and impulses directed toward men, and the girl hers toward women. The boy feels himself a girl and attracted to men. He forms passionate attachments to boys and idealizes his friends. When he has found a manly friend, he is captivated by his strength and prowess, by his love of adventure, by his courage and by his manly grace and beauty. The passion finds expression in stupro mutuo. The girl, on the other hand, forms passionate friendships with girls, as a rule, older than herself. She idealizes and deifies the beloved friend, and praises her beauty, grace and kindness. Her thoughts are full of the beloved one. She sends her invitations to come and call on her, she writes her poetry, offers her flowers and presents and is capable of every sacrifice for her friend’s sake. She delights in the bodily contact with the beloved friend. This passion finds expression in kissing, close embraces and in sleeping together in one bed. She experiences then the powerful feeling of lustful pleasure, which may be so intense that it suggests magnetic currents through her body. Alteri super alteram jacenti tactus corporeus delectationis tremorem inducit. The orgasm is induced quibusdam contrectationibus.

The homosexual pervert suffers from disloyalty and is tortured by jealousy. Tears, despair and anger are as common as in normal love if the friend forms any other friendship, no matter whether with males or females. If the pervert’s love be unrequited, he or she suffers the greatest pangs. As a rule, the inverted individuals are fastidious in their choice of friends. Their inclinations favor a certain type of men or women respectively. Once the choice is made they act like passionate lovers. The pervert’s modesty finds expression towards individuals of the same sex. The boy is embarrassed in company of young men and likes to show off in their presence, while the most attractive young women leave him cold and indifferent. Their presence is simply ignored by him. The perverted girl becomes shy and confused in the presence of an attractive individual of her own sex, but shows nothing of shyness and the engaging air of weakness and dependence which are the unconscious invitations to them in the presence of men. She feels a pronounced indifference to men.

The erotic dreams of the male pervert turn around males. The autoerotic fantasies are all of men and virilia, while normal individuals in their imagery never think of their lovers' pudibilia. The lustful dreams of the perverted girl contain only visions of females, with corresponding situations. These dreams where only women appear on the scene cause her great pleasure and sometimes even pollutions. In her day-dreams, her fancy pictures muliebria of her own sex.

The homosexual man finds delight in contrectando virilia alterius that is simply incomprehensible to the normal individual. The value he or she lays in contrectando et conspiciendo virilia aut muliebria shows at once the diseased condition. The inverted boy and girl are constantly on the alert for the opportunity to see nude men, respectively nude women. They frequent bathing establishments. They find pleasure in looking at statutes of nude males, respectively females, and are frequent visitors of museums. The sight of nude men, respectively women, awakens in them lustful feelings, while in the presence of nude women the perverted man remains indifferent, and the same is the case with the invert woman in the presence of nude men.

The perverted man has a profound longing for female clothes. He takes the greatest pleasure in the sight of female attire. He tries to dress as a woman at every opportunity. He likes to frequent masquerade balls where he can dress up as a woman and dance with women. In short, the patient has all the feelings and longings of a woman. The inverted woman, on the other hand, likes to imitate male fashions in general attire and in dressing her hair. It gives her the greatest satisfaction if she is able to dress herself entirely in men’s attire and disguise her identity. She further prefers the occupations of men and loves at every occasion to play a man’s rôle. When at a ball she likes to dance with women, and when in a hotel, she loves to discuss politics with men. In short, she feels herself a man.

The inverted creatures seek, find, recognize and love one another, and often live together ut maritus maritaque. An invert woman may sometimes enter matrimony with a man, but this is done either in ignorance of her anomaly or to secure support. Otherwise a man has no sexual attraction for her. She is totally impotent of experiencing libido in congressu cum viro, although the genital glands are, as a rule, normal and their functions regular.

In some inverts normal marriage is utterly impossible, the very thought of normal coition arouses disgust and horror. If the invert woman is forced to normal concarnatio (the invert male cannot even be forced, he has no erection in the presence of a woman), the feeling is the same as if she were compelled to take disgusting food or drink. For days afterwards she is nervous and miserable, while concubitus with her own sex affords her pleasure and leaves behind a feeling of comfort. The perverts are, therefore, thoroughly happy in their perverted feeling.

Modus operandi among male inverts is, in the first place, stuprum mutuum. The other frequent method is thigh friction, “membrum fricando inter femora cynedis qui jacet in tergo, mulieris instar.” Another quite frequent mode is insertio fascini in os. In the majority of cases paederastia consists in initus per anum. Juvenal when speaking of the “condylomes in cynedes” says: “Sed podice laevi caeduntur tumidae, medico ridente, mariscae.” “Nates sunt semper repulsae cum manibus.”

Modus operandi among homosexual female inverts is, apart from stuprum mutuum, threefold. In the majority of cases it consists of tribadism (from the Greek word τρίβειν, to rub), namely in a simple contact and “fricatio genitalium unius versus genitalia alterius,” or as in Moll’s case, “ut una premeret femur alterius.” The second mode is cunnilingus and fellatricia, which consists in “lambere lingua genitalia alterius” and in “fellare clitoridem et labia minora alterius.” The third mode is clitorism, which is only possible when the clitoris is abnormally long, so, as Martial says,

In such cases commixtio consists in the “introductio auctae clitoridis in vaginam alterius.” Such cases with enlarged clitoris are not so very rare even in normal women.

A few years ago the author performed a total vaginal extirpation on a sexually normal woman whose clitoris in non-erect state measured three and a half centimeters.

A woman masturbator is known to the author whose clitoris, when erect, measures three centimeters.

Kiernan reports a case in which a sexual invert possessed a clitoris which, when erect, measured six and a half centimeters, or two and a half inches.

Psychical Hermaphrodism.—The homosexual perversion shows four degrees. In the first degree traces of heterosexual feeling are yet to be found, but the homosexual instinct predominates. The characteristic of the so-called psychical hermaphrodism is the pronounced sexual inclination toward the same sex besides the periodically present desire for the opposite sex. The homosexual feeling is of great intensity and permanent, while the intensity of the heterosexual inclination is of a much lesser degree, and the feeling is only present at certain times.

A young man, thirty-two years of age, was seduced by a boy of fourteen to stuprum mutuum when he was only eight years old. In his lascivious dreams he sees only men. When eighteen years old he fell in love with a beautiful young girl. Initus with her, although successful, did not afford him the libido he had expected and he stopped having carnal relations with her. On the other hand, the pleasure experienced in his relations with men is of great intensity.

The other case, known to the author, is that of a man of thirty. He is married and has two healthy children. In commixtione conjugæ he has to call up the mental images of men, otherwise complete libido is missing. As a small boy, he loved contrectare parvas puellas. When thirteen years of age he began spontaneously to practise stuprum manu. At fourteen he was seduced by an urning ad stuprum manu and to paederastic practices. The embracing and kissing of homosexual men induces ejaculation and orgasm. His erotic dreams are partly filled with male, partly with female images.

Another case is that of a young man of twenty-five, who since early youth had an inclination for boys and liked to sleep with them and fondle them. At puberty he began to practise paederastia with boys of his age. His erotic dreams turn exclusively around males. Still he is also fond of girls. Although he never had any sexual relations with women, yet when dancing with them or at other occasions, when he happens to come in bodily contact with them, he frequently has sudden emissions.

Among female psychical hermaphrodites are very often found married women and mothers of children. But while in their normal sex-activity they are almost impotent of experiencing libido, the homosexual practice is accompanied with great intensity of libido.

In one of Krafft-Ebing’s cases the patient, twenty-nine years of age, came of a nervous family. When eighteen years of age, she had relations with a young man. After separation from her lover she se stuprabat manu for some time. She then donned male attire and became a tutor in a refined family. Her employer’s wife fell in love with her,BE and she left her position. Some time later she fell ill and was sent to a hospital. While there she fell passionately in love with female nurses and patients.

In another case of Krafft-Ebing’s the patient, twenty-six years of age, is married and has two children. She always inclined more to her own sex. Complexus venereus with her husband disgusts her. Since the birth of her second child she gave up this intercourse entirely. When a pupil in the seminary she was in love with other girls. At times, however, she was also drawn toward men. But the latter feeling was only of a transient character. Her desire is to fondle, kiss and embrace the beloved girl and imitari coitum cum ea.

In Moll’s case the patient is thirty-six years of age. As a child, she loved to play with boys and girls indiscriminately. She also liked to play with dolls. She was wholly innocent and had no passionate friendships, either with boys or girls.

She began to menstruate when thirteen and a half years old. At that time she began to experience the first sexual excitements. She had some vague sensations in muliebribus. She never practised manu stuprum. When sixteen and a half years of age, she was sold by a woman in fornicem, where she was forced to stay several years, until she finally succeeded in escaping.

While in this house she associated with another girl, slept with her and practised mutual cunnilingus, which gave her great delight. Yet she enjoyed concubitum with some men. She even allowed one man to practise cunnilingus secum.

After she left the house she went to Berlin and soon succeeded in finding a girl friend with whom she lived for two years and practised active cunnilingus. Afterwards she secured another friend whom she dearly loved because of her manly features.

The cunnilingus that men practised on her gave her satisfaction, but she experienced the greater delight, “si femina eam lingua lambit.” Initus no longer gave her satisfaction, nor was she ever satisfied in dreams. The images in her dreams were sometimes female, at other times male.

Strict homosexuality.—In the second degree, only homosexuality is found. The opposite sex causes frigidity and even horror. In this degree the sexual desires and inclinations are ab origine only for the same sex. But the inclinations to the same sex are limited to the “vita sexualis,” while in character and mentality the patient remains distinctly in conformity with the sexual glands. The histories of the three following cases observed by the author will well illustrate this degree of homosexuality:

A young man of thirty-five years began to feel a certain attraction toward his own sex when only ten years old. At puberty this attraction developed into the strong desire to have complexus venereus cum amicis. At the same time there was a pronounced feeling of indifference and, later on, that of actual repulsion towards women. The only way to have concarnationem cum mulieribus at all was by Venus aversa and thinking at the same time of sympathetic men.

The second case is that of a man of thirty-three years of age. As a boy of seven, he was initiated by an older friend into the mysteries of stuprum manu. At puberty he found a few friends with whom he often practised paedicatio. His erotic dreams are of men only, At the mere sight of a man’s virilia he has orgasm and ejaculation. To procure himself this enjoyment he frequently visits the seashore and other bathing places where he can see naked boys and men. Even the statues of men in museums cause erections. Women have no attraction for him. Even the most beautiful women do not excite the slightest degree of desire. No erection in their company takes place, even if they allow advances and the most intimate sensual titillations.

The following case of a man of thirty years of age shows how maladjustments of environment may develop a permanent homosexual perversion. At the age of ten the patient was abused by his tutor for paederastic purposes. Since then he was not able to give it up. Concarnatio with sympathetic men gives him the highest pleasure. His aversion to women is now complete. Before his seduction he had inclinations to little girls. Nowadays the sight of a naked woman disgusts him. He loves to be caressed, fondled and adored by men. He likes to be adored by and feel dependent upon some powerful man. He hires strong men ad inserendum fascini in anum suum. For this reason he is often found in the haunts of the worst gangs of the under-world of the city. He never as yet played the active part, quamquam erectiones et ejaculationes habet vehementes jacens in brachiis amatorum mercenariorum.

Krafft-Ebing relates the histories of several female patients belonging to this degree of homosexuality.

One of his patients was neurasthenic and always excited. From her earliest youth she was subject to sexual excitement and spontaneously stuprabat manu. She began to menstruate at the age of fourteen. Menstruation caused her great pains and was accompanied by intense sexual excitement. When she was eighteen years old she gave up manu stuprum. She never experienced inclination toward the opposite sex and married only to find a home. On the other hand, she was powerfully attracted by girls and realized that this meant more than mere friendship. The sight of a pretty girl causes her intense excitement. She has at once the desire to embrace and kiss her. She dreams of girls and revels in looking at them.

In another case of Krafft-Ebing’s the patient was twenty-two years of age and considered a beauty. Though she was very sensual, yet she refused all proposals of men and only once in her life allowed an admirer to kiss her.

Until puberty she was sexually indifferent. When seventeen years of age she happened to see one of her admirers in “actione coeundi,” “more bestiarum,” cum muliere menstruata in horto. The sight of the blood and the bestial lust of the man terrified her to such a degree that she saw henceforth in men only the embodiment of coarseness and vulgarity. When nineteen years of age she made the acquaintance of another invert with whom she indulged in wild orgies until she fell exhausted and unnerved. Cum altera jaceret in se cunnilingum faciens she felt an unspeakable thrill going through her whole body. She herself was only allowed to kiss the other’s “mammae.” These relations with her friend lasted a year.

Effemination and viraginity with psychical perversion only.—In the third degree of homosexuality, the so-called effemination or viraginity, where the entire mental existence is altered, the man of this type resembles in his mental qualities a woman, “anima muliebris in corpore virili inclusa.” But his body is still that of a perfect man. The woman, on the other hand, resembles in her mental qualities a man, while her bodily characteristics remain still feminine. The following few cases may serve as an illustration:

The patient is a man of thirty years of age, tall, manly, with broad shoulders and an abundance of hair of beard and mustache. As a child, he was disposed to girls’ games. At the time of puberty, he spontaneously acquired the vitium stupri manu, but always with the accompaniment of the prurient imagery of males. As far as he can remember he was always attached to men. He shunned women as he would a lethal pest. He also abhors paedicatio and fellatio.

He is given to introspection and self-scrutiny. He is retiring in his manners, is melancholic and often harbors suicidal inclinations. The expression of shame is toward grown men, not toward girls or women. Already when a very young boy he was ashamed to undress before a man. He is very fond of perfumes, likes to powder and paint himself and to pencil his eye-brows. He is very curious, vain, and loves to gossip.

The second case of the author is that of a physician, forty years of age. In his earliest childhood he always played with dolls, associated with girls only and avoided boys’ games. He was always sickly as a child. He began stuprum manu when he was eleven years old, seduced by one of his girl friends. At puberty he gave up stuprum manu and began to love strong men. He had frequent pollutions with male imagery which weakened him considerably. At the same time his voluptas grew stronger. He then tried to associate with meretricious venery but found himself completely impotent for erection or orgasm. Even the manusturpation of the puella publica would fail to effect an erection. His desire is to be in the arms of a strong man. In the homosexual acts he always plays the passive rôle. He is effeminate in his character, sensitive, easily moved to tears, and is greatly embarrassed and silent in men’s company; while among women he feels himself perfectly at home. He feels himself a perfect woman.

Viraginity with psychical perversion is as often found among women as effemination among men. A good many cases of this kind of viraginity have been reported in the medical literature.

One of these cases has been reported by Wise. The woman, fifty-six years of age, was always peculiar in girlhood. She preferred masculine sports and labors. She had an aversion to attentions from young men and sought the society of her own sex. She consented to marry when twenty years of age, and had one child. When she was deserted by her husband, she began to follow her predilection for masculine avocations. She donned male attire and became a trapper and hunter. She considered herself a man in all that the name applies. After many reverses she entered an almshouse and here she became attached to a young woman. When the attachment became mutual, both left the institution for the woods to commence life instar mariti maritæque. They lived in this relation until the patient had a maniacal attack that resulted in her committal to an asylum.

Another case of viraginity has been reported by Kiernan. The patient, a girl of twenty-two years of age, when a child, liked boys' games and was fond of male attire. She felt an attachment to some of her female friends and satisfied voluptatem faciendo stupra mutua cum amicis. The powerful impulse for sexual gratification came over her at regular periods. She became intensely excited at the sight muliebrium. In her lascivious dreams she saw only female pictures. She also suffered from imperative conceptions.

In Westphal’s case, the patient, thirty-five years of age, was as a child fond of boys’ games and was anxious to wear male attire. From her eighth year she felt herself drawn to certain girls. She kissed and hugged them and sometimes induced them permittere ut muliebria contrectaret. Between her eighteenth and twenty-fifth year she had frequent chances contrectandi muliebria. When such chances were wanting, she satisfied herself stupro manu. Stuprabat sese especially just before and after menstruation. When she attempted to control herself she experienced a disagreeable odor and taste, arising from muliebria sua.

The cases mentioned by Ellis also belong to this degree of female homosexuality.

Catherine Tucker nupta erat mulieri et eam comprimebat ope fascini factitii.

In Memphis, Alice Mitchells planned marriage with Freda Ward. When the scheme was frustrated by Freda’s sister, Alice killed Freda by cutting her throat.

In Chicago one of the Tiller sisters was an invert and lived stupre attached to the other. One day the healthy sister was induced to leave the invert and got married. The deserted sister then broke into the apartment of the couple and shot the husband.

Another case is that of a trained nurse in Chicago who lived stupre with a young girl of fourteen years. The latter left her four times, but was always induced to return again. One day, the girl married, whereupon the nurse shot the husband.

Effemination and viraginity with bodily perversion.—In the fourth degree of homosexuality not only are the mental characteristics peculiarly feminine, respectively masculine, but the form of the body approaches that of women, respectively of men. Only the genitals are differentiated and are completely male or female; otherwise the patient could be considered a woman, respectively a man. The following case of a male patient will illustrate this degree of the anomaly.

A man of forty had always had homosexual impulses, as far back as he can remember. His stuprosæ acts were attached by mental images of men. The autoerotic fantasies are all of men. In his erotic dreams the images of men accompany the orgasm. The patient feels himself entirely like a woman and is attracted by physically well built men. Naked men in life or in sculpture have a great attraction for him. Women have never made the slightest impression on him. The mere sight of a naked woman disgusts him. Initus with women always failed for lack of erection, while homosexual acts afford complete satisfaction.

The patient has a disinclination to masculine pursuits. He does not drink nor smoke. His habitus is entirely feminine. The body is slight and non-muscular. The shoulders are narrow, the pelvis broad, the hands and feet decidedly small. The form is rounded with an abundant development of adipose tissue. He has few hairs on beard and mustache. His complexion is fine. His voice is feminine, he speaks in falsetto voice. His gait is rocking, womanly. He wears his hair quite long.

Since childhood he was actuated by the desire to put on female attire. He always wore female undergarments, such as shirts, drawers, corsets, etc. He generally wears bracelets on his arms. Whenever he can, he dresses up like a woman and takes long walks upon the streets in such costumes. Through his love for feminine attire he came in contact with several transvestites who form a kind of club in this city. But the latter who abhor homosexual practices soon discovered his motive for the desire of feminine attire and avoided his company. In his reveries, dreams and acts the patient always plays the pathicus. For some reason or other, unknown to the author, the patient committed suicide.

The female, suffering from the fourth degree of viraginity with bodily perversion, approaches in the form of her body that of men. For this reason she may easily masquerade as a man, associate with men, go through the marriage ceremony with a homosexual woman of the class suffering from the first three degrees of homosexuality, and she will never be found out until she dies. A few cases of this class were described by Krafft-Ebing.

The patient is a talented artist, twenty-five years of age. She has masculine features, a deep voice, a manly gait and small mammae. Early in her youth she preferred to play with boys. She never had a liking for dolls or needlework and found no pleasure in domestic duties. At fifteen years of age she began to menstruate. At the same time she began to fall in love with young girls. Her love was only platonic in nature. She is perfectly indifferent toward men. She is bashful only toward persons of her own sex. In her lascivious dreams females are on the scene where she herself plays the man’s rôle.

In another case of the same author, the patient, when a girl, had inclination for boys’ sports only. Once, when she was allowed to go to a theatrical performance, dressed as a boy, she was filled with bliss. Until her marriage, at the age of twenty-one, she was indifferent to men and women alike. She began to menstruate at the age of eighteen. Her engagement was a matter of utter indifference to her. Her connubial duties were first painful and, later on, loathsome to her. She never experienced sensual pleasure, yet she became the mother of six children. Her husband began at that time to practise onanism (coitus interruptus). At the age of thirty-six she had an apoplectic stroke. From this time on she felt that a great change has taken place in her. She was mortified at being a woman. Her menstruation ceased. Her feminine features assumed a masculine expression. Her breasts disappeared. The pelvis became smaller and narrower, the bones more massive, the skin rougher and harder. Her voice grew deeper and quite masculine. Her feminine gait disappeared. She could not wear a veil. Even the odor emanating from her person changed. She could no longer act the part of a woman, and assumed more and more the character of a man. She complained of having strange feelings in her abdomen. She could no longer feel her muliebria. The vaginal orifice seemed to close and the region of her genitals seemed to be enlarged. She had the sensation of possessing a penis and a scrotum. At the same time she began to show symptoms of the male voluptas.

In another case of Krafft-Ebing the patient, thirty-six years of age, commenced se stuprare manu at the time of puberty, when thirteen years old, and became homosexual when sixteen years of age. When twenty-six years old she had the feeling of transformation. She imagined muliebria sua turning into the male form and began to urinate like a man. She does not feel ashamed to undress in the presence of a man, but is shy to do it in the presence of a woman.

One of the best examples of the fourth degree of homosexuality is that of Murray Hall, who died in New York City in 1901. Her real name was Mary Anderson. Born in Scotland, she came to America, where she lived as a man for thirty years. Her features and her behavior were so entirely masculine in character that through all these years her real sex was not even suspected by her closest friends. She became distinguished as a Tammany politician and as a man about town who knew how to make money. She associated with politicians, drank to excess, swore a great deal, smoked and chewed tobacco. She was fond of pretty girls and liked to associate with them. She entered twice into matrimonial relations with other inverted women. Her first marriage ended into separation; the second lasted twenty years and was happy until the so-called “wife” died. The secret that “Mr.” Hall was really a woman was not discovered till after her death.

A similar case is that of De Raylan, who was assistant to the Russian consul in Chicago for twelve years. When he died in December, 1906, it was found that the assistant was a woman. She smoked constantly and was possessed of a discriminating taste for liquors with ability to withstand the effects of drink better than most men. She was married with the present “Mrs. De Raylan” for the last twelve years after having been married once before and divorced.

Transvestism.—The psycho-sexual anomaly of transvestism consists in the desire for cross-dressing. The male patient has the abnormal desire to dress like a woman, and the female patient longs to dress like a man. It is in this respect akin to the anomaly of homosexuality. In the degrees of effemination and viraginity, cross-dressing is a prominent symptom. The homosexual pathicus has naturally the impulsive desire to dress like a woman, and vice versa, the Lesbian woman longs to dress like a man.

Still, cross-dressing is a pathological entity by itself. Homosexuality is a morbid sex state of gross somatic experiences. It emanates from the crude, powerful sensation of sex. The individual’s longings extend to somatic sensations. These desires often rapidly reach an obsessional state. Transvestism, on the other hand, is a sexo-esthetic inversion of pure artistic imitation. Hence it occurs mostly in artists and in men of letters, i. e., in persons endowed with a highly developed artistic taste. Such persons are, as a rule, disgusted at the sight of the organs of the sex to which the individual by anatomical configuration belongs, while such sights offer to the homosexual individual additional charm and piquancy.

Transvestism tends to accent the esthetic sensibility. The patient’s experience of an increased comfort and well-being by the gratification of the pronounced impulse of cross-dressing, is more akin to the satisfaction of the artist, experienced by the successful expression of a certain symbolism. Transvestism is more in harmony with the basal esthetic demands. The patient harbors exalted ideas and is striving to secure artistic enjoyment in the appreciation of the beautiful. The attraction is in the mind and has nothing to do with the sex-organs. Hence transvestism seldom celebrates orgies of lascivious and voluptuous practices, as often found in homosexuality. If sensuous caressing does take place, it is with a person of the other sex. For the physical part of the sex activity is perfectly normal.

The following five cases of transvestism in menBF will illustrate these points:

The first patient was very delicate all the time up to four years of age. His father died when he was four years old, and the boy was brought up by his mother. As the youngest living child (Nesthäkchen, nestling) he was rather spoiled by her. He slept with his mother until he was fourteen years old. The patient’s looks were rather girlish. He always wore girl’s shoes, on account of his high instep. Up to twelve years of age the patient played with girls, made dolls’ dresses, cooked in girls’ cooking stoves, etc. The patient’s sister was a dress-maker and often used the patient as a model to drape or to try on dresses. Otherwise the patient was never seduced by anyone to irregular practices.

CUT XLIII.

A characteristic picture of patient No. 1; posing in imitation of the celebrated painting “Psyche in Bath,” dressed in stockinet.

At puberty a certain change took place in the psyche of the patient. At this time, when about twelve years of age, he began to think how nice it would be if he could be changed into a girl. He never had any sexual desires for women. In stuprando manu he donned female attire, but his fancies had always women as the objects. When the patient is dressed like a man, no one would take him for a woman. There are no strongly pronounced feminine traits. The sex-organs are those of a normal man. The distribution of the hair on the body is almost the same as in any other man. The head is rather bald. On the arms there is no hair, but the hands are covered with hair. The hands are rather small, narrow, soft, well-shaped and artistic. The fingers are tapering. The legs and feet, when in dainty stockings, are rather feminine. The patient wears woman’s shoes. Otherwise when he is dressed like a man he looks like a normal man. But when the patient is in stockinet as in his photograph, “Psyche in Bath,” no one would take him for a man. When dressed like a woman, nobody would recognize a man in him. He has taken walks on streets unnoticed while so dressed. He never drew any attention, so perfectly does he look like a woman.

The patient’s behavior is quiet but not effeminate. His voice is low, of uncertain timbre. He tries to cultivate a female voice without resorting to falsetto. His writing is uneven, sometimes bold; mostly, however, it is a woman’s small handwriting. The gait is like that of a woman, swaying in the hips. The patient suffers from periodical hemorrhages of the nose, which he is inclined to consider as a kind of vicarious menstruation.

As far as the emotions are concerned there is a marked feminine sensibility. Tears come easily when watching emotional scenes. He smiles almost constantly when in conversation, but he rarely laughs outright. He is very sensitive to pain, but stoic enough not to complain. He blushes on the slightest pretext. He is possessed of feminine adaptability. He likes needlework and loves to do crochetting. He likes female amusements, such as “Kaffeeklatsch.” He is a freethinker in his creed.

The patient possesses normal love and admiration for the other sex. He is attracted by women, although his sexual feelings are very little pronounced. He takes the greatest pleasure in contemplating pictures of the female form. His day-dreams and fancies are only of women. He has no homosexual inclinations, but rather a profound repugnance against homosexual relationship. He never longed for a male instead of a female lover. Still he seems to want a man before whom he could expose the charms of his own person and who would kiss and caress him. His sexual desires are not developed. He never was in love with any women or men. His wife proposed to him. He may have remained otherwise single. He has three children, all perfectly healthy.

The peculiar anomaly the patient is suffering from is the desire to be a complete woman. From his childhood he had the wish to be a girl. His desire now is to live as a woman absolutely. He never had any dream where he saw himself as a woman; in fact, he never had any erotic dreams. He longs for the female form. He often wished to be castrated to be more like a woman.

The patient is attracted by beautiful women, but the instinctive feeling toward them is not the desire for possession, but more a feeling of envy that he cannot be one like them. The appeal of woman’s beauty to him is connected with the desire of inner or psychical or subjective identification of himself with the beautiful woman, the desire to be in her place—“Einfühlung, Miterleben,” as the Germans call it. He would do almost anything to see a girl in any condition of exposure, but he would experience only the desire of inner imitation. His desire to show himself in female attire is founded upon the impulse of being considered a full woman.

CUT XLIV.

First patient.

From a legal point of view the patient’s inversion is mainly confined to the sphere of clothing. He has a profound longing for female clothes. He takes pleasure in the sight of female attire. Woman’s underclothing exercise a greater charm upon him than the woman herself. He especially attaches great importance to the corset. The patient is always dressed in female underclothes. He wears only a man’s coat, vest and trousers, or the clothes belonging to the outward cover. He wears woman’s shoes, shirtwaists, corsets, stockings, etc. The earlobes are pierced for earings, which he wears every night. He takes breakfast dressed as a woman.

When the patient is dressed as a woman, he has all a woman’s feelings and longings. For this reason he tries to dress as a woman at every opportunity. The desire to be dressed like a woman takes the form of an imperative impulse. When he cannot dress up he becomes restless. He would rather commit suicide than be without female apparel.

As a literary man and brain-worker, the patient can concentrate his thoughts better when in female attire. When dressed as a woman he feels himself to be in a normal condition and is cheerful. A feeling of absolute comfort and restfulness comes over him, when in female clothes, and his behavior is in full accordance with his feelings, while in male dress there is a kind of absent-mindedness about him; he is always thinking of his female dresses.

The second case is that of a gentleman of about sixty-two years of age living in the western part of our country. As a child he was known as mother’s boy, and his mother and he were very fond of each other. He has always done his best to please her, spent as much of his time with her as possible, and took great pleasure in the tasks she would give him, such as knitting, crochet work, or plain sewing. On most of all these occasions she would first put him in girl’s clothes. The hardest tasks would then be a pleasure to him. These practices continued up to his twelfth year of age.

From his earliest recollections his playmates were always girls and his playthings were dolls, ribbons, miniature housekeeping, furniture, etc. He was an expert doll maker and could cut and make doll clothes for his sisters and other little girls. At ten years of age he could cook and prepare a meal. He was known to have no lack of courage.

His inclinations are always towards strong-minded, energetic women of the masculine type. He also has an admiration for other men of his type when they are dressed like women. He never had any homosexual inclination. He always had an almost uncontrollable desire to wear woman’s attire. When so dressed he can always think more logically, feel less encumbered, solve difficult problems. But for the popular prejudices he would always wear female attire.

The skin of the patient is soft and clear, the hair on head and beard is soft and light. He has little hair on his body. His shoulders are square and his breasts quite large. His voice is high.

He blushes readily. He could never countenance vulgarity, such as smutty stories or obscene remarks. He is receptive. He is very sensitive to pain or pleasure. He is inclined to be stubborn. His intellect is keen, and he thinks logically.

When about fifteen years old his father forbade him to wear female clothes, so he kissed his mother good-bye and made his way to the far West. There he drove a team on construction work of a railroad and in the fall of the same year found himself hunting buffalo. In the five ensuing years he has done his part in winning of the West, with the result that he carries two Indian bullets in his legs. But he covers them up with petticoats, he says, as often as opportunity permits. Then he forgets all about them, as well as all other troubles. He has served as a detective in a United States marshal’s office, as a sheriff, and as a justice of the peace. He has been able to conquer almost everything except his uncontrollable passion for female attire. When the inclination to dress comes over him, he is unable, try as he may, to resist it.

This last characteristic in the case shows that the desire for cross-dressing may often assume the degree of a veritable imperative idea. If the desire is not satisfied, some patients are seized with anxiety, accompanied by cold perspiration and palpitation of the heart.

The third case is of a gentleman, thirty-two years of age, married. In his answer to a letter written by another transvestite asking him for his life history, the patient writes that he expected the letter, because Agnes M. had told him that he would receive one. This Agnes M. was a man, and it is characteristic of these patients to call each other by girls’ names. Our patient, too, signs his name, “Yours femininely, Blanche.” The part of the history of this “Blanche” that interests us most reads as follows:

The feminine instincts first appeared at the age of four years. He was then attending a small girls’ school in the country, his mother having a business in town. At about that age, it was suggested that it was time that he was put into knickers. When he first was dressed in boy’s dress, a horrid feeling assailed him. He fought so persistently against wearing these new apparel that his mother resolved to leave him dressed in girl’s attire for a few years longer. Thus he was able to wear frocks for the first eighteen years of his life.

At that time necessity made it imperative for him to earn a living, and he was forced to go out into the world dressed as a boy. He writes, he will never forget the great aversion which assailed him when he first went out in trousers. He seemed ashamed to look anyone in the face. He always wanted to hide his legs.

He never gave up feminine underwear, only outwardly he dresses as a man. In the house, when he returns from business, he always dresses as a woman. His mind is never contented during the daytime. When the evening comes, the first job on getting home is to don a petticoat and frock and to be for the rest of the evening in the garb which his mind tells him is the right one. He feels nothing but nausea in the garb of a man.

CUT XLV.

Third patient.

The last characteristic shows plainly the morbidity of the case. A normal woman, if forced by circumstances to wear men’s clothes, may have the feeling of being improperly dressed, but she would not have the feeling of nausea. Here we have a creature with a normal male body, but on account of the complete female mind he feels nauseated when wearing male clothes.

The fourth case is that of “Prof.” M., a female impersonator, who also addresses his transvestite friends by girls’ names. His history reads as follows:

The patient is sixty-two years of age, has a beautiful form, small hands and feet and a beautiful head of hair which he can do up in lady’s fashion by the aid of switches.

CUT XLVI.

Fourth patient, dressed for the street.

His mother dressed him in girls’ clothes until he became a large-sized boy, and when she attempted to put him into boys’ clothes, he would kick and scream. Since that time, when opportunity presented itself, he would masquerade in female garb. There seems to be a peculiar fascination and pleasure to him when dressed in the clothes of the opposite sex. A sort of an irresistible impulse comes over him at times, and he cannot extricate himself. He can control his thoughts better, write and seemingly work better when dressed in skirts, and he is more contented.

His sexual organs are fully developed and do not differ from any other male organs. A number of years previously he was strong sexually and fond of the opposite sex. Nowadays he cares more for his own sex. Men look more attractive to him than women do. “It seems strange,” writes the patient, “but I think all female impersonators learn to have an abhorrence for the female sex, even a hatred in the course of time.” “Dear Miss S., as you and Maude (by the way, S. and Maude are both men) are in the same boat, I am free to tell all these things. I am pleased to find one who thinks as I do. The common herd does not understand me.”BG

This case throws a certain light upon the psyche of the woman impersonators. They do not become effeminate through the long habit of masquerading—that would be confounding cause and effect—but their innate anomaly leads them to choose impersonating as a profession. A normal man would hardly select such a profession as his life work.

The following case is that of a gentleman, aged thirty-six years, an artist painter who is about to marry. In his letter to a transvestite friend he protests against the insinuation of homosexualism. He writes as follows:

“The reason why I did not answer before is because it seems to me that our views on the matter mentioned are very diverging. As far as I can judge from your letter, it looks as if you consider man’s love for dressing in female clothes equal to homosexualism. I can tell you that homosexualism has always been an abhorrence to me, and that the sole reason for my desire to wear gowns is purely feminine love for what is beautiful and picturesque. In my relations to the other sex, I am just as normal as any other man.”

The longings for cross-dressing in our cases may be best explained, that the feminine strain, normally found in every male, exists here in a greatly exaggerated form. Every normal woman attributes an exaggerated value to clothes and, Narcissus-like, is more or less enamored with the female body.BH The same
exaggerated value to female clothes is attributed by the male transvestites. The female transvestite, on the other hand, thinks of clothes more or less as men do. Yet, the male strain in her, being a morbid phenomenon, dressing is of more importance to her than it is to the normal man.