As regards the general bearing of the inverted woman, in its most marked and undisguised form, I may quote an admirable description by Prof. Zuccarelli, of Naples, of an unmarried middle-class woman of 35: "While retaining feminine garments, her bearing is as nearly as possible a man's. She wears her thin hair thrown carelessly back alla Umberto, and fastened in a simple knot at the back of her head. The breasts are little developed, and compressed beneath a high corset; her gown is narrow without the expansion demanded by fashion. Her straw hat with broad plaits is perhaps adorned by a feather, or she wears a small hat like a boy's. She does not carry an umbrella or sunshade, and walks out alone, refusing the company of men; or she is accompanied by a woman, as she prefers, offering her arm and carrying the other hand at her waist, with the air of a fine gentleman. In a carriage her bearing is peculiar and unlike that habitual with women. Seated in the middle of the double seat, her knees being crossed or else the legs well separated, with a virile air and careless easy movements she turns her head in every direction, finding an acquaintance here and there with her eye, saluting men and women with a large gesture of the hand as a business man would. In conversation her pose is similar; she gesticulates much, is vivacious in speech, with much power of mimicry, and while talking she arches the inner angles of her eyebrow, making vertical wrinkles at the center of her forehead. Her laugh is open and explosive and uncovers her white rows of teeth. With men she is on terms of careless equality." ("Inversione congenita dell'istinto sessuale in una donna," L'Anomalo, February, 1889.)
"The inverted woman," Hirschfeld truly remarks (Die Homosexualität, p. 158), "is more full of life, of enterprise, of practical energy, more aggressive, more heroic, more apt for adventure, than either the heterosexual woman or the homosexual man." Sometimes, he adds, her mannishness may approach reckless brutality, and her courage becomes rashness. This author observes, however, in another place (p. 272) that, in addition to this group of inverted women with masculine traits there is another group, "not less large," of equally inverted women who are outwardly as thoroughly feminine as are normal women. This is not an observation which I am able to confirm. It appears to me that the great majority of inverted women possess some masculine or boyish traits, even though only as slight as those which may occasionally be revealed by normal women. Extreme femininity, in my observation, is much more likely to be found in bisexual than in homosexual women, just as extreme masculinity is much more likely to be found in bisexual than in homosexual men.
While inverted women frequently, though not always, convey an impression of mannishness or boyishness, there are no invariable anatomical characteristics associated with this impression. There is, for instance, no uniform tendency to a masculine distribution of hair. Nor must it be supposed that the presence of a beard in a woman indicates a homosexual tendency. "Bearded women," as Hirschfeld remarks, are scarcely ever inverted, and it would seem that the strongest reversals of secondary sexual characters less often accompany homosexuality than slighter modifications of these characters.[[167]] A faint moustache and other slight manifestations of hypertrichosis also by no means necessarily indicate homosexuality. To some extent it is a matter of race; thus in the Pera district of Constantinople, Weissenberg, among nearly seven hundred women between about 18 and 50 years of age, noted that 10 per cent, showed hair on the upper lip; they were most often Armenians, the Greeks coming next.[[168]]
There has been some dispute as to whether, apart from homosexuality, hypertrichosis in a woman can be regarded as an indication of a general masculinity. This is denied by Max Bartels (in his elaborate study, "Ueber abnorme Behaarung beim Menschen," Zeitschrift für Ethnologie, 1876, p. 127; 1881, p. 219) and, as regards insanity, by L. Harris-Liston ("Cases of Bearded Women," British Medical Journal, June 2, 1894). On the other hand, J. H. Claiborne ("Hypertrichosis in Women," New York Medical Journal, June 13, 1914) believes that hair on the face and body in a woman is a sign of masculinity; "women with hypertrichosis possess masculine traits."
There seems to be very little doubt that fully developed "bearded women" are in most, possibly not all, cases decidedly feminine in all other respects. A typical instance is furnished by Annie Jones, the "Esau Lady" of Virginia. She belonged to a large and entirely normal family, but herself possessed a full beard with thick whiskers and moustache of an entirely masculine type; she also showed short, dark hair on arms and hands resembling a man. Apart from this heterogeny, she was entirely normal and feminine. At the age of 26, when examined in Berlin, the hair of the head was very long, the expression of the face entirely feminine, the voice also feminine, the figure elegant, the hands and feet entirely of feminine type, the external and internal genitalia altogether feminine. Annie Jones was married. Max Bartels, who studied Annie Jones and published her portrait (Zeitschrift für Ethnologie, 1891, Heft 3, p. 243), remarks that in these respects Annie Jones resembles other "bearded women"; they marry, have children, and are able to suckle them. A beard in women seems, as Dupré and Duflos believe (Revue Neurologique, Aug. 30, 1901), to be more closely correlated with neuropathy than with masculinity; comparing a thousand sane women with a thousand insane women in Paris, they found unusual degree of hair or down on the face in 23 per cent. of the former and 50 per cent. of the latter; but even the sane bearded women frequently belonged to neuropathic families.
A tendency to slight widely diffused hypertrichosis of the body generally, not localized or highly developed on the face, seems much more likely than a beard to be associated with masculinity, even when it occurs in little girls. Thus Virchow once presented to the Berlin Anthropological Society a little girl of 5 of this type who also possessed a deep and rough voice (Zeitschrift für Ethnologie, 1891, Heft 4, p. 469). A typical example of slight hypertrichosis in a woman associated with general masculine traits is furnished by a description and figure of the body of a woman of 56 in an anatomical institute, furnished by C. Strauch (Zeitschrift für Ethnologie, 1901, Heft 6, p. 534). In this case there was a growth of hair around both nipples and a line of hair extended from the pubes to the navel; both these two dispositions of hair are very rare in women. (In Vienna among nearly 700 women Coe only found a tendency to hair distribution toward the navel in about 1 per cent.). While the hair in this subject was otherwise fairly normal, there were many approximations to the masculine type in other respects: the muscles were strongly developed, the bones massive, the limbs long, the joints powerful, the hands and feet large, the thorax well developed, the lower jaw massive; there was an absence of feminine curves on the body and the breasts were scarcely perceptible. At the same time the genital organs were normal and there had been childbirth. It was further notable that this woman had committed suicide by self-strangulation, a rare method which requires great resolution and strength of will, as at any moment of the process the pressure can be removed.
There seems little doubt that inverted women frequently tend to show minor anomalies of the piliferous system, and especially slight hypertrichosis and a masculine distribution of hair. Thus in a very typical case of inversion in an Italian girl of 19 who dressed as a man and ran away from home, the down on the arms and legs was marked to an unusual extent, and there was very abundant hair in the armpits and on the pubes, with a tendency to the masculine distribution.[[169]] Of the three cases described in this chapter which I am best acquainted with, one possesses an unusually small amount of hair on the pubes and in the axillæ (oligotrichosis terminalis), approximating to the infantile type, while another presents a complex and very rare piliferous heterogeny. There is marked dark down on the upper lip; the pubic hair is thick, and there is hair on toes and feet and legs to umbilicus; there are also a few hairs around the nipples. A woman physician in the United States who knows many female inverts similarly tells me that she has observed the tendency to growth of hair on the legs. If, as is not improbable, inversion is associated with some abnormal balance in the internal secretions, it is not difficult to understand this tendency to piliferous anomalies; and we know that the thyroid secretion, for instance, and much more the testicular and ovarian secretions, have a powerful influence on the hair.
Ballantyne, some years ago, in discussing congenital hypertrichosis (Manual of Antenatal Pathology, 1902, pp. 321-6) concluded that the theory of arrested development is best supported by the facts; persistence of lanugo is such an arrest, and hypertrichosis may largely be considered a persistence of lanugo. Such a conclusion is still tenable,—though it encounters some difficulties and inconsistencies,—and it largely agrees with what we know of the condition as associated with inversion in women. But we are now beginning to see that this arrested development may be definitely associated with anomalies in the internal secretions, and even with special chemical defects in these secretions. Virile strength has always been associated with hair, as the story of Samson bears witness. Ammon found among Baden conscripts (L'Anthropologie, 1896, p. 285) that when the men were divided into classes according to the amount of hair on body, the first class, with least hair, have the smallest circumference of testicle, the fewest number of men with glans penis uncovered, the largest number of infantile voices, the largest proportion of blue eyes and fair hair, the smallest average height, weight, and chest circumference, while in all these respects the men with hairy bodies were at the other extreme. It has been known from antiquity that in men early castration affects the growth of hair. It is now known that in women the presence or absence of the ovary and, other glands affects the hair, as well as sexual development. Thus Hegar (Beiträge zur Geburtshülfe und Gynäkologie, vol. i, p. 111, 1898) described a girl with pelvis of infantile type and uterine malformation who had been unusually hairy on face and body from infancy, with masculine arrangement of hair on pubes and abdomen; menstruation was scanty, breasts atrophic; the hair was of lanugo type; we see here how in women infantile and masculine characteristics are associated with, and both probably dependent on, defects in the sexual glands. Plant (Centralblatt für Gynäkologie, No. 9, 1896) described another girl with very small ovaries, rudimentary uterus, small vagina, and prominent nymphæ, in whom menstruation was absent, hair on head long and strong, but hair absent in armpits and scanty on mons veneris. These two cases seem inconsistent as regards hair, and we should now wish to know the condition of the other internal glands. The thyroid, for instance, it is now known, controls the hair, as well as do the sexual glands; and the thyroid, as Gautier has shown (Académie de Médecine, July 24, 1900) elaborates arsenic and iodine, which nourish the skin and hair; he found that the administration of sodium cacodylate to young women produced abundant growth of hair on head. Again, the kidneys, and especially the adrenal glands, influence the hair. It has long been known that in girls with congenital renal tumors there is an abnormally early growth of axillary and pubic hair; Goldschwend (Präger medizinische Wochenschrift, Nos. 37 and 38, 1910) has described the case of a woman of 39, with small ovaries and adrenal tumor, in whom hair began to grow on chin and cheeks. (See also C. T. Ewart, Lancet, May 19, 1915.) Once more, the glans hypophysis also affects hair growth and it has been found by Lévi (quoted in Archives d'Anthropologie Criminelle, August-September, 1912, p. 711) that the administration of hypophysis extract to an infantile, hairless woman of 27, without sexual feeling, produced a general tendency to growth of hair. Such facts not only help to explain the anomalies of hair development, but also indicate the direction in which we may find an explanation of the anomalies of the sexual impulse.
Apart from the complicated problem presented by the hair, there are genuine approximations to the masculine type. The muscles tend to be everywhere firm, with a comparative absence of soft connective tissue; so that an inverted woman may give an unfeminine impression to the sense of touch. A certain tonicity of the muscles has indeed often been observed in homosexual women. Hirschfeld found that two-thirds of inverted women are more muscular than normal women, while, on the other hand, he found that among inverted men the musculature was often weak.
Not only is the tone of the voice often different, but there is reason to suppose that this rests on a basis, of anatomical modification. At Moll's suggestion, Flatau examined the larynx in a large number of inverted women, and found in several a very decidedly masculine type of larynx, or an approach to it, especially in cases of distinctly congenital origin. Hirschfeld has confirmed Flatau's observations on this point. It may be added that inverted women are very often good whistlers; Hirschfeld even knows two who are public performers in whistling. It is scarcely necessary to remark that while the old proverb associates whistling in a woman with crowing in a hen, whistling in a woman is no evidence of any general physical or psychic inversion.