Ulrichs (“Kritische Pfeile,” p. 2, 1880) declares that, on an average, there is one person affected with contrary sexual instinct to every two hundred mature men, or to every eight hundred of the population; and that the percentage among the Magyars and South Slavs is still greater,—statements which may be regarded as untrustworthy. The subject of one of my cases knows personally, at his home (13,000 inhabitants), fourteen urnings. He further declares that he is acquainted with at least eighty in a city of 60,000 inhabitants. It is to be presumed that this man, otherwise worthy of belief, makes no distinction between the congenital and the acquired anomaly.
1. Psychical Hermaphroditism.[[112]]—The characteristic mark of this degree of inversion of the sexual instinct is that, by the side of the pronounced sexual instinct and desire for the same sex, a desire toward the opposite sex is present; but the latter is much weaker and is manifested episodically only, while the homo-sexuality is primary, and, in time and intensity, forms the most striking feature of the vita sexualis.
The hetero-sexual instinct may be but rudimentary, manifesting itself simply in unconscious (dream) life; or (episodically, at least) it may be powerfully exhibited.
The sexual instinct toward the opposite sex may be strengthened by the exercise of will and self-control; by moral treatment, and possibly by hypnotic suggestion; by improvement of the constitution and the removal of neuroses (neurasthenia); but especially by abstinence from masturbation. However, there is always the danger that homo-sexual feelings, in that they are the most powerful, may become permanent, and lead to enduring and exclusive contrary sexual instinct. This is especially to be feared as a result of the influences of masturbation (just as in acquired inversion of the sexual instinct) and its neurasthenia and consequent exacerbations; and, further, it is to be found as a consequence of unfavorable experiences in sexual intercourse with persons of the opposite sex (defective feeling of pleasure in coitus, failure in coitus on account of weakness of erection and premature ejaculation, infection). On the other hand, it is possible that æsthetic and ethical sympathy with persons of the opposite sex may favor the development of hetero-sexual desires. Thus it happens that the individual, according to the predominance of favorable or unfavorable influences, experiences now hetero-sexual, now homo-sexual, feeling.
It seems to me probable that such hermaphrodites from constitutional taint are not infrequent.[[113]] Since they attract very little attention socially, and since such secrets of married life are only exceptionally brought to the knowledge of the physician, it is at once apparent why this interesting and practically important transitional group to the group of absolute contrary sexuality, has thus far escaped scientific investigation. Many cases of frigiditas uxoris and mariti may possibly depend upon this anomaly. Sexual intercourse with the opposite sex is, in itself, possible. At any rate, in cases of this degree, no horror sexus alterius exists. Here is a fertile field for the application of medical and moral therapeutics (v. infra). The differential diagnosis from acquired contrary sexual instinct may present difficulties; for in such cases, as long as the vestiges of a normal sexual instinct are not absolutely lost, the actual symptoms are the same (v. infra). In the first degree, the sexual satisfaction of homo-sexual impulses consists in passive and mutual onanism and coitus inter femora.
Case 106. Psychical Hermaphroditism in a Lady.—Mrs. M., aged 44, exemplifies the fact that an inverted and a normal sexual instinct may be united in one person, be it in man or woman. The father of this lady was very musical, and very talented as an artist. He took life easily; and to his extraordinary beauty was added a great admiration for the opposite sex. After several apoplectic attacks, he died demented in an asylum. Father’s brother was neuro-psychopathic, and when a child was a somnambulist; and all his life he was afflicted with hyperæsthesia sexualis. Thus, although married and the father of married sons, he tried to seduce his niece, Mrs. M., with whom he was wildly in love, when she was eighteen years old. Father’s father was very eccentric and a distinguished actor. He first studied theology, but, as a result of partiality for the dramatic muse, he became an actor and singer. He committed excesses in baccho et venere; was a spendthrift and luxurious. He died at forty-nine, of apoplexia cerebri. Mother’s father and mother died of tuberculosis of the lungs.
Mrs. M. was one of eleven children, of whom six are still living. Two brothers, who resembled the mother physically, died, at sixteen and twenty, of tuberculosis. A brother suffers with laryngeal phthisis. Four living sisters and Mrs. M. resemble the father physically, and the eldest is unmarried, very nervous, and shy of people. Two younger sisters are married, healthy, and have healthy children. The other is unmarried, and suffers with nervous complaints. Mrs. M. has four children, several of whom are delicate and neuropathic.
The patient can tell nothing of importance concerning her childhood. She learned easily, and was æsthetically and poetically inclined. She was considered a little high-strung, and too much given to novel-reading and sentimentality. Her constitution was neuropathic, and she was extremely sensitive to changes of temperature, sometimes having annoying cutis anserina as a result of slight draughts. It is remarkable that one day, when she was about ten years old, she thought that her mother no longer loved her; and she put matches in her coffee to make herself really sick, that she might thus excite her mother’s love for her.
Puberty began, without difficulty, at the age of eleven. Thereafter the menses were regular. Before the time of puberty sexuality manifested itself, and, according to the opinion of the patient, its promptings have been abnormally intense all her life. The first feelings and impulses were decidedly inverted. She conceived a passionate but platonic love for a young lady. She wrote verses and sonnets to her, and was perfectly happy if she could admire “the entrancing charms” of her goddess in the bath, or steal a glimpse of her neck, shoulders, and breast while she was dressing. The wild impulse to touch these physical charms was always overcome. While a young girl, she had actually been in love with Madonnas of Raphael and Guido Reni. In all kinds of weather she would run after pretty girls and ladies for hours at a time, admiring their beauty, losing no opportunity to please them, offering them bouquets, etc. The patient asserted that, until the age of nineteen, she was absolutely without a suspicion of a difference of sex; because she had been educated as in a cloister by a very prudish aunt, who was an old maid. As a result of this great ignorance, the patient became the victim of a man who was passionately in love with her, and who had coitus with her by means of stratagem. She became the wife of this man, bore one child, and lived an “eccentric” sexual life with him. She felt perfectly satisfied with married intercourse. After a few years she became a widow. Since then, women have again been the object of her love, primarily, as the patient thinks, from fear of the results of sexual intercourse with a man.
At twenty-seven, second marriage, without love, to a phthisical husband. Patient was three times confined, and fulfilled her maternal duties. Her physical health failed, and in the later years of this married life she had an increasing aversion for her husband, partly due to a sense of his disease, though, at the same time, there was constantly present an intense desire for sexual indulgence.