doubt that some sexual inverts (and more especially bisexuals) do possess unusual sexual energy, in others it is but apparent; the frequent repetition of seminal emissions, for example, may be the result of weakness as well as of strength. It must be added that this irritability of the sexual centers is, in a considerable proportion of inverts, associated with marked emotional tendencies to affection and self-sacrifice. In the extravagance of his affection and devotion, it has been frequently observed, the male invert resembles many normal women.
SUGGESTION AND OTHER EXCITING CAUSES OF INVERSION.--In 18 of my cases it is possible that some event, or special environment, in early life had more or less influence in turning the sexual instinct into homosexual channels, or in calling out a latent inversion. In 3 cases a disappointment in normal love seems to have produced a profound nervous and emotional shock, acting, as we seem bound to admit, on a predisposed organism, and developing a fairly permanent tendency to inversion. In 8 cases there was seduction by an older person, but in at least 4 or 5 of these there was already a well-marked predisposition. In at least 8 other cases, example, usually at school, may probably be regarded as having exerted some influence. It is noteworthy that in very few of my cases can we trace the influence of any definite "suggestion," as asserted by Schrenck-Notzing, who believes that, in the causation of sexual inversion (as undoubtedly in the causation of erotic fetichism), we must give the first place to "accidental factors of education and external influence." He records the case of a little boy who innocently gazed in curiosity at the penis of his father who was urinating, and had his ears boxed, whence arose a train of thought and feeling which resulted in complete sexual inversion. In two of the cases I have reported we have parallel incidents, and here we see clearly that the homosexual tendency already existed. I do not question the occurrence of such incidents, but I refuse to accept them as supplying the causation of inversion, and in so doing I am supported by all the evidence I am able to obtain. I am in agreement with a correspondent who wrote:-- "Considering that all boys are exposed to the same order of suggestions (sight of a man's naked organs, sleeping with a man, being handled by a man), and that only a few of them become sexually perverted, I think it reasonable to conclude that those few were previously constituted to receive the suggestion. In fact, suggestion seems to play exactly the same part in the normal and abnormal awakening of sex."
I would go so far as to assert that for normal boys and girls the developed sexual organs of the adult man or woman--from their size, hairiness, and the mystery which envelops them--nearly always exert a certain fascination, whether of attraction or horror.[187] But this has no connection with homosexuality, and scarcely with sexuality at all. Thus, in one case known to me, a boy of 6 or 7 took pleasure in caressing the organs of another boy, twice his own age, who remained passive and indifferent; yet this child grew up without ever manifesting any homosexual instinct. The seed of suggestion can only develop when it falls on a suitable soil. If it is to act on a fairly normal nature the perverted suggestion must be very powerful or iterated, and even then its influence will probably only be temporary, disappearing in the presence of the normal stimulus.[188] Not only is "suggestion" unnecessary to develop a sexual impulse already rooted in the organism, but when exerted in an opposite direction it is powerless to divert that impulse. We see this illustrated in several of the cases whose histories I have presented. Thus in one case a boy was seduced by the housemaid at the age of 14 and even derived pleasure from the girl, yet none the less the native homosexual instinct asserted itself a year later. In another case heterosexual suggestions were offered and accepted in early life, yet, notwithstanding, the homosexual attraction was slowly evolved from within.
I have, therefore, but little to say of the influence of suggestion, which was formerly exalted to a position of the first importance in books on sexual inversion. This is not because I underestimate the great part played by suggestion in many fields of normal and abnormal life. It is because I have been able to find but few decided traces of it in sexual inversion. In many cases, doubtless, there may be some slight elements of suggestion in developing the inversion, though they cannot be traced.[189] Their importance seems usually questionable even when they are discovered. Take Schrenck-Notzing's case of the little boy whose ears were boxed for what his father considered improper curiosity. I find it difficult to realize that a mighty suggestion can thereby be generated unless a strong emotion exists for it to unite with; in that case the seed falls on prepared soil. Is the wide prevalence of normal sexuality due to the fact that so many little boys have had their ears boxed for taking naughty liberties with women? If so, I am quite prepared to accept Schrenck-Notzing's explanation as a complete account of the matter. I know of one case, indeed, in which an element of what may fairly be called suggestion can be detected. It is that of a physician who had always been on very friendly terms with men, but had sexual relations exclusively with women, finding fair satisfaction, until the confessions of an inverted patient one day came to him as a revelation; thereafter he adopted inverted practices and ceased to find any attraction in women. But even in this case, as I understand the matter, suggestion merely served to reveal his own nature to the man. For a physician to adopt the perverted habits which the visit of a chance patient suggests to him can scarcely be a phenomenon of pure suggestion. We have no reason to suppose that this physician practised every perversion he heard of from patients; he adopted that which fitted his own nature.[190] In another case homosexual advances were made to a youth and accepted, but he had already been attracted to men in childhood. Again, in another case, there were homosexual influences in the boyhood of a subject who became bisexual, but as the subject's father was of similar bisexual temperament we can attach no potency to the mere suggestions. In another case we find homosexual influence in childhood, but the child was already delicate, shy, nervous, and feminine, clearly possessing a temperament predestined to develop in a homosexual direction.
The irresistible potency of the inner impulse is well illustrated in a case presented by Hirschfeld and Burchard: "My daughter Erna," said the subject's mother, "showed boyish inclinations at the age of 3, and they increased from year to year. She never played with dolls, only with tin soldiers, guns, and castles. She would climb trees and jump ditches; she made friends with the drivers of all the carts that came to our house and they would place her on the horse's back. The annual circus was a joy to her for all the year. Even as a child of 4 she was so fearless on horseback that lookers-on shouted Bravo! and all declared she was a born horsewoman. It was her greatest wish to be a boy. She would wear her elder brother's clothes all day, notwithstanding her grandmother's indignation. Cycling, gymnastics, boating, swimming, were her passion, and she showed skill in them. As she grew older she hated prettily adorned hats and clothes. I had much trouble with her for she would not wear pretty things. The older she grew the more her masculine and decided ways developed. This excited much outcry and offence. People found my daughter unfeminine and disagreeable, but all my trouble and exhortations availed nothing to change her." Now this young woman whom all the influences of a normal feminine environment failed to render feminine was not physiologically a woman at all; the case proved to be the unique instance of an individual possessing all the external characteristics of a woman combined with internal testicular tissue capable of emitting true masculine semen through the feminine urethra. No suggestions of the environment could suffice to overcome this fundamental fact of internal constitution. (Hirschfeld and Burchard, "Spermasekretion aus einer weiblichen Harnröhre," _Deutsche medizinische Wochenschrift_, No. 52, 1911.)
I may here quote three American cases (not previously published), for which I am indebted to Prof. G. Frank Lydston, of Chicago. They seem to me to illustrate the only kind of suggestions which play much part in the evolution of inversion. I give them in Dr. Lydston's words:-- CASE I.--A man, 45 years of age, attracted by the allusion to my essay on "Social Perversion" contained in the English translation of Krafft-Ebing's _Psychopathia Sexualis_, consulted me regarding the possible cure of his condition. This individual was a finely educated, very intelligent man, who was an excellent linguist, had considerable musical ability, and was in the employ of a firm whose business was such as to demand on the part of its employés considerable legal acumen, clerical ability, and knowledge of real-estate transactions. This man stated that at the age of puberty, without any knowledge of perversity of sexual feeling, he was thrown intimately in contact with males of more advanced years, who took various means to excite his sexual passions, the result being that perverted sexual practices were developed, which were continued for a number of years. He thereafter noticed an aversion to women. At the solicitations of his family he finally married, without any very intelligent idea as to what, if anything, might be expected of him in the marital relation. Absolute impotence--indeed, repugnance for association with his wife--was the lamentable sequence. A divorce was in contemplation when, fortunately for all parties concerned, the wife suddenly died. Being a man of more than ordinary intelligence, this individual, prior to seeking my aid, had sought vainly for some remedy for his unfortunate condition. He stated that he believed there was an element of heredity in his case, his father having been a dipsomaniac and one brother having died insane. He nevertheless stated it to be his opinion that, notwithstanding the hereditary taint, he would have been perfectly normal from a sexual standpoint had it not been for acquired impressions at or about the period of puberty. This man presented a typically neurotic type of _physique_, complained of being intensely nervous, was prematurely gray, of only fair stature, and had an uncontrollable nystagmus, which, he said, had existed for some fifteen years. As might be expected, treatment in this case was of no avail. I began the use of hypnotic suggestion at the hands of an expert professional hypnotist. The patient, being called out of the State, finally gave up treatment, and I have no means of knowing what his present condition is.
CASE II.--A lady patient of mine who happened to be an actress, and consequently a woman of the world, brought to me for an opinion some correspondence which had passed between her younger brother and a man living in another State, with whom he was on quite intimate terms. In one of these letters various flying trips to Chicago for the purpose of meeting the lad, who, by the way, was only 17 years of age, were alluded to. It transpired also, as evidenced by the letters, that on several occasions the young lad had been taken on trips in Pullman cars by his friend, who was a prominent railroad official. The character of the correspondence was such as the average healthy man would address to a woman with whom he was enamored. It seemed that the author of the correspondence had applied to his boy affinity the name Cinderella, and the protestations of passionate affection that were made toward Cinderella certainly would have satisfied the most exacting woman. The young lad subsequently made a confession to me, and I put myself in correspondence with his male friend, with the result that he called upon me and I obtained a full history of the case. The method of indulgence in this case was the usual one of oral masturbation, in which the lad was the passive party. I was unable to obtain any definite data regarding the family history of the elder individual in this case, but understand that there was a taint of insanity in his family. He himself was a robust, fine-looking man, above middle age, who was well educated and very intelligent, as he necessarily must have been, because of the prominent position he held with an important railway company. I will state, as a matter of interest, that the lad in this case, who is now 23 years of age, has recently consulted me for _impotentia coëundi_, manifesting a frigidity for women, and, from the young man's statements, I am convinced that he is well on the road to confirmed sexual perversion.
An interesting point in this connection is that the young man's sister, the actress already alluded to, has recently had an attack of acute mania.
I have had other unpublished cases that might be of interest, but these two are somewhat classical, and typify to a greater or less degree the majority of other cases. I will, however, mention one other case, occurring in a woman.
CASE III.--A married woman 40 years of age. Has been deserted by her husband because of her perverted sexuality. Neurotic history on both sides of the family, and several cases of insanity on mother's side. In this case affinity for the same sex and perverted desire for the opposite sex existed, a combination by no means infrequent. Hypnotic suggestion tried, but without success. Cause was evidently suggestion and example on the part of another female pervert with whom she associated before her marriage. Marriage was late, at age of 35. In all these cases there was an element of what may be called suggestion, but it was really much more than this; it was probably in each case active seduction by an elder person of a predisposed younger person. It will be observed that in each case there was, at the least, an organic neurotic basis for suggestion and seduction to work on. I cannot regard these cases as entitled to modify our attitude toward suggestion.
MASTURBATION.--Moreau believed that masturbation was a cause of sexual inversion, and Krafft-Ebing looked upon it as leading to all sorts of sexual perversions; the same opinion was currently repeated by many writers. It is not now accepted. Moll emphatically rejected the idea that masturbation can be the cause of inversion; Näcke repeatedly denies that masturbation, any more than seduction, can ever produce true inversion; Hirschfeld attaches to it no etiological significance. Many years ago I gave special attention to this point and reached a similar conclusion. That masturbation, especially at an early age, may sometimes enfeeble the sexual activities, and aid the manifestations of inversion, I certainly believe. But beyond this there is little in the history of my male cases to indicate masturbation as a cause of inversion. It is true that 44 out of 51 admit that they have practised masturbation,--at all events, occasionally, or at some period in their lives,--and it is possible that this proportion is larger than that found among normal people. Even if so, however, it is not difficult to account for, bearing in mind the fact that the homosexual person has not the same opportunities as has the heterosexual person to gratify his instincts, and that masturbation may sometimes legitimately appear to him as the lesser of two evils.[191] Not only has masturbation been practised at no period in at least 7 of the cases (for concerning several I have no information), but in several others it was never practised until long after the homosexual instinct had appeared, in 1 case not till the age of 40, and then only occasionally. In at least 8 it was only practised at puberty; in at least 8, however, it began before the age of puberty; at least 9 left off before about the age of 20. Unfortunately, as yet, we have little definite evidence as to the prevalence and extent of masturbation among normal individuals.
Among the women masturbation is found in at least 5 cases out of 7. In 1 case there was no masturbation until comparatively late in life, and then only at rare intervals and under exceptional circumstances. In another case, some years after the homosexual attraction had been experienced, it was practised, though not in excess, from the age of puberty for about four years, and then abandoned; during these years the physical sexual feelings were more imperative than they were afterward felt to be. In 2 cases masturbation was learned spontaneously soon after puberty, and in 1 of these practised in excess before the manifestations of inversion became definite. In all cases the subjects are emphatic in asserting that this practice neither led to, nor was caused by, the homosexual attraction, which they regard as a much higher feeling, and it must be added that the occasional practice of masturbation is very far from rare among fairly normal women.[192] While this is so, I am certainly inclined to believe that an early and excessive indulgence in masturbation, though not an adequate cause, is a favoring condition for the development of inversion, and that this is especially so in women. The sexual precocity indicated by early and excessive masturbation doubtless sometimes reveals an organism already predisposed to homosexuality. But, apart from this, when masturbation arises spontaneously at an early age on a purely physical basis it seems to tend to produce a divorce between the physical and the psychic aspects of sexual love. The sexual manifestations are all diverted into this physical direction, and the child is ignorant that such phenomena are normally allied to love; then, when a more spiritual attraction appears with adolescent development, this divorce is perpetuated. Instead of the physical and psychic feelings appearing together when the age for sexual attraction comes, the physical feelings are prematurely twisted from their natural end, and it becomes abnormally easy for a person of the same sex to step in and take the place rightfully belonging to a person of the opposite sex. This has certainly seemed to me the course of events in some cases I have observed.
ATTITUDE TOWARD THE OPPOSITE SEX.--In 17 cases (of whom 5 are married and others purposing to marry) there is sexual attraction to both sexes, a condition formerly called psycho-sexual hermaphroditism, but now more usually bisexuality. In such cases, although there is pleasure and satisfaction in relationships with both sexes, there is usually a greater degree of satisfaction in connection with one sex. Most of the bisexual prefer their own sex. It is curiously rare to find a person, whether man or woman, who by choice exercises relationships with both sexes and prefers the opposite sex. This would seem to indicate that the bisexual may really be inverts.
In any case bisexuality merges imperceptibly into simple inversion. In at least 16 of 52 cases of simple inversion in men there has been connection with women, in some instances only once or twice, in others during several years, but it was always with an effort, or from a sense of duty and anxiety to be normal; they never experienced any real pleasure in the act, or sense of satisfaction after it. Four of these cases are married, but martial relationships usually ceased after a few years. At least four others were attracted to women when younger, but are not now; another once felt sexually attracted to a boyish woman, but never made any attempt to obtain any relationships with her; 3 or 4 others, again, have tried to have connection with women, but failed. The largest proportion of my cases have never had any sexual intimacy with the opposite sex,[193] and some of these experience what, in the case of the male invert, is sometimes called _horror feminæ_. But, while woman as an object of sexual desire is in such cases disgusting to them, and it is usually difficult for a genuine invert to have connection with a woman except by setting up images of his own sex, for the most part inverts are capable of genuine friendships, irrespective of sex.
It is, perhaps, not difficult to account for the horror--much stronger than that normally felt toward a person of the same sex--with which the invert often regards the sexual organs of persons of the opposite sex. It cannot be said that the sexual organs of either sex under the influence of sexual excitement are esthetically pleasing; they only become emotionally desirable through the parallel excitement of the beholder. When the absence of parallel excitement is accompanied in the beholder by the sense of unfamiliarity as in childhood, or by a neurotic hypersensitiveness, the conditions are present for the production of intense _horror feminæ_ or _horror masculis_, as the case may be. It is possible that, as Otto Rank argues in his interesting study, "Die Naktheit im Sage und Dichtung," this horror of the sexual organs of the opposite sex, to some extent felt even by normal people, is embodied in the Melusine type of legend.[194] EROTIC DREAMS.--Our dreams follow, as a general rule, the impulses that stir our waking psychic life. The normal man or woman in sexual vigor dreams of loving a person of the opposite sex; the inverted man dreams of loving a man, the inverted woman of loving a woman.[195] Dreams thus have a certain value in diagnosis, more especially since there is less unwillingness to confess to a perverted dream than to a perverted action.
Ulrichs first referred to the significance of the dreams of inverts. At a later period Moll pointed out that they have some value in diagnosis when we are not sure how far the inverted tendency is radical. Then Näcke repeatedly emphasized the importance of dreams as constituting, he believed, the most delicate test we possess in the diagnosis of homosexuality;[196] this was an exaggerated view which failed to take into account the various influences which may deflect dreams. Hirschfeld has made the most extensive investigation on this point, and found that among 100 inverts 87 had exclusively homosexual dreams, while most of the rest had no dreams at all.[197] Among my cases, only 4 definitely state that there are no erotic dreams, while 31 acknowledge that the dreams are concerned more or less with persons of the same sex. Of these, at least 16 assert or imply that their dreams are exclusively of the same sex. Two, though apparently inverted congenitally, have had erotic dreams of women, in one case more frequently than of men; these two exceptions have no apparent explanation. Another appears to have sexual dreams of a nightmare character in which women appear. In another case there were always at first dreams of women, but this subject had sometimes had connection with prostitutes, and is not absolutely indifferent to women, while another, whose dreams remain heterosexual, had in early life some attraction to girls. In the cases of distinct bisexuality there is no unanimity; 2 dream of their own sex, 2 dream of both sexes, 1 usually dreams of the opposite sex, and 1 man, while dreaming of both, dislikes those dreams in which women figure. In at least 3 cases dreams of a sexual character began at the age of 8 or earlier.
The phenomena presented by erotic dreams, alike in normal and abnormal persons, are somewhat complex, and dreams are by no means a sure guide to the dreamer's real sexual attitude. The fluctuations of dream imagery may be illustrated by the experiences of one of my subjects who thus indirectly summarises his own experiences: "When he was quite a child, he used to be haunted by gross and grotesque dreams of naked adult men, which must have been erotic. At the age of puberty he dreamed in two ways, but always about males. One species of vision was highly idealistic; a radiant and lovely young man's face with floating hair appeared to him on a background of dim shadows. The other was obscene, being generally the sight of a groom's or carter's genitals in a state of violent erection. He never dreamed erotically or sentimentally about women; but when the dream was frightful, the terror-making personage was invariably female. In ordinary dreams, women of his family or acquaintance played a trivial part. At the age of 24, having determined to conquer his homosexual passions, he married, found no difficulty in cohabiting with his wife, and begat several children, although he took but little passionate delight in the sexual act. He still continued to dream exclusively of men, for several years; and the obscene visions became more frequent than the idealistic.
Gradually, coarse and uninteresting erotic dreams of women began to haunt his mind in sleep. A curious particular regarding the new type of vision was that he never dreamed of whole females, only of their sexual parts, seen in a blur; and the seminal emissions which attended the mental pictures left a feeling of fatigue and disgust. In course of time, his wife and he agreed to live separately so far as sexual relations are concerned. He then indulged his passion for males, and wholly lost those rudimentary female dreams which had been developed during the period of nuptial cohabitation."
Not only is it possible for the genuine invert to be trained into heterosexual erotic dreams, but homosexual dreams may occasionally be experienced by persons who are, and always have been, exclusively heterosexual. I could bring forward much evidence on this point. (Cf. "Auto-erotism" in vol. i of these _Studies_.) Both men and women who have always been of pronounced heterosexual tendency, without a trace of inversion, are liable to rare homosexual dreams, not necessarily involving orgasm or even definite sexual excitement, and sometimes accompanied by a feeling of repugnance. As an example I may present a dream (which had no known origin) of an exclusively heterosexual lady aged 42; she dreamed she was in bed with another woman, unknown to her, and lying on her own stomach, while with her right hand stretched out she was feeling the other's sexual parts. She could distinctly perceive the clitoris, vagina, etc.; she felt a sort of disgust with herself for what she was doing, but continued until she awoke; she then found herself lying on her stomach as in the dream and at first thought she must have been touching herself, but realized that this could not have been the case. (Niceforo, who believes that inversion may develop out of masturbation, considers that dreams of masturbation by association of ideas may take on an inverted character [_Le Psicopatie Sessuale_, 1897, pp. 35, 69]; this, however, must be rare, and will not account for most of the dreams in question.)
Näcke and Colin Scott, some years ago, independently referred to cases in which normal persons were liable to homosexual dreams, and Féré (_Revue de Médecine_, Dec., 1898) referred to a man who had a horror of women, but appeared only to manifest homosexuality in his dreams. Näcke (_Archiv für Kriminal-Anthropologie_, 1907, Heft I, 2) calls dreams which represent a reaction of opposition to the dreamer's ordinary life "contrast dreams." Hirschfeld, who accepts Näcke's "contrast dreams" in relation to homosexuality, considers that they indicate a latent bisexuality. We may admit this is so, in the same sense in which a complementary color image called up by another color indicates the possibility of perceiving that color. In most cases, however, it seems to me that homosexual dreams in normal persons may be simply explained as due to the ordinary confusion and transition of dream imagery. (See Ellis, _The World of Dreams_, especially ch. ii.)
_Methods of Sexual Relationship_.--The exact mode in which an inverted instinct finds satisfaction is frequently of importance from the medico-legal standpoint;[198] from a psychological standpoint it is of minor significance, being chiefly of interest as showing the degree to which the individual has departed from the instinctive feelings of his normal fellow-beings.
Taking 57 inverted men of whom I have definite knowledge, I find that 12, restrained by moral or other considerations, have never had any physical relationship with their own sex. In some 22 cases the sexual relationship rarely goes beyond close physical contact and fondling, or at most mutual masturbation and intercrural intercourse. In 10 or 11 cases _fellatio_ (oral excitation)--frequently in addition to some form of mutual masturbation, and usually, though not always, as the active agency--is the form preferred. In 14 cases, actual _pedicatio_[199]--usually active, not passive--has been exercised. In these cases, however, _pedicatio_ is by no means always the habitual or even the preferred method of gratification. It seems to be the preferred method in about 7 cases. Several who have never experienced it, including some who have never practised any form of physical relationship, state that they feel no objection to _pedicatio_; some have this feeling in regard to active, others in regard to passive, _pedicatio_. The proportion of inverts who practise or have at some time experienced _pedicatio_ thus revealed (nearly 25 per cent.) is large; in Germany Hirschfeld finds it to be only 8 per cent., and Merzbach only 6. I believe, however, that a wider induction from a larger number of English and American cases would yield a proportion much nearer to that found in Germany.[200]