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This excerpt from Psychopathia Sexualis by Richard von Krafft-Ebing (1886), provides an account of a trans woman born in the mid-19th century. I found it extremely interesting—Astarte

Antique ladies' gloves

III. Degree: Stage of Transition to Metamorphosis Sexualis Paranoia.

A further degree of development is represented by those cases in which physical sensation is also transformed in the sense of a transmutatio sexus. In this respect the following case is unique :—

Case 129. Autobiography. "Born in Hungary in 1844, for many years I was the only child of my parents; for the other children died for the most part of general weakness. A brother of later birth is still living.

"I come of a family in which nervous and mental diseases have been numerous. It is said that I was very pretty as a little child, with blonde locks and transparent skin; very obedient, quiet and modest, so that I was taken everywhere in the society of ladies without any offence on my part.

"With a very active imagination—my enemy through life—my talents developed rapidly. I could read and write at the age of four; my memory reaches back to my third year. I played with everything that fell into my hands,— with leaden soldiers, or stones, or ribbons from a toy-shop; but a machine for working in wood, that was given to me as a present, I did not like. I liked best to be at home with my mother, who was everything to me. I had two or three friends with whom I got on good-naturedly; but I liked to play with her sisters quite as well, who always treated me like a girl, which at first did not embarrass me. I must have already been on the road to become just like a girl; at least, I can still well remember how it was always said: 'He is not intended for a boy.' At this I tried to play the boy,—imitated my companions in everything, and tried to surpass them in wildness. In this I succeeded. There was no tree or building too high for me to reach its top. I took great delight in soldiers. I avoided girls more, because I did not wish to play with their playthings; and it always annoyed me that they treated me so much like one of themselves.

"In the society of mature people, however, I was always modest, and, also, always regarded with favour. Fantastic dreams about wild animals—which once drove me out of bed without waking me—frequently troubled me. I was always very simple but very elegantly dressed, and thus developed a taste for beautiful clothing. It seems peculiar to me that, from the time of my school-days, I had a partiality for ladies' gloves, which I put on secretly as often as I could. Thus, when once my mother was about to give away a pair of gloves, I made great opposition to it, and told her, when she asked why I acted so, that I wanted them myself. I was laughed at; and from that time I took good care not to display my preference for female things. Yet my delight in them was very great. I took especial pleasure in masquerade costumes—i.e., only in female attire. If I saw them, I envied their owners. What seemed to me the prettiest sight was: two young men, beautifully dressed as white ladies, with masks on; and yet I would not have shown myself to others as a girl for anything; I was so afraid of being ridiculed. At school I worked very hard, and was always among the first. From childhood my parents taught me that duty came first; and they always set me an example. It was also a pleasure for me to attend school; for the teachers were kind, and the elder pupils did not plague the younger ones. We left my first home; for my father was compelled, on account of his business,—which was dear to him,—to separate from his family for a year. We moved to Germany. Here there was a stricter, rougher manner, partly in teachers and partly in pupils; and I was again ridiculed on account of my girlishness. My schoolmates went so far as to give a girl, who had exactly my features, my name, and me hers; so that I hated the girl. But I later came to be on terms of friendship with her after her marriage. My mother tried to dress me elegantly; but this was repugnant to me, because it made me the object of taunting. So, finally, I was delighted when I had correct trousers and coats. But with these came a new annoyance. They irritated my genitals, particularly when the cloth was rough; and the touch of tailors while measuring me, on account of their tickling, which almost convulsed me, was unendurable, particularly about the genitals. Then I had to practise gymnastics; and I simply could do nothing at all, or only indifferently the things that even girls can do easily. While bathing I was troubled by feeling ashamed to undress; but I liked to bathe. Until my twelfth year I had a great weakness in my back. I learned to swim late, but ultimately so well that I took long swims. At thirteen I had pubic hair, and was about six feet tall; but my face was feminine until my eighteenth year, when my beard came in abundance and gave me rest from resemblance to woman. An inguinal hernia that was acquired in my twelfth year, and cured when I was twenty, gave me much trouble, particularly in gymnastics. Besides, from my twelfth year on, I had, after sitting long, and particularly while working at night, an itching, burning and twitching, extending from the penis to my back, which the acts of sitting and standing increased, and which was made worse by catching cold. But I had no suspicion whatever that this could be connected with the genitals. Since none of my friends suffered in this way, it seemed strange to me; and it required the greatest patience to endure it; the more owing to the fact that my abdomen troubled me.

"In sexualibus I was still perfectly innocent; but now, as at the age of twelve or thirteen, I had a definite feeling of preferring to be a young lady. A young lady's form was more pleasing to me; her quiet manner, her deportment, but particularly her attire, attracted me. But I was careful not to allow this to be noticed; and yet I am sure that I should not have shrunk from the castration-knife, could I have thus attained my desire. If I had been asked to say why I preferred female attire, I could have said nothing more than that it attracted me powerfully; perhaps, also, I seemed to myself, on account of my uncommonly white skin, more like that of a girl. The skin of my face and hands, particularly, was very sensitive. Girls liked my society; and, though I should have preferred to have been with them constantly, I avoided them when I could; for I had to exaggerate in order not to appear feminine. In my heart I always envied them. I was particularly envious when one of my young girl friends got long dresses and wore gloves and veils. When, at the age of fifteen, I was on a journey, a young lady, with whom I was boarding, proposed that I should mask as a lady and go out with her; but, owing to the fact that she was not alone, I did not acquiesce, much as I should have liked it. While on this journey, I was pleased at seeing boys in one city wearing blouses with short sleeves, and the arms bare. A lady elaborately dressed was like a goddess to me; and if even her hand touched me coldly I was happy and envious, and only too gladly would have put myself in her place in the beautiful garments and lovely form. Nevertheless, I studied assiduously, and passed through the Realschule and the Gymnasium in nine years, passing a good final examination. I remember, when fifteen, to have first expressed to a friend the wish to be a girl. In answer to his question, I could not give the reason why. At seventeen I got into fast society; I drank beer, smoked, and tried to joke with waiter-girls. The latter liked my society, but they always treated me as if I wore petticoats. I could not take dancing lessons, they repelled me so; but if I could have gone as a mask, it would have been different. My friends loved me dearly; I hated only one, who seduced me into onanism. Shame on those days, which injured me for life! I practised it quite frequently, but in it seemed to myself like a double man. I cannot describe the feeling; I think it was masculine, but mixed with feminine elements. I could not approach girls; I feared them, but they were not strange to me. They impressed me as being more like myself; I envied them. I would have denied myself all pleasures if, after my classes, at home I could have been a girl and thus have gone out. Crinoline and a smoothly-fitting glove were my ideals. With every lady's gown I saw I fancied how I should feel in it,—i.e., as a lady. I had no inclination toward men. But I remember that I was somewhat lovingly attached to a very handsome friend with a girl's face and dark hair, though I think I had no other wish than that we both might be girls.

"At the high-school I finally once had coitus; hoc modo sensi, me libentius sub puella concubuisse et penem meum cum cunno mutatum maluisse. To her astonishment, the girl had to treat me as a girl, and did it willingly; but she treated me as if I were she (she was still quite inexperienced, and, therefore, did not laugh at me).

"When a student at times I was wild, but I always felt that I assumed this wildness as a mask. I drank and duelled, but I could not take lessons in dancing, because I was afraid of betraying myself. My friendships were close, but without other thoughts. It pleased me most to have a friend masked as a lady, or to study the ladies' costumes at a ball. I understood such things perfectly. Gradually I began to feel like a girl.

"On account of unhappy circumstances, I twice attempted suicide. Without any cause I once did not sleep for fourteen days, had many hallucinations (visual and auditory at the same time), and was with both the living and the dead. The latter habit of thought remains. I also had a friend (a lady) who knew my hobby and put on my gloves for me; but she always looked upon me as a girl. Thus I understood women better than other men did, and in what they differed from men; so I was always treated more feminarum—as if they had found in me a female friend. On the whole, I could not endure obscenity, and indulged in it myself only out of braggadocio when it was necessary. I soon overcame my aversion to foul odours and blood, and even liked them. Only some things I could not look at without nausea. I was wanting in only one respect: I could not understand my own condition. I knew that I had feminine inclinations, but believed that I was a man. Yet I doubt whether, with the exception of the attempts at coitus, which never gave me pleasure (which I ascribe to onanism), I ever admired a woman without wishing I were she; or without asking myself whether I should not like to be the woman, or be in her attire. Obstetrics I learned with difficulty (I was ashamed for the exposed girls, and had a feeling of pity for them); and even now I have to overcome a feeling of fright in obstetrical cases; indeed, it has happened that I thought I felt the traction myself. After filling several positions successfully as a physician, I went through a military campaign as a volunteer surgeon. Riding, which, while a student, was painful to me, because in it the genitals had more of a feminine feeling, was difficult for me (it would have been easier in the female style).

"Still, I always thought I was a man with obscure masculine feeling; and whenever I associated with ladies, I was still soon treated as an inexperienced lady. When I wore a uniform for the first time, I should have much preferred to have slipped into a lady's costume, with a veil; I was disturbed when the stately uniform attracted attention. In private practice I was successful in the three principal branches. Then I made another military campaign; and during this I came to understand my nature; for I think that, since the first ass ever made, no beast of burden has ever had to endure with so much patience as I have. Decorations were not wanting, but I was indifferent to them.

"Thus I went through life, such as it was, never satisfied with myself, full of dissatisfaction with the world, and vacillating between sentimentality and a wildness that was for the most part affected.

"My experience as a candidate for matrimony was very peculiar. I should have preferred not to marry, but family circumstances and practice forced me to it. I married an energetic, amiable lady, of a family in which female government was rampant. I was in love with her as much as one of us can be in love—i.e., what we love we love with our whole hearts, and live in it, even though we do not show it as much as a genuine man does. We love our brides with all the love of a woman, almost as a woman might love her bridegroom. But I cannot say this for myself; for I still believed that I was but a depressed man, who would come to himself, and find himself out by marriage. But, even on my marriage night, I felt that I was only a woman in man's form; sub femina locum meum esse mihi visum est. On the whole, we lived contented and happy, and for two years were childless. After a difficult pregnancy, during which time I lay at the point of death in the enemy's own country, my wife gave birth to our first boy in a difficult labour,—a boy still afflicted with a melancholy nature. Then came a second, who is very quiet; a third, full of peculiarities; a fourth, a fifth; and all have the predisposition to neurasthenia. Since I always felt out of my own place, I went much in gay society; but I always worked as much as human strength would endure. I studied and operated; and I experimented with many drugs and methods of cure, always on myself. I left the regulation of the house to my wife, as she understood housekeeping very well. My marital duties I performed as well as I could, but without personal satisfaction. Since the first coitus, the masculine position in it has been repugnant, and also difficult for me. I should have much preferred to have the other rôle. When I had to deliver my wife, it almost broke my heart; for I knew how to appreciate her pain. Thus we lived long together, until severe gout drove me to various baths, and made me neurasthenic. At the same time, I became so anæmic that every few months I had to take iron for some time; otherwise I would be almost chlorotic or hysterical, or both. Stenocardia often troubled me; then came unilateral cramps of chin, nose, neck and larynx; hemicrania and cramps of the diaphragm and chest muscles. For about three years I had a feeling as if the prostate were enlarged,—a bearing-down feeling, as if giving birth to something; and also pain in the hips, constant pain in the back, and the like. Yet, with the strength of despair, I fought against these complaints, which impressed me as being female or effeminate, until three years ago, when a severe attack of arthritis completely broke me down.

"But before this terrible attack of gout occurred, in despair, to lessen the pain of gout, I had taken hot baths, as near the temperature of the body as possible. On one of these occasions it happened that I suddenly changed, and seemed to be near death. I sprang with all myremaining strength out of the bath; I had felt exactly like a woman with libido. This happened when the extract of Indian hemp came into vogue, and was highly prized. In a state of fear of a threatened attack of gout (feeling perfectly indifferent about life), I took three or four times the usual dose of it, and almost died of hashish poison- ing. Convulsive laughter, a feeling of unheard of strength and swiftness, a peculiar feeling in brain and eyes, millions of sparks streaming from the brain through the skin,—all these feelings occurred. But I could not force myself to speak. All at once I saw myself a woman from my toes to my breast; I felt, as before while in the bath, that the genitals had shrunken, the pelvis broadened, the breasts swollen out; a feeling of unspeakable delight came over me. I closed my eyes, so that at least I did not see the face changed. My physician looked as if he had a gigantic potato instead of a head; my wife had the full moon on her thorax. And yet, I was strong enough to briefly record my will in my note-book when both left the room for a short time.

"But who could describe my fright when, on the next morning, I awoke and found myself feeling as if completely changed into a woman; and when, on standing and walking, I felt vulva and mammœ! When at last I raised myself out of bed, I felt that a complete transformation had taken place in me. During my illness a visitor said: 'He is too patient for a man'. And the visitor gave me a plant in bloom, which seemed strange, but pleased me. From that time I was patient, and would do nothing in a hurry; but I became tenacious, like a cat, though, at the same time, mild, forgiving and no longer bearing enmity,— in short, I had a woman's disposition. During the last sickness I had many visual and auditory hallucinations,—spoke with the dead, etc; saw and heard familiar spirits; felt like a double person; but, while lying ill, I did not notice that the man in me had been extinguished. The change in my disposition was a piece of good fortune, for I had a stroke of paralysis which would certainly have killed me had I been of my former disposition; but now I was reconciled, for I no longer recognized myself. Owing to the fact that I still often confounded neurasthenic symptoms with the gout, I took many baths, until an itching of the skin, with the feeling of scabies, instead of being diminished, was so increased that I gave up all external treatment ( I was made more and more anaemic by the baths), and hardened myself as best I could. But the imperative female feeling remained, and became so strong that I wear only the mask of a man, and in everything else feel like a woman; and gradually I have lost memory of the former individuality. What was left of me by the gout, influenza ruined entirely.

"Present condition: I am tall, slightly bald, and the beard is growing gray. I begin to stoop. Since having influenza I have lost about one-fourth of my strength.. Owing to a valvular lesion, my face looks somewhat red; full beard; chronic conjunctivitis; more muscular than fat. The left foot seems to be developing varicose veins, and it often goes to sleep; but it is not really thickened, though it seems to be.

"The mammary region, though small, swells out per- ceptibly. The abdomen is feminine in form; the feet are placed like a woman's, and the calves, etc., are feminine; and it is the same with arms and hands. I can wear ladies' hose and gloves 7½ to 7¾ in size. I also wear a corset without annoyance. My weight varies between 168 and 184 pounds. Urine without albumen or sugar, but it contains an excess of uric acid. But when there is not too much uric acid in it, it is clear, and almost as clear as water after any excitement. Bowels usually regular, but should they not be, then come all the symptoms of female constipation. Sleep is poor,—for weeks at a time only of two or three hours' duration. Appetite quite good; but, on the whole, my stomach will not bear more than that of a strong woman, and reacts to irritating food with cutaneous eruption and burning in the urethra. The skin is white, and, for the most part, feels quite smooth; there has been unbearable cutaneous itching for the last two years; but during the last few weeks this has diminished, and is now present only in the popliteal spaces and on the scrotum.

"Tendency to perspire. Perspiration was previously as good as wanting, but now there are all the odious peculiarities of the female perspiration, particularly about the lower part of the body; so that I have to keep myself cleaner than a woman (I perfume my handkerchief, and use perfumed soap and eau-de-Cologne),

"General feeling: I feel like a woman in a man's form; and even though I often am sensible of the man's form, yet it is always in a feminine sense. Thus, for example, I feel the penis as clitoris; the urethra as urethra and vaginal orifice, which always feels a little wet, even when it is actually dry; the scrotum as labia majora; in short, I always feel the vulva. And all that that means one alone can know who feels or has felt so. But the skin all over my body feels feminine; it receives all impressions, whether of touch, of warmth, or whether unfriendly, as feminine, and I have the sensations of a woman. I cannot go with bare hands, as both heat and cold trouble me. When the time is past when we men are permitted to carry sun-umbrellas, I have to endure great sensitiveness of the skin of my face, until sun-umbrellas can again be used. On awakening in the morning, I am confused for a few moments, as if I were seeking for myself; then the imperative feeling of being a woman awakens. I feel the sense of the vulva (that one is there), and always greet the day with a soft or loud sigh; for I have fear again of the play that must be carried on throughout the day. I had to learn everything anew; the knife—apparatus, everything —has felt different for the last three years; and with the change of muscular sense I had to learn everything over again. I have been successful, and only the use of the saw and bone-chisel are difficult; it is almost as if my strength were not quite sufficient. On the other hand, I have a keener sense of touch in working with the curette in the soft parts. It is unpleasant that, in examining ladies, I often feel their sensations; but this, indeed, does not repel them. The most unpleasant thing I experience is fœtal movement. For a long time—several months—I was troubled by reading the thoughts of both sexes, and I still have to fight against it. I can endure it better with women; with men it is repugnant. Three years ago I had not yet consciously seen the world with a woman's eyes; this change in the relation of the eyes to the brain came almost suddenly, with violent headache. I was with a lady whose sexual feeling was reversed, when suddenly I saw her changed in the sense I now feel myself,— viz., she as man,—and I felt myself a woman in contrast, with her; so that I left her with ill-concealed vexation. At that time she had not yet come to understand her own condition perfectly.

"Since then, all my sensory impressions are as if they were feminine in form and relation. The cerebral system almost immediately adjusted itself to the vegetative; so that all my ailments were manifested in a feminine way. The sensitiveness of all nerves, particularly that of the auditory and olfactory and trigeminal, increased to a condition of nervousness. If only a window slammed, I was frightened inwardly; for a man dare not tremble at such things. If food is not absolutely fresh, I perceive a cadaverous odour. I could never depend on the trigeminus; for the pain would jump whimsically from one branch of it to another; from a tooth to an eye. But, since my transformation, I bear toothache and migraine more easily, and have less feeling of fear with stenocardia. It seems to me a strange fact that I feel myself to be a fearful, weak being, and yet, when danger threatens, I am rather cool and collected, and this is true in dangerous operations. The stomach rebels against the slightest indiscretion (in female diet) that is committed without thought of the female nature, either by ructus or other symptoms; but particularly against abuse of alcoholics. The indisposition after intoxication that a man who feels like a woman experiences is much worse than any a student could get up. It seems to me almost as if one feeling like a woman were entirely controlled by the vegetative system.

"Small as my nipples are, they demand room, and I feel as though the pelvis were female; and it is the same puberty the nipples swelled and pained. On this account, the white shirt, the waistcoat and the coat trouble me. I feel as though the pelvis were female; and it is the same with the anus and nates. At first the sense of a female abdomen was troublesome to m e; for it cannot bear trousers, and it always possesses or induces the feminine feeling. I also have the imperative feeling of a waist. It is as if I were robbed of my own skin, and put in a woman's skin that fitted me perfectly, but which felt everything as if it covered a woman; and whose sensations passed through the man's body, and exterminated the masculine element. The testes, even though not atrophied or degenerated, are still no longer testes, and often cause me pain, with the feeling that they belong in the abdomen, and should be fastened there; and their mobility often bothers me.

"Every four weeks, at the time of the full moon, I have the molimen of a woman for five days, physically and mentally, only I do not bleed; but I have the feeling of a loss of fluid; a feeling that the genitals and abdomen are (internally) swollen. A very pleasant period comes when, afterward and later in the interval of a day or two, the physiological desire for procreation comes, which with all power permeates the woman. My whole body is then filled with this sensation, as an immersed piece of sugar is filled with water, or as full as a soaked sponge. It is like this: first, a woman longing for love, and then, for a man; and, in fact, the desire, as it seems to me, is more a longing to be possessed than a wish for coitus. The intense natural instinct or the feminine concupiscence overcomes the feeling of modesty, so that indirectly coitus is desired. I have never felt coitus in a masculine way more than three times in my life; and even if it were so in general, I was always indifferent about it. But, during the last three years, I have experienced it passively, like a woman; in fact, oftentimes with the feeling of feminine ejaculation; and I always feel that I am impregnated. I am always fatigued as a woman is after it, and often feel ill, as a man never does. Sometimes it caused me such great pleasure that there is nothing with which I can compare it; it is the most blissful and powerful feeling in the world; at that moment the woman is simply a vulva that has devoured the whole person.

"During the last three years I have never lost for an instant the feeling of being a woman, and now, owing to habit, this is no longer annoying to me, though during this period I have felt debased; for a man could endure to feel like a woman without a desire for enjoyment; but when desires come, the happiness ceases! Then come the burning, the heat, the feeling of turgor of the genitals (when the penis is not in a state of erection the genitals do not play any part). In case of intense desire, the feeling of sucking in the vagina and vulva is really terrible —a hellish pain of lust hardly to be endured. If I then have opportunity to perform coitus, it is better; but, owing to defective sense of being possessed by the other, it does not afford complete satisfaction; the feeling of sterility comes with its weight of shame, added to the feeling of passive copulation and injured modesty. I seem almost like a prostitute. Reason does not give any help; the imperative feeling of femininity dominates and rules everything. The difficulty in carrying on one's occupation, under such circumstances, is easily appreciated; but it is possible to force one's self to it. Of course, it is almost impossible to sit, walk, or lie down; at least, any one of these cannot be endured long; and with the constant touch of the trousers, etc., it is unendurable.

"Marriage then, except during coitus, where the man has to feel himself a woman, is like two women living together, one of whom regards herself as in the mask of a man. If the periodical molimina fail to occur, then come the feelings of pregnancy or of sexual satiety, which a man never experiences, but which take possession of the whole being, just as the feeling of femininity does, and are repugnant in themselves; and, therefore, I gladly welcome the regular molimina again. When erotic dreams or ideas occur, I see myself in the form I have as a woman, and see erected organs presenting. Since the anus feels feminine, it would not be hard to become a passive pederast; only positive religious command prevents it, as all other deterrent ideas would be overcome. Since such conditions are repugnant, as they would be to any one, I have a desire to be sexless, or to make myself sexless. If I had been single, I should long ago have taken leave of testes, scrotum and penis.

"Of what use is female pleasure, when one does not conceive? What good comes from excitation of female love, when one has only a wife for gratification, even though copulation is felt as though it were with a man? What a terrible feeling of shame is caused by the feminine perspiration! How the feeling for dress and ornament lowers a man! Even in his changed form, even when he can no longer recall the masculine sexual feeling, he would not wish to be forced to feel like a woman. He still knows very well that, heretofore, he did not constantly feel sexually; that he was merely a human being uninfluenced by sex. Now, suddenly, he has to regard his former individuality as a mask, and constantly feel like a woman, only having a change when, every four weeks, he has his periodical sickness, and in the intervals his insatiable female desire. I f he could but awake without immediately being forced to feel like a woman! At last he longs for a moment in which he might raise his mask; He can only find but that moment does not come. amelioration of his misery when he can put on some bit of female attire or finery, an under-garment, etc.; for he dare not go about as a woman. To be compelled to fulfil all the duties of a calling with the feeling of being a woman costumed as a man, and to see no end of it, is no trifle. Religion alone saves from a great lapse; but it does not prevent the pain when temptation affects the man who feels as a woman; and so it must be felt and endured! When a respectable man who enjoys an unusual degree of public confidence, and possesses authority, must go about with his vulva—imaginary though it be; when one, leaving his arduous daily task, is compelled to examine the toilette of the first lady he meets, and criticise her with feminine eyes, and to read her thoughts in her face; when a journal of fashions possesses an interest equal to that of a scientific work (I felt this as a child); when one must conceal his condition from his wife, whose thoughts, the moment he feels like a woman, he can read in her face, while it becomes perfectly clear to her that he has changed in body and soul—what must all this be ? The misery caused by the feminine gentleness that must be overcome? Oftentimes, of course, when I am away alone, it is possible to live for a time more like a woman; for example, to wear female attire, especially at night, to keep gloves on, or to wear a veil or a mask in my room, so that thus there is rest from excessive libido. But when the feminine feeling has once gained an entrance, it imperatively demands recognition. It is often satisfied with a moderate concession, such as the wearing of a bracelet above the cuff; but it imperatively demands some concession. My only happiness is to see myself dressed as a woman without a feeling of shame; indeed, when my face is veiled or masked, I prefer it so, and thus think of myself. Like every one of Fashion's fools, I have a taste for the prevailing mode, so greatly am I trans- formed. To become accustomed to the thought of feeling only like a woman, and only to remember the previous manner of thought to a certain extent in contrast with it, and, at the same time, to express one's self as a man, requires a long time and an infinite amount of persistence.

"Nevertheless, in spite of everything, it will happen that I betray myself by some expression of feminine feeling, either in sexualibus, when I say that I feel so and so, expressing what a man without the female feeling cannot know; or when I accidentally betray that female attire is my talent. Before women, of course, this does not amount to anything; for a woman is greatly flattered when a man understands something of her matters; but this must not be displayed to my own wife. How frightened I once was when my wife said to a friend that I had great taste in ladies' dress ! How a haughty, stylish lady was astonished when, as she was about to make a great error in the education of her little daughter, I described to her in writing and verbally all the feminine feelings! To be sure, I lied to her, saying that my knowledge had been gleaned from letters. But her confidence in me is as great as ever; and the child, who was on the road to insanity, is rational and happy. She had confessed all the feminine inclinations as sins; now she knows what, as a girl, she must bear and control by will and religion; and she feels that she is human. Both ladies would laugh heartily if they knew that I had only drawn on my own sad experience. I must also add that I now have a finer sense of temperature, and, besides, a sense of the elasticity of the skin and tension of the intestines, etc., in patients, that was unknown to me before; that in operations and autopsies, poisonous fluids more readily penetrate my (uninjured) skin. Every autopsy causes me pain; examination of a prostitute, or a woman having a discharge, a cancerous odour, or the like, is actually repugnant to me. In all respects I am now under the influence of antipathy and sympathy, from the sense of colour to my judgment of a person. Women usually see in each other the periodical sexual disposition; and, therefore, a lady wears a veil, if she is not always accustomed to wear one, and usually she perfumes herself, even though it be only with handkerchief or gloves; for her olfactory sense in relation to her own sex is intense. Odours have an incredible effect on the female organism; thus, for example, the odours of violets and roses quiet me, while others disgust me; and with Ylang-Ylang I cannot contain myself for sexual excitement. Contact with a woman seems homogeneous to me; coitus with my wife seems possible to me because she is somewhat masculine, and has a firm skin; and yet it is more an amor lesbicus.

"Besides, I always feel passive. Often at night, when I cannot sleep for excitement, it is finally accomplished, si femora mea distensa habeo, sicti mulier cum viro concumbens, or if I lie on my side; but an arm or the bed- clothing must not touch the mammœ, or there is no sleep; and there must be no pressure on the abdomen. I sleep best in a chemise and night-robe, and with gloves on; for my hands easily get cold. I am also comfortable in female drawers and petticoats, because they do not touch the genitals. I liked female dresses best when crinolines were worn. Female dresses do not annoy the feminine-feeling man; for he, like every woman, feels them as belonging to his person, and not as something foreign.

"My dearest associate is a lady suffering with neurasthenia, who, since her last confinement, feels like a man, but who, since I explained these feelings to her, coitu abstinet as much as possible, a thing I, as a husband, dare not do. She, by her example, helps me to endure my condition. She has a most perfect memory of the female feelings, and has often given me good advice. Were she. a man and I a young girl I should seek to win her; for her I should be glad to endure the fate of a woman. But her present appearance is quite different from what it formerly was. She is a very elegantly dressed gentleman, notwithstanding bosom and hair; she also speaks quickly and concisely, and no longer takes pleasure in the things that please me. She has a kind of melancholy dissatisfaction with the world, but she bears her fate worthily and with resignation, finding her comfort only in religion and the fulfilment of her duty. At the time of the menses, she almost dies. She no longer likes female society and conversation, and has no liking for delicacies.

"A youthful friend felt like a girl from the very first, and had inclinations towards the male sex. His sister had the opposite condition; and when the uterus demanded its right, and she saw herself as a loving woman in spite of her masculinity, she cut the matter short, and committed suicide by drowning.

"Since complete effemination, the principal changes I have observed in myself are:—

  1. The constant feeling of being a woman from top to toe.
  2. The constant feeling of having female genitals.
  3. The periodicity of the monthly molimina.
  4. The regular occurrence of female desire, though not directed to any particular man.
  5. The passive female feeling in coitus.
  6. After that, the feeling of impregnation.
  7. The female feeling in thought of coitus.
  8. A t the sight of women, the feeling of being of their kind, and the feminine interest in them.
  9. At the sight of men, the feminine interest in them.
  10. At the sight of children, the same feeling.
  11. The changed disposition and much greater patience.
  12. The final resignation to my fate, for which I have nothing to thank but positive religion; without it I should have long ago committed suicide.

"To be a man and to be compelled to feel that chaque femme est futuée ou elle désire d'etre is hard to endure." The foregoing autobiography, scientifically so important, was accompanied by the following no less interesting letter :—

"SIR,—I must next beg your indulgence for troubling you with my communication. I lost all control, and thought of myself only as a monster before which I myself shuddered. Then your work gave me courage again; and I determined to go to the bottom of the matter, and examine my past life, let the result be what it might. It seemed a duty of gratitude to you to tell you the result of my recollection and observation, since I had not seen any description by you of an analogous case; and, finally, I also thought it might perhaps interest you to learn, from the pen of a physician, how such a worthless human, or masculine, being thinks and feels under the weight of the imperative idea of being a woman.

"It is not perfect; but I no longer have the strength to reflect more upon it, and have no desire to go into the matter more deeply. Much is repeated; but I beg you to remember that any mask may be allowed to fall off, particularly when it is not voluntarily worn, but enforced.

"After reading your work, I hope that, if I fulfil my duties as physician, citizen, father and husband, I may still count myself among human beings who do not deserve merely to be despised.

"Finally, I wished to lay the result of my recollection and reflection before you, in order to show that one thinking and feeling like a woman can still be a physician. I consider it a great injustice to debar woman from Medicine. A woman, through her feeling, gets on the track of many ailments which, in spite of all skill in diagnosis, remain obscure to a man; at least, in the diseases of women and children. I f I could have my way, I should have every physician live the life of a woman for three months; then he would have a better understanding and more consideration in matters affecting the half of humanity from which he comes; then he would learn to value the greatness of woman, and appreciate the difficulty of her lot."

Remarks: The badly tainted patient was originally psycho-sexually abnormal, in that, in character and in the sexual act, he felt as a female. The abnormal feeling remained purely a psychical anomaly until three years ago, when, owing to severe neurasthenia, it received over-mastering support in imperative bodily sensations of a transmutatio sexus, which now dominate consciousness. Then, to the patient's horror, he felt bodily like a woman; and, under the impulse of his imperative feminine sensations, he experienced a complete transformation of his former masculine feeling, thought and will; in fact, of his whole vita sexualis, in the sense of eviration. At the same time, his "ego" was able to control these abnormal psycho-physical manifestations, and prevent descent to paranoia,— a remarkable example of imperative feelings and ideas on the basis of neurotic taint, which is of great value for a comprehension of the manner in which the psycho-sexual transformation may be accomplished. In 1893, three years later, this unhappy colleague sent me a new account of his present state. This corresponded essentially with the former. His physical and psychical feelings were absolutely those of a woman; but his intellectual powers were intact, and he was thus saved from paranoia (vide infra).

A counterpart to this case, which is of clinical and psychological moment, is that of a lady as given in :—

Case 130. Mrs. X . , daughter of a high official. Her mother died from nervous disease. The father was untainted, and died from pneumonia at a good old age. Her brothers and sisters had inferior psychopathic dispositions ; one brother was of abnormal character, and very neurasthenic.

As a girl Mrs. X . had decided inclinations for boys' sports. So long as she wore short dresses she used to rove about the fields and woods in the freest manner, and climbed the most dangerous rocks and cliffs. She had no taste for dresses and finery. Once, when they gave her a dress made in boys' fashion, she was highly delighted; and when at school they dressed her up in boys' clothes on the occasion of some theatrical performance, she was filled with bliss.

Otherwise nothing betrayed her homo-sexual inclinations. Up to her marriage (at the age of twenty-one) she could not recall to mind a single instance in which she felt herself drawn to persons of her own sex. Men were equally indifferent to her. When matured she had many admirers. This flattered her greatly. However, she claimed that the difference of the sexes never entered her mind; she was only influenced by the difference in the dress.

When attending the first and only ball she felt interest only in intellectual conversation, but not in dancing or the dancers.

At the age of eighteen the menses set in without difficulty. She always looked upon menstruation as an unnecessary and bothersome function. Her engagement with a man who, though good and rich, yet possessed not the slightest knowledge of woman's nature, was a matter of utter indifference to her. She had neither sympathy for nor antipathy against matrimony. Her connubial duties were at first painful to her, later on simply loathsome. She never experienced sexual pleasure, but became the mother of six children. When her husband began to observe coitus interruptus, on account of the prolific consequences, her religious and moral sentiments were hurt. Mrs. X . grew more and more neurasthenic, peevish and unhappy.

She suffered from descensus uteri, erosions on the portio vaginalis, and became anaemic. Gynecological treatment and visits to watering-places procured but slight improvements.

At the age of thirty-six she had an apoplectic stroke, which confined her to bed for two years, with heavy neurasthenic ailments (agrypnia, pressure in the head, palpitation of the heart, psychical depression, feelings of lost physical and mental power, bordering even on insanity, etc.). During this long illness a peculiar change of her psychical and physical feelings took place. The small talk of the ladies visiting her about love, toilet, finery, fashions, domestic and servants' affairs disgusted her. She felt mortified at being a woman. She could not even make up her mind again to look in the mirror. She loathed combing her hair and making her toilet. Much to the surprise of her own people her hither-to soft and decidedly feminine features assumed a strongly masculine character, so much so that she gave the impression of being a man clad in female garb. She complained to her trusted physician that her periods had stopped,— in fact, she had nothing to do with such functions. When they recurred again she felt ill-tempered, and found the odour of the menstrual flow most nauseating, but definitely refused the use of perfumes, which affected her in a similar unpleasant manner.

But in other ways she felt that a peculiar change had come over her entire being. She had athletic spells, and great desire for gymnastic exercises. At times she felt as if she were just twenty. She was startled,—when her neurasthenic brain allowed of thought at all,—at the flight and novelty of her thoughts, at her quick and precise method of arriving at conclusions and forming opinions, at the curt and short way of expressing herself, and her novel choice of words not always becoming a lady. Even an inclination to use curse words and oaths was noticeable in this otherwise so pious and correct woman.

She reproached herself bitterly, and grieved because she had lost her femininity, and scandalised her friends by her thoughts, sentiments, and actions.

She also perceived a change in her body. She was horrified to notice her breasts disappearing, that her pelvis grew smaller and narrower, the bones became more mass- ive, and her skin rougher and harder.

She refused to wear any more a lady's night-dress or a lady's cap, and put away her bracelets, earrings and fans. Her maid and her dressmaker noticed a different odour coming from her person; her voice also grew deeper, rougher, and quite masculine.

When the patient was finally able to leave her bed, the female gait had altered, feminine gestures and movements in her female attire were forced, and she could no longer bear to wear a veil over her face. Her former period of life spent as a woman seemed strange to her, as if it did not belong to her existence at all ; she could play no longer the rôle of woman. She assumed more and more the character of a man. She experienced strange feelings in her abdomen; and complained to the physician attending her that she could feel no longer the internal organs of generation, that her body was closed up, the region of her genitals enlarged, and often had the sensation of possessing a penis and scrotum. She showed, also, unmistakable symptoms of male libido. All these observations affected her deeply, filled her with horror, and depressed her so much that an attack of insanity was apprehended. But by incessant efforts and kind advice the family physician finally succeeded in calming the patient and piloting her safely over this dangerous point. Little by little she gained her equilibrium in this novel, strange and morbid physico-psychical form. She took pains in performing her duties as housewife and mother. It was interesting to observe the truly manly firmness of will which she developed, but her former softness of character had vanished. She assumed the rôle of the man in her house, a circumstance which led to many dissensions and misunderstandings. She became an enigma which her husband was unable to solve.

She complained to her physician that at times a "bestial masculine libido" threatened to overcome her, which made her despondent. Marital intercourse with the husband appeared to her most repulsive—in fact, impossible. Periodically the patient experienced feminine emotions, but they became scarcer and weaker as time went by. At such periods she became conscious again of her female genitals and breasts, but these episodes affected her painfully, and she felt that such a "second trans- mutation" would be unbearable, and would drive her to insanity.

She now became reconciled to her transmutatio sexus, brought about by her severe illness, and bore her fate with resignation, finding much support in her religious convictions.

What affected her most keenly was the fact that, like an actress, she must move in a strange sphere—i.e, in that of a woman (Status Praesens," Sept., 1892).