The classification of the varieties of sexual inversion is still a matter of some difficulty. While some authorities are inclined to regard nearly all cases as acquired, others regard nearly every case as really congenital. Before the study of inversion was placed on a scientific basis all cases were, of course, regarded as acquired. The point of view is now so different that Moll, one
Of the latest and shrewdest students of the matter, in the first edition of his book was inclined to regard acquired inversion as
Almost non-existent. In the second edition he modified this view and concluded that acquired cases did certainly occur, but only rarely, many cases which by Krafft-Ebing would be considered acquired being by Moll regarded as cases of psychosexual her-
Maphroditism. With this modified conclusion I concur. I put aside those cases, of a more or less morbid character, in which old men with failing sexual powers, or younger men exhausted by heterosexual debauchery, are attracted to boys. With this exception I regard acquired inversion as rare, and I should not be surprised to find that a more minute investigation would show that even in these rare cases there is a congenital element. I am only able to bring forward three cases which can fairly be regarded as acquired and without obvious congenital element. The determination of the congenital or acquired nature of a particular case of inversion is frequently by no means so easy as many persons who dogmatically lay down the law on one side or the other seem to believe. The case must first be presented to us in much greater fullness than we are accustomed to get it. Then, before we can assert that it is a purely congenital case, we must be quite sure that no imprint of environment or suggestion, made at some "psychological moment," has had a controlling influence. And before we can assert that a case is purely acquired, we must possess a sufficiently minute knowledge of the subject in early life to be able to assert that his emotions and ideals as a child, and the nature of his physical organism, have not predisposed him to homosexual impulses. When we are able to investigate our cases with due fullness and precision, I think it will be found that in many cases we may fairly call acquired
There is a congenital element, and that in many cases we may fairly call congenital some accident of environment has had an influence in developing latent tendency. Unfortunately I have not been able to investigate all my cases personally, so that many points in the following histories remain obscure; but many of the cases not personally observed have been investigated with due care, through very reliable channels; so far as the histories go they may, I believe, be accepted
I do not propose to adopt any more complex classification than the clinical distinction between simple inversion and psychosexual hermaphroditism, as it is usually called, the first class including all those individuals who are sexually attracted only to their own sex, the second class those who are attracted to both sexes. In each group I will first present the apparently acquired cases
Case I. — Both parents healthy; father of unusually fine physique. He is himself a manual worker, and also of exceptionally fine physique
He is, however, of nervous temperament. He is mentally bright, though not highly educated, a keen sportsman, and in general a good example of an all-round healthy Englishman. While very affectionate, his sexual desires are not strongly developed on the physical side, and seem never to have been so. He sometimes masturbated about the age of puberty, but never afterward. He does not appear to have well-marked erotic dreams. There used to be some attraction toward women, though it was never strong. At the age of 26 he was seduced by a woman and had connection with her once. Afterward he had reason to think she had played him false in various ways. This induced the strongest antipathy, not only to this woman, but to all marriageable women. A year after this episode homosexual feeling first became clear and defined. He is now 33, and feels the same antipathy to women; he hates even to speak of marriage
There has only been one really strong attraction, toward a man of about the same age, but of different social class, and somewhat a contrast to him, both physically and mentally. So far as the physical act is concerned this relationship is not definitely sexual, but it is of the most intimate possible kind, and the absence of the physical act is probably largely due to circumstances. At the same time there is no conscious desire for the act for its own sake, and the existing harmony and satisfaction is described as very complete. There is, however, no repulsion to the physical side, and he regards the whole relationship as quite natural
Case II. — Highlander, aged 37, a "chance" child of rather poor birth, and employed as a postman. He is very amorous by nature, with good
Intelligence, but feeble will. His heart is weak, and there is a tendency to hypochondriasis. Latterly he has taken drugs to a considerable ^extent to relieve his heart-trouble, and has also become almost impotent
As a young man he was very fond of the girls, and showed a morbid degree of erethism (emission at sight of women, etc.) ; he had one or two serious love-affairs and disappointments. Then the passion gradually veered around to his own sex; he does not know why. At the present time his life is always wrapped up in some male friend, but without much response on the physical side from the other person. His sleeping and waking life is filled with a continual procession of images of physical and emotional desire. His temperament is somewhat artistic. The first case is slightly neurotic in character, in the second there is a high degree of general feebleness and hyperesthesia. which is distinctly morbid; in both the inversion seems to be acquired. Unfortunately, in neither case have I had an opportunity of making any extended investigation into the history; a love-disappointment, it need not be said, is no adequate cause for a total change in the direction of the sexual current; it is possible that a more minute examination might reveal some predisposition to inversion in the first case, while in the second the sexual hyperesthesia is an important factor
