[239] Magnan has in recent years reaffirmed this view ("Inversion Sexuelle
et Pathologic Mentale," _Revue de Psychothérapie_, March, 1914): "The
invert is a diseased person, a degenerate."
[240] It is this fact which has caused the Italians to be shy of using the
word "degeneration;" thus, Marro, in his great work, _I Caratteri del
Delinquenti_, made a notable attempt to analyze the phenomena lumped
together as degenerate into three groups: atypical, atavistic, and morbid.
[241] Hirschfeld and Burchard among 200 inverts found pronounced stigmata
of degeneration in only 16 per cent. (Hirschfeld, _Die Homosexualität_,
ch. xx.)
[242] Alcohol has sometimes been considered an important exciting cause of
homosexuality, and alcoholism is certainly not uncommon in the heredity of
inverts; according to Hirschfeld (_Die Homosexualität_, p. 386) it is well
marked in one of the parents in over 21 per cent, of cases. But it
probably has no more influence as an exciting cause in the individual
homosexual person than in the individual heterosexual person. From the
Freudian standpoint, indeed, Abraham believes (_Zeitschrift für
Sexualwissenschaft_, Heft 8, 1908) that even in normal persons alcohol
removes the inhibition from a latent homosexuality, and Juliusburger from
the same standpoint (_Zentralblatt für Psychoanalyse_, Heft 10 and 11,
1912) thinks that the alcoholic tendency is unconsciously aroused by the
homosexual impulse in order to reach its own gratification. But we may
accept Näcke's conclusions (_Allgemeine Zeitschrift für Psychiatrie_, vol.
lxviii, 1911, p. 852), that (1) alcohol cannot produce homosexuality in
persons not predisposed, that (2) it may arouse it in those who are
predisposed, that (3) the action of alcohol is the same on the homosexual
as the heterosexual, and that (4) alcoholism is not common among inverts.
CHAPTER VII.
CONCLUSIONS.
The Prevention of Homosexuality--The Influence of the School--Coeducation--The Treatment of Sexual Inversion--Castration--Hypnotism--Associational Therapy--Psycho-analysis--Mental and Physical Hygiene--
Marriage--The
Children of Inverts--The Attitude of Society--The Horror Aroused by
Homosexuality--Justinian--The _Code Napoléon_--The State of the Law in
Europe Today--Germany--England--What Should be our Attitude toward
Homosexuality?
Having now completed the psychological analysis of the sexual invert, so
far as I have been able to study him, it only remains to speak briefly of
the attitude of society and the law. First, however, a few words as to the
medical and hygienic aspects of inversion. The preliminary question of the
prevention of homosexuality is in too vague a position at present to be
profitably discussed. So far as the really congenital invert is concerned,
prevention can have but small influence; but sound social hygiene should
render difficult the acquisition of homosexual perversity, or what has
been termed pseudo-homosexuality. It is the school which is naturally the
chief theater of immature and temporary homosexual manifestations, partly
because school life largely coincides with the period during which the
sexual impulse frequently tends to be undifferentiated, and partly because
in the traditions of large and old schools an artificial homosexuality is
often deeply rooted.
Homosexuality in English schools has already been briefly
referred to in chapter iii. As a precise and interesting picture
of the phenomena in French schools, I may mention a story by
Albert Nortal, _Les Adolescents Passionnés_ (1913), written
immediately after the author left college, though not published
until more than twenty-five years later, and clearly based on
personal observation and experience. As regards German schools,
see, e.g., Moll, _Untersuchungen über die Libido Sexualis_, p.
449 et seq., and for sexual manifestations in early life
generally, the same author's _Sexual Life of the Child_; also
Hirschfeld, _Jahrbuch für sexuelle Zwischenstufen_, vol. v,
1903, p. 47 et seq., and, for references, Hirschfeld, _Die
Homosexualität_, p. 46 et seq.
While much may be done by physical hygiene and other means to prevent the
extension of homosexuality in schools,[243] it is impossible, and even
undesirable, to repress absolutely the emotional manifestations of sex in
either boys or girls who have reached the age of puberty.[244] It must
always be remembered that profoundly rooted organic impulses cannot be
effectually combated by direct methods. Writing of a period two centuries
ago, Casanova, in relating his early life as a seminarist trained to the
priesthood, describes the precautions taken to prevent the youths entering
each other's beds, and points out the folly of such precautions.[245] As
that master of the human heart remarks, such prohibitions intensify the
very evil they are intended to prevent by invoking in its aid the impulse
to disobedience natural to every child of Adam and Eve, and the
observation has often been repeated by teachers since.
We probably have to
recognize that a way to render such manifestations wholesome, as well as
to prepare for the relationships of later life, is the adoption, so far as
possible, of the method of coeducation of the sexes,[246]--not, of course,
necessarily involving identity of education for both sexes,--since a
certain amount of association between the sexes helps to preserve the
healthiness of the sexual emotional attitude.
Association between the
sexes will not, of course, prevent the development of congenital
inversion. In this connection it is pointed out by Bethe that it was
precisely in Sparta and Lesbos, where homosexuality was most ideally
cultivated, that the sexes, so far as we know, associated more freely than
in any other Greek State.[247]
The question of the treatment of homosexuality must be approached with
discrimination, caution, and skepticism. Nowadays we can have but little
sympathy with those who, at all costs, are prepared to
"cure" the invert.
There is no sound method of cure in radical cases.
At one time the seemingly very radical method of castration was advocated
and occasionally carried out, as in a case I have recorded in a previous
chapter (History XXVI). Like all methods of treatment, it is sometimes
believed to have been successful by those who carried it out. Usually,
after a short period, it is found to be unsuccessful, and in some cases
the condition, especially the mental condition, is rendered worse. It is
not difficult to understand why this should be. Sexual inversion, is not a
localized genital condition. It is a diffused condition, and firmly
imprinted on the whole psychic state. There may be reasons for castration,
or the slighter operation of vasectomy, but, although sexual tension may
be thereby diminished, no authority now believes that any such operation
will affect the actual inversion. Castration of the body in adult age
cannot be expected to produce castration of the mind.
Moll, Féré, Näcke,
Bloch, Rohleder, Hirschfeld, are all either opposed to castration for
inversion, or very doubtful as to any beneficial results.
In a case communicated to me by Dr. Shufeldt, an invert had
himself castrated at the age of 26 to diminish sexual desire,
make himself more like a woman, and to stop growth of beard. "But
the only apparent physical effect," he wrote, "was to increase my
weight 10 per cent., and render me a semi-invalid for the rest
of my life. After two years my sexuality decreased, but that may
have been due to satiety or to advancing years. I was also
rendered more easily irritated over trifles and more revengeful.
Terrible criminal auto-suggestions came into my head, never
experienced before." Féré (_Revue de Chirurgie_, March 10, 1905)
published the case of an invert of English origin who had been
castrated. The inverted impulse remained unchanged, as well as
sexual desire and the aptitude for erection; but neurasthenic
symptoms, which had existed before, were aggravated; he felt less
capable to resist his impulses, became migratory in his habits of
life, and addicted to the use of laudanum. In a case recorded by
C.H. Hughes (_Alienist and Neurologist_, Aug., 1914) the results
were less unsatisfactory; in this case the dorsal nerve of the
penis was first excised, without any result (see also _Alienist
and Neurologist_, Feb., 1904, p. 70, as regards worse than
useless results of cutting the pudic nerve), and a year or so
later the testes were removed and the patient gained tranquillity
and satisfaction; his homosexual inclinations appeared to go, and
he began to show inclination for asexualized women, being
specially anxious to meet with a woman whose ovaries had been
removed on account of inversion. (Reference may also be made to
Näcke, "Die Ersten Kastrationen aus sozialen Grunden auf
europäischen Boden," _Neurologisches Centralblatt_, 1909, No. 5,
and E. Wilhelm in _Juristisch-psychiatrische Grenzfragen_, vol.
viii, Heft 6 and 7, 1911.)
More trust has usually been placed in the psychotherapeutical than the
surgical treatment of homosexuality. At one time hypnotic suggestion was
carried out very energetically on homosexual subjects.
Krafft-Ebing seems
to have been the first distinguished advocate of hypnotism for application
to the homosexual. Dr. von Schrenck-Notzing displayed special zeal and
persistency in this treatment. He undertook to treat even the most
pronounced cases of inversion by courses lasting more than a year, and
involving, in at least one case, nearly one hundred and fifty hypnotic
sittings; he prescribed frequent visits to the brothel, previous to which
the patient took large doses of alcohol; by prolonged manipulations a
prostitute endeavored to excite erection, a process attended with varying
results. It appears that in some cases this course of treatment was
attended by a certain sort of success, to which an unlimited good will on
the part of the patient, it is needless to say, largely contributed. The
treatment was, however, usually interrupted by continual backsliding to
homosexual practices, and sometimes, naturally, the cure involved a
venereal disorder. The patient was enabled to marry and to beget
children.[248] It is a method of treatment which seems to have found few
imitators. This we need not regret. The histories I have recorded in
previous chapters show that it is not uncommon for even a pronounced
invert to be able sometimes to effect coitus. It often becomes easy if at
the time he fixes his thoughts on images connected with his own sex. But
the perversion remains unaffected; the subject is merely (as one of Moll's
inverts expressed it) practising masturbation _per vaginam_. Such
treatment is a training in vice, and, as Raffalovich points out, the
invert is simply perverted and brought down to the vicious level which
necessarily accompanies perversity.[249]
There can be no doubt that in slight and superficial cases of
homosexuality, suggestion may really exert an influence.
We can scarcely
expect it to exert such influence when the homosexual tendency is deeply
rooted in an organic inborn temperament. In such cases indeed the subject
may resist suggestion even when in the hypnotic state.
This is pointed out
by Moll, a great authority on hypnotism, and with much experience of its
application to homosexuality, but never inclined to encourage an
exaggerated notion of its efficacy in this field. Forel, who was also an
authority on hypnotism, was equally doubtful as to its value in relation
to inversion, especially in clearly inborn cases.
Krafft-Ebing at the end
said little about it, and Näcke (who was himself without faith in this
method of treating inversion) stated that he had been informed by the
last homosexual case treated by Krafft-Ebing by hypnotism that, in spite
of all good-will on the patient's side, the treatment had been quite
useless. Féré, also, had no belief in the efficacy of suggestive
treatment, nor has Merzbach, nor Rohleder. Numa Praetorius states that the
homosexual subjects he is acquainted with, who had been so treated, were
not cured, and Hirschfeld remarks that the inverts
"cured" by hypnotism
were either not cured or not inverted.[250]
Moll has shown his doubt as to the wide applicability of suggestive
therapeutics in homosexuality by developing in recent years what he terms
association-therapy. In nearly all perverse individuals, he points out,
there is a bridge,--more or less weak, no doubt,--which leads to the
normal sexual life. By developing such links of association with
normality, Moll believes, it may be possible to exert a healing influence
on the homosexual. Thus a man who is attracted to boys may be brought to
love a boyish woman.[251] Indications of this kind have long been observed
and utilized, though not developed into a systematic method of treatment.
In the case of bisexual individuals, or of youthful subjects whose
homosexuality is not fully developed, it is probable that this method is
beneficial. It is difficult to believe, however, that it possesses any
marked influence on pronounced and developed cases of inversion.[252]
Somewhat the same aim as Moll's association-therapy, though on the basis
of a more elaborate theory, is sought by Freud's psychoanalytic method of
treating homosexuality. For the psychoanalytic theory (to which reference
was made in the previous chapter) the congenital element of inversion is a
rare and usually unimportant factor; the chief part is played by perverse
psychic mechanisms. It is the business of psychoanalysis to straighten
these out, and from the bisexual constitution, which is regarded as common
to every one, to bring into the foreground the heterosexual elements, and
so to reconstruct a normal personality, developing new sexual ideals from
the patient's own latent and subconscious nature. Sadger has especially
occupied himself with the psychoanalytic treatment of homosexuality and
claims many successes.[253] Sadger admits that there are many limits to
the success of this treatment, and that it cannot affect the inborn
factors of homosexuality when present. Other psychoanalysts are less
sanguine as to the cure of inversion. Stekel appears to have stated that
he has never seen a complete cure by psychoanalysis, and Ferenezi is not
able to give a good account of the results; especially as regards what he
terms obsessional homosexuality, he states that he has never succeeded in
effecting a complete cure, although obsessions in general are especially
amenable to psychoanalysis.[254]
I have met with at least two homosexual persons who had undergone
psychoanalytic treatment and found it beneficial. One, however, was
bisexual, so that the difficulties in the way of the success--granting it
to be real--were not serious. In the other case, the inversion persisted
after treatment, exactly the same as before. The benefit he received was
due to the fact that he was enabled to understand himself better and to
overcome some of his mental difficulties. The treatment, therefore, in his
case, was not a method of cure, but of psychic hygiene, of what Hirschfeld
would call "adaptation-therapy." There can be no doubt that--even if we
put aside all effort at cure and regard an invert's condition as inborn
and permanent--a large and important field of treatment here still
remains.
As we have seen in the two previous chapters, sexual inversion cannot be
regarded as essentially an insane or psychopathic state.[255] But it is
frequently associated with nervous conditions which may be greatly
benefited by hygiene and treatment, without any attempt at all to overcome
a homosexual attitude which may be too deeply rooted to be changed. The
invert is specially liable to suffer from a high degree of neurasthenia,
often involving much nervous weakness and irritability, loss of
self-control, and genital hyperesthesia.[256] Hirschfeld finds that over
67 per cent. inverts suffer from nervous troubles, and among the cases
dealt with in the present _Study_ (as shown in chapter v) slight nervous
functional disturbances are very common. These are conditions which may be
ameliorated, and they may be treated in much the same way as if no
inversion existed, by physical and mental tonics; or, if necessary,
sedatives; by regulated gymnastics and out-of-door exercises; and by
occupations which employ, without overexerting, the mind. Very great and
permanent benefit may be obtained by a prolonged course of such mental and
physical hygiene; the associated neurasthenic conditions may be largely
removed, with the morbid fears, suspicions, and irritabilities that are
usually part of neurasthenia, and the invert may be brought into a fairly
wholesome and tonic condition of self-control.
The inversion is not thus removed. But if the patient is still young, and
if the perversion does not appear to be deeply rooted in the organism, it
is probable that--provided his own good-will is aiding--
general hygienic
measures, together with removal to a favorable environment, may gradually
lead to the development of the normal sexual impulse. If it fails to do
so, it becomes necessary to exercise great caution in recommending
stronger methods. Purely "Platonic association with the other sex," Moll
points out, "leads to better results than any prescribed attempt at
coitus." For even when such attempt is successful, it is not usually
possible to regard the results with much satisfaction.
Not only is the
acquisition of the normal instinct by an invert very much on a level with
the acquisition of a vice, but probably it seldom succeeds in eradicating
the original inverted instinct.[257] What usually happens is that the
person becomes capable of experiencing both impulses,--
not a specially
satisfactory state of things. It may be disastrous, especially if it leads
to marriage, as it may do in an inverted man or still more easily in an
inverted woman. The apparent change does not turn out to be deep, and the
invert's position is more unfortunate than his original position, both for
himself and for his wife.[258]
It may be observed in the Histories brought forward in chapter iii that
the position of married inverts (we must, of course, put aside the
bisexual) is usually more distressing than that of the unmarried. Among my
cases 14 per cent. are married. Hirschfeld finds that 16
per cent. of
inverts are married and 50 per cent. are impotent; he is unable to find a
single cure of homosexuality, and seldom any improvement, due to marriage;
nearly always the impulse remains unaffected. The invert's happiness is,
however, often affected for the worse, and not least by the feeling that
he is depriving his wife of happiness. An invert, who had left his country
through fear of arrest and married a rich woman who was in love with him,
said to Hirschfeld: "Five years' imprisonment would not have been worse
than one year of marriage."[259] In a marriage of this kind the homosexual
partner and the normal partner--however ignorant of sexual matters--are
both conscious, often with equal pain, that, even in the presence of
affection and esteem and the best will in the world, there is something
lacking. The instinctive and emotional element, which is the essence of
sexual love and springs from the central core of organic personality,
cannot voluntarily be created or even assumed.[260]
For the sake of the possible offspring, also, marriage is to be avoided.
It is sometimes entirely for the sake of children that the invert desires
to marry. But it must be pointed out that homosexuality is undoubtedly in
many cases inherited. Often, it is true, the children turn out fairly
well, but, in many cases, they bear witness that they belong to a neurotic
and failing stock;[261] Hirschfeld goes so far as to say that it is always
so, and concludes that from the eugenic standpoint the marriage of a
homosexual person is always very risky. In a large number of cases such
marriages prove sterile. The tendency to sexual inversion in eccentric and
neurotic families seems merely to be nature's merciful method of winding
up a concern which, from her point of view, has ceased to be profitable.
As a rule, inverts have no desire to be different from what they
are, and, if they have any desire for marriage, it is usually
only momentary. Very pathetic appeals for help are, however,
sometimes made. I may quote from a letter addressed to me by a
gentleman who desired advice on this matter: "In part, I write to
you as a moralist and, in part, as to a physician.
Dr. Q. has
published a book in which, without discussion, hypnotic treatment
of such cases was reported as successful. I am eager to know if
your opinion remains what it was. This new assurance comes from a
man whose moral firmness and delicacy are unquestionable, but you
will easily imagine how one might shrink from the implantation of
new impulses in the unconscious self, since newly created
inclinations might disturb the conditions of life.
At any rate,
in my ignorance of hypnotism I fear that the effort to give the
normal instinct might lead to marriage without the assurance that
the normal instinct would be stable. I write, therefore, to
explain my present condition and crave your counsel.
It is with
the greatest reluctance that I reveal the closely guarded secret
of my life. I have no other abnormality, and have not hitherto
betrayed my abnormal instinct. I have never made any person the
victim of passion: moral and religious feelings were too
powerful. I have found my reverence for other souls a perfect
safeguard against any approach to impurity. I have never had
sexual interest in women. Once I had a great friendship with a
beautiful and noble woman, without any mixture of sexual feeling
on my part. I was ignorant of my condition, and I have the bitter
regret of having caused in her a hopeless love--
proudly and
tragically concealed to her death. My friendships with men,
younger men, have been colored by passion, against which I have
fought continually. The shame of this has made life a hell, and
the horror of this abnormality, since I came to know it as such,
has been an enemy to my religious faith. Here there could be no
case of a divinely given instinct which I was to learn to use in
a rational and chaste fashion, under the control of spiritual
loyalty. The power which gave me life seemed to insist on my
doing that for which the same power would sting me with remorse.
If there is no remedy I must either cry out against the injustice
of this life of torment between nature and conscience, or submit
to the blind trust of baffled ignorance. If there is a remedy
life will not seem to be such an intolerable ordeal.
I am not
pleading that I must succumb to impulse. I do not doubt that a
pure celibate life is possible so far as action is concerned. But
I cannot discover that friendship with younger men can go on
uncolored by a sensuous admixture which fills me with shame and
loathing. The gratification of passion--normal o