Abstract
The sexological research questionnaire, which became a central research tool in twentieth-century sexology, has a methodological-developmental history stretching back into mid-nineteenth century Germany. It was the product of a prolonged, disruptive encounter between sexual scientists constructing sexual case studies along with newly assertive homosexual men supplying self-penned sexual autobiographies. Homosexual autobiographies were intensely interesting to these men of science but lacked the brevity, structure, and discipline of a formal clinical case study. In the closing decades of the century, efforts to harness and regularize this self-penned material resulted in a series of methodological adaptations. By the turn of the century this process had resulted in the first use of a formal sexual research questionnaire.
Introduction
Germany’s most prominent twentieth-century sexologist, Magnus Hirschfeld, devised a psychobiological questionnaire for use in clinical practice in 1898 and then proceeded to use it over a thirty-year period to assess patients visiting his sexological clinic. 1 Hirschfeld’s questionnaire originally ran to eighty-five questions, but by 1930, after going through several revisions, it had grown to comprise 137. 2 Although the records of the answered questionnaires are now mostly lost, some estimates suggest as many as 40,000 were administered. 3 Hirschfeld can be credited as the first to publish a sexological research questionnaire, and he was responsible for driving its widespread adoption across the discipline. 4 However, Hirschfeld was not the first person to use a questionnaire in sexual science.
Questionnaires as statistical tools had first been used in London in 1838 and Germany in 1856. 5 Their use as research questionnaires within the human sciences took rather longer to emerge. Prior to Hirschfeld’s questionnaire, there had already been published research where the research material – case studies of homosexual men and lesbian women – had been generated through the distribution of formal questionnaires. These questionnaires had in turn been based on developments in prior works going back to the mid-nineteenth century. The history of the development of the sexological questionnaire as a research method is not one of the straightforward adoption of an established research strategy. Rather, the sexological research questionnaire evolved through a series of minor research gambits adopted by scientists, and in some cases introduced by non-scientists, over a protracted period. The form of this paper, charting the story of this evolution in the second half of the nineteenth century, I have called a “methodological narrative.” It is the chronological story of the disruptive interaction between sexual scientists and their sexual subjects that drove the adoption of the research questionnaire as a research method. What we are talking about is the evolution of a new method within a wider research methodology to gather and make best use of autobiographical case studies. These autobiographical case studies, sent unsolicited to sexual scientists, required the development of new research techniques and, in so doing, “disrupted” orthodox research methods. This was not the sudden adoption of a new methodology to handle a new dataset. Rather, from 1850 onwards there were a series of small shifts in methodology that ultimately led to a profound evidentiary shift.
In Germany, in the second half of the nineteenth century, something extraordinary was happening to society. The period between 1850 and 1900 in Germany saw a profound ontological shift that allowed a new class of assertive men, largely unashamed of their same-sex sexual attraction, to speak up for their own rights. This assertive advocacy by newly radicalized sexual activists had several targets, one of which was the world of medical science. They lobbied scientists with accounts of their own lived experience, something that was intensely interesting to sexual scientists. It made them turn their attention toward the subject and was one of the driving forces in the development of a recognizable sexual science.
The earliest sexual scientists, in the 1850s and 1860s, were forensic examiners, court-appointed physicians who encountered and described men accused of “Päderastie” (anal intercourse). 6 Forensic medicine in the form of independent expert medical witnesses in the court system was a new discipline in the mid-nineteenth century, and its pioneers were Johann Christian August Heinroth (1773–1843), Johann Ludwig Casper (1796–1864), and Auguste Ambroise Tardieu (1818–79). The works of Casper in the 1850s show that even in the early period there were “pederasts” willing and able to assert their own identities. By the 1870s, psychiatrists in Germany began to study the phenomenon and developed their own ways to manage self-reported material.
Sexology, as a stand-alone medico-scientific discipline, would not emerge until the early twentieth century, but its psychiatric precursor arose from the early forensic interest. The eminent Viennese psychiatrist Richard Freiherr von Krafft-Ebing (1840–1902) first published Psychopathia Sexualis in 1886, and this can be seen as a foundational document. 7 The advent of same-sex-attracted men willing to advocate for their rights to sex and love was crucial to this redirection away from the criminal to the medical-psychological purview and ultimately to the evolution of the new discipline of sexology. The cross-disciplinary dialogue between medical science, other related disciplines, and the newly vocal sexual minorities themselves would become crucially important in early sexology, and the disruptive encounter between sexual science and its assertive subjects could be seen as an early example of this. 8 The sexual identities themselves were in part created through this sexual scientific discourse, but the disruptive encounter also meant that the sexual minorities left their mark on the science. In the process, the autobiographical accounts of sexual awakening generated by same-sex-attracted men became of intense interest as a source of knowledge to these scientists. The methodological innovations that led to the research questionnaire were the direct result of this disruptive encounter.
Examining the evolution of the case study in German sexual science reveals that there were several important methodological innovations that together led to the development of the first questionnaires for use in sexological research. The formation of sexual science and its methods was mediated through a confrontation between medicine and the inception of a social movement of homosexual men in Germany. Commencing prior to the start of sexual science proper within the discipline of forensic medicine, Johann Ludwig Casper made a thorough attempt to examine medical evidence of anal intercourse. Casper’s studies included the first trove of formal clinical case studies on a sexual subject. In the process of gathering these he encountered self-reports from the men he was investigating. These self-reports appeared to be the visible artifacts of an ontological revolution underway in Germany’s sexual minorities. Nobody encapsulated this revolution more than the jurist Karl Heinrich Ulrichs, who started to write his pamphlets in the year Casper died. These became the conduit for an outpouring of testimonies that Ulrichs received in correspondence and led to the first step in the development of the sexological questionnaire. Ulrichs also, through persistent lobbying over many years, was responsible for capturing the attention of German psychiatry. In the 1870s German psychiatrists began to capture the inner life of patients in psychiatric case studies, a process beset by limitations in ideology and patient selection. Some psychiatrists began to look beyond the psychiatric hospital for subjects and, like Ulrichs, began to receive substantial numbers of self-reports. Richard von Krafft-Ebing adopted a novel approach that he and his colleagues used to turn these self-reports into usable case studies. Finally, the scientific discourse, which had been almost entirely German up to this point, started generating significant works in English. John Addington Symonds used Ulrichs’s and Krafft-Ebing’s approaches, in his collaboration with Henry Havelock Ellis, to design a questionnaire that would generate case studies.
Terminology
Over the period under consideration (1850s to 1890s), the terminology used in the literature to describe same-sex-attracted individuals went through several major transitions. The emergence of a class of assertive individuals conscious of their own same-sex-attracted selves was a striking dimension to late-nineteenth-century Germany, and contemporary scientific literature reflected this. 9 Forensic physicians used the legal term “Päderastie” (pederasty) for the crime they were investigating. Ulrichs invented his own terminology, “urning,” in the 1860s, which the psychiatrists of the 1870s did not use, preferring their own “konträre Sexualempfindung” (contrary sexual feeling/sexual inversion). Finally, the word “homosexual” came into vogue in the 1890s. For the purpose of this paper, I will use the English versions of the chronologically appropriate terms at each stage of the historical narrative I am describing. Ulrichs’s terminology, “urning,” is the exception and will be rendered in the German form, as the English equivalent “uranian” has a different historical location in English. While each term brought with it different shades of meaning, it is important to note that “urning,” “invert,” and “homosexual” overlapped and were used interchangeably in the scientific literature of the 1890s. 10
Sexual autobiography and the self-reported patient case study
The sexological questionnaire as a research method was a methodological response to the self-advocacy of same-sex-attracted men in the second half of the nineteenth century in Germany. The principal site of this disruptive influence on medical science was most visible in the sexual case study. These sexual patient case studies were central to the emerging field of sexology in mid-nineteenth-century Germany. 11 Case histories in the sexual sciences, as in other specializations, made the diseases (atypical sexuality) regular and understandable and were used for pedagogical purposes to exemplify or challenge a subcategory. 12 Sexual case studies were unlike standard medical case studies. Sexuality, unlike medical conditions, was not something that could be observed and assessed through physical examination. Even for the major psychiatric conditions, minimal patient interaction could elicit the necessary information to arrive at a conclusive diagnosis. Not so with sexology: the doctor was not present when the patient was sexually active. 13 The history of sexual behavior and other details of how the patients saw themselves and interpreted their sexual subjectivity could only be extrapolated through extended discussion or a self-report. The patient voice therefore achieved greater prominence in the sexological case study than it had in the case studies presented by other medical disciplines.
In mid-nineteenth-century Germany, the evolution of the sexual case study was coincident with the development of a new kind of sexual autobiography. Sexual autobiography had a history distinct from medicine prior to the nineteenth century. Early works such as the sixteenth-century autobiography of Benvenuto Cellini or the seventeenth-century works of the Marquis de Sade dealt with the sexual exploits, rather than the inner life, of their protagonists. Pornographic or erotic texts similarly dealt with acts rather than any self-conscious identity. What was distinct in the autobiographical self-reports that proliferated from the 1850s onwards in Germany was that they were preoccupied with the inner life, with identity rather than sexual acts. They were a visible record of a seismic epistemological/ontological change that was turning individuals guilty of the sexual sin and crime of sodomy into a new ‘species’ defined by the sex of their sexual object choice.
Foucault famously pinpointed 1870 as the date of birth of the “homosexual species.” 14 Others have suggested alternative dates and nuanced genealogies, which Eve Kosofsky Sedgwick dubbed the “Great Paradigm Shift.” 15 The rapid industrialization of Germany had led to its cities growing at a faster pace than in its European neighbors. Large, anonymous, poorly policed cities allowed for the development of liminal subcultures, including men who had sex with men. This coincided with transformations in society and literature so that there was a far greater focus on interiority and investigations into personal psychology. 16 There was also a geopolitical dimension when the revolutions of 1848 across the German cities set up a dynamic desire for German unification that gave life to other utopian progressive inclinations in some quarters. The cultural importance of scientific progress, with the explosion of scientific writing, was another important dimension. 17 These all came together in Germany in the late nineteenth century to give rise to a community of men willing to speak and write about their same-sex attraction.
The ontological/epistemological change that was occurring in Germany during this period resulted in men for the first time using their lived experience, their sexual autobiographies, as a political tool. The generation and dissemination of these personal accounts was a quasi-political act intended to effect change in those who read them, in this case principally medical scientists. Autobiographical case studies were submitted voluntarily by these men, often with the stated aim of aiding German science. 18 Homosexuals, as Foucault claimed, were speaking on their own behalf and asserting their naturalness in the language and categories of medicine. 19
Prior to the period under consideration, published works examining human sexuality, although ostensibly drawn from clinical interviews and examinations with patients, were mostly written as textbooks expressing the conclusions of the physician alone. 20 However, the self-penned testimonials from homosexuals commanded the attention of clinicians, changing the way case studies were reported. This was a two-way process where scientists were being lobbied by, as well as turning their attention toward the inner lives of, such men. In return, sexual scientists sought to formalize the configuration of these autobiographical case studies so that they conformed to the strictures of medical discourse. 21 The engagement between the two, while advancing the science of sexuality, also resulted in the increasing prominence of self-reports and the sexual autobiography. The sexological questionnaire emerged as a tactic to manage and make use of these unsolicited self-reports. The research questionnaire was also a potential tool in the drive for a more consistent, objective approach to the human sciences, which was a feature of this period in history. 22
In the early phase of the sexual sciences, unsolicited autobiographies all came from educated bourgeois men familiar with the literature. 23 Reading those letters now, it is clear that the objective of the writers was to educate the clinicians that received them. In most cases, the clinicians receiving them had shown themselves to be receptive to such approaches. These autobiographies then had a persuasive purpose that impacted directly on their tone and content. The audience for these case studies also extended well beyond the peer group of clinical scientists and included wider “sexual publics” that crossed boundaries of nationality, gender, education, or professional standing. 24 Case studies in the sexual sciences therefore had a polemical power that, at least in the early period, reached beyond the narrow confines of the medical disciplines. The men were at pains to stress their mental and physical health, the innateness of their sexualities, and the fact that they had fully accepted their nature as a positive facet of themselves. These autobiographies were an expression of identity where the elements of biography were seen through this prism and presented in order to deliver a positive impression of the current integrated sexual identity.
This autobiographical lobbying extended the boundaries of the epistemological transformation sweeping the communities of pederasts/urnings/inverts/homosexuals and led to a change in the nature and content of the case studies themselves. With a greater focus on the lived experience of the subjects under consideration, medical discourses abandoned long held assumptions and increasingly advocated a sexually modern position where homosexuality was regarded as a normal variation in human sexuality rather than as pathological. The independent generation of autobiographical case study material predated any medical definitions or categories and may have been a driving force in their formulation. It was also the driving force behind the adoption of the research questionnaire as a methodological response.
Methodological narrative through the German sexual sciences
The methodological narrative that follows maps the interaction between scientists and same-sex-attracted men onto innovations in research methods in the sexual sciences across the second half of the nineteenth century. It charts five stages in the genealogy. The first stage, from the 1850s onwards, comprised forensic studies of men accused of pederasty in the court system. In the 1860s the field of sexual science was energized by a polemic onslaught from the lawyer and activist Karl Heinrichs Ulrichs. Ulrichs’s lobbying drew the interest of psychiatrists in the 1870s, who began to study and write about inverts. In the 1880s, the psychiatric interest matured and began to make greater efforts to secure the patient voice. In the final decade of the century, an English work of sexual science, based on the German studies that had preceded it, used the first formal case study questionnaires.
Documenting pederasty in the forensic sciences
The first physicians in Germany to publish formal case studies of men who had had sex with other men were forensic physicians employed by the courts to complete physical examinations of the accused. Such case studies were a feature of the 1850s and early 1860s and, over this period, they were the only medical studies with this focus. The terminology they used was drawn from the crime the men were suspected of: “Päderastie” (pederasty). As noted above, in this context pederasty referred specifically to anal intercourse and did not imply age difference between the participants.
Short and perfunctory, the patient voice in these case studies was confined to establishing basic details and confirming the charge sheet. The established practice for the examination of those accused of sodomy before this period had been outlined in a medico-legal text published by an Italian, Paul Zacchias, in 1688. 25 Zacchias asserted that anal fissures, hemorrhoids, and loosening of the sphincter muscles were all indicative of penetration and that the penetrating accomplice should have his penis inspected to see if it was capable of the act. 26 A more contemporary forensic guide came from the French surgeon Michel Cullerier who, according to Ambroise Tardieu, asserted that receptive sodomy could be identified from “the funnel-shaped appearance of the rectum.” 27 Tardieu himself extended Zacchias’s diagnostic criteria from his years of experience in forensic practice to assert that sodomites could be identified by clear physical signs. Specifically, he asserted that receptive pederasty could be identified through fleshy buttocks and active pederasty through “pointy penises” – like those of dogs. 28
Johann Ludwig Casper’s 1852 study of rapists and pederasts, which included eleven short case studies of men accused of breaking the German law against sodomy, was one of the most important early studies in sexual science. 29 This work profiled prisoners that Casper had examined in his role as a court physician. His responsibility was to ascertain whether culpability for sexual crime could be proven through physical examination. Casper’s intention was not to discover inherent truths about sexuality, but instead to evaluate the diagnostic criteria forensic doctors were using in the German courts to assess men accused of sexual crimes. 30
Much of his initial discussion was devoted to the criteria that Zacchias had stipulated for the diagnosis of passive and active sodomy, and consequently the case studies that followed all focused almost exclusively on the inspection of his subjects’ sexual organs, buttocks, and anuses. 31 Minimal biographical details and general markers of health were also included. Although some of Zacchias’s signs were present, none were apparent consistently enough for forensic diagnostic purposes. Most of the case studies contained no sense of the inner life of these subjects and there was no inclusion of the patient voice.
However, this work included references to a self-report in the form of a diary that came into Casper’s possession. Seven of the eleven case studies came from a single source: the trial of Alfred, Count of Maltzan-Wedell (1792–1858), where the principal accused had identified numerous lovers in his diaries.
32
Casper gave this reaction, having read the diaries: “Since it is completely new and outrageous in the annals of psychology and criminal justice, I have to mention it in greater detail. New and outrageous – because who has heard of written diaries, daily notes of a pederast about his adventures, loves, sentiments, continued through many years.”
33
Casper did not name Maltzan-Wedell, calling him “Cajus” in the case study, and was surprised at the naivety of the man in recording on paper acts that he had not realized were illegal. Although it is the longest of his case studies, and much of Casper’s account described the diaries, he did not include any quotations from it. Although I consider it my duty to give back to the whole of science what the coincidence of my official position has made me perceive by a rare luck in such a dark province, and yet still belonging to science, I can nevertheless only give hints myself, because the pen fails, if I wanted to do it, to give back here the description of the orgies from these diaries.
34
Casper realized the transformational importance of these insights into the inner life of one of his subjects but felt unable to reveal its content because of its frank openness about sexual matters. As we shall see, as this narrative history continues, Casper was not the only medical scientist to struggle to accommodate autobiographical material. However, he did give the diaries a detailed study and they seem to have helped him better understand his subjects. For example, he made a general comment that at least some of his pederasts might have been born that way: “The sexual inclination between men is innate in some unfortunates – but I suspect they are in the minority – while in many other men it appears only in late life, as a result of being submerged in an over-satiation in the ordinary service of Venus.” 35 While Casper did not condone pederasty in this study, through the reading of the Cajus diaries he had acquired a more sympathetic and profound understanding of his subjects than any of his forensic colleagues. 36
When Casper returned to the subject of pederasty in 1863, eleven years after his first foray, his views had consolidated and softened.
37
As a Berlin-based court physician, Casper probably had greater exposure to the burgeoning subculture of pederasts in the city and almost certainly assessed many more of them in the courts than court physicians in other parts of Prussia or the other German states. In a study published in 1863, the year before his death, he presented thirteen more forensic case studies.
38
Casper demonstrated in the course of his 1863 work that most of Zacchias’s, Cullerier’s, and Tardieu’s diagnostic signs were not consistently seen in his subjects and were therefore of little diagnostic utility. Once again, the focus of these case studies was the physical appearance of his subjects. However, he opened with an observation that the trajectory of reform, even in Prussia, suggested that pederasty in the future would no longer be considered a crime and he added: It can be regarded as established from all experience that the pederast in many cases, perhaps in most cases, by a wonderful, dark, and inexplicable ingrained urge feels attracted exclusively to individuals of his own sex, and with the same disgust turns away from women as the not so unhappily born man of men, so that in it would have to be sought a quasi-excuse for his sins. For every true expert knows that this is the case and I find it confirmed every year in my repeated official observations.
39
Casper had been lobbied by at least one pederast himself, and the first case he presented in the 1863 series was a long letter from this man that he reproduced in full, with permission, as “The self-confession of a pederast.” 40 This “self-confession” was probably the first published example of the new genre of sexual autobiography from a same-sex- attracted individual. Casper had published his first case studies in 1852. Shortly afterwards, this man, who was possibly a medical doctor since he had read Casper’s study, had written to him from Italy. The man wrote about his youth, his first awareness of his sexual nature, his coming to terms with the same, his engagement with the subculture in Berlin, his principal lovers, and his overall good health and good fortune.
This autobiographical letter was radically different from Casper’s other case studies. It was an idealized account of its author’s past, framed in terms of a present scientific/political objective. It displayed pederasty as an innate but also noble, harmless, and edifying facet of his personality – though it led him to be oppressed and victimized by public prejudice. As such, it was an eloquent plea for tolerance and understanding and sat in stark contrast to the miserable accounts of broken, shamed men undergoing degrading physical inspections that characterized the rest of Casper’s case studies. Casper noted: “For my own purposes of teaching, this document was of great value to me, and I am not depriving science of it, which has not yet shown anything similar.” 41
Covering a little over four pages, this early example of the pederast autobiographical voice was extremely long compared with the half-page case studies that were more typical. Casper does not appear to have substantially edited the letter, though he did make “a few omissions unsuitable for printing.” 42 If such long-form self-penned case studies were to have any utility in published pedagogical works, there needed to be some means of containing both the volume and content.
The era of urning liberation
Within months of Casper’s second foray into case studies of pederasts, a lawyer, Karl Heinrich Ulrichs, published the first two works of what was to be a multivolume series under the title “Forschungen über das Räthsel der mannmännlichen Liebe” [Research into the Riddle of Man-Manly Love]. There would ultimately be twelve of these books published between 1864 and 1879, and they would have a profound impact on the study of sexual science in the years that followed. Marking a break with the literature that had preceded his works, Ulrichs employed a new non-prejudicial language where pederasts became “urnings” and men who were oriented toward the opposite sex were “dionings.”
Although Ulrichs drew widely from available current scholarship, he did not refer to Casper’s studies until his seventh book in the series, Memnon, published in 1868. 43 Otherwise, he presented arguments using contemporary science that, though idiosyncratically composed, were highly influential on his medical readers. Ulrichs ensured his work reached a medical readership by proactively lobbying prominent doctors and sending them his works. 44
Early on in his program of literary activism, Ulrichs began to receive letters from his readers. On May 23, 1864, his publisher, H. Matthes, forwarded a package of letters that was to open new possibilities for further research. 45 Although his first two books had been intended to convince the wider public, and specifically medical and legal men, the responses in the main came from urning men. 46 This package was the first of what would eventually be a flood of letters from urnings in Germany and beyond, including Italy, Austria, France, Russia, and England. Ulrichs immediately realized that these letters, with their testimonies of the thoughts and personal experiences of his urning readers, were a valuable research resource: “Since the publication of Vindex and Inclusa, my mind has been opened more than ever before. I was partly inspired by an exchange of ideas, and my own research led me to certain conclusions. Besides this, many people recently supplied me with very useful information.” 47 From this point on, the letters of his correspondents became one of his main sources of new evidence and helped him expand and adapt his theories in ten further books. As a resource of cases to be studied and investigated, they were unequaled in scale and depth. In Vindicta, Formatrix, and Ara Spei, Ulrichs quoted from or referred to forty-two individual letters. Of these, twenty-six were from urnings, eighteen of which were directly quoted. 48 This amounted to substantially more case studies than Casper had evaluated over his entire career, and in this case they were all self-reports.
In most cases, Ulrichs presented only excerpts from his letters; he selected the material that was most relevant to the discussion in hand. However, in his third book, Vindicta, he reprinted one of the letters in full. This letter, sent to him on May 23, 1864, covered four pages and was from a young urning who had read his second book. 49 Like the letter Casper reproduced in 1863, this was a long-form sexual autobiography – an idealized presentation of the author’s past from the framework of a resolved present. Such long-form autobiographical texts were unwieldy to use in full for research purposes. Ulrichs tried to paraphrase some of the sections toward the end of the letter but it is little wonder that he only rarely used such long passages.
To direct his correspondents to send only relevant content, Ulrichs appealed for more letters and framed a list of subjects he would like them to address: I entreat every Urning, and every truth-seeking Dioning to share with me any factual information by writing to the publisher. You need not sign, just include any direct or indirect data, anthropological or sociological, concerning Uranian
50
love, for example: 1. on the feminine or non-feminine habits and other particulars of Uranian behavior, 2. on the gentle and fine character of Urnings, 3. on Uranodionism [bisexuality] and women who love as men do [lesbians], 4. on the persecution of Uranian love.
51
He added that he was also interested in hearing stories about criminal investigations (but only those since May 1864) and the names of policemen, judges, lawyers, and informants so that he could make case reports. He also indicated he would like to receive cuttings or reviews of anything written about uranian love, whether it was positive or negative. He extended the request to dionings and asked all correspondents to give their opinions on his theories.
There is no indication that Ulrichs expected to receive the initial letters with their self-penned case studies. The first flurry of letters responding to his booklets must have varied considerably in quality, content, and length. The set of themes Ulrichs had proposed were not framed as questions or presented in the fashion of a formal questionnaire and nor did his correspondents respond by addressing each theme in order as one might do in a modern questionnaire. However, by proposing them, Ulrichs was prefiguring directive research tools such as the research questionnaire in the sexual sciences that would follow. This was a “proto-questionnaire” and it attempted to instill some systematic direction and thematic coherence to readers’ letters, so that Ulrichs could make the most of it as research material. There is no indication that Ulrichs had any realization that his research method was innovative in the sexual sciences or even that his proto-questionnaire was a research method. It was just a practical solution to encourage thematic coherence in the flurry of unsolicited contributions. When Ulrichs constructed his short proto-questionnaire in the autumn of 1864, there had been, up to that point, no similar instruments used in German psychiatric or medical settings and none in relation to sexual science.
Ulrichs might not have been a medical scientist, but the impact of his Forschungen on the sexual sciences was profound and enduring. He ensured his booklets were noticed by the leading medical minds of his day by sending each a copy by post. The next section will survey the fruits of that outreach in a generation of psychiatrists in the 1870s who turned their attention toward human sexuality.
The psychiatric turn
By the 1870s, psychiatrists had begun to take a research interest in men and women who were sexually attracted to their own sex. Unlike the forensic physicians who had preceded them in the sexual sciences, psychiatry was less interested in external physical concomitants of same-sex attraction and instead attempted to reveal and interpret the inner life. German psychiatry may have been directed toward the inner life, but it had nevertheless made no room for the voice of the patient or the inclusion of self-reports. Such material was routinely overlooked as unreliable since at the time there was a prevailing distrust of personal accounts from psychiatric patients. One reason for this exclusion of patient voices was the fashionable theory of “degeneration,” which had become an explanatory heuristic of choice within Germanic psychiatry. 52 The French alienists Valentin Magnan (1835–1916), Jean-Martin Charcot (1825–93), and Bénédict Augustin Morel (1809–73) had promulgated a theory that pathologized atypical sexuality as being the result of instabilities, omissions, or excitations of certain nervous centers caused by hereditary taint. Degeneration was seen as the failure of the higher faculties to inhibit base functions as a result of illness, addiction, or immorality. 53 Consequently, case studies of sexual deviants started with a listing of the mental or neurological illnesses of first-degree relatives. 54 This was a straightforward thing to do if your patient was an inpatient in a mental hospital, but considerably less easy to accomplish if the case study was derived from a self-report from an otherwise healthy man.
The preferred term among the sexual scientists of this period was “konträre Sexualempfindung” (contrary sexual feeling), which was often rendered in English as “sexual inversion.” The term, coined by Carl Westphal, was an attempt to “medicalize” Ulrichs’s theory that same-sex-attracted men had a female soul within a male body. Ulrichs had almost certainly lobbied Carl Westphal, whose 1869 dual case study paper is probably the first formal psychiatric sexological study. 55 The two case studies had been derived from Westphal’s clinical practice at the Charité Hospital in Berlin, and he quoted extensively from Ulrichs’s Incubus in the paper. 56 Rather than use Ulrichs’s nomenclature, Westphal coined his own. Aside from the terminology, Westphal otherwise seemed to accept Ulrichs’s framework for understanding sexuality, albeit with the overlay of degeneration theory. Westphal’s subjects were therefore pathologized through his intervention.
Unlike the case studies of Casper and other forensic physicians, Westphal paid extensive attention to the inner lives of his two patients, interpreting them through the degeneration heuristic. The patient voice was not clearly reproduced, but Westphal had obviously listened to his patients and formulated his case studies around Ulrichs’s idea of gender inversion. Westphal had adopted the standard alienist practice of generating psychiatric case studies. Psychiatric clinical history-taking as a means to diagnosing mental illness had changed little, in practice if not theory, since it was first advocated by the demonologist Johann Weyer in 1583. 57 In Enlightenment France, alienists such as Philippe Pinel had adapted the procedure away from the religious trappings of its past and would spend hours in long conversations with their patients. 58 The trained psychiatrist would, through a clinical interview, elicit the necessary medical and mental history and would then arrive at a diagnosis. These were then recorded as case histories, which often deviated from an objective medical perspective in the form of a straight listing of symptoms by adding in biographical details. This approach allowed Westphal to focus on the inner life of his subjects while remaining fully in control of what content would form part of his case studies.
The case studies were long but not overwhelmingly so, and this approach allowed Westphal to deploy the degeneration theory as an explanatory cause. In the psychiatric setting, the subjects of research, by being in the criminal court or psychiatric hospital systems, were not in any way a representative sample and often exhibited other psychiatric or physical illnesses. Evidence of physical or mental deficiencies was noted and each case usually commenced with a listing of the medical or other predisposing factors of parents or grandparents.
Methodologically, Westphal had listened to his patients, noting down the details of their interior lives that he would use in the case studies. This was distinctly different from the physical examinations of Casper. However, even though the clinician sought the inner life of their patients, the patient voice was distorted and occluded by the clinician’s interpretation.
In the months and years that followed, psychiatric publications containing pathologizing case studies of contrary sexual feeling began to proliferate. Schminke (1872) and Scholz (1873) presented one case study each, while Gock (1875) and Servaes (1876) each presented two and Stark (1877) presented a total of four. 59 Over the same period, there were also multiple case studies presented outside of Germany, all responding to Westphal’s initial paper and using the same approach. 60
In 1877, Richard von Krafft-Ebing, a young German psychiatrist with a dynamic interest in the new field of biological psychiatry, published his first full study on contrary sexual feeling. 61 This paper surveyed the case studies from all the relevant papers since Westphal’s and added three more using the same degeneration heuristic. Like Westphal, Krafft-Ebing had been a recipient of lobbying from Ulrichs and made a serious study of Ulrichs’s booklets. 62
Ulrichs was not overly impressed with Krafft-Ebing’s first attempts or any of the other psychiatric attempts to impose degeneration on contrary sexual feeling. Pointedly, he wrote in his last booklet, Critische Pfeile, that “my scientific opponents are mostly psychiatrists. They are, for example, Westphal, Krafft-Ebing, and Stark. They made their observations on urnings who were in institutions for the mentally ill. They appear never to have seen mentally healthy urnings.” 63 Ulrichs had a point. All the medical case studies up to that time (except the letter published by Casper in 1863) had been either about men assessed post-arrest as part of the court process or men, and sometimes women, detained in psychiatric hospitals in connection with other major psychiatric complaints. Ulrichs had republished the letters of a cross-section of men for the most part untroubled by prosecution or illness. Psychiatry would soon start to do the same.
Krafft-Ebing and the homosexuals of Vienna
The patient voice was to attain a far larger place in sexual case studies as the century drew to a close. The subjects of case studies became outspoken in asserting they did not agree with pathologizing classifications. The eloquence and assertiveness of some case study subjects became a feature in the 1880s, as did sexual autobiographical stories sent by letter. During this period, the terminology was in flux. While contrary sexual feeling was the term most used in science, the subjects under investigation called themselves urnings, and a newer term, “homosexual” (coined in 1868 by Karl Maria Kertbeny but popularized in 1878 by Gustav Jäger), was also starting to be used. Although the three terms had different nuances of meaning in the early decades of the twentieth century, they all referred to men defined by their sexual object choice, and in the 1890s were used interchangeably, as in the works of Richard von Krafft-Ebing.
The transformation of Krafft-Ebing’s outlook on homosexuality in the course of his long career has already been convincingly demonstrated by Harry Oosterhuis. 64 Whether or not he was stung by Ulrichs’s criticism (he certainly read Critische Pfeile as he quoted from it in later papers), Krafft-Ebing did change substantially the patient group he was working from. In 1880 he resigned from his position as medical superintendent at the psychiatric asylum near Graz and focused instead on his academic position at the university and his small psychiatric clinic. 65 This move was accompanied by a change in the way he approached his case studies. In 1882, he published three case studies of upper-class men, two of whom he had encountered and written about before. The tone of this new study reflected a far greater sympathy for, and acknowledged the fixed nature of, the sexual disposition of his subjects. 66 Krafft-Ebing also did not shy away from reporting that the men had no sense that there was anything morally wrong or pathological about their sexualities. From this point on, Krafft-Ebing seems to have treated his upper-class patients as quasi-equals, partners in the development of his case studies.
The following year he published another case study where the subject, a thirty-three-year-old Hungarian businessman, was a private patient who had consulted him in his clinic for another complaint. 67 In the course of the examination, the patient disclosed his sexuality and Krafft-Ebing encouraged him to write his own self-penned account, which was then quoted in full within the case study. This more humane approach started attracting the attention of certain urnings. Five of the case studies in his next publication (four men and one woman), published in 1884, were all upper middle-class private patients in his clinic. 68 This was significant, as most of these patients came on their own initiative, attracted by Krafft-Ebing’s humane approach. This was also true of a sixth case study, which was derived from a letter and written in his own words by a thirty-eight-year-old businessman living in exile in America who had read the 1882 paper in the Allgemeine Zeitschrift fuer Psychiatrie. 69 He had been impressed by Krafft-Ebing’s sympathetic approach and offered up his sexual autobiography for the good of science. Krafft-Ebing published a further paper in 1885 that had two case studies, both consisting of letters where men recounted their sexual stories in their own words. 70
Over the course of three years Krafft-Ebing had reported twelve case studies, of which six were from private patients in his clinic and three were derived from letters. These case studies, published between 1882 and 1885, whether they were recorded from a consultation or extracted from a letter, all followed the same general structure: family history of degeneration; patient health and bearing; interests and (sexual) practices; biography, including signs in infancy, first awareness, first sex; and current situation. Though the order did vary a little, every case study contained each of these elements. Krafft-Ebing, when presenting his first self-report case study, stated the patient had written him “a longer letter, the most important contents of which can be found in the excerpt here.” 71 Krafft-Ebing was selecting the passages from the letter that best addressed the topics he wanted the case study to cover. This was Krafft-Ebing’s solution to the superfluity of some passages in the self-penned autobiographies: to contain them by setting them to a regular, preconstructed template. In time this may have been less necessary as the men writing to him, familiar with the case studies in his publications, sought to emulate them. One man, a young Latvian nobleman referred to as Von R., who sent a self-penned autobiography to Krafft-Ebing, had even structured his letter as if it was a psychiatric case study, complete with marginal diagnostic notes. 72
In the 1885 publication, Krafft-Ebing appealed for more self-reports in order to supplement the small number of case studies. 73 What had been a trickle would turn into a steady stream of letters. Interestingly, in the two 1885 case studies he included the awakening of the patients’ homosexual identities through the works of Ulrichs and, in all the self-reported case studies, he included passages where the patient rejected any pathological interpretation. Krafft-Ebing retained editorial control and could have excluded references to their own sense that they were not pathologically affected. Instead, he included material that ultimately called into question the degeneration hypothesis. Similarly, the case of a Polish landowner reported in 1884 showed that electrotherapy was less effective for treating the patient’s neurasthenia than a sexually promiscuous trip to Venice (the neurasthenia returned in full force when he returned home and had no sexual outlet). 74 Krafft-Ebing was undermining the degeneration hypothesis within his published case studies. In time, he would abandon it as an explanatory heuristic entirely. Over the course of these publications, his softening stance was also revealed in the terminology he used. Krafft-Ebing moved from using only the established medical terminology of Westphal, konträre Sexualempfindung, to also using Ulrichs’s term, urning (the term his patients were using that carried no implication of pathology) and a new term, homosexuality.
All these case studies from each of his publications, plus many others, were to form part of his most major work, Psychopathia Sexualis, published in thirteen editions between 1886 and his death in 1903. 75 In his second edition, published in 1887, Krafft-Ebing again appealed, based on increasing accounts of statutory persecution, for urnings to contact him with accounts of their lives. Versions of this appeal were placed in the introduction of the book in every successive new edition, and it seems that the appeal had a significant response from homosexual men and women. Consequently, the volume of self-reported homosexual case studies grew and grew to form the largest component in the book, dwarfing all the other sections concerning other variations in sexual behavior. In total, out of 440 case studies across all indications, over the multiple editions, more than half related to homosexual men and women and included forty-seven that were supplied in correspondence and 172 in face-to-face consultations in the private clinic. 76 All followed the template structure, in part or in full, whether they were in the patients’ own words or written by the physician.
English sexual scientific synthesis
One of those to read and be struck by the contents of Psychopathia Sexualis was the English poet and literary critic John Addington Symonds. Early in 1889, Symonds had set himself the task of writing a “sexual autobiography” under the impression he was one of the first to do so. He wrote to his friend Henry Dakyns that “There does not exist anything like it in print; and I am certain that 999 men out of 1000 do not believe in the existence of a personality like mine.” 77 At this point he was unaware of the works of clinical forensic medicine, sexual science, or Ulrichs’s polemic works. After struggling to make sense of his own sexuality in the first few chapters of the book in March to May 1889, Symonds left Venice, where he had been writing, to return to his home in Davos, Switzerland. Symonds sought out relevant scholarship and found works by Johann Ludwig Casper, Richard von Krafft-Ebing, and Carl Heinrich Ulrichs. 78 He was particularly struck by Ulrichs’s work, probably Memnon, but was also nonplussed by Krafft-Ebing’s dogged adherence to at least the formal inclusion of degeneration theory. He immediately wrote an indignant letter to Krafft-Ebing couched in the terminology and assertiveness of Ulrichs. This letter was published in the next and every subsequent edition of Krafft-Ebing’s Psychopathia Sexualis. 79
Like Krafft-Ebing, Symonds was wont to use the three terms sexual invert, urning, and homosexual interchangeably. He completed his memoir and privately printed a polemic work, Problem in Modern Ethics, after which he struck up a correspondence with and eventually visited Ulrichs, now living in exile in Italy. 80 Over the course of this correspondence he came to the firm conviction that he would have to write a scientific work on “Sexual Inversion.” 81 Aware of his limitations in scientific knowledge and standing, he sought a collaboration with a medical expert. Among his correspondents over the years had been a young medical doctor, Henry Havelock Ellis, who shared a devotion to Walt Whitman and a love of literature. Ellis had already published The Criminal, a work of psychiatry, in 1890. Symonds contacted him and they soon came to an agreement on a collaborative work on sexual inversion where Symonds would supply chapters focused on historical background and case studies drawn from his acquaintances, while Ellis wrote an introduction and four chapters on the medical and scientific arguments that would draw on the literature review that Symonds had presented in A Problem in Modern Ethics. 82
The works of Ulrichs and Krafft-Ebing were very much on Symonds’s mind, particularly the practicalities of acquiring case studies. He set about gathering case studies, writing to Havelock Ellis on February 12, 1893: “You will observe my method in eliciting these confessions. I framed a set of questions upon the points which seemed to me of most importance after a study of Ulrichs and Krafft-Ebing.” 83 Symonds did not explicitly say he was copying the methodology, but by framing questions he was doing effectively what Ulrichs did in his third booklet with his proto-questionnaire. But whereas Ulrichs’s questions were diffuse, the more rigid structure and subjects covered in Krafft-Ebing’s case studies suggested structured headings that could give rise to more specific questions. The questions in Symonds’s questionnaire, which was never actually published, can be surmised from the published case studies in Sexual Inversion. It addressed the same subjects as Krafft-Ebing’s case studies, using the technique of a formal set of questions like Ulrichs’s proto-questionnaire. It was in effect a fusion of the two.
Symonds sent the questionnaires individually to each potential case study in a more formal manner than Ulrichs. 84 Other case studies gathered by Edward Carpenter and case studies of lesbians gathered by Havelock Ellis’s wife, Edith Lees, also followed the same approach, using the questionnaire. These questionnaires were being filled in by friends, lovers, and acquaintances of Symonds, Lees, and Carpenter – people who saw the value of, and were invested in, the collaborative endeavor of gathering case studies. Symonds died in 1893 before the publication of Sexual Inversion, but in due course it was to become the key text of sexology in English and the first in a series of books about human sexuality. In Havelock Ellis’s subsequent work there is evidence that he continued to use questionnaires. In Ellis’s book on Eonism (transvestism), a questionnaire was almost certainly used to gather the case studies he included. 85
Although Symonds’s questionnaire was not published with the case studies, it was clear from the structure of each of them that they followed broadly the same categories, suggestive of the questions that prompted each answer. There were twenty-seven male case studies and four case studies of women, all between a half page and one page long. Although all were derived from self-penned sources, the case studies were presented in the third person. The questionnaire had compressed sexual autobiographies into a manageable length and, by adhering to set questions, each case study was directly comparable with all the others. Symonds and Ellis had found a means to contain the voluminous outpouring of a sexual life story into a short and usable case history appropriate for analysis in scientific study.
Conclusion
The evolution of the questionnaire as a means of taming the sexual autobiography and overcoming the limitations of existing methods spanned the years 1865 to 1892 and ensured that the questionnaire as a research tool in sexology was well established when Hirschfeld started his career. The works of Ulrichs, Krafft-Ebing’s Psychopathia Sexualis, and Symonds’s and Ellis’s Sexual Inversion, or at least the German edition Das konträre Geschlechtsgefühl, were well known to him. 86 Early sexology pioneered the use of questionnaires to record self-reported patient case histories. Ulrichs’s innovative practical solution to unexpected self-penned case study letters in 1865, Krafft-Ebing’s templating of self-reported case studies in the 1880s, and Symonds’s practical use of a simple questionnaire to record case studies in the 1890s had become, by the turn of the century, an increasingly important methodological approach for gathering self-reports in sexological research.
This methodological innovation was entirely appropriate to the subject in hand. Sexology was far less amenable to quantifiable diagnostic testing regimens than other fields of medicine, and researchers were highly dependent on what their subjects told them about their sexual feelings. 87 Forensic physicians such as Casper struggled to find meaningful diagnostics based on physical examination alone. This made it even more remarkable that Casper’s final work included the first formal self-penned sexual autobiography, which had been sent to him by post. The newly vocal community of homosexuals became an external force that transformed the science itself. In parallel with the interest psychiatry was taking in sexuality, homosexuality was forming “a ‘reverse’ discourse: homosexuality began to speak on its own behalf, to demand that its legitimacy or ‘naturality’ be acknowledged, often in the same vocabulary, using the same categories by which it was medically disqualified.” 88 Ulrichs’s works provoked an outpouring of this “reverse discourse” from his readers that Ulrichs was happy to include in his subsequent works. While they may have disparaged the source, Ulrichs’s works were impossible for clinical scientists to ignore. The assertive challenge changed the whole way medical science approached the subject. Seeking to make best use of the material supplied, medical researchers effected a methodological change that placed the clinical research questionnaire at the center of sexological practice.
The focus on patient self-reporting, self-penned case studies, and the use of questionnaires to source directed self-reports from patients marked a substantial deviation for sexology from the therapist-mediated clinical interviews that had been the mainstay of psychiatry for a century or more. It seems obvious to us now that questionnaires would be a sensible way to examine a psychological characteristic like sexuality that had no observable physical characteristics. But that would not have been obvious to clinicians confronted with unsolicited, long, and emotive letter autobiographies and having to balance them with their traditional practitioner-mediated psychiatric case studies. A questionnaire offered a way to tame the self-reported case study into a manageable structure and narrative. As a tool, it evolved in its own way within the emerging discipline of sexology and was the product of innovations by Ulrichs, Krafft-Ebing, and Symonds.
Although this use had been pioneered for the extraction of sexual autobiographical testimonies, there were other applications for the questionnaire. At the very start of this paper, I outlined Magnus Hirschfeld’s use of questionnaires throughout his clinical practice of over thirty years. His publication of it as a clinical and a research method ensured the widespread use of standardized questionnaires across the growing field of sexology. Hirschfeld also used questionnaires in other settings. In 1897 he had helped establish the Scientific Humanitarian Committee: Germany’s, and the world’s, first homosexual rights organization. One of the first substantial research activities of the Scientific Humanitarian Committee was a major survey in 1903/4 where questionnaires were distributed to cohorts of students at the Berlin Technical University and members of the Berlin Metalworker’s Union. 89 These questionnaires were anonymized, in code, and accompanied by an explanatory letter directing recipients to circle which sex/gender they were sexually attracted to. In this way, the Scientific Humanitarian Committee was able to examine the prevalence of homosexuality and bisexuality in two specific cohorts and use this as research collateral in their lobbying activities. The centrality of the questionnaire as an important research tool would later reach its zenith in the research of Alfred Kinsey (1894–1956). 90 In this setting, the questionnaire became instead a tool for quantitative population analysis rather than the original vehicle for case histories.
Where the questionnaire was still used for recording case histories, the reciprocal relationship meant that the autobiographies themselves began to reflect the medical discourses they were produced for. As mentioned above, Oosterhuis opened the introduction to his Stepchildren of Nature with a letter from “Von R.”, whose self-penned case copied entirely the language, structure, and even the marginal notes of one of Krafft-Ebing’s psychiatric case studies. 91 In one case, that of N. O. Body, an autobiography was published that mapped precisely the progression of questions in Hirschfeld’s psychobiological questionnaire. 92 The medical definitions for sexual categories may in some cases have become “biographical prosthetics,” where the authors relied heavily on the medical discourse in defining themselves. 93 This was a byproduct of the close relationship between clinicians and their sexual subjects rather than evidence of medically imposed categories or identities. However, over time the balance of reciprocity in this relationship shifted. Where researchers initially shaped their theories in response to homosexual life histories, as time progressed, homosexuals adapted their life histories to the shape of sexological case studies.
The sexual research questionnaire was developed to accommodate collaborative and dialogic encounters in the closing decades of the nineteenth century. By the twentieth century it had become an important scientific method in and of itself. The process of development began with unsolicited lobbying by same-sex-attracted men and their autobiographical accounts. Sexual scientists wanted to use these accounts but found them unwieldy and unfocused. This resulted in a cascade of small methodological shifts over the passage of five decades. In the process, the dynamic interaction between the two transformed both the science and its sexual subjects. For science, it resulted in the development of the sexual research questionnaire.
Footnotes
Acknowledgements
I am grateful, first and foremost, to my supervisor, Dr Timothy Jones, in the Department of Archaeology and History at La Trobe University. Some of the material covered in the paper was translated from primary sources and I am grateful to Rolf Thalmann for transcribing this material and to Michael Lombardi-Nash, translator of Ulrichs’s Forschungen, for checking and correcting my translations. I am also grateful to Dr Liz Conor for reviewing and advising me on this manuscript.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded through a Commonwealth Australian Federal Research Training Program (RTP) Scholarship (La Trobe University Research Grant, 2018), a grant from the School of Humanities and Social Sciences Internal Research Grant Scheme (IRGS), and a La Trobe University Social Research Platform Grant.
1.
The questionnaire, first published in 1899, was to go through several revisions over time. Magnus Hirschfeld, “Die objective Diagnose der Homosexualität,” Jahrbuch für sexuelle Zwischenstufen unter besonderer Berücksichtigung der Homosexualität 1 (1899): 4–35, 26–35.
2.
Rainer Herrn, Michael Thomas Taylor, and Annette F. Timm, “Magnus Hirschfeld’s Institute for Sexual Science: A Visual Sourcebook,” in Michael Thomas Taylor, Annette F. Timm, and Rainer Herrn (eds.), Not Straight from Germany: Sexual Politics and Sexual Citizenship since Magnus Hirschfeld (Ann Arbor: Michigan University Press, 2017), pp.37–79.
3.
Erwin J. Haeberle, “The Jewish Contribution to the Development of Sexology,” The Journal of Sex Research 18/4 (1982): 305–23.
4.
Elena Mancini, Magnus Hirschfeld and the Quest for Sexual Freedom: A History of the First International Sexual Freedom Movement (London: Palgrave Macmillan, 2010), p.85.
5.
Fourth Annual Report of the Statistical Society of London, Journal of the Statistical Society of London 1/1 (1838): 5–13; Robert H. Gault, “A History of the Questionnaire Method of Research in Psychology,” The Pedagogical Seminary 14/3 (1907): 366–83.
6.
In this context, and throughout this article, “pederasty” is used to refer specifically to anal intercourse and does not imply age difference between the participants.
7.
J. Hoenig, “Dramatis Personae: Selected Biographical Sketches of 19th Century Pioneers in Sexology,” in J. Money and H. Musaph (eds.), Handbook of Sexology (New York: Elsevier/North-Holland Biomedical Press, 1977), pp.21–43.
8.
Jana Funke and Kate Fisher, “Sexual Science beyond the Medical,” Lancet 387 (2016): 840–41.
9.
Scott Spector, “Introduction: After the History of Sexuality? Periodicities, Subjectivities, Ethics,” in Scott Spector, Helmut Puff, and Dagmar Herzog (eds.), After the History of Sexuality: Genealogies with and beyond Foucault (New York: Berghahn Books, 2012), pp.1–16.
10.
Robert Deam Tobin, Peripheral Desires: The German Discovery of Sex (Philadelphia: University of Pennsylvania Press, 2015), p.23.
11.
Ivan Crozier, “Pillow Talk: Credibility, Trust and the Sexological Case Study,” History of Science 10/6 (2008): 375–404; Philippe Weber, Der Trieb zum Erzählen: Sexualpathologie und Homosexualität, 1852–1914 (Bielefeld: Transcript Verlag, 2008), pp.44–57.
12.
Ibid., p.379.
13.
Ibid., p.375.
14.
Michel Foucault, The History of Sexuality, Volume 1: An Introduction, trans. into English by Robert Hurley (New York: Pantheon Books, 1978), p.43.
15.
Eve Kosofsky Sedgwick, Epistemology of the Closet (Los Angeles: University of California Press, 2008), p.44.
16.
Jürgen Habermas, The Structural Transformation of the Public Sphere; An Enquiry into a Category of Bourgeois Society, trans. into English by Thomas Burger and Frederick Lawrence (Cambridge, MA: MIT Press, 1991), p.162.
17.
Peter Watson, The German Genius: Europe’s Third Renaissance, the Second Scientific Revolution and the Nineteenth Century (New York: Harper Perennial, 2011), p.426.
18.
Klaus Müller, Aber in meinem Herzen sprach eine Stimme so laut (Berlin: Verlag rosa Winkel, 1991), pp.327–8.
19.
Foucault, History of Sexuality, p.101 (note 14).
20.
See, for example, the relevant works of Auguste Ambroise Tardieu (1818–79), Jean-Martin Charcot (1825–93), Bénédict Augustin Morel (1809–73), and Ezechia Marco Lombroso (1835–1909).
21.
Birgit Lang, Joy Damousi, and Alison Lewis, A History of the Case Study: Sexology, Psychoanalysis, Literature (Manchester: Manchester University Press, 2017), p.8.
22.
Lorraine Daston and Peter Galison, Objectivity (New York: Zone Books, 2007), p.27.
23.
Harry Oosterhuis, “Richard von Krafft-Ebing’s ‘Step-Children of Nature’: Psychiatry and the Making of Homosexual Identity,” in Vernon A. Rosario (ed.), Science and Homosexualities (New York: Routledge, 1997), pp.67–88.
24.
Joy Damousi, Birgit Lang, and Katie Sutton, Case Studies and the Dissemination of Knowledge (New York: Routledge, 2015), p.8.
25.
Paulus Zacchias, Quaestionum Medico-legalium Tomi Tres (Frankfurt: Johannis Melchioris Bencard, 1688), pp.382–3.
26.
Ibid., p.383.
27.
Ambroise Tardieu, Etude Médico-Légale sur les Attentats aux Mœurs (Paris: J. B. Bailliére et fils, 1858), p.135.
28.
Ibid., pp.137–47.
29.
Weber, Der Trieb zum Erzählen, pp.44–5 (note 11); Johann Ludwig Casper, “Ueber Nothzucht und Päderastie und deren Ermittelung Seitens des Gerichtsarztes,” Vierteljahrsschrift für gerichtliche und öffentliche Medicin 1 (1852): 21–78.
30.
Scott Spector, Violent Sensations: Sex, Crime & Utopia in Vienna and Berlin 1860–1914 (Chicago: University of Chicago Press, 2016), p.85.
31.
Casper, “Ueber Nothzucht,” pp. 46–52 (note 29).
32.
Jens Dobler, Zwichen Duldungspolitik und Verbrechensbekämfung: Homosexuellenverfolgung durch die Berliner Polizei von 1848 bis 1933 (Berlin: Verlag für Polizeiwissenschaft, 2008), p.45.
33.
Author translation of “da sie in den Annalen der Psychologie und Criminaljustiz ganz neu und unerhört ist, muss ich etwas ausführlicher erwähnen. Neu und unerhört – denn wer hat wohl von schriftlichen Tagebüchern, täglichen Aufzeichnungen eines Päderasten über seine Abentheuer, Liebschaften, Empfindungen, durch viele Jahre fortgesetzt, gehört.” Casper, “Ueber Nothzucht,” p.67 (note 29).
34.
Author translation of “Obgleich ich es für meine Pflicht halte, der gesammten Wissenschaft wiederzugeben, was mich der Zufall meiner amtlichen Stellung durch ein seltenes – Glück in einer so ganz dunkeln, und dennoch der Wissenschaft angehörigen Provinz hat wahrnehmen lassen, so kann ich doch selbst nur Andeutungen geben, denn die Feder versagt, wenn ich es unternehmen wollte, die Schilderung der Orgien aus diesen Tagebüchern hier wiederzugeben.” Ibid., p.68.
35.
Author translation of “Die geschlechtliche Hinneigung von Mann zu Mann ist bei vielen Unglücklichen – ich vermuthe aber bei der Minderzahl – angeboren, während sie bei vielen andern Männern erst im spätern Leben, als Folge einer Uebersättigung im gewöhnlichen Dienste der Venus, austaucht.” Ibid., p.62.
36.
See, for example: Hieronymus Fränkel, “Homo Mollis,” Medicinische Zeitung von dem Vereine für Heilkunde in Preussen 22 (1853): 102–3.
37.
Johann Ludwig Casper, Klinische Novellen zur gerichtlichen Medicin: nach eigenen Erfahrungen (Berlin: Hirschwald, 1863).
38.
Ibid., pp.45–52.
39.
Author translation of “so kann es nach allen Erfahrungen als feststehend betrachtet werden, dass der Päderast in vielen, vielleicht in den meisten Fällen durch einen wunderbaren, dunkeln, und unerklärlichen eingebornen Drang sich ausschliesslich zu Individuen seines eignen Geschlechts hingezogen fühlt und mit demselben Ekel sich von Weibern abwendet, wie der nicht so unglücklich geborne Mann von Männern, so dass also darin quasi eine Entschuldigung für seine Sünden gesucht werden müsste. Denn, dass dem so ist, weiss jeder wirkliche Fachkenner und finde ich alljährlich in meinen immer wieder erneuten amtlichen Beobachtungen fortwährend bestätigt.” Ibid., p.34.
40.
Ibid., pp.35–9. Wilhelm Griesinger may have received a similar letter a few years later, perhaps from the same individual, as he reported: “wenn man einmal von einem soliden, fein gebildeten und in der feinen Welt lebenden, aber allerdings hereditär stark belasteten Individuum das Geständniss entgegen genommen hat, dass er seit seinem achten Lebensjahre einen bei jeder Gelegenheit aufsteigenden, sexualen Trieb zu seinem eigenen Geschlechte, niemals aber noch einen gesunden und natürlichen empfunden hat” [once one has received the confession from a solid, finely educated individual living in the fine world, but hereditarily heavily burdened, that since the age of eight he has felt an ascending sexual urge to his own sex at every opportunity, but never again a healthy and natural one]. Wilhelm Griesinger, ‘Vortrag zur Eröffnung der psychiatrischen Clinic zu Berlin’, Archiv für Psychiatrie und Nervenkrankheiten 1 (1868): 636–54.
41.
Translation of “Für meine eigne Belehrung war mir dies Schriftstück von grossem Werth, und ich entziehe es der Wissenschaft nicht, die noch kein ähnliches aufzuweisen hat.” Casper, Klinische Novellen, p.36 (note 37).
42.
Translation of “mit wenigen, für den Druck nicht geeigneten Ausslassungen.” Ibid., p.35.
43.
Karl Heinrich Ulrichs, “Memnon I,” Book Seven of The Riddle of “Man-Manly” Love: The Pioneering Work on Male Homosexuality Volume I, trans. into English by Michael A. Lombardi-Nash (Buffalo, NY: Prometheus Books, 1994), pp.289–333, 320n.
44.
Ulrichs describes this lobbying at frequent junctures in his books, as well as the replies he gets from individual medical luminaries such as Rudolph Virchow and Richard von Krafft-Ebing.
A list of medical men who responded positively to his lobbying can be found in Karl Heinrich Ulrichs, “Prometheus,” Book Ten of The Riddle of “Man-Manly” Love, The Pioneering Work on Male Homosexuality Vol. II, trans. into English by Michael A. Lombardi-Nash (Buffalo, NY: Prometheus Books, 1994) §45, pp.541–600.
45.
Karl Heinrich Ulrichs, “Vindicta,” Book Three of The Riddle of “Man-Manly” Love: The Pioneering Work on Male Homosexuality Volume I, trans. into English by Michael A. Lombardi-Nash (Buffalo, NY: Prometheus Books, 1994), ff. pp.97–126.
46.
Ibid., Preface (l), p.101.
47.
Karl Heinrich Ulrichs, “Formatrix,” Book Four of The Riddle of “Man-Manly” Love: The Pioneering Work on Male Homosexuality Volume I, trans. into English by Michael A. Lombardi-Nash (Buffalo, NY: Prometheus Books, 1994) §106, pp.127–180.
48.
The twenty-six letters here are deemed to be from urnings because either the correspondents self-describe as such or give biographical details that confirm this. Of the other sixteen letters some are written in a professional capacity (lawyers or doctors), some make an explicit claim to be dionings and some do not make any claims one way or the other.
49.
Ulrichs, “Vindicta,” §§31–41, pp.117–19 (note 45).
50.
Michael Lombardi-Nash translated “urnische Liebe” here as “Uranian love.” The rendering of Ulrichs’s terminology in English is complicated by the fact that, other than in the works of John Addington Symonds’s later works, and Edward Carpenter, it has no extant history in contemporary English usage. In Symonds’s earliest work on the subject, A Problem in Greek Ethics (written in 1873 and privately published 1883), he described Pausanias’s account as “Uranian love”: John Addington Symonds, A Problem in Greek Ethics (Bristol: self published, 1883), p.43. Symonds used “uranian” similarly in his memoir – Amber Regis, The Memoirs of John Addington Symonds: A Critical Edition (London: Palgrave Macmillan, 2016), p.198. Edward Carpenter used “urning” and “uranian” interchangeably and clearly stated that uranian was the English translation of urning: Edward Carpenter, The Intermediate Sex: A Study of Some Transitional Types of Men and Women (London: Swan Sonnenschein & Co., Ltd, 1908), p.21, < 
> (August 23, 2019).
51.
Ulrichs, “Vindicta,” gg, p.107 (note 45).
52.
Harry Oosterhuis, Stepchildren of Nature: Krafft-Ebing, Psychiatry, and the Making of Sexual Identity (Chicago: University of Chicago Press, 2000), p.53.
53.
Ibid., p.54.
54.
Crozier, “Pillow Talk,” p.384 (note 11).
55.
Karl Friedrich Otto Westphal, “Die conträre Sexualempfindung: Symptom eines neuropathischen (psychopathischen) Zustandes,” Archiv für Psychiatrie und Nervenkrankenheiten 2 (1869): 73–108.
56.
Ibid., 92–4.
57.
George Huntington, “Psychiatry in History – De Praestigiis Daemonum: The Origins of Psychiatric History Taking,” The British Journal of Psychiatry 207 (2015): 489.
58.
Dora B. Weiner, “Philippe Pinel’s ‘Memoir on Madness’ of December 11, 1794: A Fundamental Text of Modern Psychiatry,” American Journal of Psychiatry 149/6 (1992): 725–732. In this way, the psychiatrist retained the position of the demonologist to control the patient interaction. This was a Foucauldian transmission of power/knowledge from the confessional to the psychiatric chair. (Foucault, History of Sexuality, pp.61–5 [note 14].)
59.
Dr Schmincke, “Ein Fall von conträrer Sexualempfindung.” Archiv für Psychiatrie und Nervenkrankheiten 3 (1872): 225–6; Dr Scholz, “Bekentnisse eines an perverser Geschlechtsrichtung Leidenden,” Vierteljahrschrift für Gerichtliche Medizin 19 (1873): 321–8; Dr H. Gock, “Beitrag zur Kenntniss der conträren Sexualempfindung,” Archiv für Psychiatrie und Nervenkrankheiten 5 (1875): 564–74; Dr F. Servaes, “Zur Kenntniss von der conträren Sexualempfindung,” Archiv für Psychiatrie und Nervenkrankheiten 6 (1876): 484–95; Dr Stark, “Ueber contäre Sexualempfindung,” Allgemeine Zeitschrift für Psychiatrie 23 (1877): 209–16.
60.
For example: Arrigo Tamassia, “Sull’ inversione dell’ istinto sessuale,” Rivista sperimentale di freniatria e di medicina legale 2 (1878): 97–117; Johan A. Backman, “Ett fall af konträr sexualkänsla,” Finska Läkaresällskapets Handlingar 24 (1882): 151–60; G. Alder Blumer, “A Case of Perverted Sexual Instinct (Conträre Sexualempfindung),” American Journal of Insanity 39 (1882): 22–35; J. C. Shaw and G. N. Ferris, “Perverted Sexual Instinct,” The Journal of Nervous and Mental Disease 10 (1883): 185–204; James G. Kiernan, “Insanity: Lecture XXVI–Sexual Perversion,” Detroit Lancet 7 (1884): 481–4; George F. Shrady, “Perverted Sexual Instinct,” Medical Record 26 (1884): 70–71; Julius Krueg, “Perverted Sexual Instincts,” Brain 4 (1881): 368–76.
61.
Richard von Krafft-Ebing, “Ueber gewisse Anomalien des Geschlechtstriebs und die klinisch-forensische Verwerthung derselben als eines wahrscheinlich functionellen Degenerationszeichens des centralen Nervensystems,” Archiv für Psychiatrie und Nervenkrankheiten 7 (1877): 291–312.
62.
Letter from Krafft-Ebing in Graz to Ulrichs, January 29, 1879: “Das Studium Ihrer Schriften über mannmännliche Liebe hat mich in hohem Maß interessiert, . . . da Sie . . . zum ersten Mal diese Thatsachen öffentlich besprechen. . . . Von dem Tage an, wo Sie mir – ich glaube, es war 1866 – Ihre Schriften zusandten, habe ich meine volle Aufmerksamkeit der Erscheinung zugewendet, welche mir damals ebenso räthselhaft war als interessant; und die Kenntniß Ihrer Schriften allein war es, was mich veranlaßte zum Studium in diesem hochwichtigen Gebiet und zur Niederlegung meiner Erfahrungen in dem Ihnen bekannten Aufsatz im (Berliner) ‘Archiv für Psychiatrie’” [The study of your books on man-manly love interested me a great deal . . . Because for the first time, you discuss these facts publicly. From that day when you sent your writings – I believe it was in 1866 – I have turned my full attention to this phenomenon, which was just as puzzling as it was interesting to me; and it was only the knowledge of your books that motivated me to study this highly important area and to write down my experiences in the essay known to you in the Berlin “Archiv für Psychiatrie”]. Karl Heinrich Ulrichs, “Critische Pfeile,” Book Twelve, The Riddle of “Man-Manly” Love: The Pioneering Work on Male Homosexuality Volume II, trans. into English by Michael A. Lombardi-Nash (Buffalo, NY: Prometheus Books, 1994), §125, pp.625–690.
63.
Ibid., §126, p.688.
64.
Oosterhuis, Stepchildren (note 52).
65.
Ibid., p.85.
66.
Richard von Krafft-Ebing, “Zur ‘conträren Sexualempfindung’ in klinisch-forensischer Hinsicht,” Allgemeine Zeitschrift fuer Psychiatrie und psychisch-gerichtliche Medizin 38 (1882): 211–27.
67.
Richard von Krafft-Ebing, Lehrbuch der Psychiatrie auf klinischer Grundlage für practische Ärzte und Studirende, 2nd ed. (Stuttgart: Ferdinand Enke, 1883), p.85.
68.
Richard von Krafft Ebing, “Zur Lehre von der conträren Sexualempfindung,” Der Irrenfreund 26 (1884): 1–14.
69.
Ibid., pp.2–5.
70.
Richard von Krafft-Ebing, “Die conträre Sexualempfindung vor dem Forum,” Jarbücher für Psychiatrie 6 (1885): 34–47.
71.
Author translation of “ein längeres Schreiben, dessen wichtigster Inhalt hier im Auszug Mittheilung finden mag.” Krafft-Ebing, “Zur Lehre von der conträren Sexualempfindung,” 2 (note 68).
72.
Oosterhuis, Stepchildren, pp.1–6 (note 52).
73.
Krafft-Ebing, “Die conträre Sexualempfindung vor dem Forum,” p.36 (note 70).
74.
Krafft-Ebing, “Zur Lehre von der conträren Sexualempfindung,” p.13 (note 68).
75.
There were also later editions of Psychopathia Sexualis published after Krafft-Ebing’s death under the stewardship of other editors.
76.
Oosterhuis, Stepchildren, p.151 (note 52).
77.
Letter 1709 from John Addington Symonds to Henry Dakyns, March 27, 1889, in Herbert M. Schueller and Robert L. Peters (eds.), The Letters of John Addington Symonds, Volume III: 1885–1893 (Detroit, IL: Wayne State University Press, 1969), p.364.
78.
Phyllis Grosskuth, John Addington Symonds: A Biography (London: Longmans, 1964), p.279.
79.
Richard von Krafft-Ebing, Psychopathia Sexualis (Stuttgart: Verlag von Ferdinand Enke, 1892), p.410.
80.
Grosskuth, Symonds, pp.281–2 (note 78).
81.
Letter 1982 from John Addington Symonds to Arthur Symons, June 13, 1892, in Herbert M. Schueller and Robert L. Peters (eds.), The Letters of John Addington Symonds, Volume III: 1885–1893 (Detroit, IL: Wayne State University Press, 1969), pp.690–92.
82.
Grosskuth, Symonds, p.289 (note 78).
83.
Letter 2087 from John Addington Symonds to Havelock Ellis, February 12, 1893, in Herbert M. Schueller and Robert L. Peters (eds.), The Letters of John Addington Symonds, Volume III: 1885–1893 (Detroit, IL: Wayne State University Press, 1969), p.817.
84.
Grosskuth, Symonds, p.290 (note 78).
85.
Crozier, “Pillow Talk,” p.382 (note 11).
86.
Charlotte Wolff MD, Magnus Hirschfeld: A Portrait of a Pioneer in Sexology (London: Quartet Books Ltd, 1986), pp.34–6.
87.
Crozier, “Pillow Talk,” pp.378–9 (note 11).
88.
Foucault, History of Sexuality, p.101 (note 14).
89.
Wolff, Magnus Hirschfeld, p.65; Robert Beachy, Gay Berlin: Birthplace of a Modern Identity (New York: Vintage Books, 2015), p.95; Magnus Hirschfeld “Das Ergebnis der statistischen Untersuchungenüber den Prozensatz der Homosexuellen,” Jahrbuch für sexuelle Zwischenstufen 6 (1904): 109–78.
90.
Donna J. Drucker, The Classification of Sex: Alfred Kinsey and the Organization of Knowledge (Pittsburgh: University of Pittsburgh Press, 2014), p.89.
91.
Oosterhuis, Stepchildren, pp.1–7 (note 52).
92.
Ina Linge, “Gender and Agency between ‘Sexualwissenschaft’ and Autobiography: The Case of N.O. Body’s Aus eines Mannes Mädschenjahren,” German Life and Letter 68/3 (2015): 387–405.
93.
Müller, Aber in meinem Herzen, p.332 (note 18).