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The Transsexual Phenomenon

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H. Benjamin

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The TRANSSEXUAL PHENOMENON
Harry Benjamin, M.D.



The Transvestite in older and newer aspects next

Men who dress as women can have a variety of motivations for doing so. Their emotional lives may or may not be involved. 

Nonaffective dressing

To dress in female attire may be merely an expediency, a disguise in order to remain unrecognized, for instance, when trying to hide or escape arrest or when crossing a border. The same disguise may be used by women who put on men's clothes. Crimes are known to have been committed with such help, entrance has been gained into otherwise inaccessible places such as club rooms, closed meeting places, and the like. Detectives have masqueraded as women for the purpose of entrapment. None of such persons is a transvestite.

Professional female impersonators "dress" on the stage, but not all of them are transvestites and even fewer are transsexuals, who attain emotional relief through their job. The majority are homosexual with or without transvestitic tendencies, while a few are "straight" and merely make their living in this type of stage work.

There are also homosexual men who go "in drag," that is to say, dress as women in order to compete at a contest or, as male prostitutes, wish to attract normal men. Their aetions usually have nothing to do with transvestism either, the female attire being incidental, nonaffective, and without eroticism. There are, of course, also transsexual male prostitutes, as we will see later on.

In transvestism proper, the emotions are always involved, tinged more or less with eroticism, sexual stimulation, - and often masturbatory satisfaction.
  

Pseudo transvestism

The mildest form of transvestism (I on the S.O.S.) would be represented by the following case:

V.A. is a professional man, an art teacher, and a student of psychology. Now in his sixtieth year, he considers himself largely homosexual, at least in the last few years of his life. He was married twice but has no children. His second wife, who died only recently, was an attorney and a very understanding companion. His sexual history would classify him on the Kinsey Scale as a 3 (bisexual) throughout his younger years, and now probably a 5.

When asked about transvestism, he said: "Certainly I used to get a kick out of putting on some female underwear and even 'dressing' entirely. It was a sexual stimulant and could help with girls as well as boys. Now I 'dress' no more, and even in the past I didn't do it too often".

Many such cases undoubtedly exist, but since they are not obsessive or likely to cause complications, they require no treatment and are of minor importance to the individual as well as to society. They may be called pseudo-transvestites.

Another, probably very small group of men may belong to the same category. They do not ever "dress" overtly, out of fear or shame, but greatly enjoy transvestitic fantasies and literature. It is probably immaterial whether to classify them as pseudo or not at all.
   

The true male transvestite

A large group of male transvestites (TVs) can be called "true" because cross-dressing is the principal if not the only symptom of their deviation. They dress out of a strong, sometimes overwhelming, emotional urge that - to say the least - contains unmistakable sexual overtones. Some of them can resemble addicts, the need for "dressing" increasing with increasing indulgences.

This true male transvestite may be called periodic or, in other instances, partial, when he dresses only on more or less frequent occasions or when he merely wears some female garments under his man's clothes. He would be constant if he lived altogether as a woman.

The facts may apply to the female as well as to the male, but this chapter will be devoted to the male only. Female transvestism seems to be rare and of somewhat doubtful reality. Women's fashions are such as to allow a female transvestite to indulge her wish to wear male attire without being too conspicuous. Her deviation has been considered merely arrogant while male transvestism is to many objectionable because, in their opinion, it humiliates.

Transvestism has been known throughout history and is not confined to any races or racial groups [1], nor to any stratum of society. A competent student of transvestism and a transvestite himself who wrote under the name of "Janet Thompson" says this: "It appears to develop in families ranging from the apparently wellbalanced emotionally and financially secure to the insecure, impoverished, or broken families. Neither economic, social, marital, family status, nor type of career ean be pointed to as being particularly conducive to the development of transvestism."[2]
  

Sexual roots of transvestism

Many times I have asked transvestites: "Whlat do you get out of 'dressing' ?" The answers naturally differed from individual to individual.

"When I dress, it feels as if I have a continuous orgasm," was the frankest sexual answer.

"A great erotic stimulant," "a sexual release," "a sexual glow," "a wonderful erotic pleasure," were others.

There were nonsexual answers too, usually among the older transvestites or from the transsexuals or from those under estrogen medication. They said:

"When I dress, I feel at last myself," or "it's a delicious relaxation." "That's the life," exclaimed one, stretching himself voluptuously, and many similar expressions, pointing more to a relief of gender discomfort than to sexual pleasure.

Sexual reasons for male transvestism are especially evident in the early stages of a transvestitic career. No experienced clinician can doubt the sexual roots in the large majority of transvestites. In most of the medical literature it is, therefore, perhaps not too fortunately, referred to as a sexual deviation or perversion. The often admitted masturbatory activities during or after a transvestitie spree confirm this view. The frequently reported guilt feelings and disgust that are followed, with purges, that is to say, getting rid of all female attire, likewise point to the, - basically - sexual nature of transvestism ("Post coitum omne animal triste?").

In a heterosexual relationship (and most true TVs are overtly heterosexual; some may be bisexual), potency can often be assured only by partial "dressing," for instance, in a female nightgown [3].

It is undoubtedly correct that many TVs, in the later years of their lives, "dress" more for emotional comfort than for conscious sexual reasons. But it must also be remembered that the tendency exists with many TVs to minimize the sexual nature of their "caprice" because they like to conform to morality, that is to say, to the antisexual atmosphere of our culture.

Emphatic among present-day writers as to a supposedly nonsexual nature of transvestism is Charles Prince, Ph.D., who himself is a transvestite. He would like to see the term transvestism replaced by "femiphilia," indicating "the love of things feminine," and he believes that in this way much of the association between transvestism and sex may be eliminated. More will have to be said on his concept a little later.

The aforementioned, rather keenly observant "Janet Thompson" does not completely deny the sexual roots of the disorder, but adds these words: "Transvestism falls into the category of a behavior problem rather than into that of a sexual problem as it is usually being classified."

Older European writers on the subject, such sexologists as Krafft-Ebing, Havelock Ellis, Hirschfeld, Moll, Bloch, Rohleder, and others have recorded numerous types of TVs according to other accompanying symptoms, most of them having a definite sexual implication. We find references, to "heterosexual," "homosexual," "bisexual," "automonosexual" (autoerotic), "narcissistic," "fetishistic," and "sadomasochistic," and also to the above mentioned "constant, " "partial," or "periodic" TVs, and so on. All these definitions are largely descriptive and such would be their principal value. All kinds of combinations may exist and no two cases are ever alike.

Every TV follows his own individual pattern that does not readily fit into a too rigid classification. Anticipating a later discussion, I may say here that in my opinion, TVs are products of their congenital or inborn sexual constitution that is shaped and altered by cultural factors and by childhood conditioning. It can, therefore, produce an endless variety of clinical pictures.

Havelock Ellis believed in two basic groups of transvestites: one that only "dresses," and another that "feels" [4] himself to belong to the opposite sex, although having no delusion as to his or her anatomical conformation. This concept is strikingly similar to my own: One group includes the transvestites, and the other the transsexuals.

Kinsey and collaborators [5] recognize the phenomenon to have "many different situations and many different origins."

The inception or the "trigger" of transvestitic desires and activities (inception not being synonymous with causation or etiology) can, I believe, be twofold: (1) fetishistic (S.O.S. II) and (2) latent and basically transsexual (S.O.S. III). The first would represent a sexual deviation; the second a gender disharmony as well.
  

The fetishistic transvestite

The fetishistic transvestite usually starts, often even in childhood, with a morbid interest in a particular object of the female wardrobe (usually mother's or older sister's as the ones most readily available and therefore not incestuous). They are panties, bloomers, corsets, bras, nightgowns, or other garments, but also shoes (especially with high heels), stockings, or gloves. These articles often serve masturbation. A thoughtful student of transvestisrn, drawing from personal experience and intimate talks with other transvestites, has divided these fetishistic preferences into "overs" and "unders." The "overs" begin with shoes, the "unders" with undergarments. More and more articles of female clothing can then become fetishes, the "overs" gradually leading to the complete act of female impersonation with total feminine simulation in hair-do, dress, and makeup." [6] The "under" group of fetishistic transvestites dress less often in complete attire but go through life like any other man, only constantly wearing some female garments like panties or bras underneath their normal male clothing. Without them, their frustration may become well-nigh intolerable.

One of my patients of many years ago [7] a man in his late sixties, was accustomed to this form of transvestism when he went out. Only at home did he "dress" completely. Once he was in a street accident and was taken unconscious to a hospital. When the female undergarments were discovered, the examining physician, completely unacquainted with transvestism, wrote the fact into the hospital record (where I saw it), together with the diagnosis of "concussion" and "patient evidently a degenerate." The only consoling feature is that this example of medical ignorance occurred over twenty years ago.

Another one of my patients, a nearly sixty-year-old, largely heterosexual pharmacist, who looks little more than forty, combines his fetishistic "dressing" with a strong fetish for youthful apparel (civistism). He gets an even greater "sexual glow" (as he describes it) from dressing like a very young boy than as a woman. Once, he related, when he was almost fifty, he was alone at home and indulged in dressing in a young boy's suit. The bell rang and he opened the door. A man was there and in the poorly lighted entrance hall, he mistook my patient for a child and asked: "Sonny, is your mother home?" That thrilled him to such an extent that he almost had an orgasm.
  

The transvestite with a latent transsexual trend

The second inception of transvestism is not fetishistic but in all probability the result of an inborn or early acquired transsexual trend of "latent" character. (S.O.S. III). Those patients (like true transsexuals), invariably date the beginning of their deviation to earliest childhood. "As long as I can remember, I wanted to be a girl" is a frequent part of their history. [8] While it is quite possible that such statements may merely express the wish that it may be so, most evidence gained not only from patients but also from relatives points to the fact that transvestitic tendencies, in the great majority of all cases, were noted in the first five or six years of the child's life.

A sharp differentiation between a fetishistic and a latent transsexual inception of transvestism is not always possible. The fetishistic can gradually develop into the (basically) transsexual variety, as case histories have repeatedly shown me. The former, however, may well contain elements of the latter from the very beginning. Otherwise the initial morbid interest in one or several articles of female wardrobe would hardly have evolved into the desire for total "dressing." The basic transsexualism may therefore explain an occasional and, seemingly, progressive nature of transvestism.

The sexual element in transvestism seemed to me always more manifest in the fetishistic than in the latent transsexual type where (as in true transsexualism) a low sex drive and gender dissatisfaction frequently predominated.
  

Transvestite publications

One of the most devoted students of the transvestitic puzzle is the aforementioned Charles Prince, who is the founder and (under the name of Virginia Prince) editor of Transvestia, a magazine "by, for, and about transvestites." This magazine, founded in 1959, has been enormously helpful to persons who had suffered intensely under this lonely deviation and, for the first time, learned that they were not alone and that many others are in the same situation. By accepting themselves as they are, many have learned to live with transvestism in reasonable contentment.

Transvestia gives the impression of a "subjective" publication, "Virginia' s" name dominating the pages of many issues as teacher, mentor, and spokesman for the transvestitic "sorority." Support is given by a co-editor, "Susanna," who rarely fails to contribute interesting thoughts. Through questionnaires sent to subscribers and through lectures and articles for scientific and educational journals, Prince has made valuable contributions "from within," while most other writers on the subject (including the present one), decidedly approach the subject "from without."

Prince coined the word "Femmepersonator" (F.P.) to replace transvestite for two reasons: first, to counteract the popular confusion with homosexuality, under which the word transvestism suffers, and second, as mentioned before, to try to take "some sex out of it." Unfortunately, Femmepersonator readily invites confusion with female impersonator," and is therefore hardly the best term. The de-sexing attempt is merely one example of the frequent lack of realism among transvestites and their ever-present capacity for illusion and self-deception.

The inability of many of them to look at themselves objectively is their great handicap. It explains that all too often they do not look like women at all when "dressed," but like men dressed up as women. They do not see it and that is why some of them are arrested. One only has to look at some of the photos published in Transvestia and Turnabout to recognize the truth of this observation. While unfortunate, the self-deception is understandable if we think of the wish being the ever-present motivating force.

Side publications by Prince, called Femme Mirror and Clip Sheet, add little if anything to the original educational nature of a praiseworthy enterprise and may even - by its vague commercializing charaeter - detract from its value.

The denial of sexual motives for transvestites, except for those that are fetishists, is meant to make TVism more respectable and therefore more acceptable to the public. "Virginia" and her followers believe in "the need for adornment and personality expression" and in the "relief from the problems of masculinity and social expectancy" as explanation and justification for transvestism.

Prince has developed a rather elaborate theory. He believes the cause for transvestitic desires and behavior to be largely cultural. Boys are taught to do this, and not to do that, for instance, not acting in feminine ways, not crying too easily, or not playing with dolls instead of with trains. In this way, the female component in their constitutional makeup is artificially suppressed. But it may break through sooner or later in life, leading to transvestitic urges.This is an interesting concept but the objective and emotionally uninvolved outsider and clinician cannot agree. The cultural pressure applies to practically everybody, but transvestites are only few, very few, in proportion to the population.

Besides, to take sex out of transvestism is like taking music out of opera. It simply cannot be done. The histories of too many patients prove that sex is more often involved than gender, although gender too can naturally supply a vital motive for cross-dressing.

The actual cause of sex and gender disorientation, with its transvestitic and transsexual syndromes, is still to be discovered. An immature or an infantile sexual constitution (fostered by a faulty upbringing) may have something to do with the cause of transvestism, even if gradually, and with advancing years, the social contentment and a gender harmony that goes with "dressing" overshadows or even replaces its original eroticism.

A seemingly more objective approach to the problem can be found in the pages of Turnabout, another more recent magazine of transvestism. Its competent editor, Fred Shaw, writing under different pseudonyms, with several qualified collaborators, likewise provides self-expression for their readers through letters and photographs, but they provide, at the same time, education and information through scientific debates, giving expression to diversified views.

They disagree with "Virginia Prince" and her principal theory that "the girl within" prompts transvestites to be what they are and to act as they do. Yet - as we have seen - such theory does contain a grain of truth, namely, the biological fact that in every male there is an element of the female, and vice versa. Our culture and upbringing, however, lead to the practical demands (for males and females), for masculinity and femininity as such, and allow no "girls within" men. It does exist only under just such abnormal conditions as transvestism, transsexualism and certain cases of homosexuality with effeminacy. All this, however, permits no generalization.

In both publications, Transvestia and Turnabout, articles written by TVs and letters to the editor furnish interesting and valuable material for the psychologist. The often infantile and completely self-centered attitude of many transvestites and transsexuals is occasionally and strikingly illustrated, together with a deeply disturbed, unrealistic, frustrated frame of mind which is the more outspoken, the more the writer inclines toward transsexualism. Many articles and letters, however, are remarkably sensible and sometimes humoristic.

In any event, the opportunity to write these contributions and see them printed has a therapeutic value that should not be minimized. Full credit should go to those who had courage enough to furnish the opportunity by pioneering the respective publications. If a danger exists that they may, here or there, seduce a susceptible person, the probability is that, sooner or later, this person would have come to transvestism anyway. And any such theoretical risk to a few is greatly outweighed by the actual benefit for many.

Those TVs, however, who wish to get away from their disturbing hobby would have to shun these publications, together with all transvestitic temptations, gatherings, and the like, and train themselves to live in a completely "normal" (sit venia verbo) environment.

TV publications with their detailed descriptions of "dressing" and their many photos over female names can be an endless delight to the TVs. They can be instructive to the psychologist, but are an unmitigated bore to all others. So are undoubtedly "girlie magazines" to homosexuals and "muscle men" pictures to the heterosexuals. Shoe stores and lingerie shop windows can be sexually stimulating ("obscene," our moralists would say) to the respective fetishists and utterly indifferent to others. So the old clichés are only too true. "It's all in the mind of the spectator," or "One man's meat is another man's poison."
   

Interpretations of transvestism

The idea that transvestism may be a latent or masked form of homosexuality was expressed by several writers but particularly by the Viennese psychoanalyst, Wilhelm Stekel [9], and is still favored by some of his followers. The explanation seems simple enough, but to the unprejudiced clinical observer it does not ring true. Kinsey and his collaborators also consider it incorrect. There are too many clearly heterosexual transvestites and it could do no good to saddle them with another (the homosexual) emotional burden, a deviation that they often greatly resent and reject.

But psychoanalytic theories are something like a cult, if not a religion, and are often quite incomprehensible to ordinary clinicians. To them, their explanations and analyses many times appear far-fetched, even absurd, in spite of their often intriguing and sometimes poetic quality.

Psychoanalysis has a language and jargon all its own. In the field of transvestism (and homosexuality) we owe to the psychoanalysts the concepts of the "mother with a penis," the "phalic woman," the "castration fear" which "transvestism attempts to overcome" and others, unnecessary to describe here. These psychoanalytic concepts have been accepted variously as important scientific discoveries, or as ingenious theories, but have also been criticized and rejected as merely intellectual "games," a sophisticated voodoo, if not as plain nonsense and balderdash. This author neither feels competent to pass judgment as to which of the above characterizations is most likely correct, nor would this be the place to express a preference on his part. The prominent psychiatrists and university professors Buerger-Prinz, Giese, and Albrecht in an important German monograph [10] call some psychoanalytic theories "think possibilities without evidence in clinical observation" (phenomenology).

Johann Burchard, psychiatrist and teacher at the University of Hamburg, Germany, gives us a much more acceptable interpretation than the psychoanalytic one. In bis recent German monograph [11] on the subject, he says that homosexual and heterosexual transvestites and transsexuals are, sexually, double-oriented: toward the ego and toward a partner. In an asexual transvestite or transsexual, even masturbation can be dispensed with, the libido being completely reverted to the ego. These cases become anorgasmic.

In other types, a partner or an object (fetish) plays a part and the narcissistic transvestite has his mirror image. Burchard says transvestism is the result of a pathological development, the etiolgy of which is yet unrecognizable. It is a nonpsychotic syndrome similar to other sexual perversions.

Freud himself, if alive today, would not deny a possible constitutional basis, as he believed in "hereditary, organically fixated, and not only educational factors." [12]

Dr. Robert J. Stoller of the University of Cahfornia, Los Angeles Medical School, in his recent lectures on the biological basis of human sexual behavior, recalled Freud's conviction that sexual conduct has its roots deep in the physical structure of the brain, to which brain chemistry may have to be added.

Around 1930, I once called on Freud during one of my visits to Vienna. At that time, he was still in his home and office at the Bergstrasse. A mutual friend, Dr. Eugen Steinach, Professor of Physiology at the Vienna University and the famous discoverer of the "puberty gland" [13] had made the introduction and appointment for me.

The hour I spent with Freud can never be forgotten. Among many other topics, we discussed the body-mind relationship (suggested by Steinach's researches) and when the pun came to my mind that "the disharmony of the emotions may well be due to a dishormony of our endocrine glands," Freud laughed and fully agreed.

If I learned one thing from this visit, it was that Freud certainly was no "Freudian," in the sense of some of today's practitioners. His biological background and training protected him against the "extremism" of the Bergler and like types. Besides, Freud was big enough to recognize his own occasional errors, admitted them, and tried to correct them.
   

Illegality of transvestism

The typical or true transvestite is a completely harmless member of society. He derives bis sexual pleasure and his emotional satisfaction in a strictly solitary fashion. The absence of a partner for bis particular sex expression differentiates him radically from all so-called sex offenders. According to a strict interpretation of the law, however, he can be prosecuted just the same, even for "dressing" in the privacy of his own home (in an "enclosure"); more so, of course, if he appears in public in female attire.[14]

Some transvestites have learned to dress and make up so cleverly and move in such a natural, feminine way that they cannot be "read," as the saying goes. This affords additional satisfaction because the transvestite now feels he has succeeded in creating a new (and second) personality for himself. [15] This "new" female personality reinforces the female name that all transvestites assume. The male speaks of his female counterpart as of another person, a habit that can be most confusing to the uninitiated. I have examples of transvestites possessing two driver's licenses, one in a male and one in a female identification. Also, two social security cards, in case they hold jobs as males and females at different times.
  

Family life of transvestites

The majority of transvestites I know make their livings as men, but can be quite miserable when dressed in male clothes. Not being interested, they do not dress well as men and frequently look shabby. They long for the moment when they come home and can relax in their feminine finery, perhaps only a fancy dressing gown. There, the best is never too good. The wife is often in a quandary, lest the children get a glimpse of their father dressed as a woman, or visitors may come before the husband can disappear into the bathroom and change clothes.

For their future psychological development, children should certainly be protected against learning of their father's transvestism and seeing him "dressed." Especially, a boy's identification with the father image may suffer irreparable damage. I have one patient, a transsexual, who told me "she" (this patient is living as woman although she has had no operation), has never seen her father dressed as a man, nor has she ever seen her mother (who was also a transvestite) dressed as a woman. It would appear most unlikely that under such pathological conditioning a normal adult male could have resulted. This, however, is an extreme case, possibly consciously or unconsciously exaggerated to justify the patient's own transsexualism. It is by no means typical.

In any event, it seems inexcusable for any father to let his chil,en see him openly indulging in his transvestitic pleasures. Few wives and mothers would stand for it either, although I have known of two or three such marriages to persist.

Transvestites for whom "dressing" is necessary to preserve an emotional balance can develop other and more serious symptoms, if frustrated too long. I have seen alcoholic excesses acting as substitutes, and drug habits may find their inception in this way. I have also seen great nervous irritability develop so that a job was lost and family life disrupted. "He flies off the handle at the least provocation," a wife said of her husband, when he was unable to "dress" from time to time and "be himself" in female attire.

One of my patients, a rather shy and timid person as a man, changes completely when he assumes his female role. As a woman, he loses his self-consciousness and his feeling of insecurity which he himself explains: "Self-reliance, a certain aggressiveness and dominance are expected of a man. This is against my nature. It is not expected of a woman. Therefore, as a woman, I feel at ease, more secure and my true self." In his male role, this patient suffers from intense fear of high places. He panics at the idea of traveling by plane. When "dressed," no such fear exists and he takes trips by plane regularly and can enjoy them.

Not all such "nervous" symptoms need be psychogenic. It would be wise for a doctor to be hypoglycemia-conscious. Intense frustration to which TVs and TSs are subject, coupled with (frequently observed) poor eating habits, can produce a functional hypoglycemia that may give rise to emotional extremism, lack of judgment and control, compulsive actions, together with physical manifestations, dizziness, fainting spells, heart palpitations, and so on. Proper medical treatment with particular attention to diet can then be very helpful.
  

Transvestites' wives

The wives of transvestites constitute a psychological problem by themselves. I have spoken to at least a dozen. Most of them put up a brave front, claiming to be unaffected in their love for their husbands, but admitting they are certainly not happy about the TVism, even suffering acutely at times. Few, but very few, say they enjoy helping their husbands to "dress" and "make up" and actually like him in his female as much as his male role. Are they fooling themselves, or are they lesbians? I have asked myself these questions many times. Only deeper psychological probing may provide the answers. The husband's ability as a lover and the wife's sexual needs are often deciding factors as to whether a marriage can endure or not. Some can (if mutual concessions are made). Many cannot.

I have observed rare examples when the wife actually was more homo- than heterosexual and liked her husband better as a woman than as a man. A lesbianlike relationship existed that satisfied both, with the husband's transvestism on a transsexual basis (S.O.S. III-IV) finding an almost ideal outlet.

Perhaps a majority of transvestites' wives are willing to tolerate he husband's hobby, provided they do not have to see him dressed as a woman. I also know marriages of many years' standing when the wife actually never knew of the husband's transvestism, although he indulged in it regularly, several times a month outside of the house.[16] Hugo Beigel, in an article, "Wives of Transvestites,"[17] described the situation in similar terms.

No transvestite should ever marry a girl without telling her of his peculiarity beforehand. It would be too unfair. Too many have not done so and paid dearly later on. Among Buchner's subjects, 72 per cent did not tell.
  

Concomitant deviations

Accompanying perversions or deviations that often complicate transvestism have been hinted at earlier. They occasionally worry the wives particularly or aggravate their problem. They are rarely mentioned in the literature, except in the TV publications.

The most dangerous is probably the desire for "bondage," occasionally with self-strangulation attempts. How often these attempts may go just a little too far, or help may come just a little too late and an unexplained and mysterious "suicide" makes the headlines, anybody may guess.

Flagellation is occasionally demanded by TVs visiting prostitutes in female attire or wanting to "dress" in their homes and merely talk "girl talk" to them like "one girl to another." Some TVs with masochistic inclinations want to be humiliated at the same time. They dress in a servant girl's clothes and want to be ordered around to do washing, cleaning, scrubbing floors, and the like. They are willing to pay well for this kind of "sex service." I knew a noted cardiologist who indulged regularly in this, his only adequate sex life.

Fetishism (S.O.S. II) complicates other TVs' sex lives. At the same time, it puts an additional strain on married life. There are those who like furs or leather. They buy jackets, coats, and entire outfits at considerable expense so that the wife has a just grievance, if she cannot afford anything like it for her own wardrobe.

That applies equally to expensive silk gowns and still more so to shoes made to order, often with extra high heels, and new ones all the time. Considerable expenditures also go into the purchase of wigs, jewelry, and accessories.

Much has been made of narcissistic tendencies in TVs. True, most of them spend an abnormal time in front of mirrors, admiring their images as women, only too often overdressing and overadorning themselves with costume jewelry. But whether they are really "in love" with themselves as the classic Narcissus was supposed to be is another question. Exaggerated female vanity may account for the same actions and also for the delight in being photographed in all kinds of poses to show off their new dresses, wigs, or hair-dos. Mirror and camera are certainly indispensable adjuncts to a transvestite's life. Since they are harmless and help emotionally, they have their justification.

The transvestite types discussed here are the S.O.S. II and III principally. In them the symptom of cross-dressing is by far in the foreground of the clinical picture. The TVs with their desire to see such physical changes as gynecomastia through hormone treatments or plastic operations show enough of an overt transsexual trend to be included in the following chapter.
  

Footnotes

[1]  See Appendix C, by Dr. Richard Green, page 173.

[2] International J. Sexology, May 1951.

[3] A. Taylor Buckner, in a master's thesis for the University of California, based on a questionnaire sent to 262 subscribers to Transvestia (a magazine for transvestites), reported that the following were worn during intercourse:

Garment Percentage
Shoes with high heels 10
Stockings 16
Panties 22
Nightgown 26
Full costume 19

[4] This reference to "feeling" here and in other places is of little scientific significance, as it is too vague, too subjective, and could vary in its meaning, not only from case to case, but also from mood to mood in the same individual.

[5] Kinsey, Pomeroy, Martin, Gebhard: Sexual Behavior in the Human Female, W. B. Saunders Co., 1953, p. 679.

[6] Turnabout, No. 3, pg. 3. 1964.

[7] His case was fully described by Dr. B. S. Talmey in the NY Medical Journal of February 21, 1914, except for the incident here reported, which occurred toward the end of the patient's life.

[8] Buchner found that first transvestitic experience in his group of Transvestia readers were:

Age Percentage
Before 4.9 years 14
Between 5 and 9.9 years 39
Between 10 and 17.9 years 39
After 18 years 8

[9] Stekel was first a pupil of Sigmund Freud, but later became his rival and antagonist.

[10] Buerger-Prinz, H., Albrecht, H., Giese, H. Zur Phenomenologie des Transvestismus bei Maennern. Enke Verlag, 1953.

[11] Struktur und Soziologie des Transvestismus und Transsexualismus, Enke Verlag, 1961.

[12] Sigmund Freud. Ges. Werke. Imago Publications, London, Vol. 70.

[13] The hormone-producing part of the testicle.

[14] See Chapter 9 on legal aspects.

[15] Among Buchner's subjects, from 20 to 37 per cent seem to feel that way.

[16] Buchner found the wives' attitudes as follows:

Attitude of wife Percentage
Completely accepting and cooperativea 25
Permits dressing only at home but in her presence 11
Permits, but does not want to see 20
Knows about TVism but completely antagonistic 21
Unaware of husband's transvestism 18

a According to my observations, the 25 per cent is too optimistic.

[17]Sexology Magazine, July 1963.

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