As to Hereditary Circumstances, Early Youth, etc.
Are you aware of any similisexual traits in your parents? Of your ancestry in general, or of collateral blood-relatives, either remote, deceased, etc., or living? If so, in what relationship?
Have there been cases of nervous disease, or other psychic disturbances in the history of your family, such as hysteria, exaggerated passions, mental weakness, epilepsy, convulsive maladies, erotic mania, alcoholism, melancholy, suicidal or other manias? State briefly any degree and grade.
Have there been cases of distinct moral deficiency—kleptomania, untruthfulness as a trait, business-dishonesty, tendency to intrigue unscrupulously, eccentricity, etc?
What was the degree, if any, of relationship between your parents? The difference in their ages?
Have you had brothers or sisters? If so, in what proportion as to sex?
Have you any idea whether before your birth, or after it, your sex was not quite acceptable to your father or mother; especially to your mother?
Was your physique at birth, so far as you can ascertain, entirely normal and perfect?
Was the process of teething in your case, as far as you can learn, easy—normal and timely?
Were you, generally speaking, a healthful child?
Did you learn quickly to speak, walk, run, etc?
Were you brought up with special tendencies to treat you as if you were of the opposite sex? Were you allowed to trend that way, by your own wishes?
Were you petted more than most children?
Were you inclined to play more with boys or girls? What were you inclinations as to active, muscular sports, and the like? Were you ever mocked, or otherwise spoken-of, by your companions or by adults, as being a "girl-boy"—"sissie",—"tomboy" etc.?
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