II. Degree: Eviration and Defemination.—If, in cases of contrary sexual instinct thus developed, no restoration occurs, then deep and lasting transformations of the psychical personality may occur. The process completing itself in this way may be briefly designated eviration. The patient undergoes a deep change of character, particularly in his feelings and inclinations, which become those of a female. After this, he also feels himself to be a woman during the sexual act, has desire only for passive sexual indulgence, and, under certain circumstances, sinks to the level of a prostitute. In this condition of deep and more lasting psycho-sexual transformation, the individual is like the (congenital) urning of high grade. The possibility of a restoration of the previous mental and sexual personality seems, in such a case, excluded.
The following case is a classical example of this variety of lasting acquired contrary sexual instinct:—
Case 98. Sch., aged 30, physician, one day told me the story of his life and malady, asking explanation, and advice concerning certain anomalies of his vita sexualis. The following description gives, for the most part verbatim, the details of the autobiography; only in some portions is it shortened:—
“My parents were healthy. As a child I was sickly; but with good care I thrived, and got on well in school. When eleven years old, I was taught to masturbate by my playmates, and gave myself up to it passionately. Until I was fifteen, I learned easily. On account of frequent pollutions, I became less capable, did not get on easily in school, and was uncertain and embarrassed when called on by the teacher. Frightened by my loss of capability, and recognizing that the loss of semen was responsible for it, I gave up masturbation; but the pollutions became even more frequent, so that I often had two or three in a night. In despair, I now consulted one physician after another. None were able to help me.
“Since I grew weaker and weaker, by reason of the loss of semen, with the impulse to sexual satisfaction growing more and more powerful, I sought houses of prostitution. But I was there unable to find satisfaction; for, even though the sight of a naked female pleased me, neither orgasm nor erection occurred; and even manustupration by the puella was not capable of inducing erection. Scarcely would I leave the house, when the impulse would seize me again, and I would have violent erections. I grew ashamed before the girls, and ceased to visit such houses. Thus a couple of years passed. My sexual life consisted of