Archiv für Sexualwissenschaft

Science in the Bedroom A History of Sex Research
VERN L. BULLOUGH
For BONNIE BULLOUGH my wife, my frequent collaborator, and always my helpful colleague Originally published in 1994 by BasicBooks, A Division of HarperCollins Publishers, New York, N.Y.
Contents     ACKNOWLEDGMENTS     Introduction Sex Research and Assumptions: From the Greeks to the Nineteenth Century Homosexuality and Other Factors in Bringing about Sex Research Karl Heinrich Ulrichs Ulrichs's Theory and Activities Influence on the Medical Community Krafft-Ebing Other Medical Researchers The three Alberts: Moll, Eulenburg, and von Schrenck-Notzing Albert Moll Albert Eulenburg Albert von Schrenck-Notzing Ambivalence of Researchers Eugenics Pornography Oscar Wilde Richard Burton Other Popularizers The Jewish Influence Hirschfeld, Ellis, and Freud Magnus Hirschfeld Harden-Eulenburg-von Moltke Affair Hirschfeld Early Years Hirschfeld´s Theory Homosexuality and Politics Hirschfeld the Researcher International Sexology Congresses Hirschfeld,the Nazis, and his Death Havelock Ellis Homosexuality Modesty and Others Studies Ellis´s and Hirschfeld´s Strengths and Weaknesses Sigmund Freud Psychoanalysis and Sexuality Mega Theory Sexology The American Experience Medical Researchers Civilized Morality Women and Prostitution Sexually Transmitted Diseases Prevention of Sexually Transmitted Diseases Sexual Alternatives Many Forms of Reform Anthony Comstock Prince A. Morrow Contraception Hostility Clelia Mosher Robert Latou Dickinson Max J. Exner Katharine Bement Davis and John D. Rockefeller Jr. Gilbert V. Hamilton Summary Endocrinology Research and Changing Attitudes Frank R. Lillie Endocrinology Quackery and Endocrinology Female Hormones Isolation of Hormones Menstrual Cycle Gregory Pincus Marriage Manuals and the Sexualization of Love Marie Stopes Theodoor van de Velde Emmanuel Haldeman-Julius Censorship and Sex Contraception Summary From Freud to Biology to Kinsey Freud and Science Alfred Adler Wilhelm Stekel Carl Jung Wilhelm Reich Herbert Marcuse Animal Studies Anthropological Studies Historical Data Studies on Premarital Sexual Activities Homosexuality and Lesbianism Alfred Kinsey From Statistics to Sexology Kinsey´s research The Kinsey Interview Kinsey and Statistics Kinsey Definitions and Homosexuality Other Findings Criticism Congressional Investigation Kinsey and Censorship Contraception IUDS Testing Failures Hormonal Contraceptives Russell Marker The Pill Masters and Johnson The Beginnings Sexual Response Cycle Sample Sexual Dysfunction Sex Therapy Professional Organizations Summary The Matter of Gender: Masculinity, Femininity, and Cross-Gender Behavior John Money Biology Chromosomes Hormones Hermaphroditism Transsexualism Transvestites Gender Identity Nature versus Nurture Endocrinology Behavior Sociobiology Interaction Masculinity and Femininity and Gender Identity Formation Summary Other Voices, Other Views Feminism Michel Foucault Rape Sexual Harassment Pornography Prostitution Abortion Limerence Children Homosexuality Summary Problems of an Emerging Science Sexological Education Views of Therapy and Sexology Sexology Fads AIDS and HIV Other Sexually Transmitted Diseases Sexology and Science Sexology and the Law Summary   NOTES   INDEX: A   B   C   D   E   F   G   H   I   J    K   L   M   N   O   P   Q   R   S   T   U   V   W   Y   Z
ACKNOWLEDGMENTS Though this work has been under way for many years, Susan Rabiner of Basic Books was the crystallizing force in finally getting it done. The whole staff at Basic Books deserves praise, but I would also like to single out Jane Judge, who was project editor, and Candace Levy, copyeditor. The index was prepared by Liz Cunningham.
INTRODUCTION In terms of observable human anatomy it would seem that sex is a simple thing. A male has a penis and testes and produces sperm, while a female has a vagina, uterus, and breasts and menstruates. These simple distinctions have probably always been evident to humans. Note that the information about the female reproductive organs was much less complete than that about the male, because the female organs are less visible. Also much of the extant data have been derived from male sources. Still, it was assumed that when the male put his semen (seed) into the female's vagina there was a possibility that the woman would then proceed to nurture the seed until it grew into a baby.     Although there probably has never been a time when males did not know they had something to do with procreation, if only because the animal examples around them were so obvious, they also knew that not every act of sexual intercourse led to a pregnancy. That is, intercourse might be a necessary cause of pregnancy, but it was not always believed to be sufficient in itself. The reasons why pregnancy did not always occur were fully understood only in the twentieth century. The issue was further complicated by the fact that some males were impotent or sterile and some females did not get pregnant no matter how many times they had intercourse. What was known, moreover, raised further questions and even problems. Sexual intercourse, for example, was a source of pleasure whether or not a pregnancy resulted. Even touching the penis or clitoris could give a pleasurable sensation as could mutual masturbation between two individuals regardless of sex. This knowledge, early in human history, led to discussions over whether it was natural for an individual to touch himself or herself or for two persons of the same sex to lie together. Different cultures had different ideas about these phenomena. Various cultures also had their own answers to the question of why some acts of intercourse resulted in male babies and others in female babies. This remains a question for which we have no simple explanation. There was also a great deal of concern about the occasional appearance of babies with ambiguous genitalia, hermaphrodites if you will. What was the cause of this? Again different cultures gave different answers, some going so far as to claim that such offspring were monsters. Humans also wondered what the menses were and what their purpose was.     We have answers to these and many other questions from the ancient Egyptians as well as from early civilizations that appeared in the Tigris-Euphrates Valley, the Indus Valley, and China. More than two thousand years later, information was collected by the classic Greeks, and this became the basis of much of Western knowledge about human sexuality. These Greek ideas remained more or less dominant until the nineteenth century, when advances in science allowed us to ask new kinds of questions about sex and sexual behavior. The lack of what might be called scientific answers, however, did not prevent people in the past from attempting to frame answers to questions about human sexuality. These answers varied from culture to culture and changed through time, but generally they were a combination of observations, mythology, morals, and magic. Even when Investigators came up with more rational explanations for some aspects of human sexual activity, they continued to rely on tradition for most answers, simply because the science of the time was not sophisticated enough to give more complete explanations.     CatholicismYFurther complicating any attempt to come up with scientific explanations about sexuality is the fact that sexual behavior, unlike many other aspects of human activity, traditionally has been regarded more as a matter of morals than physiology or psychology. In the Western world, this has meant that attitudes toward sex have been dominated by the assumptions of the Judeo-Christian tradition, particularly as this was interpreted by Christian writers from the third to the sixth centuries. These early Christians set the patterns of Christian dogma and are collectively known as the "Fathers of the Church". Sexual matters were points of major concern to these men and continued to be important for later generations.     For example, sexually related issues made up more than a quarter of medieval Roman Catholic canon law, and continue to do so. Particularly influential in setting Western Christian ideas was St. Augustine (354-430), who held that the ideal Christian life was one of celibacy. Fortunately, he recognized that not all people could live a celibate life, and he reluctantly allowed that God had countenanced marriage as well. According to Augustine, however, the only purpose of sex within marriage was for procreation, and sexual intercourse should only be undertaken with that purpose in mind. All other sexual activities were sinful. Augustine went further and taught that the only proper position in sexual intercourse was with the woman on the bottom and that the only proper act was one in which the penis penetrated the vagina. He absolutely condemned the use of any other orifice (such as oral-genital sex).1 He also condemned masturbation either done alone or with others.     In fact, it was the knowledge of sex that constituted the original sin that occurred in the Garden of Eden. Augustine, who also set Christian doctrine on this, held that the sin of Adam and Eve is transmitted from parents to children through the sexual act, which, by virtue of the lust that accompanies it, is inherently sinful. It was only through baptism that the taint of this original sin was washed away. The result of the writings of St. Augustine and other Church Fathers was to make Western Christianity what I have called a sex-negative culture. Even though the Western tradition has always included significant minorities such as Jews as well as Christian groups that do not subscribe to the Augustinian theology, it was the Augustinian interpretation of sex that tended to dominate public discourse until the twentieth century.     As a result, research into sex was a somewhat doubtful enterprise, because those who engaged in it were regarded as not quite respectable. This attitude continued to exist even during my own lifetime. A good illustration of this mind-set is the case of William Masters. As he was finishing medical school at the University of Rochester, he began seriously to think of devoting his life to research in sex. He turned for advice to Professor George W Corner, who, as will be explored later in this book, was a significant figure in American sex research. Corner advised him not to start out as a sex researcher but to establish his reputation as a scientist in another field. After Masters made his reputation, was in his late thirties or early forties, was happily married, and had a family, then and only then could he begin to investigate aspects of human sexuality without damaging his scientific reputation. I received similar advice, and I gradually and gingerly entered into serious Sex research only after gaining tenure at a university. Whether such hesitation was necessary in my case is unclear, but the perception that it was tended to affect the nature of sex research during much of the twentieth century.     Initially, I was interested in studying the kinds of individuals who could be regarded as societal barrier breakers because of their willingness to investigate sexual topics. Thus this book seems occasionally to digress from the theories and findings to give brief biographies of the different personalities who have engaged in sex research. I was particularly interested in their coping mechanisms, and though these varied, some general patterns emerge. One way that many of these individuals coped was simply by denying that they were sex researchers. Instead, they called themselves endocrinologists, urologists, gynecologists, or some other less stigmatizing term, even though their primary interest was in sex. Another way many seemed to cope was to distance themselves from their subjects by labeling them with words such as deviant, pathological, and perverse, emphasizing in the process that although it was necessary for society to know about the existence of such individuals, most people, including the researcher, were not like them.     Still others, and many of the early American researchers are in this category, were concerned by the evils wrought on innocent wives and children from sexually transmitted diseases, which the investigators believed resulted from contact with prostitutes. They came to believe that the answer lay in sex education and thus emphasized the dangers of premarital and extramarital sexuality and the need to practice abstinence except within marriage. It was only with the failure of these early efforts that some researchers turned to science to gain a better understanding of human sexuality, although for many of them science was seen as a partner in their moral crusade against sexually transmitted diseases.     Some of these individuals, however, entered into the studies of sexuality to understand themselves and to clear up their own as well as the public's misconceptions. Among the early sex researchers were homosexuals, who were interested in demonstrating that homosexuality was not a perversion. Feminists were determined to eliminate much of the erroneous information about women put forth by the male establishment, which tended to hold that women were inferior to males. Some of these individuals remain propagandists for a particular viewpoint, but many moved beyond their initial preoccupation to become major scientific investigators.     The personality of the researchers is only part of the question, however. Another aspect of the development of sex research is why the last part of the nineteenth century began to see the development of what Paul Robinson called the modernization of sex.2 This is a subject that has been little explored. The pioneer in the field was Edward M. Brecher, who was far more interested in the events surrounding Alfred Kinsey and his successors than in an attempt to explain how modern research developed.3 This is a question that I have spent many years trying to answer, and this book is the result of my inquiry.     Part of the answer is simply the growth of specialization in science, which has been a fact of life for more than one hundred years. If opthalmologists could specialize in the study of the eye, then others could begin to specialize in urology and gynecology. These medical specialists, however, dealt with sex problems only indirectly. There were a growing number of scientists who felt that the sex organs needed to be studied but that sexual relationships and sexual behaviors also needed to be analyzed. They believed that investigation should not be limited to the medical arena but should draw from a number of the emerging disciplines in the biological and social sciences.     Within the scientific community itself, interest in sexual matters had become widespread, in part because of the theories of Charles Darwin (1809-82). Darwin believed that sexual selection was a key to evolution. Sex coupling, the bringing together the sexual elements of two organisms who had been exposed to different environments, led to more vigorous offspring than did self-fertilization. Building on this insight, some of Darwin's followers went so far as to hold that sex existed for the good of the species. This misinterpretation of Darwin became the dominant view, albeit an erroneous one, until the middle of the twentieth century, and proved a strong impetus for studies in sexuality.4 It was also a major factor in removing some of the stigma from the study of sex.     Other researchers seized on the concept of sexual selection to explain any number of factors. Sir Francis Galton (1822-1911), a cousin of Darwin's, believed that sexual selection could prove to be a means for improving the human race. He coined the term eugenics in 1885, and though he himself concentrated on urging judicious marriages and large families for the wealthy and gifted (terms he used more or less synonymously), others went much further and argued that the high birth rate of the poor and less intellectually endowed was a threat to civilization. One result was a growing concern with attempting to better plan family size through various birth control methods. Though other factors also affected the birth control movement, as will be described later in the book, the attempt to limit the growth of "inferiors" and extend the numbers of "superiors" cannot be overlooked.     Some scholars who agreed with Darwin about the importance of sexual selection in evolution came to believe in the existence of degeneracy caused by a defect in an individual's heredity. The resulting degenerate strainsfor the defect was believed to be both progressive and inherent-involved nervous illness, physical weakness, and deviant behavior. For some writers, almost any departure from proper, conventional behavior was regarded as a sign of degeneracy. Included in this was any variation of the norms of sexual behavior, and the result was the growth of the concept of the sexual degenerate.     Cesare Lombroso (1836-1909) used Darwinian assumptions to bolster his argument that sexual deviates were on a lower stage of the evolutionary ladder than normal, heterosexual individuals. Lombroso and his allies accepted the belief that animal life had evolved from lower forms, but they went further, arguing that life had progressed sexually from a hermaphroditic or self-fertilizing stage to a higher monosexual stage. Just as life itself had evolved, so had human species, and as humans had progressed from primitive society to higher levels of civilization, they had outgrown robbery, murder, promiscuity, and perversion, or at least the most civilized among humans had done so. Because, however, a child had to repeat the progression of the species to become civilized, it was understandable that those with a defective heredity would become criminals, deviants, or mental defectives. It was also understandable why sexual behavior common among primitive groups or observed among animals would be unacceptable in higher, civilized societies.5     Inevitably, another factor in the development of sex research, as hinted at above, was the efforts of many of those labeled as deviate, defective, or criminal to find alternative answers. As is discussed later, one of the major elements in the emergence of the German sexological movement was the effort of homosexuals to escape the stigmatizing labels applied to them by such people as Lombroso.     A principal reason that the theories of Lombroso and others had become so well known was because of public concern about the perceived problems of the growth of the modern city. The nineteenth century saw the enormous growth of cities as individuals moved from an agricultural way of life to an industrialized and commercialized one. Vast numbers of rural inhabitants made their way to the expanding metropolitan areas of the nineteenth century, which led not only to rapid population growth but to wider disparities among the various segments of the population as well as to the demand for greater law enforcement.     Problems that would have been overlooked or gone unreported in a rural community were accentuated by the concentration of population. For example, hundreds, perhaps thousands of books were written on prostitution in the nineteenth century as authorities struggled with the problems of how to deal with it. Similarly, previously isolated homosexuals, who might have felt themselves to be unique, found others like themselves in the crowded cities. Inevitably, as they formed groups, they came to the attention of the police and the courts, who lacked understanding and precedent about how to deal with all sorts of sexual behavior. Much of this behavior had previously been ignored or had been regarded as something that only an isolated individual had done. One of the founders of modern sex research, Richard von Krafft-Ebing, took as his task the exploration of a variety of sexual behaviors to assist the courts, and he did so as one convinced that sexual pathology was a real threat to society. Some of his contemporaries even felt that the sex drive itself held potential danger, and Sigmund Freud, while not quite going this, far, emphasized the importance of the ego and superego in controlling such a primeval force.     The beginning of what is called the first wave of feminism also affected the development of sex research. Much of the interpretation of sexual matters had been from the male point of view, and in general, such a view held that women were regarded as inferior males turned inside out. Some of the early sex researchers were women, and as indicated in the following chapters, they sought successfully to challenge many of the male stereotypes and assumptions. The feminists were also active in campaigns for the abolition of prostitution, for access to birth control information, and for other issues, which tended to encourage new kinds of sex research. Many of the early sex researchers were also interested in marriage reform, since they felt women were often prisoners in loveless marriages. The result was an outpouring of marriage manuals and of new findings about human sexuality as well as the organization of groups to bring about reform. Such activity also led to the splintering of sex researchers into the so-called pure scientists whose goal was to publish their findings about human sexuality and the so-called reformers who wanted to lobby to implement some of their findings.     All of these factors tended to come together in the last few decades of the nineteenth century and were carried over with greater impetus into the twentieth. Ideas about sexuality changed, and the traditional Christian norms accepted since St. Augustine came under attack and in many cases were discarded. Sex research itself broadened into an interdisciplinary field that depended on expertise in biology, psychology, and sociology; historical and cross-cultural perspectives; and information provided by professionals in medicine, law, nursing, religion, and others.     I wrote this book to explain the development of sex research, to help a wider audience understand what sexology is all about, and to describe how changes in pubic attitude occurred. It is a subject to which I have devoted much of the past decade, and it is my fervent hope that my analysis will prove helpful. Though I concentrate on the last 150 years, research in the nineteenth century did not begin in a vacuum. It too had a history, which at least must be summarized, and a mind-set, which must be examined. This is where the first chapter begins, after which I turn to the more recent developments and controversies.
1 SEX RESEARCH AND ASSUMPTIONS FROM THE GREEKS TO THE NINETEENTH CENTURY Generally, as indicated in the introduction, much of the early information about sex was gathered from animal observations. Interestingly, however, observations about sexual activity among plants was ignored, perhaps because with few exceptions, such as the date palm, it was not very obvious. One result of this early lack of attention to plants has been that in Western culture flowering plants such as the rose have been regarded as symbols of chastity and coupling animals as symbols of concupiscence. There have even been religious groups, such as the Albigensians, who prohibited their adherents from eating any product of sexual union but allowed them to eat vegetables, fruits, and fish, because they believed these forms of life did not result from sexual union.     All of this is a way of emphasizing that Western concepts of sexuality up to the nineteenth century represented a hodgepodge of ideas and contributors. Historically, the most influential premodern author on sexual activity among animals and humans was the fourth-century B.C. Greek philosopher Aristotle, whose History of Animals, Parts of Animals, and Generation of Animals can be regarded as the foundation not only of Western zoology but also of Western sexology. So great was his influence that almost anything attributed to him was believed, with the result that his name was attached to books that had little to do with what he said. For example, the most widely used source of information about sex in the English-speaking world from the seventeenth through the nineteenth centuries was known as Aristotle's Masterpiece, although only fragments of the information and misinformation it served up can be traced to Aristotle.1     Sex was a key to Aristotle's classification scheme, because on this basis he assigned animals to one of three groups: those that reproduced (1) by sexual means, (2) by asexual means, and (3) by spontaneous generation. This last category included a number of lower animals such as fleas, mosquitoes, and flies, which he believed were produced out of putrefying substances. Among the shellfish, he tried to differentiate those that reproduced through bud formation from those that came from self-generation. His data were a combination of acute observation and folklore. He held that the hermit crab grew spontaneously out of the soil and slime and found its way into unoccupied shells, shifting to ever larger shells as it grew. Usually, however, he came down on the side of spontaneous generation only when he could find no other explanation, as in the case of the eel. He reported that eels lacked milt or spawn and when dissected no passages for such secretions could be found. Adding to the puzzle was the fact that eels seemed to appear sponta-neously after a rainfall, while they never appeared in stagnant pools, even in times of drought. This led him to conclude that eels were derived from the "earth's guts" and grew spontaneously in mud on sustenance from rainwater.     Some of Aristotle's descriptions of reproduction showed remarkable skills of observation. For example, he wrote that in mating of the octopus, two octopuses swam about, intertwining mouths and tentacles until they fit closely together. Then one octopus rested its so-called head against the ground and spread its tentacles; the two sexes then brought their suckers into mutual connection. He added that some asserted that "the male has a kind of penis in one of his tentacles, the one in which are the largest suckers, and they further assert that the organ is tendinous in character, growing attached right up to the middle of the tentacle, and that the latter enables it to enter the nostril or funnel of the female."2     This is a more or less accurate description of mating in which the male uses his hectostylus (a tentacle serving as the arm of procreation) to remove a semen cartridge from his own mantle and then places it in the female's. Because Aristotle's classification scheme seemed so all-comprehensive, even though it was a mixture of masterful insights and popular superstition, there was a reluctance to challenge his conclusions. Most damaging was his belief in spontaneous generation, and it was not until this concept was lain to rest that it was possible to understand fully the importance of sexuality. In the seventeenth century, the Italian Francesco Redi demonstrated that maggots were not born from putrescent material but came from fly eggs. Still, though Redi demonstrated the source of maggots, he was unwilling to mount a frontal assault on the theory of spontaneous generation, perhaps because the Christian theology, based on Aristotelian assumptions, supported such a belief to justify the concept of original sin. Put simply, the people of the time could not visualize how Adam and Eve could have lived happily in Paradise before their expulsion if they were plagued by the earthly ills brought on by tapeworms, roundworms, and other parasites. Yet, according to the Bible, God had created all plant and animal forms before he created humans. To answer this apparent contradiction, the theology of the Church held that parasites came about not with Creation but as a consequence of original sin through spontaneous generation. Redi was not about to confront the Church about its belief in spontaneous generation but was content to modify Christian doctrine in some particulars. Others continued such modification until Louis Pasteur's discovery in the nineteenth century that fermentation was caused by the existence of minute organisms led most of the scientific community not only to abandon the Aristotelian notions but in fact for the most part to ignore questions about the origin of life and simply describe the way various forms of life reproduced. In this way, a conflict with religion was avoided, although gradually religious ideas changed.     Long before Pasteur's discovery, some investigators had even begun to speculate that plants might also have a form of sexual reproduction. One of the early explorations of this possibility appears in the writings of the seventeenth-century Englishman Nehemiah Grew. In his Anatomy of Plants, published in 1685, he postulated that the flowers on plants were sexual organs, the pistils were the female organs, the stamens were the male ones, and pollen was the male seed. Since the flowers he observed encompassed elements of both sexes, Grew also held that plants were hermaphrodites. This belief, at least for some plants, was challenged by his German contemporary Rudolph Jacob Camerarius in his 1694 essay Letter on the Sex Life of Plants. Camerarius had observed that an isolated fruit-bearing mulberry tree produced only empty, sterile seed vessels. He wondered if this might be because it had not been fertilized, and this led him to hypothesize that there might well be male and female plants. He began experimenting with a plant popularly known as dog's mercury (Mercurialls perennis), which he had observed in two different variations. Some of the plants had only stamens in their flowers but bore no seeds or fruits, while others, lacking stamens in the flowers, bore fruit. Isolating the fruit-bearing from the pollen-producing plants, he demonstrated that although seed vessels still appeared on the former, they were sterile.     Though this further strengthened the idea of male and female elements in plants, the basic question remained of how they made contact with each other. In the eighteenth century, Josef Gottlieb Kölreuter through his study of the stamens in hibiscus plants found that both wind and insects were important in the fertilization process and that fertilization was only successful when it took place between plants belonging to the same species.     Continuing and expanding on this research was another German, Christian Konrad Sprengel, who published The Newly Revealed Mystery of Nature in the Structure and Fertilization of Flowers in 1795. Convinced that God had put everything in nature for a purpose, Sprengel set out to determine what useful purposes the different parts and properties of flowers had been created to serve. He concluded that color in flowers was to attract insects and that certain colors attracted certain insect forms. He then observed that the flower was adapted not only to the general conditions of its own life but also to those of the insects it wanted to attract. He argued that even though some flowers appeared to be hermaphrodites and had both stamen and pistil, a differential development cycle made it impossible for the flower to be fertilized by its own pollen. Instead, fertilization was by pollen conveyed by insects from other flowers. This led him to philosophize that nature did not desire a flower to be fertilized by its own pollen.3 His whole approach made his findings appear as nature's demonstration of the wonders that God had worked.     If investigators had difficulty in fully understanding the importance of sexual reproduction in lesser forms of life, they had similar problems in trying to explain how conception took place not only in humans but in most animal species. Again, the basis for many of the Western cultural notions about conception and sexual reproduction came from the Greeks, and Aristotle was a major figure. But Aristotle did more than try to explain human reproduction; his philosophical assumptions about reproduction led him to posit different roles for men and women. This gave a political connotation to ideas about sex and reproduction from which we have not yet fully escaped.4     Aristotle believed that the male was the major factor in reproduction, although he did grant that the female supplied the matter for shaping. If, then, the male, stands for the effective and active, and the female considered as female, for the passive, it follows that what the female would contribute to the semen of the male would not be semen but material for semen to work upon."5 In his defense, Aristotle presented the role of the female somewhat more favorably than did some of his contemporaries, who simply regarded the woman as a vessel designed to carry the male seed to fruition.6 There was, moreover, a strong minority of Greek writers who went so far as to give equal credit to the female as the male, although their views never became as influential as those of Aristotle. A good example is the writer of the Hippocratic work On Generation, who stated that two seeds were involved in conception, the male contributing semen and the female, vaginal secretions.7 The second-century medical writer Galen also held the two-seed doctrine, claiming both the male and female seeds had coagulative power and receptive capacity for coagulation but that one was stronger in the male and the other in the female.     Although some later writers also adopted the two-seed doctrine, Aristotle's views triumphed in the West, because they had been adopted and advocated by the eleventh-century Arabic writer Avicenna, who was a key transmitter of Aristotelian ideas to medieval Europe. Avicenna, who also incorporated some of concepts of Galen, held that the male agent was equivalent to the clotting agent of milk and the female to the coagulum.8 This was the explanation adopted by St. Albertus Magnus in the thirteenth century. Though Albertus used the term female semen, he made it clear that it could only be called semen in an equivocal sense and that the male contributed the essential material for generation.9 In this belief, he was supported by his pupil St. Thomas Aquinas, who held that the female generative power was imperfect compared with the male.10     Better understanding of the process depended on a more effective knowledge of the human body. In this, the anatomical work of Andreas Vesalius in the sixteenth century proved important, as did the more specialized studies on female anatomy by Gabriele Falloppio, his younger contemporary. Falloppio described the clitoris as well as the tubes that bear his name. Falloppio was also important in the study of male anatomy; he described the arteria profunda of the penis, which led to a better understanding of how the organ became erect. of males increased, those of the female, particularly the uterus, remained linked with mystery and superstition. Plato, the teacher of Aris     Even as knowledge about the anatomy of the reproductive organs totle, for example, had popularized the belief that an inactive uterus caused female hysteria. He wrote that when the uterus, an indwelling creature desirous of childbearing, "remains barren too long after puberty, it is distressed and sorely disturbed, and straying about in the body and cutting off the passages of the breath, it impedes respiration and brings the sufferers into extreme anguish and provokes all manners of disease besides."11 Fortunately, most medical writers rejected such notions. Soranus of Ephesus, the second-century writer on gynecology, held that although the uterus was conceived by some as having an Independent existence, similar to that of an animal, it did not. Such misunderstandings arose, he explained, because the uterus actually did have some characteristics similar to those of an animal, as it would contract when cooling agents were applied and relax when warming ones were,12 Galen also opposed the theory of the wandering womb, emphasizing that it was impossible for it to jump over the stomach to touch the diaphragm, but nonetheless, he believed that the womb desired to be pregnant and that the only solution for many jemale complaints was intercourse and pregnancy. This was because the uterus produced a secretion similar to the male semen and that the retention of this substance in the uterus led to the spoiling and corruption of the blood. This in turn led to a cooling of the body and an irritation of the nerves, and eventually resulted in hysteria.13     Although Vesalius and other anatomists of the sixteenth century finally put to rest the concept of the wandering uterus, there was still considerable misunderstanding of female physiology and exactly how reproduction came about. The first effective challenge to the overwhelming importance of the male came from William Harvey, whose Anatomical Exercitations Concerning the Generation of Living Creatures was published in Latin in 1651 and translated into English in 1653. Although best known for his demonstration of the circulation of the blood, Harvey spent much of his life studying generation. He observed reproduction and gestation in all types of animals, with particular emphasis on the day-to-day development of the chick embryo. He also dissected the uteri of deer at various stages during mating and pregnancy. This research led him to highlight the significance of the egg in generation. Some hint of the role of the egg was earlier advanced by Hieronymus Fabricus of Aquapendente, a student of Fallopius, but it was Harvey who pushed the oviparous theory to its logical conclusion.     Harvey could find no evidence that the seminal mass of the cock entered into or even touched the hen's eggs during their formation. He did find that for a time a hen could continue producing fertile eggs after all detectable traces of semen had vanished from her body. To Harvey, this seemed to offer solid evidence that the contribution of the cock's semen to generation was indirect and incorporeal; it simply conferred a certain fecundity on the hen and then played no further role in the actual generation of the egg or chick. Once endowed with this fecundity, the hen could, entirely on her own, produce fertile eggs.     To explain how this happened, Harvey compared the process to the spread of disease by contagion as it was then understood. Exposure to a sick individual, he held, could engender within a second individual an internal principle that subsequently reproduced in him or her the same specific disease. For Harvey, fecundity was transmitted to the female in the same way by the male semen. The role of the hen and cock is not to produce a chick but to create a fertile egg that subsequently gives rise to a chick through its own innate powers. He believed he had demonstrated this by his dissections of deer uteri, in which he observed with his own eyes (this was before the development of the microscope) that it was long after the disappearance of semen in the uterus that the first evidence of conception appeared. This led him to formulate his famous dictum that "an egg is the common primoridum of all animals," implying in effect that the role of parents in generation was indirect. BritainThey produced a fertile egg or conceptus or seed, and this subsequently produced a new animal or plant through innate vegetative powers.14     Other researchers came forth with supporting conclusions, particularly Marcello Malpighi, whose study of chick embryos was published in 1672. At about the same time Regnier de Graaf observed changes taking place in rabbits' ovaries in the first days after fertilization and concluded that similar changes probably took place not only in the rabbit doe but in the human female.     Ovists, however, ran into a temporary roadblock created by the studies of Anton van Leeuwenhoek (1632-1723), who made observations with a simple, early microscope that were not equaled until the more powerful instruments of the nineteenth century allowed others to confirm in detail what he had said. Leeuwenhoek became interested in male semen after Johan Ham, a medical student, consulted him about microscopic creatures that he had observed in the semen of a patient suffering from nocturnal emissions. Ham brought a glass bottle containing the semen to Leeuwenhoek for confirmation. Leeuwenhoek observed the microscopic creatures, noting that they were different from other animalcula (microscopic animals) he had observed; all such creatures in the semen had round bodies with tails five or six times as long as their bodies. As he studied them further, he reported they made swimming movements similar to those of an eel and that such movements gradually slowed and ultimately ceased, although the animalcula remained clearly recognizable.     To make certain these little animals were not the result of any sickness, Leeuwenhoek and Ham examined the semen of "healthy" males and observed the same kind of creatures. They estimated there must be a thousand or more in the space that could be occupied by a grain of sand. As additional data were gathered under a variety of conditions, it was found that the animalcula died with 24 hours if kept in cold temperatures, but they survived several days if kept in warm conditions. Leeuwenhoek called these creatures spermatozoa.     Almost immediately after the results of his discoveries were published in the proceedings of the British Royal Society in 1678, all kinds of findings began to be reported. One observer noted seeing a miniature horse in the semen of a horse, and another, a miniature donkey in the semen of a donkey. Still others believed they could distinguish male and female sperm, and at least one researcher reported that he saw male and female sperm copulating and then giving birth to little sperm. The effect of the discovery, in spite of the ludicrous tales, was to reassert -at least in the minds of many- the supremacy of the male in reproduction.15     One of the results of the observations of eggs and spermatozoa was to emphasize that sex was universal. This belief was strongly supported in the eighteenth century by the great Swedish biologist Carolus Linnaeus (1707-78), who based his classification scheme of all living things on their means of reproduction. For him, vivum omne ex ovo, or everything living comes from the egg-although in the case of plants, the egg was in the form of a seed. So strong were his beliefs that he wrote that there could be no deviation from this general law of nature. As Colin Milnes of the Linnaean Society in England said in 1771: "No being owes its formation to chance, and all are probably produced by a similar mode of generation, depending on the concourse of the two sexes, the minutest insect as well as the elephant, the smallest moss, as well as the most stately and elevated oak."16     Linnaeus, however, spoke too soon, and in the early years of the nine-teenth century, his classification system came under challenge as it became apparent that there were asexual spore-bearing, forms of life. But a more serious problem was the difficulty in identifying what was involved in fertilization. A minority of investigators even went so far as to argue that the so-called spermatozoa seen under the microscope were simply parasites, while another group held they were separate organisms. Moreover, even the advocates of sperm as the key were as yet unable to explain how sperm entered the male body or how they were manufactured. Answering these questions was impossible until the development of the cell theory by Matthias Jakob Schleiden and Theodor Schwann. In 1838, Schleiden concluded from his intense microscopic observations that plants were not a single living thing but an aggregate of individual, self-contained organic molecules. Uncertain of what he had discovered, he discussed it with his friend Schwann, who replied that he had seen similar structures in animal membranes. Their discovery resulted in the foundation of cytology (the study of the structure and function of cells) and the realization of the complexity of life.     One of their early discoveries was that although unicellular organisms normally reproduced by budding and division they also produced sexually by a process described as autogamy, conjugation, and copulation. Schleiden and Schwann speculated that although the budding process resulted in tremendous population growth it also resulted in extreme inbreeding, a difficulty that could be overcome by occasional autogamy. Some forms of life, they found, alternated between sexual and asexual propagation, as did Plasmodium, the agent that causes malaria. In humans, Plasmodia reproduce by dividing, but in the intestine of the mosquito, they reproduce sexually. Schleiden also emphasized the importance of pollen in the fertilization process of plants. The combination of the observations of Schleiden and Schwann gave new importance to sex in reproduction, a concept that Darwin, as mentioned in the introduction, made all-important.     But what kind of process led to fertilization? The existence of a mammalian egg had been discovered in 1827, but it was not until 1875 that Oscar Hertwig observed the moment of fertilization in the sea urchin, one of the so-called higher animals. Hertwig chose the sea urchin because its eggs are transparent, occur in large number, and develop rapidly. This made it possible for him to observe the coming together of two nuclei in the egg, an event he interpreted as fertilization. Not until four years later did Herman Fol actually observe the spermatozoon penetrate the egg and contribute the second nuclei.     Further light was thrown on the process with discovery of chromosomes in 1873, a finding that Eduard van Beneden used to demonstrate that fertilization resulted in joining together two half sets of chromosomes to form one full set. This phenomenon, It was postulated, also took place in human beings, although the ova of the human female were not observed until the twentieth century.17     This rather simplified summary of the developing biological understanding of the nature of sex and reproduction seems to Imply an ever-steady trend toward greater and more accurate knowledge. Missing from this account are the numerous dead ends and erroneous leads that were followed and that for a time challenged what is now the perceived wisdom. Moreover, the account itself cheats a little by carrying ideas and findings into the early twentieth century, somewhat beyond the starting place of this book. Issues of debate were still not settled in the nineteenth century, and throughout much of the century, there was considerable debate over the reasons why sexual reproduction occurred in the first place. Interestingly, much of the debate centered on the role of the female, generally to the disadvantage of women. There was a tendency, for example, to associate the ova with asexual cells that began the reproductive process only after being triggered by the sperm, though it was not yet clear how or why. This explanation, minus the asexual aspect, is not far from what we accept today. It resulted, however, in many "authorities" emphasizing that sex was simply the means of procreation used by higher organisms that had, by the division labor, placed the task of procreation into the hands (or, more apposite, ovaries) of a special individual, the female. Some saw this as both sociological and biological proof that the female existed solely to bear and raise offspring. In a sense, this is as accurate as arguing that the only purpose of the male is to fertilize the egg. This latter perspective, however, was not what many of the nineteenth-century interpreters argued. Rather, they held -following traditional societal attitudes toward women- that the subordinate status of women was a law of nature; to argue otherwise was to threaten the social and biological fabric of the species.18     This example of arguing for a biological justification for the subordina-tion of women emphasizes just how much attitudes and beliefs about human sex and gender were based on much more than a physical explanation. Rather, such attitudes depended heavily on psychological, sociological, cultural, and historical factors. Inevitably, each new finding about sexuality in nature took on a social and political context when it was applied to humans. Generally, data were interpreted to strengthen traditional Christian ideas about sexuality, which as indicated in the introduction, was deeply influenced by the sex-negative ideas of St. Augustine. As the assumptions about sex and reproduction on which religious authority had based its moral teachings were undermined, commentators on human sexuality seized on science to give a new foundation for traditional morality. If anything, this tended to strengthen negative attitudes toward sex, because those serving up advice could argue that they gave more accurate guidance than their predecessors, since they included the new findings of science. Moreover, as secular knowledge grew in the eighteenth and nineteenth centuries, there was a corresponding growth of faith in science itself.     Although there had been some challenges within the Christian community to Augustinian ideas about sex and although Protestants, in general, and Puritans, in particular, looked on sex within marriage as a source of pleasure, all segments of the Christian community continued to believe that marriage was a prerequisite for sexual intercourse.19 It was in this mind-set that discussion about human sexuality took place. Increasingly, however, sexual discussion was dominated by the medical community, in part because most of the discoveries recounted so far in this chapter were made by physicians. Engaging in research, however, was limited to a few individuals, whereas giving advice to patients about sexual matters was something that every physician was expected to do. The practicing physician, moreover, was in a difficult situation when patients came to him (and all physicians up to the nineteenth century were males) for treatment of sexually related problems. Even with the observations and findings of a Harvey or a Leeuwenhoek, it was difficult to explain to a patient complaining about an inability to conceive why this might be the case. The state of knowledge was simply not up to this problem. Instead, the perceived necessity to offer a diagnosis and make a prognosis encouraged the growth of what might be called medical systems. In simple terms, these systems were organized medical theories that were all-inclusive explanations of why illness occurred and what a physician could do to treat it. System makers had existed since medicine emerged as a profession, but the systems of the seventeenth and eighteenth centuries became ever more elaborate and continued to have adherents well into the nineteenth century. Moreover, many of the system makers, influenced by their own philosophical and religious beliefs, held that sexual activity in itself was potentially dangerous. As a result, illness and pathology replaced sin in the discussion of sexual activities.     One of the most influential system makers was the great eighteenth-century Dutch clinician Hermann Boerhaave (1668-1738), who in his Institutiones Medicae wrote that the rash expenditure of semen brought "on a lassitude, a feebleness, a weakening of motion, fits, wasting, dryness, fevers, aching of the cerebral membranes, obscuring of the senses, and above all the eyes, a decay of the spinal chord, a fatuity, and other like evils."20     Boerhaave's observations on the dangers of sexual activity fit well with some of the new medical theories such as vitalism, a theory based on the works of Georg Ernst Stahl (1660-1734) and others. Vitalism emphasized a unity of body and soul, symbolized by the anima, which protected the body from the deterioration to which it tended. When the movements representing normal life were altered by the body or its organs, disease supervened. Disease was thus little more than the tendency of the anima (or of nature) to reestablish the normal order of tonic movements as quickly and efficiently as possible. A contemporary of Stahl, Friedrich Hoffman (1660-1742) held that the living organism was composed of fibers having a special characteristic tonus, namely the ability to contract and dilate. This process was regulated by the nervous system, headquartered in the brain. When the tonus was normal, the body was healthy, but every modification of the tonus brought with it a disturbance of health. For him, individuals who practiced masturbation gradually damaged their memory because of the strain on the nervous system.21     Several other theorists, including John Brown (1735-88) and Théophile de Bordeu (1772-76), built on this foundation. Brown's medical philosophy was based on his own experience with gout, a disease from which he had suffered most of his life. In his preface to his Elements of Medicine, he wrote that after failing to cure himself with traditional treatment, he sought other remedies, and eventually arrived at the conclusion that "debility was the cause of his disorders and that the remedy was to be sought in strengthening measures." To banish his gout, he had to strengthen himself, avoid debilitating foods, and treat himself with wine and opium. Whether his gout was cured or not remains doubtful, but from his experience, he built a medical philosophy known as Brunonianism. Basic to his teachings was the notion of excitability, defined as the essential distinction between the living and the dead. The seat of excitability was in the nervous system, and all bodily states were explained by the relationship between debility and excitement. Too little stimulation was bad, but excessive stimulation could be worse because it could lead to debility by exhausting the excitability. Excitability was compared to fire: If there was not enough air (insufficient excitement), the fire would smolder and go out; but under a forced draft (too much excitement), the fire would burn excessively, become exhausted, and also go out. From these assumptions, he concluded there were two kinds of diseases: those arising from excessive excitement (sthenic) and those from deficient excite-ment (asthenic). Too much stimulation carried an asthenic ailment into a sthenic one. For example, mutual contact of the sexes as in kissing or even being in each other's presence, gave an impetuosity to the nerves. This nervous condition could be relieved by sexual intercourse, but in giving tempo-rary relief, it could also result in the release of far too much turbulent energy; and if carried to excess, this too caused difficulty. Bordeu ended up with the same conclusions as Brown. Bordeu, however, maintained that the lymphatic glands as well as the nervous system had vital activity, and secretions -including semen- drained the vital essences that resided in every part of the body.22     Particularly influential in emphasizing the dangers of sexual activities were the writings of S. A. D. Tissot (1728-87). Tissot believed that physical bodies suffered a continual waste, and unless this loss was periodically restored, death would result. Though much of the waste lost through natural processes such as urination and bowel movements could be restored by ingesting food, even with an adequate diet, the body could not fully restore the waste that resulted from blood loss, diarrhea, and sexual activity. Particularly dangerous was the loss of seminal emission or vaginal discharges in the female.     Semen, he explained, was extremely important to the well-being of the male. As evidence of this, he pointed out that its appearance coincided with the growth of the beard and the thickening of the muscles, something that did not happen if a male was castrated. Because semen was so important to the development of the male, it seemed obvious to him that any excessive loss of it would weaken the male. Although he agreed that some loss was necessary for reproduction to replenish the human race, the real danger was excessive intercourse. Even more dangerous was the loss of semen brought about by nonprocreative sex or through unnatural means -practices that he called onanism. Though onanism is sometimes simply equated with masturbation, Tissot used the term in a broader sense to include all nonprocreative sex from homosexuality to masturbation to the use of the wrong orifice to the use of a contraceptive. He listed a number of dangers that could result from the excessive waste of semen, including (1) cloudiness of ideas and sometimes even madness; (2) a decay of bodily powers, resulting in coughs, fevers, and consumption (tuberculosis); (3) acute pains in the head, rheumatic pains, and an aching numbness; (4) pimples of the face, suppurating blisters on the nose, breast, and thighs, and painful itching; (5) eventual weakness of the power of generation as indicated by impotence, prema-ture ejaculation, gonorrhea, priapism, and tumors in the bladders; and (6) disordering of the intestines, resulting in constipation, hemorrhoids, and so forth.     Onanism affected females in the same ways as males, but not surprisingly, the effects were ever so much more severe. In addition to suffering from the same problems as did men, women also were likely to have severe cramps, ulceration of the cervix, uterine tremors, incurable jaundice, and hysterical fits. Moreover, masturbation in the female often resulted in mutual clitoral manipulation, and this resulted in women loving other women with as much fondness and Walousy as they did men, a practice that lowered them from the high status of womanhood to the level of the most lascivious, vicious brutes.     Even worse than masturbation in adults was the existence of the practice in youth who had not yet attained puberty. Here, it tended to destroy the mental faculties by putting too great a strain on the nervous system.23     It is easy for late-twentieth-century commentators to make fun of Tissot and others who wrote in a similar vein. One of the reasons earlier writers attributed so many dangers to sexual activity is that the sequelae of sexually transmitted diseases, particularly the third stage of syphilis, were accredited to sexual acts in general. It was not until the nineteenth century that all the stages of syphilis were discovered and explained, and there could be a more rational explanation of what Tissot attributed to excessive sexual activity. Actually, there was probably even some kind of rough correlation between what Tissot attributed to sexual activity and the sequelac of syphilis. Moreover, those most likely to get syphilis were those who had a variety of sexual partners and so, in Tissot's terms, were visualized as losing abnormal amounts of their body energy through waste. Even after the course of syphilis was theoretically worked out by Philip Ricord (1800-1889), there was still confusion, because it was not until the isolation of the spirochete in 1905 that Ricord's hypotheses could be proven.24     Tissot's ideas, in one form or another, proved extremely influential through much of the nineteenth and even into the twentieth century. For a time it seemed that each writer tried to outdo the other in portraying the dangers of sex. In the United States, Tissot's ideas were popularized by Benjamin Rush (1745-1813), probably the most significant American physician at the end of the eighteenth century; he is remembered today as a signer of the Declaration of Independence. Rush, who had studied in Edinburgh, returned to America to introduce a variation of John Brown's medical ideas. All disease could be reduced to one basic causal model: either the diminution or increase of nervous energy. Because sexual factors were a major cause of excitement, Rush taught that careless indulgence in sex would lead to everything from impotence to epilepsy to death.     Rush, however, did not entirely discount the positive aspects of sex, stressing that abnormal restraint in sexual matters was also dangerous, because it might produce "tremors, a flushing of the face, sighing, nocturnal pollution, hysteria, hypochondriasis, and in women, the furor uterinus."25     One did not have to be a physician to trumpet the dangers of sex. Sylvester Graham (1794-1851), a health reformer perhaps best remembered for his advocacy of unbolted wheat, or graham flour, and commemorated today in the graham cracker, taught that his contemporaries suffered from an increasing incidence of debility, skin and lung diseases, headaches, nervousness, and weakness of the brain, much of which resulted from sexual excess. This was because the human body was a composite of animal and organic life, both of which were controlled by a network of nerves.26 Because reproduction, almost alone of the body's functions, involved both an animal and organic component, sexual activity was seen as putting a unique strain on the body. Moreover, it was not simply the sex act itself that posed dangers and eventually resulted in insanity but lascivious thoughts and the contemplation of sexual activities also could be harmful. Individuals, therefore, had to be ever alert to the dangers of sexual desire. Sexual feelings could even be aroused by eating dishes that were highly seasoned and "overrich" as well as by eating too much meat.27 One result was the growth of fears about the dangers of untrammeled sexuality.28     In fact, the dangers of sex became part of the arsenal of all the faddist reformers of the last part of the nineteenth century, including John Harvey Kellogg, whose Battle Creek Sanitarium introduced new breakfast foods to the world. He gave a long list of signs that distinguished a person who was masturbating. Listed among the signs was every form of conduct found in teenagers: fickleness, bashfulness, unnatural boldness, lassitude, and capricious appetite. Masturbation also, according to Kellogg, resulted in acne, paleness, shifty eyes, the use of tobacco and profanity, bed wetting, and fingernail biting. As masturbation continued, the ultimate dangers were terrible to behold, because the nervous shock resulting from the exercise of the sexual organs was the most profound to which the nervous system was subject. Even those who engaged in sex for procreative purposes had to limit their activities or else insanity would result.29     But why, if sexual activity was so harmful, had not generations of individ-uals became insane in the past? Those concerned with chronicling the great dangers of sex had an answer. It was the growing complexities of modern civilization and the higher evolutionary development of humanity that had made sexual activity so much more dangerous now than it had ever been in the past. In fact, many nineteenth-century physicians taught that the whole of modern society suffered from neurasthenia, a deficiency of nerves. This was a new disease first discovered by the American George M. Beard (1838-83), and it was symptomatic of the growing complexities of modern civilization as well as the higher evolutionary development of humanity. It was particularly widespread and dangerous to the educated, brainy workers in society who represented a higher stage on the evolutionary scale than the less-advanced social classes. The theory had wide appeal, because it seized on the new scientific concepts of evolution to justify class and race consciousness. According to Beard, the chief cause of nervous exhaustion was sexual intercourse, and it was important for individuals to regulate and guard against any unnecessary (nonprocreative) sexual activity.30 For a time, Beard's ideas were extremely influential in both America and Europe.     Predictably, the result of these theories was the reinforcement by science of the traditional Western hostility to sex, which had been such an influential factor in Christianity. Writers of most popular sex manuals, whether physicians, clergy, teachers, or reformers, seized on new scientific evidence to mount a crusade against sex, hitting with sledgehammer force the horrible dangers of "unnatural sex" (in other words, all nonprocreative sex, including the use of any form of contraception). The word masturbation, not onanism, often became a codeword for all sorts of unnatural sexual activity, from the use of contraceptives to homosexuality.31 Unnatural sex was regarded as ten times worse than simple illicit intercourse between an .unmarried man and woman, because at least children might result from heterosexual fornication.32 It not only was described as criminal and pernicious33 but also eventually came to be described consistently as a disease, and sometimes even a contagious one.34     Unnatural sex was worse than almost any other disease for it constantly drained off the vital body fluids and gradually took away life itself.35 Every loss of semen was regarded as equivalent to the loss of 4 ounces of blood,36 and although the body could eventually replace this loss, it took time to recuperate. The only thing worse than seminal loss in the male was masturbation and unnatural sex in the female.37 Though not all health professionals subscribed to such exaggerated ideas, many felt it was much less dangerous to exaggerate than to leave the patient and the public in ignorance?38 Others were fearful of the ostracism that might result if they said anything contrary to the dominant view about sex and so simply remained silent. Silence, however, did not always save them, because they were sometimes attacked by other physicians, who alleged that their silence led to wasted lives.39 Often the attack was led by respectable and honored physicians. Abraham Jacobi (1830-1919), for example, the founder of pediatrics in the United States, was simply reflecting some of the best medical opinion when he blamed infantile paralysis and infantile rheumatism on masturbatory practices, which had weakened the body's resistance.40 Masturbation also encouraged the formation of "morbid attachments" for persons of the same sex41 and led to pederasty and child abuse.42     Some commentators attempted to define masturbation as including coitus interruptus, oral-genital contact, pederasty, bestiality, mutual masturbation, coitus interfemora, and self-pollution.43 Others simply used the term without defining it. One of the dangers posed by the masturbator, according to G. Stanley Hall (1846-1924), a founder of American psychology and an early writer on adolescence, was that such a person seduced others into experimenting with masturbation, and once established, masturbation was the major cause of "one or more of the morbid forms of sex perversion."44     In the new conservatism on sexual issues, any unusual position in intercourse or any action besides that designed to impregnate the female could be labeled as masturbation and righteously condemned. One physician reported the case history of a young woman whose husband "had the fatal habit of applying the tongue and lips to his wife's genitals to provoke in her a venereal orgasm." This had resulted in "gastralgia" and "constant exhaustion" in the woman. So concerned was the physician treating, her that he felt obliged to warn her that her very life would be in danger unless her husband ceased this foul practice. Moreover, if her husband continued such practices, he would probably get cancer of the tongue. It was not just the dangers of cunnilingus with which he was concerned but the fact that such practices resulted in orgasm and this could only lead to even greater afflictions.45 In case his warnings were not enough to stop them from engaging in such practice, he added that any child born to them would have "perverted instincts."46     Some writers were bothered about the possibility not only that women could have orgasms but also that women might find sex pleasurable. In their minds, sex, though clearly essential to procreation, should only be engaged in for this purpose. Those able to otherwise preserve marital continence would, it was claimed, be rewarded "by a sound constitution, an approving mind, and the applause of the deserving and considerate."47 Even those unable to be totally continent but who still managed to en gage only moderately in sexual activity would elevate the noblest faculties of their minds.48 In no case was it ever possible for chastity to be excessive.49 Married couples interested in sex only for procreation were advised to limit their attempts at coition to "one indulgence to each lunar month." This was all the "best health of the parties can require," and it was sufficient to ensure pregnancy if that was God's wish.50 It was held by many to be a law of God that no animal, let alone a human, should "use the reproductive powers and organs for any other purpose than simple procreation."51 The more individuals were able to confine their sexual indulgence to the generation and development of offspring, the nearer they came to fulfilling the "supreme law" of being and the nearer they came to being true Christians.52     In the United States, medical practitioners, most of whom thought of themselves as Christians, saw as part of their duty the education of the public to realize that God had designed "intercourse of the sexes" for the production of offspring and no other reason.53 Though it could not be denied that the male received pleasure in doing his duty to beget children, couples were warned about seeking or prolonging pleasures. This was because, among other things, there were "undeniable instances where children begotten in the moment of intoxication remained stupid and idiots during their whole life."54 Logic was also marshaled to demonstrate that conception during time of ill-humor, bodily indisposition, or too much nervous strain would also affect the resulting offspring.55     Women especially had to be careful not to enjoy sex, because they were maternal, rather than sexual, creatures. Only the diseased female had an "excessive animal passion."56 Advice, however, was of necessity somewhat contradictory, because some writers, following older medical texts, believed that a woman would not get pregnant unless she had an orgasm during intercourse. Generally, however, this idea was ignored or downplayed in most nineteenth-century medical texts, although fortunately, it remained a popular belief. Certainly any woman who participated in the enjoyment of sex while she was pregnant endangered her role as a mother and could bring about a miscarriage.57 In fact, any couple engaging in intercourse during pregnancy reduced the constitutional vigor of the fetus and predisposed it to debilitating diseases.58 Moreover, women were particularly susceptible to such debilitating diseases. A standard textbook on gynecology published in 1888 had a concluding chapter titled "Gynecology as Related to Insanity in Women." The author wrote:
	I take it for granted that all will agree that insanity is often caused by diseases of the procreative organs, and on the other hand, that mental derangement frequently disturbs the functions of other organs of the body, and modifies diseased action in them. Either may be primary and causative, or secondary and resultant. In the literature of the past, we find the gynecologist pushing his claims so far as to lead a junior in medicine to believe that if the sexual organs of the women were preserved in health, insanity would seldom occur among them.59
Women, in fact, were believed by some to dislike sexual intercourse. The well-known English physician William Acton taught that women had no desire for sex at all and only engaged in sex with their husbands to have children or to keep their husbands from straying.60 He admitted that some low and vulgar women might not only enjoy sex but seek out sexual partners, but this was something no proper wife and mother would ever do. For many of the writers on sex, a female who enjoyed sex was either a sick creature or somehow an imperfect woman. Interestingly, many women writers seemed to agree, perhaps because they saw that one of the few ways they could liberate their sex from the continual burdens of pregnancy and lactation was to deemphasize female sexuality. E. B. Duffy, a married woman, wrote that real women should regard all adult men not as lovers but as stepsons for whom they had a mother's "tenderness."61     Almost all advice writers recommended that intercourse between a married couple cease when the women entered menopause, because this was nature's way of putting a "cessation" to the female's sexual functions.62 Those men and women who persisted in engaging in sexual intercourse after this time would find themselves exhausted and dangerously prone to illness.63 Thus in "well regulated lives," the sexual passions become less and less imperious, diminishing gradually until -at an average age of forty-five for woman and fifty-five for men- they were but rarely awakened and seldom satisfied.64     Perhaps the best summation of all these negative ideas about sex was by Elizabeth Osgood Goodrich Willard, who coined the term sexology. She held that the sexual orgasm was more debilitating to the system than a hard day's work. She regarded sex as more or less a loathsome thing and was unhappy that people were generated under a system that was so easily abused. She argued that humankind must stop the waste of energy
	through the sexual organs, if we would have health and strength of body. Just as sure as that the excessive abuse of the sexual organs destroy their power and use, producing inflammation, disease, and corruption, just so sure is it that a less amount of abuse in the same relative proportion, injures the parental function of the organs, and impairs the health and strength of the whole system. Abnormal action is abuse.65
With such attitudes toward the dangers of sexual abuse, there was a determined effort to find preventatives for those unable to control their own sexuality. Some physicians perforated the foreskin of the penis and inserted a ring or cut the foreskin with jagged scissors to lessen possibilities of male pleasure. Others applied ointments that would make the genitals of both sexes tender to the touch, and still others applied hot irons to the inner thighs. In some cases, clitoridectomies were performed on females, and in a few cases, amputation of the penis was attempted to prevent masturbation in males. Castration was occasionally recommended. Most popular, however, were mechanical devices that the interested could purchase; large numbers of these are listed under the category of medical appliances in the U.S. Patent Office records, including various kinds of devices with metal teeth designed to prevent erection in the male and various kinds of guards to be worn around the genitalia of the female. There were special devices for patients in mental institutions, including a unique pair of gloves that prevented the patient from touching his or her genitals. There was even a device to prevent bedcovers from coming into contact with sensitive areas.66     The system makers were attempting to use scientific knowledge to preserve the status quo of traditional attitudes toward not only sexual issues but sex or gender roles as well. Women were the weaker sex, set apart by biology to bear children as evidenced by their menses. American physicians, in particular, emphasized that menstruation by itself made women special creatures, something the medical men could state with impunity because so little was know about it. Though there was a growing belief that ovulation and menstruation were connected,67 there was uncertainty as to whether the onset of the menses marked ovulation or whether it came afterward. Even as late as the 1890s, when the first experimental work leading to the understanding of human hormones was taking place, American physicians were still discussing the question of whether the ovaries triggered menstruation, whether the uterus was an independent organ and performed the menstrual function without external aid, or whether the falloplan tubes were responsible for the monthly flow.68     In 1861, E. F. W. Plüger (1829-1910) demonstrated that menstruation did not take place in women whose ovaries had been removed, a finding that reinforced the ovarian theory but did not end the debate over the physiology of menstruation, as Pflüger hypothesized that there was a mechanical stimulus of the nerves by the growing follicle that was responsible for congestion and menstrual bleeding. This led him to argue that menstruation and ovulation occurred simultaneously.69 It was not until the twentieth century, when the physiology of hormones was better known, that the timing of ovulation and the stimuli involved were fully understood (see chapter 5). In the meantime, Pflüger's theory that nervous stimulation triggered menstruation was widely accepted.     The theory itself was not unreasonable, based on observations of the influence of stress and tension on menstrual irregularity. But many were not content simply to see this as a possible explanation of the menses. Instead, they used it to erect new theories about the nature and purpose of the female. Leaders in the theorizing were the men who seemed to be most threatened by the changing relationships between the sexes that were taking place in the nineteenth century. One indicator of this change was the successful demand by women to enter into college and universities, something that had been forbidden to them before. Similar demands and changes were occurring in other parts of the Western world, and this new generation of educated women sought to enter the all-male professions. Medical schools found themselves under attack for failure to admit women, and a few women such as Elizabeth Blackwell managed to receive medical training, something that the rank and file of the medical profession opposed, some of them with great hostility. It was in this setting that Edward H. Clarke (1820-77), a physician at Harvard Medical College opposed to the intrusion of women into his profession, set out to demonstrate why menstrual disabilities should make women ineligible for higher education.     In 1873, Clarke wrote that although women undoubtedly had the right to do anything of which they were physically capable, the physiology of being female put natural limits on their opportunities, including going to college. He explained this by stating that while the male developed steadily and gradually from birth to manhood, the female, at puberty, had a sudden and unique period of growth when the development of the reproductive system took place.70 This, he said (following Pflüger), involved special demands on the female nervous system, because it had to work not only on developing the brain, as it did in males, but also on developing the reproductive organs. This made the female different from the male, whose nervous system could concentrate solely on intellectual development. He then argued that because the nervous system could not do "two things well at the same time" it was important for the female between the ages of twelve and twenty to concentrate most of her energy on developing her reproductive system. This implied that females should not devote much time to higher education, because if they did so, the signals from the developing organs of reproduction would be ignored in favor of those coming from the overactive brain.     There was more to his argument than this brief summary, but Clarke eventually concluded that women who concentrated on education rather than the development of their reproductive system underwent mental changes. Not possessing the physical attributes of men, they tended to lose their maternal instincts and become coarse and forceful, with the result that a new class of sexless humans analogous to eunuchs was appearing among women. To solve this alarming problem, he recommended strict separation of the sexes during education, particularly after elementary school. He urged that female schools provide periodic rest times for students during their menstrual periods. The young women would also have shorter study hours, because they were by nature weak and less able to cope.
	A girl cannot spend more than four, or, in occasional instances, five hours of force daily upon her studies, and leave sufficient margin for the general physical growth that she must make.... If she puts as much force into her brain education as a boy, the brain or the special apparatus [i.e., the reproductive system] will suffer.71
Inevitably, he "reluctantly" concluded that women could not be admitted to Harvard Medical School or any intellectual competition with males not only for their own protection but for the preservation of the human race.     Although it seems obvious to today's reader that Clarke was using his own biases and prejudices to construct a theory of female inferiority, it was not so evident to his contemporaries who subscribed to the dispassionate truth of science.72 Even those physicians who challenged the association of menstruation with development of the nervous system, simply replaced it with other theories that emphasized female inferiority and instability. This was the case of John Goodman's theory of the "menstrual wave," 73 which was used by George J. Englemann (1847-1903) in his presidental address before the American Gynecological Society In 1900 to urge that schools for girls should heed the "instability and susceptibility of the girl during the functional waves which permeate her entire being" by providing rest during the menstrual periods.74     Fearful that Clarke and others might be correct, educational institutions that had already admitted women, such as the University of Wisconsin, tried to protect the femininity of its women students in 1877 by officially noting as Wisconsin did that "every physiologist is well aware that at stated times, nature makes a great demand upon the energies of early womanhood and that at these times great caution must be exercised lest injury be done." Although education for women was to be desired, "it is better that the future matrons of the state should be without a University training than that it should be produced at the fearful expense of ruined health; better that the future mothers of the state should be robust, hearty, healthy women, than that, by over study, they entail upon their descendants the germs of disease."75 Perhaps it was because of the fears aroused in young women as a result of such ideas that a number of women were pioneers in American sex research. It was only by undermining the standard assumptions about sex that women could argue that they were not victims of a natural disability.     Because modern sex research began in this setting, it is thus not surprising that one of the problems it had to overcome was this mind-set. Some how, the would-be sex researcher had to find some justification for challenging the prevailing belief pattern without threatening his or her professional image. In a sense, much of the sexual advice literature of the nineteenth century might be regarded as a reaction to the challenges of industrialization and urbanization. It was a kind of a mythologizing of a past that had never existed combined with the hope and expectation that if the tendency to sexual immorality so ever present was kept in cheek, the future would be better. Though it claimed science as the source of its conclusions, it was essentially a new kind of moralizing in which sex had replaced the devil and become the symbol of evil. As indicated in the introduction, the growing urbanization posed new problems and made the observers more conscious of the sins of the flesh than was evidenced in rural villages and towns of earlier years. The growing concentration of population permitted what might have been an isolated case in the village to become the conduct of numerous individuals in the city. Certainly, it increased the numbers of prostitutes, but it also made it easier for homosexual individuals to find each other and to realize that they were not alone in the world.     Industrialization also led to vast displacement of people who lacked the family support and group censorship that had existed in a more encapsu-lated universe. The growing cities were not at first centers for family life; instead they attracted new immigrants, primarily male, who were at the height of their sexual drives and who were much less observant of the intellectualized prohibitions against sex than females. Moreover, it was a time of a double standard, and even St. Augustine, that most antisexual person of the early Church fathers, had argued that prostitution was a necessary evil; just as there had to be sewers to carry of the filth of the city so there had to be prostitutes to carry away the evils of sex, thereby protecting the good women and preventing those who turned to the prostitutes from turning to each other. These problems were not new; they had existed in the Rome of St. Augustine's time, had appeared in fifteenth-century Florence and Venice, and had existed in eighteenth-century London and Paris, but they became much more widespread and universal in the nineteenth century. Courts of law were called on to deal with various kinds of sex behaviors that they previously had ignored and about which they knew little. Judges and political authorities wanted and needed information, and they turned to the medical profession for assistance. Modern sex research then began with what the people of the time called "perversions" and "degeneracy," which, as emphasized, could be interpreted as almost all sexual behavior. It was believed that if science could throw light on these actions, they could be eliminated. There was a consciousness that modern society was somehow different from the past and that new solutions might be needed.     One of the earliest examples in the sex field of the attempt to use scientific data was in the area of prostitution. At least in some countries, government administrators and legislative bodies, motivated by a new sense of responsibility for the well-being of the citizenry, not only in protecting the women in the community but in attempting to limit the spread of sexually transmitted diseases, had rationalized the control of prostitution to a remarkable degree. In Paris, they established municipal guidelines, registration systems, and venereal disease examinations, all under the direction of the police des moeurs. Physicians became involved in the program rather unobtrusively at first, from an administrative decision in 1802 to provide facilities to examine public prostitutes for venereal disease; shortly after this, such examinations were made mandatory. What this Paris legislation did was link the old system of toleration of the necessary evil with an organized method of disease control, one widely copied by other European governmental jurisdictions.76     It was not enough, however, simply to establish new regulations or institutions; there was also concern with how they were working. The physician was the natural person to give answers, since both the growing concern over public health issues and the long-established tradition of medical writing on sexuality gave the physician the status of expert in a society that was often ambivalent about open discussions of sexual matters. Such an ambivalence, however, did not mean that the public was uninterested in gaining information about sex, which seemed to undermine public morality.77     Prostitution especially needed objective study, and it was the investigations of the physician Jean Baptiste Parent-Duchâtelet (1790-1836) into the life of prostitutes in Paris that might be regarded as the pioneer endeavor of modern social science research into sexual topics. Parent-Duchâtelet was the leading public hygienist of the first part of the nineteenth century, a member of the Paris Conseil Général de Salubrité and a founding editor and contributor to the Annales d'Hygiène Publique et de Médicine Légale. Though primarily an expert on sewage and waste disposal, Parent-Duchâtelet conducted a study of prostitution that, when posthumously published, made his reputation. He initiated his study in an effort to go beyond traditional medicine and, in his words, bring the methods of science to the study of people.78     To this end, he gathered information about the 3,558 registered prostitutes of Paris (he excluded the clandestine, part-time, and amateur prostitutes). He found that the inscribed prostitute was in her late teens or early twenties, illiterate, poor, probably illegitimate or from a broken family, and likely to have regarded herself as a prostitute for a relatively brief period. She was also willing to leave prostitution if something better turned up, a finding that has more or less consistently appeared in research into prostitution in Western culture for more than 150 years. Today, this type of research would probably be undertaken by a sociologist, not a physician, but sociology and the social sciences had not yet emerged as independent or specialized fields of study, and the physician was in a position to explore such topics, because he or she was the expert on sexual matters.79 Sex, after all, was a part of anatomy and physiology, and though physicians had always mentioned the subject in their writings, they had shared expertise in the past with priests and canon lawyers. In the new age of science, however, it was the physician as scientist that the public turned to for data.     Many physicians responded, such as the American William Sanger later did, because they were concerned with public health issues, particularly the problem of sexually transmitted diseases. Although it was perhaps somewhat stigmatizing for the male physician who studied prostitutes, it was not a subject that would cause anyone to doubt his masculinity. This was not the case with homosexuality, yet it was homosexuality more than prostitution that consolidated the position of the medical expert. The major development in this field, however, took place in Germany, and it was as a result of the aftermath of these studies that modern sexology can be said to have begun.     Members of the German-speaking medical community had as early as the eighteenth century demonstrated interest in the link between physical disorders and sexual problems. This interest was on a somewhat different basis from Tissot's, because the German physicians were more interested in classifying than Tissot was.80 This meant that a major problem these early investigators faced was defining the kind of sexual behavior with which they were concerned. This was particularly important for those engaged in forensic medicine, because they were called on to advise the courts. Johann Ludwig Casper (1796-1864), whose writings on medical forensics were widely read and translated, described the difficulties he encountered with the term paederastia, often used in medical works and in the courts to describe same-sex activities. Casper held that the such usage was erroneous, because same-sex desires and practices existed between adult individuals and not just between adults and children. Similarly, he felt the word sodomy, often used as a catchall term in the courts and in medical writings, should be limited to bestiality.81 Although he continued to hold that more precision was needed for physicians to make accurate diagnoses, he failed to include any precise diagnoses in the various editions of his handbook on forensic medicine, probably because he himself felt inadequate to do so.82     Physician writers themselves were handicapped by their lack of knowledge about the variations in sexual behavior, and most of them who wrote about it were what might be called antiquarians of sexuality. They mainly assembled a number of different cases about various sexual phenomena, primarily from history and some from their own practice. To explain such behavior, many in the middle of the nineteenth century turned to the philosophical views of Arthur Schopenhauer (1788-1860), who held a deterministic view of human action and motivation. Whatever a person did or does was necessarily an expression of his or her inner will and thus was fixed and unalterable. For Schopenhauer, a wrongful sexual act was an act in which a person by expressing his or her own will denied or inhibited the will of another. Justice consisted of refraining from such injurious acts. What these early German sexologists did not do was any of the kind of analysis associated with the best medical practice of the time. Still, even the Schopenhauer approach established a receptivity to research in the area of sexuality.     The final impetus for more intense medical investigations came from individuals in the German homosexual community. Though homosexual activity and desire have, I believe, existed in every society and time period, the concept of homosexuality is a nineteenth-century one. The acceptance of the notion implies that homosexuals are different from others, that homosexuality is "possessed" by some people and not others,83 a notion that fit in with the ideas of Schopenhauer.     Many of these men and women who were attracted to members of the same sex ended up in law courts for one reason or another, while others made their appearance in the physician's office.     Both the state and physicians wanted answers on how to deal with such individuals.BritainIn this respect, the German-speaking areas were probably no different from other areas of Europe or America. However, Germany was in the process of unification under Prussian hegemony, and Prussian laws on same-sex activitv were different from those in other areas of Germany. Much of western Germany had been influenced by the changes in the civil law wrought by the Napoleonic code, which said nothing about same-sex relationships per se but concentrated on such things as age of consent and use of force to define illegal conduct.84 The Prussian code, on the other hand, made sodomy a crime, and this was interpreted to include same-sex activities. This fear of a possible change in legal status through the incorporation of their home areas into Prussia encouraged some homosexuals to be very vocal. The major figure in focusing this concern was Karl Heinrich Ulrichs (1825-95), perhaps the modern world's first "self proclaimed homosexual."85 The result of his efforts and its implications for sex research are the subjects of the next chapter.
2 HOMOSEXUALITY AND OTHER FACTORS IN BRINGING ABOUT SEX RESEARCH KARL HEINRICH ULRICHS Karl Heinrich Ulrichs, the seminal figure in bringing about new thinking and research on same-sex love, was born August 28, 1825, in Westerfeld, East Friesland, in Hannover. He came from a long line of Lutheran pastors, and both his mother's brother and father served as such, and later one of his sisters married a pastor. His father was an architect in the service of the royal Hannoverian government and died as a result of an accident on a construction site when Ulrichs was ten. Ulrichs attended the University of Göttingen for two years, after which he transferred to the University of Berlin. In 1847, he took his examination to become a civil servant in Hannover and began to advance up the ranks until he rather abruptly resigned in 1854, probably over a homosexual incident.     As he became more conscious of his homosexuality, he, like many homosexuals both before and after him, began an investigation of same-sex attraction in an attempt to find answers. He first tried to explain it in terms of animal magnetism, basing his ideas on the earlier, and generally discarded, theories of Friedrich Anton Mesmer (1733-1815). The more he studied, the more important research into the topic became for him. In February 1862, he wrote an autobiographical statement that he deposited under seal in the Freies Deutsches Hochstift für Wissenschaften, Künste, und Algemeine Bildung (Free German Foundation for Science, Art, and General Culture) in Frankfurt, to which he belonged. In the statement, which has survived, he emphasized the necessity of researching and propagandizing on same-sex love. The necessary first step for him was to make his homosexuality known, and in June of that same year, he told his sister Ulrike that he was attracted to other males, a statement to which she initially reacted with considerable hostility. Undeterred by her reaction, he determined he had to campaign for homosexual rights.     As one of his first efforts, he decided he had to come to the defense of an acquaintance, Johann Baptist von Schweitzer, who had been arrested on a morals charge. Two women had reported to the authorities that they had overheard Schweltzer propositioning an unidentified fourteen-year-old boy in a castle garden. Although the boy never came forward, Schweitzer was convicted on the basis of the testimony of the two women and sentenced to two weeks in jail.* Ulrichs, immediately following the arrest and without asking Schweitzer, began planning a defense, but it was not used. This fallure only emphasized to Ulrichs that homosexuals had to identify themselves publicly. Though his sister was still urging him to change his ways by seeking the help of God, he felt it essential to announce his homosexuality to his family. In September 1862, he sent another letter to his sister, asking her to circulate it to other family members. In it he defended his homosexuality as natural and said that because God had given him his same-sex drive, he had the "right to satisfy it."1 He also began work on the first of his monographs on same-sex love, which was published in 1864. He eventually wrote a total of twelve booklets. The first five were written under his pseudonym, "Numa Numantius," but the later ones, beginning in 1868, appeared under his own name as he publicly emerged from the closet in which homosexuals had hidden. The twelfth booklet appeared in 1879.2 Ulrichs's timing was fortuitous because many in the medical-scientific community were looking for explanations about sexual variation that went beyond the biblical sin model or that could better explain differences than the Tissot masturbation thesis.
	* In spite of his conviction, which might well have been politically motivated, because he was associated with left-wing politics, Schweitzer continued to be active in politics. He later became a leading Social Democrat as well As a prominent writer of popular comedies for the stage.
ULRICHS'S THEORY AND ACTIVITIES     Ulrichs's writings, which he distributed to various professionals, served as the foundation for researchers who were striving to understand homosexuality. Ulrichs put forth a mishmash of mythological, literary, historical, physiological, and other data as well as his own personal beliefs and experience to explain same-sex love and attraction. In all his writings, he argued that what eventually came to be called homosexuality in men was due to a strong feminine element in such men, and this element had been present in them since their birth. Such a person he eventually came to call an urning, a term he derived from the speech of Pausanias in Plato's Symposium:
	For we all know that love is inseparable from Aphrodite, and if there were only one Aphrodite there would be only one Love; but as there are two goddesses there must be two Loves. And am I not right in asserting that there are two goddesses? The elder one, having no mother, who is called the heavenly Aphrodite -she is the daughter of Uranus; the younger, who is the daughter of Zeus and Dione- her we call common.... The Love which is the offspring of the common Aphrodite ... is apt to be of women.... But the offspring of the heavenly Aphrodite is derived from a mother in whose birth the female has no part.... Those who are inspired by this love turn to the male.3
According to Greek mythology, life had begun when Gaea (Earth) and Uranus (Heaven) burst out of the silver egg formed in the divine ether. The two elements copulated, giving birth to Cronos and other Titans. Uranus, however, hated children, and as they were born, he confined them in Tartarus, a place beneath the earth, as far below Hades as heaven was above. Eventually, they rebelled, and Uranus was castrated and dethroned by Cronos, the father of Zeus, Poseidon, and Hades, among others. One of Uranus's children was Aphrodite, who sprang to life from the foam gathering around his limbs and thus was not of woman born.4     Ulrichs assumed that all urnings were like himself and that any love that is directed toward a man, even though it is by another man, is necessarily a woman's love. This suggested to him that the source of such a feeling in a male must be traced to a strong feminine component in that man. He argued that just as the hermaphrodite was a creature of God and part of nature, so were urnings. He held that the sexes in utero were the same up to a certain stage of development, after which a threefold division took place into male, female, and urning (or urningin, the female counterpart), this last group being made up of individuals who had the physical features of one sex but whose sexual instinct failed to correspond to their sexual organs. The result was an inversion of sexual desires. Ulrichs also believed that the line of differentiation between males and females had been overemphasized; as proof, he pointed out that normal males had rudimentary breasts and normal females a rudimentary penis. Many people, not only hermaphrodites, failed to develop along expected lines, and so it seems easily understandable to him, and he thought it should be to others, why a person might have the body of one sex and the soul of another.     Though his relatives had tried to discourage him from disseminating his ideas publicly, he explained,
	I believe that I owe it to my poor and, from my standpoint, innocently persecuted comrades-in-destiny. I shared my idea with several of them and they think the publication an urgent necessity. For my part, too, I feel the need finally to present openly a justification of myself against all the humiliations that have been laid onto me up to now, against which I do not know what else to set.5
Ulrichs had ambitious plans to follow up the publication of his first five booklets with an organization for urnings and even a periodical devoted to timings. He petitioned the congress on German law held in Graz in 1865, urging the abrogation of the articles in the Prussian code dealing with homosexuality. This petition had been rejected by the organizers as not suitable for consideration by the congress.     His activities were interrupted by the Prussian invasion and annexation of Hannover in 1866. Ulrichs spoke out publicly against this action and was twice imprisoned. Exiled from Hannover on his release from prison in 1867, Ulrichs went to Munich to resume his earlier fight. Undeterred by his 1865 rejection, he again petitioned to be heard in the 1867 Munich congress on German law. Though his request was denied, he was allowed to protest formally the exclusion of his proposal at the closing meeting of the General Assembly on Thursday, August 29. He began by emphasizing the need for legal uniformity, and to this end, he urged the German jurists to follow the Napoleonic code in dealing with a specific class of persons "to which many of the greatest and noblest intellects of our and other nations have belonged." At this point, his speech was interrupted by catcalls, and he left the platform without formally presenting his plan. In the aftermath of the incident, however, Ulrichs dropped the pseudonym of Numa Numantius and turned to using his own name, an action that makes him the first out-of-the-closet homosexual man in modern history.6 His attempts at the German legal congresses to gain legal recognition for homosexuals are today also regarded by homosexuals as marking the beginning of the public movement for homosexual emancipation.7 INFLUENCE ON THE MEDICAL COMMUNITY     Ulrichs sought allies everywhere, particularly in the medical community. In 1867, he believed he had found just such an ally in Richard von Krafft-Ebing, who had already written on the need for scientific investigation of those sexual behaviors currently being dealt with in the German courts.8 Encouraged by the tone of Krafft-Ebing's writing, Ulrichs sent him his own publications on homosexuality, and these helped focus Krafft-Ebing's developing concepts of homosexuality and other stigmatized behaviors. Some indications of the influence of Ulrichs on Krafft-Ebing is indicated in a letter Krafft-Ebing wrote to him on January 29, 1879:
	The study of your writing on love between men interested me in the highest degree . . . since you . . . for the first time spoke openly about these matters. From that day on, when -I believe it was in 1866- you sent me your writing, I have devoted my full attention to this phenomenon which at the time was as puzzling to me as it was interesting; it was the knowledge of your writings alone which led to my studies in this highly important field9
Also influenced by Ulrichs's writing was Carl Westphal (1833-90), the physician usually given credit for putting the study of stigmatized sexual expression on a "scientific" basis with his 1869 article in the Archiv für Psychiatrie und Nervenkrankheiten.10 Westphal described at length two cases: The first was of a young woman who from her earliest years liked to dress as a boy and engage in boys' games and who found herself attracted only to women; the second was of a man who wanted to wear women's clothes and act the part of a woman. In attempting to give a diagnostic category to these cases, Westphal coined the phrase Konträre Sexualempfindung, usually translated as "contrary sexual feeling." In spite of the new term, Westphal based his assumptions on Ulrichs's theories. He cited the early work of Ulrichs and knew the term urning. Westphal also agreed with Ulrichs that such an "abnormality" could be congenital, not acquired, and that in such cases, it should not be termed a vice. Still, Westphal emphasized that it was possible only in a few isolated cases to be a homosexual without pathological symptoms, although his illustration of these cases allowed more exceptions than might appear on the surface. He stated, for example, that though there are pathological stealing, murder, and sexual aberrations, there are also nonpathological cases of theft, murder, and variant sexual behavior. In fact, he predicted that if section 143 of the Prussian legal code condemning homosexuality was ever repealed and the "ghost" of imprisonment removed as a threat, many more homosexuals would come to the physician's office for treatment. Here, in his mind, was where they should go instead of to prison. Westphal's work marks the beginning of the medicalization of homosexuality, and though the writings of Ulrichs had served as a basis for information and conceptualization, scientists such as Westphal fit those ideas into their own illness-oriented approach.     Ulrichs eventually came to regard Krafft-Ebing and Westphal as opponents, holding that their observations had come primarily from work with individuals in lunatic asylums or jails and that they had never seen healthy urnings or urningins. Still, both essentially adopted the core of Ulrichs's theory, namely, the congenital nature of at least some forms of homosexuality.     It was, however, not Ulrichs's term, or variants of it, or even Westphal's concept of contrary sexual instinct that carried the day but, rather, one developed by another self-appointed defender of homosexuality: the German-Hungarian writer Karl Maria Benkert (1824-82), who in 1847 was formally authorized to use the noble name of his family - Károly Mária Kertbeny. It is as Kertbeny that he is most generally known. The first appearance of the words homosexuality and heterosexuality appear in the draft of a private letter Kertbeny wrote to Ulrichs on May 6, 1868.11 From 1869 to 1875, Kertbeny lived in Berlin, and while there he also published two anonymous pamphlets encouraging the repeal of section 143 of the Prussian legal code and, more important, opposing the adoption of it as section 152 by the North German Confederation. In these pamphlets, he used the terms Die Gleichgeschlechtlichen ("those of the same sex") and Der Gleichgeschlechtlicher Akt ("the same-sex act") as well as the word homosexual, which he coined to distinguish such individuals from those who were heterosexual.12 Kertbeny was not particularly interested in what caused homosexuality but in getting legal barriers against homosexuality removed. He wrote, "As much as we pride ourselves that ours is a time when science rules, when no riddle of nature goes unsolved, we must in shame admit precisely in regard to the apparent riddle of nature that scientific research, with a prudery held to only here, has up to now not once come near the subject."13     Kertbeny proved no more successful than Ulrichs in influencing German lawmakers, and after the unification of Germany in 1871, the offending paragraph became section 175 of the German imperial legal code. But he was successful in another regard. The term homosexuality, with the Greek prefix grafted onto the Latin root word, was adopted and popularized by Krafft-Ebing, and as a consequence, the term was distinguished from other activities and behaviors with which it had previously been lumped, including bestiality, sodomy, and pederasty. For a time, Westphal's term contrary sexual feeling was used by some medical and scientific writers, including Albert Moll, but that term was eventually dropped because of its imprecision. Though Ulrichs's terms were more precise, his nomenclature had become increasingly complicated as he coined new words to describe a number of forms of behavior. His terms were also associated with certain assumptions about same-sex love with which a researcher might feel uncomfortable. Other terms were also used, such as Havelock Ellis's sexual inversion, and for a time, the term third sex was popular; but it was homosexuality that was adopted as the medical term, primarily because of the influence of Krafft-Ebing. KRAFFT-EBING The most significant medical writer on sex of the last part of the nineteenth century was Richard von Krafft-Ebing (1840-1902). He was the oldest of four children born into the aristocratic Krafft-Ebing family of Mannheim, and he had the hereditary title of Freiherr ("baron"). His mother was the daughter of a renowned Heidelberg lawyer, and when Krafft-Ebing attended the University of Heidelberg, he lived with his maternal grandparents. It was while living there that he developed an Intense interest in criminal cases involving "deviant" sexual behavior, a subject of great interest to his grandfather as well. To pursue this interest, Krafft-Ebing turned to medicine and became a psychiatrist, or alienist -a nineteenth-century term used to describe those treating mental patients. At the age of thirty-two, he was appointed professor of psychiatry at Strasbourg and subsequently occupied similar positions at Graz and, in 1889, at Vienna. He died on December 22, 1902, near Graz.14     Edward M. Brecher, who wrote a popular study of modern sex research, viewed Krafft-Ebing as an unmitigated disaster, a psychiatrist who, "without a shred of evidence," compared a lust murderer with a fetishist who wore white kid gloves or high-heeled shoes. This is a harsh and unjustified condemnation of Krafft-Ebing, who tried his best to keep up with the latest research in sex.15     Krafft-Ebing, however, was very much a man of his own time. He accepted at face value the widely acknowledged belief of the dangers of masturbation and thought it to be a source of mental illness and sexual pathology. Still, as a scientist, he also tried to incorporate into his system the latest findings. To do so, he combined several prevailing nineteenth-century theories: the idea that disease was caused by the physical nervous system, the belief that there were often hereditary defects in this system (hence some forms of homosexuality), and the concept that degeneracy can result from overstressing the system through such activities as masturbation. He distinguished between innate and acquired perversions, but eventually held that even acquired perversions could exist only when there were hereditary weaknesses in the nervous system, such as epilepsy. He argued that there was a strong association of an intense sexual instinct with epilepsy, which often led to sexual perversity during or following an attack. Though he accepted this association, he also emphasized that those who believed the epileptic element was present in all cases of "peculiarity" of sexual life were wrong.16 In fact, shortly before his death, he wrote an article in the Jahrbuch für Sexuelle Zwischenstufen in which he said that homosexuality was not a manifestation of degeneracy or pathology but could occur in otherwise normal subjects.17     Krafft-Ebing, in short, was struggling to bring greater understanding to the field of human sexuality but was very much a prisoner of his own cultural assumptions. So, it might be added, were most of the other scientists of the time. Charles Darwin, for example, also subscribed to the idea that sex was part of the nervous system.18     To his credit, Krafft-Ebing early recognized the importance of the sex drive. Sexuality for him was the "most important factor in social existence, the strongest incentive to the exertion of strength and acquisition of property, to the foundation of a home, and the awakening of altruistic feeling, first for a person, then for the offspring, and in a wider sense for all humanity"19     Still, he saw the essential purpose of sex as reproduction and believed all sexual activities lacking this ultimate purpose were "unnatural practices" and a perversion of the sexual instinct, even though such perversions often resulted from inborn characteristics. Moreover, even though sex was important, civilization had been made possible only by the tempering of lust through altruism and restraint. Religion, law, education, and morality had given civilized people the means to restrain their passions, yet both men and women were always in danger of sinking from the clear height of pure and chaste love into the mire of a common sensuality. To maintain morality, men and women had to fight a constant struggle with natural impulses: "Only characters endowed with strong wills are able to completely emancipate themselves from sensuality and share in the pure love from which springs the noblest joys of human life."20 It was on just such assumptions that Freud laid the foundation of psychoanalysis, arguing that in the struggle to emancipate themselves from sensuality, men and women repressed their sexual drives rather than coming to terms with them.     To illustrate his theories, Krafft-Ebing presented a number of clinical case studies, 238 of them by the twelfth edition of his Psychopathia Sexualis.21 Homosexuality was just one of four broad categories of sexual variation that Krafft-Ebing discussed at length and to which he gave names that are still used. The others were fetishism, sadism, and masochism, and his attempts to analyze them were similar. If someone had given a name to a phenomenon, as Kertbeny had to homosexuality, and it seemed a good term to him, he kept it. He read extensively on what others had to say, collected his case studies, and arrived at his conclusions.     BritainFetishism, for example, was a term that had initially been coined by the French psychologist Alfred Binet (1857-1911).22 Krafft-Ebing adopted the term but not all of Binet's assumptions. He went on to describe the behavior as the peculiar or unreasonable fascination and sexual meaning that objects, or their parts or simply their oddities, had to some individuals because of their association to something else. Much of such association came through masturbatory fantasies, a causal factor in which he originally strongly believed, but he later proved willing to modify this belief somewhat.     When he could find no other suitable term, Krafft-Ebing coined his own. The term sadism he borrowed from the attitudes expressed in the novels of the Marquis de Sade (Donatien Alphonse Frangols de Sade, 1740-1814).23 Krafft-Ebing defined it as an act of sexual arousal (Including orgasm) produced by inflicting pain. Masochism, he defined as opposite of sadism, namely the desire to suffer pain and be subjected to force. He again turned to a literary figure for his term, this time the writings of the Austrian Leopold von Sacher-Masoch (1836-95), who was a historian, dramatist, and novelist. Sacher-Masoch's fictional writings became stereotypes, almost always featuring a woman in furs (he had a fetish for fur) who, with a whip, symbolic of lust, scourged her male lover for his animal lusts. In his classic Venus in Pelz, Wanda and Gregor are, respectively, the active and passive participants in flagellation,24 the reversal of traditional character traits, because Krafft-Ebing held that sadism was a pathological intensification of the masculine character and masochism a pathological degeneration of the female character.     Krafft-Ebing also gave brief expositions on satyriasis, nymphomania, necrophilia, incest, and pedophilia, but these topics were primarily discussed in terms of the legal implications. The significance of Krafft-Ebing to the study of sexual behavior was the large number of variant acts that he brought out into the open and made the subject of public discussion. This was contrary to his expressed intentions, namely helping his fellow physicians to cope better with the sexual problems of their patients and to aid the courts in dealing with various forms of sexual behavior. In fact, when he found that not only professionals were reading his book but the general public as well, he tried to make the book more "scientific" (and obscure?) by using more technical language and putting the specific descriptions of sexual acts into Latin. Even with these changes, he was often condemned for delving into human sexuality as a scientist and physician. The typical attitude, even among his colleagues, was expressed in an 1893 editorial in the British Medical Journal about an English translation of Psychopathia Sexualis:
	We have taken some time to consider whether we should notice this book or not, and have, in the end, decided that the importance of the subject and the position of the author render it necessary to refer to it. it is, we believe, unique in the fullness with which the subject has been treated, but we question whether it need to have been translated. Anyone wishing to study the subject might just as well have gone to the original, and some may be disposed to go even further and regret that the whole had not been written in Latin, and thus veiled in the decent obscurity of a dead language. There are many morally disgusting subjects which have to be studied by the doctor and by the Jurist, but the less such subjects are brought before the public the better.25
OTHER MEDICAL RESEARCHERS Once Westphal and particularly Krafft-Ebing established the importance of the medical study of sexuality, other physicians, encouraged by their example, turned to the study of sex in spite of the prudishness of many of their professional colleagues. They usually argued it was essential to investigate sexual behavior to deal with patient problems. Although most of them continued to look on much of sexual behavior as pathological, not all of them agreed with KrafftEbing's explanation. A major disagreement arose between Krafft-Ebing and Binet, who, using fetishism as an example, argued that the medical appeal to the hereditary nature of perversions ignored the question of how such behaviors had been acquired by a given patient's ancestors. Drawing on the case histories of Westphal and Krafft-Ebing as well as those of some of the French allenists, such as Jean-Martin Charcot (1825-93), Binet emphasized early childhood experiences. Though he recognized that each child might be affected differently by the same experience, he held that there was a congenital "morbid state" in those adults adversely affected by a childhood experience.26 For him the major forms of sexual pathology -from homosexuality to fetishism- were specifically determined by chance events, and a fetishist could have become a homosexual given exposure to a different determining event.     This theory, known as associationism, was later abandoned by Binet, who went on to develop the intelligence scale and become a key figure in functional psychology, a movement that attempted to interpret phenomena with reference to the part they played in the life of the organism rather than describe or analyze the facts of experience or behavior. Nonetheless, associationism had considerable influence on some of the teachers of Freud as well as others.27 For example, Albert von Schrenck-Notzing (1872-1919), who adopted some of the theory, claimed that he could cure some homosexuality by hypnotism and suggestion therapy. At the First International Congress on Hypnotism held in Paris in 1889, he reported on a homosexual from a tainted family whom he had successfully treated in forty-five hypnotic sessions over a four-month period.28 Von Schrenck-Notzing continued his experiments, and three years later he reported on some seventy other cases of homosexuals and patients with other stigmatized sexual behaviors; he claimed he had been able either to cure them or to reduce their urges. He then held that if homosexuality could be cured by such external influences, then it as well as other "pathological" sexual behaviors might be acquired through influences such as those posited by Binet.29 Others built on this concept, emphasizing that precocious childhood sexual experiences, even though forgotten, may persist in the unconscious and ultimately form the psychological foundation of adult sexual experience.30     Krafft-Ebing came to believe that the associationist theory had some plausibility, particularly for fetishism. He thought, however, that it was unable to explain how an accidental childhood sexual association, even in the most precocious individual, could by itself lead to sadism or masochism and stated that in most cases acquired sexual anomalies were rare. This nature-versus-nurture argument was also tied into Darwinian evolutionary views, and in this sense, Krafft-Ebing was seen as a subscriber to Darwin's evolutionary theories, and he held to the belief in the transmission of marked moral qualities.31     Ellis summarized the developments in sexology up to Krafft-Ebing's time:
	It was during the second half of the nineteenth century, when a new biological conception, under the inspiration of Darwin, was slowly permeating medicine, that the idea of infantile and youthful "perversion" began to be undermined; on the one hand the new scientific study of sex, started by the pioneering work of Krafft-Ebing at the end of the third quarter of the century, showed how common are such so called "perversions" in early life while, on the other hand, the conception of evolution began to make it clear that we must not apply developed adult standards to undeveloped creatures, what is natural at one stage not necessarily being natural at the previous stage.32
The gradual acceptance of evolution, however, led to a growing acceptance of what Frank Sulloway, a biographer of Freud, called the biogenetic views of homosexuality. Many of the theorists in this area were Americans who emphasized the original bisexuality of the ancestors of humans.33 One of those who put it most clearly was James G. Kiernan (1852-1923), the medical superintendent of the Chicago County Asylum for the Insane. He wrote:
	The original bisexuality of the ancestors of the race, shown in rudimentary female organs of the male, could not fail to occasion functional, if not organic, reversions when mental or physical manifestations were interfered with by the disease or congenital defect....It seems certain that a femininely functionating brain can occupy a male body, and vice versa. Males may be born with female external genitals and vice versa. The lowest animals are bisexual and the various types of hermaphrodism are more or less complete reversions to the ancestral type.34
Going further was another American physician, G. Frank Lydston (1857-1923), who held that the worst types of perversions could be blamed on either maldevelopment or arrested development, with the most severe sexual aberrations making an appearance before the commencement of sexual differentation.35 In a sense, these Americans were reflecting what Cesare. Lombroso had earlier proclaimed, namely a biogenetic evolutionary view of criminality and deviance. Lombroso held that the "criminal type" had been born, not made, and that the criminal was an atavistic being who reproduced in his or her person some of the instinct of primitive humanity and inferior animals.36 These American physicians, however, were not adopting the atavistic view of Lombroso but instead a developmental view that could be influenced by in utero developments. In this, they were more likely to follow Ulrichs than Lombroso. This view was summed up by Krafft-Ebing shortly before his death:
	In view of the realization that contrary sexuality is a congenital anomaly, that it represents a disturbance in the evolution of the sexual life towards monosexuality and of normal psychical and somatic development in relationship to the kind of reproductive glands [possessed by the individual], it is no longer possible to maintain the idea of [degenerate] "disease" in this connection.... Not infrequently one runs across neuropathic and psychopathic predispositions among homosexuals, for example, constitutional neurasthenia and hysteria ... which may lead to the most severe aberrations of the sexual impulse. And yet one can prove that, relatively speaking, heterosexuals are apt to be much more depraved than homosexuals.37
THE THREE ALBERTS: MOLL, EULENBURG, AND VON SCHRENCK-NOTZING ALBERT MOLL     Supporting Krafft-Ebing in his changing view was Albert Moll (1862-1939), a Berlin physician who paved the way for a number of Berlin investigators into the field of sex. In 1891, Moll published Die Konträre Sexualempfindung, in which, following Krafft-Ebing, he differentiated between innate and acquired homosexuality. Much earlier than Krafft-Ebing, he put an emphasis on the innate, arguing that because all biological organs and functions are susceptible to variations and anomalies, there is no reason why the sexual instinct should be any different. He described the homosexual as "a stepchild of nature."38 Moll was highly critical of the belief that early sexual activity was an important correlate of later perversion. He questioned the dangers of masturbation, emphasizing that mutual masturbation was often practiced in childhood by individuals who showed no signs of inversion.39     Moll broke new paths by comparing normal and abnormal sexual developments side by side because he argued that it was the failure of sexologists to study normal sexuality that led to their disagreements about abnormal forms. Moll posited that two major instincts were involved in the sexual impulse: Detumescenztrieb ("detumescence drive") and Contrectationtrieb ("drive to touch, fondle, or kiss the sexual object").40 The former was fundamentally individualistic, while the latter was social. Moll theorized that primeval organisms, which reproduced asexually by fission or budding, possessed only the instinct of detumescence but that higher organisms, which reproduced by conjugation or sex, have acquired the instinct of contrectation as well. In sexually reproducing animals, the instinct of detumescence was no longer sufficient to guarantee reproduction and had to be supplemented by the instinct of contrectation, closely resembling what we call love. Love itself was thus a byproduct of the evolution of sex. Either impulse could emerge first, but both impulses emerged well before puberty in sexually normal individuals. He wanted to "destroy" the belief "that physical puberty is a necessary preliminary condition for the sexual inclination of male and female. On the contrary, as has already been mentioned several times, the psychic element, in a number of cases, may develop much earlier than physical puberty."41 He admitted, however, that it was often difficult to draw the line between sexual and social feelings before puberty, although even in extreme cases, the love of the child for its mother may always be distinguished from the sexual love of the child for another.     While shame, jealousy, and preferential expressions of love are all affected by the child's sexuality,42 children may also have erections and begin masturbating as early as the first or second year of life, because both detumescence and contrectation impulses may emerge precociously in one and the same child. He adopted, with modifications, the two-stage theory of sexual development put forth by Max Dessoir (1867-1947). Dessoir had called the first stage the undifferentiated stage; this appeared in girls between the ages of twelve and fourteen and in boys between thirteen and fifteen. During the first stage, the sexual instinct could express itself in either a heterosexual or a homosexual manner or even turn toward animals, but this was followed by the second stage -differentiation- in which heterosexual relationships become the exclusive goal of the libido. Some individuals, however, remain in an embryonic state and continue to express homosexual, bisexual, or other inclinations as adults.43 Moll insisted that the undifferentiated stage went back into early childhood, and this might well include same-sex love, but at puberty, when differentiation took place, most selected their love object from members of the opposite sex.44 The failure to develop normally he felt was due to congenital weakness or susceptibility to various forms of perversions, although even the details of these perversions might be influenced by habits formed early in life so that each might respond to his or her congenital weakness in a slightly different way.45 These concepts eventually led him to place more stress on homosexuality as an illness. By 1911, he was offering a cure for acquired homosexuality through association therapy, in which he replaced same-sex associations with those of the opposite sex.46 Part of his changing opinion might have been influenced by his opposition to Hirschfeld; he eventually became the major opponent of Hirschfeld, as recounted later in this book. In fact, in spite of his contributions to sexual theory and the high regard in which he was held by Ellis and others, particularly for his early work, Moll did not get along well with the later generation of sex researchers. He was critical not only of Hirschfeld but of Freud. It might well be that his disagreements with Freud later caused him to be ignored by most English-speaking sex researchers, because Freudian ideas became so dominant in the English-speaking world in the first half of the twentieth century. ALBERT EULENBURG     Albert Eulenburg, another prominent physician, first wrote about sex in 1895 but became more deeply involved as a significant figure in sex research only because of criticism of his twenty-six-volume Real Encyclopädie für Medizin.47 This was because his multivolume comprehensive overview of medicine was singled out by Hermann Rohleder in 1901 as an example of the way in which the medical profession still managed to ignore sexual issues.48 Eulenburg responded to these criticisms by demonstrating his expertise on such matters through publishing a series of studies on sadism and masochism, although he used the term algolagnia,49 a term put forth by another German sex researcher, von Schrenck-Notzing.50 ALBERT VON SCHRENCK-NOTZING     Von Schrenck-Notzing is perhaps typical of this growing group of physician researchers in emphasizing that without careful study of the circumstances attending the development of sexual anomalies, the physician would never be in a position to give treatment. He held that behaviors such as homosexuality were not inborn but resulted from suggestion and that the individual with such behavior would be open to a similar cure by hypnosis. He claimed to have been able to cure a number of homosexuals through this method, but he also said that he occasionally had to turn to more direct methods to force a new direction in the behavior of the "invert." One of his cures was to take a patient off to a brothel, where he persuaded the prostitutes to bring all their erotic arts in an effort to achieve heterosexual desire. AMBIVALENCE OF RESEARCHERS Generally, the physician researcher approached sexual topics gingerly, conscious of societal ambivalence about sexuality, although not always of their own prejudices. Sex was something to be controlled and not liberated, and the physician had to be aware of this; in fact it might well have been the fear of unbridled sex that led some of them to class so many sexual activities as pathological. The use of such stigmatizing terms emphasized that although they investigated sexual problems, they themselves were very conscious of the evils of some of the conduct they wrote about. Krafft-Ebing, for example, reflects the ambivalence of his own southern German Catholic upbringing in his discussions of sex. For him, unbridled passion resembled a "volcano which scorches and eats up everything, or an abyss wherein everything is walled up-honor, property, health. [By establishing monogamous marriages and reinforcing religious bonds] the Christian peoples obtained a spiritual and material pre-eminence over other peoples, particularly those of Islam."51 Krafft-Ebing was simply expressing the classical Christian dualism between the spirit and the flesh. The flesh, of which sex was a part, was weak, always threatening to pull men and women from contemplation of higher things of the spirit into the gutter and sewers of fleshly existence.52      BritainThe mind or spirit, however, is capable of controlling and should control the desires of the physical body, and the community is better off if the volcano of unbridled passion is dormant. Krafft-Ebing stressed the need for scientific description of various sexual pathologies over the need for new theory, because to connect other impulses and voices of the soul with sexual drives was to enlarge the sphere of the latter and detract from the magnificence of the former. Indeed, when greeted with the news of Freud's 1896 attempt to track the origins of hysteria to childhood sexual development, Krafft-Ebing responded that Freud's work sounded "like a scientific fairy tale."53     In fact, the growing possibilities of a confrontation between traditional religious ideology and the new findings about sex emphasize another important factor in the growth of sex research: the need for an attitude about sex that could go beyond the traditional Christian dualistic ones that had influenced Tissot and his followers and that continued to be dominant in most nineteenth-century studies. The key missing ingredient was a willingness to accept sexuality, not just procreation, as a fact of life; a willingness to look on sex as a vital physical force that was capable of doing more good than harm; and a willingness to see it as one of life's pleasures. Krafft-Ebing had struggled to come to terms with a need for change but had not quite succeeded. Though there was a growing middle class willing to accept pleasure as an important element in their lives, the medical community as a whole either saw no need to challenge or were unwilling to challenge traditional ideology.54 EUGENICS There was a growing demand for better information about sexuality that was not so much concerned about changes in laws about homosexuality as in a better understanding of the relationships between the sexes. The British eugenicist Karl Pearson (1857-1936), for example, called for a new "science of sexualogy" to emerge to help society decide what the status of women should be:
	Not until the historical researches ... [and] anthropological studies ... have been supplemented by careful investigation of the sanitary and social effects of past stages of sex-development, not until we have ample statistics of the medico-social results of the various regular and morbid forms of sex-relationship, will it be possible to lay the foundations of a science of sexualogy. Without such a science we cannot safely determine whither the emancipation of women is leading us, or what is the true answer which must be given to the woman's question.55
Eugenicists in fact served as a political pressure group, and many of the British and the Americans who wrote about sex at the turn of the century had some connection with the eugenics movement. Unfortunately, the eugenicists were often zealots for a certain elitist viewpoint about the status and conditions of the poor, disabled, and minorities of the world, and though this background is sometimes difficult for sexologists to acknowledge, it is nonetheless there. The eugenicist represented the attitudes of a large segment of middle-class professionals, and their concerns helped bring discussion of sexuality out into the open.     The movement had been founded by Sir Francis Galton, a major figure in nineteenth-century science. Galton, through his studies of gifted individuals, came to believe that heredity played an essential part in the development of individuals of unusual competence (that is, geniuses). To encourage both study and policy development, he founded what he called the science of eugenics -the study of forces under social control that enhance or impair the inborn qualities of future generations. The purpose of eugenics was a deliberate attempt to increase from one generation to another the proportion of individuals with better-than-average intellectual endowment.56     Pearson not only was the founder of the twentieth-century science of statistics but was Galton's disciple and advocate. Galton wanted to concentrate on the elite, but Pearson decried the high birth rate of the poor, which he felt was a threat to civilization. He believed that it was essential that the "higher races" supplant the "lower."57 Although the English Eugenic Society, founded by Galton, eventually opposed Pearson's racist views, large sections of the eugenics movement continued to hold racist and antipoverty views, and the American eugenics movement, founded in 1905, initially adopted Pearson's view wholeheartedly.58     As a group, the American eugenicists believed that the "white race" was superior to other races and that within the white race the Nordic white was superior to other whites. It was also assumed that upper-class people had superior hereditary qualities that justified their being the ruling class. To document this assumption, eugenicists gathered all possible evidence supporting their interpretation, including the results of intelligence tests, which had been introduced in the early 1900s by Binet. In spite of the opposition of Binet himself to what he regarded as a misuse of his tests, the eugenicists held that such tests measured the innate, genetic intelligence of individuals. On the basis of such tests, eugenicists classified all people whose IQs gave them a mental age of twelve as feebleminded or morons, without regard to the educational backgrounds or deprived environments that might have led to such test results. Criminality was considered a concomitant of feeblemindedness. Insane, idiotic, imbecilic, feebleminded, and epileptic persons at the urging of the eugenicists were often sterilized -elther voluntarily or involuntarily- and so in some cases were habitual criminals, "moral perverts," and others deemed socially undesirable.59     Although the development of genetics undermined many of the simplistic assumptions of the eugenicists, such views were not vanquished. They were particularly important in sex education in the United States, and many of the boo dealing with sex in the United States as late as the 1940s were published by eugenic groups or the Eugenics Press. The eugenicists were particularly concerned with what they regarded as sexual perversion, which they equated with certain races and peoples, and so they seized on Ulrichs's ideas of genetic causes to include "sexual perverts" in their category of inferiors.     Though Galton's purpose had been to encourage the "better people" to reproduce more, the eugenicists also mounted campaigns to prevent the "lower elements" -that is the poor, blacks, immigrants, and so forth -from producing so many children. Much of the early contraceptive movement inevitably became involved with the eugenicist movement, even though individuals such as Margaret Sanger did not agree with them. Although most of the racial and class overtones have long since been removed from the current generation of Planned Parenthood programs, lingering suspicions about family planning still exist among some of the more militant representatives of minorities. The eugenicists generally were interested in contraceptives not so much for the upper classes but for the poor. It should be emphasized, however, that there were many other individuals and groups working for better contraceptives and more effective sex education who had entirely different viewpoints. Many of the early feminists, for example, were concerned with helping the overburdened mother who did not want to have additional children, and a number of people were interested in helping women in general overcome what was called their biological destiny.     Still, the activities of the eugenics movements in promoting certain sexual ideas as well as the efforts of Ulrichs to legitimatize homosexuality emphasize that much of the research about sex was not conducted by disinterested, dispassionate scientists. Sexual activity, as was stated in the introduction, had all kinds of political overtones, and in looking at developments In sex research, it is important to look at the agendas the individual researchers had and just how much such agendas influenced their findings. Fortunately, there were competing agendas; the eugenicists, for example, were countered somewhat by both feminists and radicals, and those trying to advance homosexual rights were opposed by the heterosexual moralists. Occasionally, the competing groups came together, but it is important and essential in any discussion of human sexuality to try to separate the rhetoric from the data. PORNOGRAPHY CatholicismThis separation was more difficult in the last part of the nineteenth century than it had been earlier or than it became later, because much writing about sex had come to be classified as pornography by the state. Though unofficial censorship had existed since books began to be widely circulated and official Church censorship had existed since the Catholic Index had been established at the end of the sixteenth century, the state itself generally did not get involved until the nineteenth century. The first laws against pornography in England were passed in 1853 and then supplemented in 1857 by Lord Campbell's Act. The laws gave magistrates the power to order the destruction of books and prints if, in their opinion, publication would amount to a "misdemeanor proper to be prosecuted as such"60 The meaning of what constituted pornography was further extended by the so-called Hicklin decision in 1868, In which Sir Alexander Cockburn wrote that the test of obscenity was whether the "tendency of the matter as obscenity is to deprive and corrupt those whose minds are open to such immoral influences and into whose hands a publication of this sort may fall."61 Unfortunately, such a decision potentially meant that whether or not something was pornographic would depend on whether a child could read it or, in Victorian times, whether a woman perchance might see it.     Almost immediately, pamphlets giving birth control information came under attack as pornographic, as did many treatises on sex, including for a time those written by Ellis. In United States, the person identified most with the new repression of information about sex was Anthony Comstock (1844-1915), who, with his supporters, not only managed to lobby through Congress a law governing the depositing of "obscene materials" in the U.S. mail but also got himself appointed a special agent of the post office. Not every publication on sex was obscene to Comstock, because those "properly" condemning sexual activity were not censored; however, serious discussions of contraception, prostitution, and other facets of sex that were aimed at the general public were regarded by him as obscene. Often quite detailed descriptions of such things as masturbation were approved by him if they were negative enough.     Although Comstockery, as the movement he was identified with came to be called in the United States, put serious difficulties in the path of any open discussion of sex, the United States in many ways remained more liberal in its publication policies than England, providing such literature did not enter the malls or through certain ports of entry, in particular New York City, where Comstock was headquartered. Comstockery was more than Comstock himself and might be taken as symbolic of the fears that many Americans had about the growing evil believed to be present in the rapidly growing cities where traditional morality was under attack. Comstock seems to have been somewhat of an innocent, basically unaware of many forms of sexuality, and in a sense, he was like the mythical little Dutch boy, putting his finger in the dike to keep the floods of sexuality at bay. OSCAR WILDE Sometimes the late-nineteenth-century response to sex, popularly called Victorianism, was like the three monkeys who saw no evil, spoke no evil, and heard no evil. This did not mean that evil did not exist, and neither did Victorianism mean that sexuality and sensuality were not present. In fact, there were a number of events that brought the unmentionable to public attention, despite all efforts of a Comstock to prevent this. One such event in the English-speaking world was the charges of homosexuality leveled against Oscar Wilde (1854-1900). His subsequent trial received widespread public attention throughout the Western world. Wilde, poet, novelist, playwright, and founder of an aesthetic movement of "art for art's sake," had long hair, wore flamboyant clothes, and like Andy Warhol nearly a century later, was a superb self-publicist. His attention-getting behavior led to his being satirized in the Gilbert and Sullivan operetta Patience in 1881 and in such magazines as Punch. It also made him a popular lecturer. In 1891, he became sexually involved with Lord Alfred Douglas, the handsome son of the marquess of Queensberry, now remembered for his boxing rules. Believing that Wilde had drawn his son into homosexuality, the marquess brought matters to a head in February 1895 by leaving his card for Wilde at the Albemarle Club, to which both men belonged, with the notation: "To Oscar Wilde, Posing as a Somdomite! [sic]" This misspelled missive led Wilde to sue Queensberry for criminal libel.     Three trials followed. The first trial was the one initiated by Wilde, but when the defendants gathered enough evidence to support the marquess's allegation that Wilde indeed engaged in homosexual relationships, Wilde withdrew his suit. On the strength of the evidence gathered against him, Wilde himself was put on trial, and when the jury in the second trial could not agree on a verdict, a third trial was held. He was found guilty of several acts of gross indecency and sentenced to two years at hard labor.62 It was in part his attempt to be clever that led to his conviction, because he had managed to deny everything until he blundered into saying that he never kissed a certain boy because he was much too ugly. RICHARD BURTON Though Wilde was a victim of the prejudices of his time, the publicity given the case opened up a whole new world of sex for many. They wanted more information, and there were a number of Individuals out there willing to make it available, although it was much safer to do so by looking at non-Western cultures. One missionary for new attitudes toward sexual activities was Richard Burton (1821-90), the explorer and polymath. In his notes to his translation of the Thousand Nights and a Night, he summarized Western attitudes toward sexuality by recounting the story of the newly married husband who came into the bedchamber on his wedding night to find his bride chloroformed and a note stuck on her pillow that read: "Mamma says you're to do what you like."63 This was an attitude that Burton felt he had to challenge.     Burton's father was a retired lieutenant colonel in the British army, and his mother came from a well-to-do Herefordshire family. Early in his life, Burton's parents moved to Tours in France, because his father thought the hunting was good, the prices were cheap, and educational facilities were available for his children. Burton matriculated at Trinity College, Oxford, but did not graduate and instead became a cadet in the Indian army. He found his niche when he was assigned to do a survey of the Sind area in India. This allowed him to plunge into Indian life, live among the natives, learn new languages, write learned books about his experiences, and have all sorts of adventures. As part of his Sind survey, he compiled information on homosexual brothels in Karachi, and his report to his commanding officer in India, Sir Charles Napier, contained such detail that when it was later circulated secretly among some of his fellow officers. his army career was ruined. It was not so much that he personally was suspected of homosexuality but that he demonstrated such poor judgment in discussing such a subject so dispassionately. His dismissal was recommended, and though this did not happen, he left India for a life of adventure and publication.     He took a pilgrimage to Mecca in disguise with the assumed name of Al-Haz and later published an account about it. He went exploring for the source of the Nile with John Harming Speke, he visited the Mormons in Salt Like City, he served as British consul to various Near Eastern cities, and he lectured and published widely. Burton's exploits made him almost a household name, but he was more anthropologist than explorer. He had mastered twenty-five languages plus numerous dialects; wrote a grammar of the Jataki dialect in India; compiled dictionaries in Hagar, Dahomey, and Brazil; and made transliterations of proverbs in ten different African argots. He translated works from Sanskrit, Portuguese, Neapolitan Italian, and Latin as well as Arabic and Persian. He also produced some forty-three volumes on his travels and explorations, which usually included information about the sexual and marital customs of the peoples he had seen.64     Burton wrote on prostitution, homosexuality, pederasty, castration, and infibulation -much of it buried in monographic reports. In 1863, he had founded the Anthropological Society of London in the hope that its journal would provide a scholarly means for publishing more such studies. Although he did publish his notes on a hermaphrodite there, the subject so frightened the editors that Burton had to find other means of publishing material on sexually related topics. His research, such as his essay on homosexuality that was based on his long-repressed study of Sind, appeared as a supplement to his translation of The Book of the Thousand Nights and a Night, originally published in ten volumes in 1885.65     Publication of this work was part of Burton's effort to translate and publish erotica, an effort in which he was engaged from 1876 to his death in 1890. With his friends Foster Fitzgerald Arbuthnot and H. S. Ashbee, Burton conceived the idea of a pseudonymous publishing house with a fictitious headquarters. This led to the formation of the Kama Shastra Society of London and Benares (India), although the Benares listing was meaningless, because the actual printing of the books took place in Stoke Newington in England.     Burton had amassed a large library of works on the art of love and sexual practice and was able to write about sex in a language that did not seem obscene to any but the most innocent readers. In addition to his translations of the Nights, he translated and published the Kama Sutra, the Hindu classic that offers advice on the many ways of sexually satisfying women and a description of the various positions possible in sexual intercourse. This was followed by the publication of the Ananga Ranga, which gives explicit recommendations for enhancing marriage as well as advice on how to seduce a new partner. Among other things, he also published The Perfumed Garden of the Cheikh Nefzaoui, containing bawdy stories and much advice on how to have better sex, and an English translation (from Latin) of Priapei or The Sportive Epigrams of Divers Poets on Priapus.66 OTHER POPULARIZERS Burton was not alone in trying to educate the public about sexuality. in this respect was the German gynecologist Hermann Ploss (1819-85), who was proclaimed by one of his contemporaries to have founded "a new branch of science called anthropological and ethnographical gynecology." His two-volume work on women in nature and culture, Das Weib, contained up-to-date discussions of women's anatomy and physiology, together with legends, myths, rituals, and beliefs that were influential in shaping women's lives. He collected a vast amount of data concerning every aspect of the female known at that time, plowing through anthropological, philosophical, and psychological data as well as through research into physiology and aesthetics. In a sense, he might be considered a pioneer in women's studies.67 In a subsequent revised posthumous edition edited by Max Bartels, the compilation was considerably expanded, aided by Ploss's notes. Eventually illustrations were added. Though a feminist commentator has complained that Das Weib was not a natural history of females but a history of woman as a "sex object,"68 it still is regarded as a major effort to deal with some of the sexual issues that the emerging sexologists of the nineteenth century felt were important.     Perhaps the most influential of the researchers using historical and anthropological data was the German dermatologist Iwan Bloch (1872-1922). Though much of early sex research literature had included historical case studies, Bloch broke new ground in advocating the establishment of sexualwissenschaft ("sexual science"), which was to include not only biological and psychological data but cultural, social, and historical informatioll as well. One of his first efforts in this regard was Beiträge zur Aetologie der Psychopathia Sexualis, published in two volumes in 1902 and 1903. Bloch held that perversions were found in every culture and in every historical period. One of the richest sources, he found, was religious writings. Religion for him was a museum of sexual beliefs and institutions in which everything ranging from sacred prostitution to fetishism to phallic cults to exhibitionism and learned discussion on such topics as sadism, masochism, and homosexuality could be found. From his data, Bloch concluded that every sensory organ could function as an erotogenic zone and thereby form the basis for a perverse sexual impulse.69 The wonder was not that there were people with perverse sexual instincts but that more of us did not exhibit such behavior.     In this work, he criticized Krafft-Ebing's notion of congenital psychopathia sexualis (he later changed his mind, at least on homosexuality) and held that "aberrations" were due to the need for varied sexual stimuli as well as the influence exerted on the sexual instinct by "accidental external conditions." These three words -accidental external conditions- made up the descriptor he used to explain perversion arising in childhood, while the need for varied stimuli explained those arising in later years of adulthood.70 Bloch examined childhood sexuality in some detail and noted the great frequency of copulatory attempts and other forms of sex play among children of primitive people. He emphasized that the elders in these groups did not look down on such childhood activities as abnormal or indecent.71     His study The Sexual Life of Our Time and Its Relations to Modern Culture in its German original is perhaps the best overall survey of sexual knowledge at that time.72 Bloch became convinced by his earlier studies that the key to current problems of human sexuality was historical understanding. To this end, Bloch undertook a major study of prostitution, a topic, he stated, that enabled him to study the role and status of women as well as many aberrant forms of sexual behavior.* In spite of its limitations, Bloch's study of prostitution was the most comprehensive study of the subject up to his time. Unfortunately, he never completed it and thus never could draw the conclusions he felt were so important.73     Similarly, he argued that the problem of venereal disease, particularly syphilis, was emblematic of the problems of sexuality in society and that once the medical problems posed by syphilis could be overcome, humanity could look forward to a brighter future.74 It is important to note that the few works of his that were translated into English are usually heavily abridged and are not indicative of the breadth of his scholarship.     Hirschfeld, after reading Bloch, felt for the first time that it was possible for sexology to be a real science and started Zeitschrift für Sexualwissenschaft, the first journal devoted to sexual science. Rohleder, also impressed by Bloch's concept of sexual science created a special category of "sexual science" in Reichsmedizinalanzeiger, the medical journal he edited.75 Freud credited Bloch with having replaced the pathological approach to the study of sexual inversion with an anthropological one.76     Bloch was certainly more involved in the scientific and scholarly circles than Burton, but both were significant in challenging traditional ideas about sex. Also busy at work in gathering ethnographic-historical data was Friedrich S. Krauss, on whom Bloch in part relied and who influenced both Freud and Hirschfeld. BritainIn 1904, Krauss founded the journal Anthropophyteia to publish ongoing research on the history and ethnology of sexual morality. Among other things, he did a study of homosexuality in Japan.77 An ethnographic study of homosexuality was also done by E Karsch-Haack, this time in various primitive cultures.78     Resources for finding data also increased. Symbolic of this new effort to hunt down sexual information is the bibliographical collection of banned books by Pisanus Fraxi (Ashbee's pseudonym), which first appeared in 1877. He described many of the underground erotic classics available in the British Museum and elsewhere and was, it is believed, the author of an extraordinary eleven-volume anonymous sexual memoir, My Secret Life, in which lie described affairs with more than twelve hundred women.79     Novelists and others were also challenging the prudery of the time, not always successfully. George Eliot (Mary Ann Evans's pen name) was reprimanded in the Saturday Review on February 26, 1859, for discussing pregnancy at length in Adam Bede. Gustave Flaubert was legally prosecuted for publishing Madame Bovary, as was Charles Baudelaire for Fleurs de Mal. And even Alfred, Lord Termyson was rebuked in 1855 for his emphasis on adultery, fornication, and suicide in his "monodrama" "Maude."80
	* Bloch was important both in making definitions and in gathering data. Sometimes it seems as if he is a vacuum, sucking up information from historical, medical, and legal records. He is said to have possessed a personal library of eighty thousand volumes, but readers of Bloch should carefully check his citations, perhaps because he tended to cite things from memory. Many of his notes do not hold up.
THE JEWISH INFLUENCE Within the medical-scientific community, there was a growing number of individuals who were willing to emphasize the pleasures of sexuality, including Hirschfeld and Ellis (who will be discussed more fully in chapter 3). Even those not quite willing to go as far as Hirschfeld and Ellis, however, found it important to pay attention to human sexuality, if only to help their patients. The largest number of such medical professionals at the turn of the century were in German-speaking areas, particularly Austria and Germany. Interestingly, the generation of physicians following Krafft-Ebing in medical discussions of sexuality were mainly those with Jewish backgrounds, perhaps because this segment of the medical community was somewhat freer of Christian ideology about certain forms of sex.81     The real or alleged influence of Jewish physicians in sex research is somewhat controversial for a variety of reasons. One of the difficulties is in determining who is and who is not Jewish; such a subject also brings up painful memories of the Nazi era. With the exception of Enoch Heinrich Kisch (1841-1918), a gynecologist who wrote on female sexuality,82 few of the physicians with Jewish backgrounds involved in sex research were practicing Jews. Eulenburg, though of Jewish descent, had been baptized a Christian when he was seven.83 Dessoir, who emphasized the psychological origins of sexuality as well as the ability of men and women to reshape their own souls and world,84 had a Jewish father but had been raised a Protestant.85 In fact, most of those physicians of Jewish background, even the politically more conservative ones such as Moll, were very secularized, and only the Nazis would classify them as Jewish.86     This raises the question of whether this "new" view of sex was part of a growing secularism or whether it was restricted to persons of Jewish background. The evidence favors the first rather than second explanation, because Orthodox Jewish views of sex were as hostile to nonheterosexual activity as Christian views. Moreover, Eulenburg, if asked, probably would have replied that it was his scientific objectivity rather than his Jewish origins that led to his attempts to understand human sexuality. In his book on sadomasochism, Eulenburg wrote, "It is of course impossible for me as a doctor to throw morally critical stones at the living as well as the dead."87 On the other hand, there was some consciousness of a difference in Jewish attitudes toward sex that was expressed by some of those who wrote about it at a slightly later date. The Jewish sexologist Max Marcuse (1877-1963), for example, wrote, "Christians tend to give the sexual life of man a stigma of baseness which is not at all the case in the Jewish community."88 Moreover, some of the Jewish physicians might well have had some hostility to Christian conservatism about sex. Fritz Wittle, for example, a Jewish physician who was a member of a psychoanalytic group following Freud, admitted early in the twentieth century that it was "his extreme delight to hurl the importance of sex into the teeth of society."89     On balance, it was probably not so much Jewish attitudes about sex that accounted for the disproportionately large number of Jewish physicians in the sex field as the fact that unlike in most areas of medical practice there was little hostility to Jewish physicians entering this somewhat stigmatized field, because it had mostly been ignored by other physicians. Though by law (originally signed on July 3, 1869) Jews could compete officially for any occupation they chose in Germany,90 there is ample evidence to indicate that they had difficulty getting high civil service and university positions. They could, however, become physicians, and a disproportionate number of Jews who entered the professions did so to study medicine. Although there were difficulties in entering certain medical specialties, research and practice in the areas of sexual behavior were not among them. Obviously, there also was increasingly widespread public interest in various aspects of human sexuality, as demonstrated by the explosion of literature on the topic. In Vienna, much of the study of sexuality came to be associated with Freud and psychoanalysis, and most of Freud's early followers were Jewish. In other German-speaking areas, the sexological movement was much less psychoanalytical, but the Jewish presence was still very strong.     The Jewish presence in the German sexological movement was emphasized by the Nazis, who classified sexology as a Jewish science. Sexologists such as Hirschfeld were among the first persons they attacked when they took power. Unfortunately, much of the information and resources that had been collected by these early Jewish investigators were either lost or deliberately destroyed: Books were burned and sexologists fled, died under house arrest (as did Moll), or were sent to concentration camps. It has only been in the last twenty or so years that the early German Jewish contribution to modern sex research has begun to be better understood.     Two of the three giants of modern sex research in the first part of the twentieth century -Hirschfeld of Germany and Freud of Vienna- were Jewish, and though Freud's psychoanalytic movement found a haven in the United States, the work of Hirschfeld was generally ignored and dismissed. The other major figure, Ellis, was British, and it was Ellis, even more than Freud or Hirschfeld, who carried the message of the new kind of sexology to the English-speaking world. Increasingly, the study of sex in the twentieth century became broader, moving from its early focus on psychopathology to general sexual behavior. It is to this topic, as it centered around the lives and works of Hirschfeld, Ellis, and Freud, that the next chapter is devoted.
3 HIRSCHFELD, ELLIS, AND FREUD Three men dominated sexology during the early years of the twentieth century: Magnus Hirschfeld (1868-1935), Havelock Ellis (1859-1939), and Sigmund Freud (1856-1939). Hirschfeld and Ellis could be called empirical data gatherers, while Freud was a system maker who, on the basis of his system, developed a new therapy for those afflicted with sexual and other problems. Though each man knew of the work of the others and had contact with the others, Freud increasingly distanced himself from not only Hirschfeld and Ellis but other sex researchers to devote his energy to developing his own model.     For a time, at least in the United States, Freudian ideas about sexuality were the dominant ones. One of the reasons for this is that Freud, through his treatment modalities, provided a way for those interested in sexology to earn a living. Hirschfeld was independently wealthy, and though he practiced medicine and treated patients, his research was supported by his own funds. Ellis, while also a physician, supported himself almost entirely by his own writings, many of which were outside of the sex field. Freud, on the other hand, earned his living as a practicing physician and as such was far more interested in treatment than the other two. Thus while the data that Hirschfeld and Ellis collected were invaluable, these men did not necessarily provide treatment modalities that a practicing physician could use to help patients. Inevitably, Freud, the new system maker, became the model for much of the medical community, particularly in America, where the developing field of psychiatry came to dominate not only the treatment of patients but the writing and research about human sexuality until well past the middle of the twentieth century.     The psychiatrist or psychoanalyst saw patients who sought help with their problems, and the professional then usually published the case histories, including analysis and treatment. The result was almost a circular process: Because the Freudians dominated the publications dealing with sexual problems, they received the patients with such problems. While the urologist and gynecologist could deal with some aspects of sexuality, the psychiatrist and psychoanalyst had a theoretical construct into which all aspects of sexuality could be included. Moreover, Freudian theories inevitably spread to many other elements in the intellectual community, further adding to the dominance of his ideas. Though succeeding generations of psychoanalysts and disciples of Freud added to or slightly modified Freudian theories, the system itself was challenged only as a new generation of empirical data gatherers appeared, mainly in the universities, a setting previously not receptive to sex researchers except in the biological sciences. The new generation held professorships, which provided them with the financial security that Ellis never achieved through his writings and that Hirschfeld was born to. It also enabled them to challenge the medical dominance of sex research. MAGNUS HIRSCHFELD The most neglected, at least in America, of the three men discussed in this chapter is Hirschfeld. Undoubtedly influenced by his own homosexuality, he did not pretend, at least at first, to be the dispassionate reporter of the varieties of human sexuality as Krafft-Ebing claimed to be. Instead he seemed, particularly in his early years, to have had an almost missionary zeal to bring the "truth" about sexuality to everyone. Though Hirschfeld started out as a political propagandist for homosexuality, he eventually became a significant researcher into human sexuality. A major reason for his comparative neglect, however, is that many of his contemporaries never forgot the fact that he had been a strong advocate for homosexuality and that sometimes, in his zeal, he tended to go to excess. In his later life, he was also a radical in politics, believing that only through changing the system could long-delayed changes in laws about sexuality take place. There were other reasons as well.     Hirschfeld's writings, for example, were often poorly organized and early on were not so well thought out, although he tended to improve with age. He turned out a variety of books and articles, some of which were outstanding and some of which seem to have been hurried into production to meet deadlines or fill space. His own lifestyle also worked against him, and he was ready to give battle anytime he felt homosexual rights were being threatened. Sometimes he seemed to lack common sense. A good illustration of this last is his participation in the Harden-Eulenburg trial, an action brought by the enemies of Kaiser Wilhelm II and the imperial court. HARDEN-EULENBURG-VON MOLTKE AFFAIR     Critics of the policies of Kaiser Wilhelm were afraid to attack the kaiser openly and thus sought to attribute to a cliquish group of his advisers, some of whom were believed to be homosexual, those policy actions that they opposed. A small group of opponents came to believe that an attack on the alleged homosexuality of his advisers might force the kaiser to dismiss them, which would then result in a change of policy. The seed for such an attack came from the kaiser's support of his friend Friedrich Krupp (1854-1902), who at age thirty-three had inherited control of the Krupp industrial empire. Though married, Krupp lived much of the time on the island of Capri off the coast of Naples, away from his wife. There he allegedly brought young fishermen, mule drivers, and others, some of whom were legally minors, to engage in sexual relations with him. Though homosexual activities in themselves were not against Italian law, corruption of minors was, and Krupp, after being declared persona non grata, was expelled from Italy for his alleged involvement with minors. In the ensuing scandal, Krupp died, probably by committing suicide, but the kaiser tried to quell the public uproar and defend the house of Krupp by giving his friend a state funeral.1     Just how much influence the kaiser's enemies had in encouraging the Italians to bring charges is unclear, but his opponents saw the kaiser's efforts to minimize the scandal as a chance to claim that his court was riddled with homosexuality. Matters came to a head when Maximilian Harden, publisher of a Berlin periodical, Die Zukunft, and an opponent of imperial policies, charged that the kaiser was surrounded by a group of catamites who were perverting Germany policy. When this failed to bring a response, Harden mentioned two individuals by name: Prince Philip Fürst zu Eulenburg, former ambassador to Austria-Hungary, and Count Kuno von Moltke, military commander of Berlin. In October 1907, von Moltke launched a libel suit against Harden, but Harden produced extensive data about the alleged homoerotic tendencies of von Moltke, and Hirschfeld testified as an "expert witness" that von Moltke was a homosexual on the basis of such evidence. Harden was acquitted, but von Moltke appealed. In the second trial, Harden was convicted and sentenced to four months in jail, and much of the evidence produced in the first trail against von Moltke was demonstrated to be fraudulent. Eulenburg, who was initially charged with perjury for denying his homosexuality, never was brought to trial.     Although Hirschfeld may have thought that he was only performing a professional service by testifying, his testimony played into the hands of those who wished to label homosexuals in high places as a peril to the fatherland, and neither the original conviction nor the eventual acquittal helped the cause of homosexuality. It also threw doubt on Hirschfeld's expertise, and more important, made him anathema to the kaiser and his court, whose support was essential if homosexuality was to made legal.     Some of his critics also opposed Hirschfeld on more professional grounds. Sexologists like Moll, though initially somewhat supportive of Hirschfeld's ideas, ultimately ended up in open opposition both to his theories and to the nature of his research. The disagreements between Moll and Hirschfeld in their later years, however, were more than scientific or scholarly disputes, Although the disagreements did have a professional basis, the men increasingly seemed to have been motivated by personal hostilities and rivalries. Their conflict forced many in the sexology field to choose sides.     Freud also had initially praised Hirschfeld, and in fact, Hirschfeld had Joined with Karl Abraham in founding the Berlin Psychoanalytical Society in 1911, at the Weimar Congress of the Psychoanalytical Association, Freud treated Hirschfeld as an honored guest and described him as the Berlin authority on homosexuality.2 When Hirschfeld, however, left the society shortly after the Weimar Congress, Freud put him down, calling his "departure no great loss" and Hirschfeld "a flabby, unappetizing fellow, incapable of learning anything."3 This not atypical Freudian putdown of his critics or "deserters" meant that many psychoanalysts, particularly those active in the United States, later ignored Hirschfeld's work. HIRSCHFELD'S EARLY YEARS     Hirschfeld was the son of Hermann Hirschfeld, a well-known physician and philanthropist in the seaside spa of Kolberg in Pomerania, and Frederika Mann, a member of a prominent Jewish family from Pomerania. He, like his two brothers, decided to follow his father's footsteps and started his medical education at Strasbourg. He soon left there for Berlin, then moved to Munich. Hirschfeld also studied at Heidelberg and finally returned to Berlin to complete his studies. His dissertation was on the effects of influenza on the nervous system. He then visited the United States and returned by way of Morocco, Algiers, and Italy.     In 1894, he opened an office in his hometown as a general practitioner and obstetrician, but two years later he moved to Berlin where he became a specialist in hydropathy. It was in Berlin that he launched his career as an investigator of sex. His first entry into the field was a thirty-four-page pamphlet titled Sappho und Socrates, Wie erklärt sich die Liebe der Mannër & und Frauen zu Personen des eigenen Geschlechts? (Sappho and Socrates, How Can One Explain the Love of Men and Women for Individuals of Their Own Sex?). Hirschfeld wrote the pamphlet shortly after learning of the suicide of one of his patients, a young homosexual officer who shot himself through the head on the eve of his marriage. Just before doing so, he had mailed Hirschfeld a letter in which he announced that he killed himself because he felt so tortured by the double life he was forced to lead. He urged Hirschfeld to tell others his tragic story in the hope that they could better understand the difficulties under which homosexuals lived. Writing under the name of Th. Ramien, Hirschfeld argued that homosexuality was part of human sexuality, that both its causes and its manifestations should be the object of scientific investigation, and that the penal laws against homosexuality should be changed in the interest of society.4     The pamphlet opened with a quote from Friedrich Nietzsche -"what is natural cannot be immoral"- and aroused more interest than might have been expected because of the publicity generated by the trial of Oscar Wilde in England. Hirschfeld, relying heavily on the work of Moll,5 and to a lesser extent on Krafft-Ebing, stated that all of the sciences had demonstrated that homosexuals composed a third sex. He then went much further than Krafft-Ebing, however, and declared that homosexuality was simply a variety of human sexuality. The key to his theory lay in embryology (as did that of Ulrichs), although he was not fully aware of what Ulrichs had written. He attempted a 10-point scale to classify people based on his basic three principles of development; actually there were six principles, because he felt 3emales and males went through the same three phases but with slight differences. HIRSCHFELD'S THEORY     Most people, according to Hirschfeld, were originally bisexual, but in the course of their natural development, they lost their desire for members of the same sex. These people were the heterosexuals who loved members of the opposite sex. The second category of individuals was made up of the psychohermaphrodites -men and women whose sexual organs had developed normally but whose feeling centers for one or the other sex were imperfect, and as a result, these people could love individuals of both sexes. The third category consisted of those individuals whose sexual organs developed normally but in whom the desire for same-sex individuals in the feeling center failed to recede. The results were men who loved men and women who loved women. Hirschfeld continued to modify his theory of the causes of homosexuality over the next four decades but never really came to a satisfactory formulation, probably because none of what he said could really be proven.     The pamphlet Sappho und Socrates represents the strength and weaknesses of much of Hirschfeld's later work. He dismissed outright those people who disagreed with him, was sloppy in his historical data (he had Sappho killing herself because of unrequited love for a woman), and was quick to claim earlier historical figures as homosexuals or lesbians without much evidence. He also assumed that his was the only correct explanation for homosexuality, a claim that was quickly challenged by other homosexuals. In fact almost immediately after the appearance of Hirschfeld's pamphlet, another pamphlet was brought out by the same publisher, Max Spohr. The anonymous author of this pamphlet held that homosexuality was not an inborn condition but rather was acquired through an individual's passage through life. The problem, however, was not with the individual who developed into a homosexual but that society punished the homosexual, when it should really accept him or her.6     Many of the ideas in this second pamphlet were similar to those expressed by Benedict Friedländer and Adolf Brand, who opposed Hirschfeld's notion of a third rid ma well have been written by them. Friedländer later argued that theories such as Hirschfeld's made all homosexuals effeminate (or in the case of lesbians, masculine), while they regarded homosexuality as an idealized aspect of male bonding such as had existed in ancient Greece. For them, homosexual love was spiritual and not a physical or animal desire; in other words, sexual intercourse was to have no place in such relationship. Friedländer and Brand did note that sexual intercourse could (and did) take place, but in circumstances in which the idealized love between two such individuals led to an intimate sharing of bodily fluids, the act was different from animal love.7 This view was later more fully developed by Hans Blüher, who divided homosexuals into three types: the heroic male, the effeminate invert, and the suppressed homosexual.8 Though Friedländer and like thinkers recognized that society was organized primarily around the family and the state -a heterosexual base- they also believed it had a secondary base in male bonding, Which involved homoerotic feelings; this was the major role for the heroic male. HOMOSEXUALITY AND POLITICS     This split over possible theories for the existence of homosexuality went beyond hypotheses that neither side could prove or disprove; it was a political split as well -and Hirschfeld was very much a politician. On his twenty-ninth birthday, May 14, 1897, Hirschfeld founded the Wissenschaftlich-Humanitäre Komitee (Scientific Humanitarian Committee) to give new life to the struggle started earlier by Ulrichs and others for the repeal of the antihomosexual provision, by then section 175 of the imperial penal code as adopted in 1871. The imperial law imposed a maximum of two years' imprisonment for "lewd and unnatural conduct" between males. As part of their campaign, the committee members circulated petitions to be signed by supporters of the legal change, and many people prominent in public life signed their names. For a time, the cause was adopted by some of the political parties. August Bebel, the leader of the German Social Democratic Party, spoke on the floor of the Reichstag in favor of the petition. As a result of his efforts, the petition was put on the agenda, although it was not officially discussed until 1905, at which time it was quietly removed.9 While awaiting such discussion, Hirschfeld and the committee persuaded district attorneys in several of the larger German cities to refrain from prosecution if consensual sex was involved.     The failure of the committee to achieve its political goals tended to accentuate the split between the followers of Hirschfeld on the one hand and Friedländer and Brand on the other. The unity of the group was further damaged over the Harden-Eulenburg-von Moltke trials, although Hirschfeld continued to push for reform all of his life.     More important in the long run than the political activities of the committee were its scholarly activities on behalf of homosexuality, particularly the publication, starting in 1899, of Jahrbuch für Sexuelle Zwischenstufen (Yearbook for Sexual Intermediates), the title of which reflected Hirschfeld's concepts about a third, or intermediate, sex. Hirschfeld edited the twenty-three volumes that appeared (under slightly varied titles) between 1899 and 1923. Many of those published during World War I, when paper rationing was severe, were little more than newsletters, and several issues were combined into one. The series was briefly revived in stronger form after the war, only to fold with the monetary collapse of Germany in the early 1920s. The journal was a mixture of scholarly articles, reprints of classical articles such as Kertbeny's earlier pamphlets, propaganda pieces, political essays, biographical studies, and special pleading. Though in its early issues it had significant contributors such as Krafft-Ebing, the journal generally was ignored by official science and scholarship in Germany. For anyone studying the history of sex, however, the series remains invaluable. HIRSCHFELD THE RESEARCHER     Hirschfeld also began to carry out sex surveys, and his 1903 report that 2.2 percent of all those surveyed were homosexual led Moll to break with Hirschfeld over what he felt were exaggerated statistics. Though Hirschfeld's claim seems a remarkably accurate one in light of current knowledge, it brought nothing but hostility to Hirschfeld, and it served as one more excuse for his enemies to attack him.10     The rejection of the petition for reformation of sex laws, and particularly the defection of various groups from Hirschfeld's committee, forced a rethinking on the part of Hirschfeld. Though he had claimed that science had demonstrated that homosexuality was not pathological, few had agreed with him, and his writings on the topic had been far more polemical than objective. For a time, he felt that science was not on his side, because of the various disagreements among both his followers and his opponents. It was in this setting that he turned to Iwan Bloch, who had been emphasizing sexualwissenschaft, or sexual science. It was through this new kind of sexual science that Hirschfeld sought to move the discussion of sex from the political arena to the scholarly, scientific disciplinary one, and in the process, he hoped to provide solutions to sexual problems.     Hirschfeld quickly rededicated himself to finding a scientific basis for his beliefs, and he embraced Bloch's new view of sexualwissenschaft. One of Hirschfeld's first acts was to begin publishing in 1908 a new journal devoted to sexology as a science: Zeitschrift für Sexualwissenschaft. The very first issue of this journal contained an article by Freud titled "Hysterical Fantasy and Its Relation to Bisexuality," and subsequent issues presented original works by Alfred Adler, Karl Abraham, and Wilhelm Stekel, among others. Hirschfeld, at that time, made a significant effort to include the Austrian psychoanalytical movement as part of the legitimate study of sexological science. Hirschfeld also traveled to Italy to solicit personally articles from Paolo Mantegazza and Lombroso, an indication that he hoped that sexology could become a new international science.     Hirschfeld also encouraged controversy. Helene Stöcker, an early Berlin feminist, contributed an article on the differences between the love lives of women and men; this was a response to a chauvinistic article on more or less the same topic by Wilhelm Stemberg. Stöcker was somewhat upset at the diversity of views in the journal and took Hirschfeld to task for publishing the Stemberg article, which she said was contrary to Hirschfeld's own views on the topic.     Journal articles came from a variety of disciplines, and during the first year, articles dealt with historical, philological, pedagogical, biological, medical, and ethnological aspects. Serving with Hirschfeld as coeditors of the journal were the Viennese ethnologist Friedrich Salomon Krauss and the Leipzig physician Hermann Rohleder, both instrumental in broadening the concept of sex research.     Unfortunately, the plans were far more ambitious than the finances. After only a year of publication, the journal was merged with Sexual Probleme, a more popular and less scholarly journal. The resulting amalgam appeared under the title Zeitschrfit für Sexualwissenschaft und Sexual Politik and later under still different titles, as other attempts were made to revive it.11 Undaunted by the failure of the journal, Hirschfeld, for his part, continued to apply what he believed was his newfound scientific objectivity to his research. His first work to qualify as a major contribution was Die Transvestiten (1910), a term he coined. This ignored classic (it was translated into English only in 1991) challenged the view that all cross-dressers were homosexual, since Hirschfeld found many such individuals were heterosexual. After examining possible correlations of cross-dressing with homosexuality, fetishism, and masochism, he said that while all might have some bearing, the transvestite was different. The difference between the homosexual man and the transvestite man (he also included some women) was not in behavior but in the focus of pleasure. Transvestites differed from fetishists, because fetishists tended to attach the object of the fetish to a beloved person, while transvestites focused on themselves and their clothing. While there was some masochistic tendencies, since male heterosexual cross-dressers tended to seek out masculine women, he felt that this was not a major causal factor.12 His observations and data on cross-dressing, if not his theory, were not matched until the last decade of the twentieth century.     Hirschfeld then published Die Homosexualität des Mannes und des Weibes (1914), in which he repeated his ideas, summarized above, with slight modification. His use of the term homosexuality consolidated it into the community.13 What is most valuable about Hirschfeld is the amount of data he compiled about homosexuality, transvestism, and other forms of sexual activity. He held that a variety of sexual behaviors were normal, and he was more interested in describing this variety than condemning it.     Hirschfeld was not content to rely solely on his practice or on case studies passed on to him by others; he set out to seek information from a large variety of informants. Shortly after 1900, he developed what he called a psychobiological questionnaire, which contained some 130 questions and which he administered to more than ten thousand men and women. On the basis of this, he wrote what he called his first sexobiological book, Naturgesetze der Liebe, which marked a breakthrough in his research: He was no longer just interested in the "pathological" but in sex behavior in general. This study was strongly influenced by the German evolutionary biologist Ernst Haeckel (1834-1919), who laid stress on the fundamental biogenetic law that ontogeny recapitulates phylogeny, or that the organism in its development demonstrates, to a great extent, the morphological changes that occurred during the evolution of the species. Haeckel, who developed a theory called monism, held that the material basis of true-life phenomena -nourishment and reproduction- was due to an intricate chemical interaction and said that an "erotic chemotropism" was the very source of love.     Hirschfeld adopted this belief and asserted that some kind of internal secretions, what we now call hormones, were the principal source of the feelings of love and sexual attraction. He held that the testes secreted a chemical substance that he called "gandrin" and the ovaries, something he called "gynecin," although such substances had not yet been isolated.14 Part of the difficulty with Hirschfeld is that, as his biographer, Charlotte Wolff, said, "he tapped at the door of modern science but could not get it to open."15 He wanted to find a biological explanation for all kinds of sexual behavior, and when the science of the time could not give them, he hypothesized such explanations. He often was on the right path, but sometimes his ideas were based on fallacies. In his defense, he occasionally seemed to realize there were difficulties with his concepts, such as the existence of a third sex, because he admitted that physically normal people could be homosexuals or bisexuals, but he still insisted on a third sex.     Part of the Hirschfeld's difficulty derived from his use of the monist theory, which lay at the core of both his and Moll's theories. Monism tended to deprive the idea of sexuality of its traditional, limited meaning. As Lawrence Birken pointed out, evolutionary theory posed a dilemma for sexologists, because by relating all forms of desire to each other, it gave them a generic unity that subverted difference. Yet, at the same time, it emphasized the possibility of controlling these desires by relating them to each other in a developmental hierarchy. In sexology, women and children became sexualized even as they continued as sexless denizens of the innocent world outside competitive society. Sexuality was simultaneously universal and the function of the adult male alone. The problem was the necessity of upholding the idea of difference with a theory that emphasized differentiation from a common sameness. As long as the accent was on the differentiation, difference could be sustained; but there was a gradual tendency to shift the emphasis to the common sameness underlying the apparent difference. In sexology, this saw a shift from the idea of an adult male sexuality to one of a universally defined sexuality.16 Birken held that "the phylogenetic origins of sexuality in primeval undifferentiated desire undercut any attempt to distinguish the sexual from the nonsexual. In this context, social energies might appear as nothing more than a rarefied form of sexual energy. In other words, the social appeared as a higher stage of the sexual. arising out of but in opposition to primeval desire."17     It was Freud who broke through this difficulty, replacing the difference between social and sexual desire with a concept by which social and sexual love become differentiated unequally from each other. In replacing difference with differentiation, Freud was able to explain precisely how relations within the family were connected to relations outside the family in a hierarchical order. The Oedipus complex of Freud, in a sense, was a defense against an even more unbearable idea, the dissolution of the hierarchical order of the sexes.     Hirschfeld, however, never visualized any of this debate as a problem and so never dealt with it. He remained interested in organization, continually trying to extend the network of sexologists and inform the public. The Humanitarian Committee, in spite of disaffections of some, continued to agitate for change, but Hirschfeld also wanted more data and information. In 1913, he was instrumental in the founding of the Ärtzliche Gesellschaft für Sexualwissenschaft und Eugenik (Medical Society for Sexual Science and Eugenics), which was conceived of as the beginning of a worldwide movement for sexual reform. This led to a revival of the Zeitschrift für Sexualwissenschaft under the editorship of Eulenburg and Bloch.     World War I proved to be a major setback to the German sexological movement. Hirschfeld, who had long been a pacifist, initially threw himself into the German war effort, and in his tendency to exaggerate, which always plagued him, he became the supreme German patriot. In his absolute certainty that Germany was in the right, he made statements that never should have been made. When his passions began to cool, he quickly abandoned his early enthusiasm for the war, ending up involved in the movement to oust the kaiser and establish a democratic government in Germany. For the rest of his life, he was strongly left wing -probably, at least for a time, a Communist- and this influenced the reception of his ideas about sex.     During the war he began publishing Sexual Pathology, which he regarded as an update to Krafft-Ebing. Though It has a large number of excellent observations, it is weakened either by poor theory or by unfortunate remarks. Still, one of his most important contributions was to challenge Krafft-Ebing's baneful beliefs in the effects of masturbation. Amplifying on the studies of the German sexologist Rohleder, who had reported that 90 percent of all people younger than twenty had masturbated,18 Hirschfeld found that if anything this was an understatement and reported that in his estimation 96 percent had done so. He wrote that the harmfulness and consequences of masturbation have been greatly exaggerated. "In most cases the exaggerated fear of the harmful consequences of masturbation is far more harmful to health than the act itself. A certain lassitude and inability to concentrate may, of course, be induced by excessive masturbation, but will pass very quickly of itself if the subject's mode of life is natural and normal."19 Hirschfeld, however, could not quite overcome the nineteenth-century fears of masturbation, and believed, following others, that there was such a thing as hyperactive self-gratification and recommended sterilization of men and clitorectomy in women to prevent it.20     Overall, his Sexual Pathology is a considerable advance over what had gone before, and when he wrote of chromosomal abnormalities or hormonal abnormalities, he was reporting on the cutting edge of the known research, but when he advanced his beliefs about psychoendocrinism -the interaction of organic and psychological factors- he was going beyond what the science of the day could confirm. Science had not advanced far enough to give the kind of answers that he tried to give, and unfortunately, he did not always distinguish between what he believed and what the existing evidence could demonstrate. When data were lacking, he fell back on theories that, in the end, turned out not to be valid. In many areas, however, he was quite cautious. For example, though he rejected Freud's theory about sexuality per se, he agreed with Freud about the sexual origin of many neuroses and with his emphasis on it in hysteria and obsessional ideas. He did not agree with Freud on psychic influences and complexes or with infantile experience.21     In 1919, Hirschfeld finally realized a long-term dream with the foundation of his Institute of Sexual Science in Berlin; there he could consolidate and extend his data and house his library of more than twenty thousand volumes and thirty-five thousand pictures that supported his research. Using his psychobiological questionnaire, he continued his wide-scale study of sexual habits. He established a marriage counseling service, gave out advice on contraception and sex problems, and continued his prolific writing (he himself claimed 187 works).22 Increasingly, Hirschfeld and his colleagues branched out into studies of female sexuality, marriage, contraceptives, and prostitution, becoming less concerned with sexual variance and more concerned with general sexual problems. INTERNATIONAL SEXOLOGY CONGRESSES     Still, Hirschfeld increasingly felt the key to understanding sexuality was endocrinology. In 1921, his dreams of having an international sexological movement came to fruition with the International Conference of Sexual Reform Based on Sexual Science, which took place in Berlin from September 15 to 20. The theme of the conference was the importance of internal secretions for human sexuality, but the papers from the thirty-six speakers were wide ranging and did not always hold to the theme. Included in the audience were physicians from Germany, Finland, the Soviet Union, Czechoslovakia, Hungary, Italy, Sweden, Denmark, Norway, Holland, France, the United States, Argentina, China, and Japan as well as the emerging independent Baltic states. Four of the participants were women. The fact that Hirschfeld was host and keynote speaker solidified his standing in the sexological community, and out of this meeting eventually came the World League for Sexual Reform. The economic and other postwar difficulties in Germany made it difficult to follow through on this until 1928, when J. Leunbach of Copenhagen organized the second meetings, this time known as the Congress of the World League for Sexual Reform. Coming from United States to the congress was Harry Benjamin, Margaret Sanger, and William Robinson, all of whom continued to be active in international sexological meetings; in a sense, these Americans were involved in the transitional development of one wing of the sexological movement.     Again Hirschfeld gave the opening lecture, and the league became formally organized with three co-presidents: Auguste Forel of Switzerland, Ellis of the United Kingdom, and Hirschfeld. The chief points of the league policy was an advocacy of sexual education, sexual equality of men and women, reform of marriage and divorce laws, encouragement of contraception and birth control, reformation of the laws on abortion, protection of the unmarried mother and the illegitimate child, prevention of sexually transmitted diseases, removal of the economic factors that led women into prostitution, promotion of a rational attitude toward sexually "abnormal" persons, and reformation of the laws regarding sexual offenses. In short, the platform combined Hirschfeld's ideas of sexual reform and research but the emphasis was on reform.     The Third International Congress, held in London, again saw Hirschfeld give the keynote address. He was followed by one hundred other speakers including such nonsexologists as the philosopher Bertrand Russell, the dramatist John van Druten, and the writer Desmond MacCarthy. Many of the talks were devoted to contraception and were marked by an effort by those in attendance to try to distance themselves somewhat from the eugenics movement.     The Fourth International Congress, held in Vienna in 1930, was again keynoted by Hirschfeld, still one of the three co-presidents (Norman Haire of the United Kingdom and Leunbach were the others). The conference had fewer participants than the earlier ones, and many of the scheduled speakers, such as Ellis and Benjamin, could not attend, although their lectures were printed in the book of congress papers.     The Fifth Congress had originally been planned for Moscow and then for Paris but ended up, in 1932, in Brno, Czechoslovakia. This congress was important because, unlike the others. it took place in an academic atmosphere at a university. It also had the sponsorship of the Czech president, Jan Masaryk. Many of the participants broadcast their speeches back to their own countries over the radio. In spite of such a public relations coup, the congress was the last to be held, partly due to the rapid decline of the German sexological movement but also due to the strong differences between Haire and Leunbach. Leunbach wanted the league to join with the revolutionary workers' movement, but Haire was determined to keep all revolutionary activity out of the league and to concentrate on educational projects. The ultimate result was the dissolution of the league.23 HIRSCHFELD, THE NAZIS, AND HIS DEATH     The Brno congress marked the end of one phase of European sex research in other ways as well. Within a year of its conclusion, Nazi hoodlums. encouraged by the newly legitimatized Nazi government, on May 6, 1933, broke into Hirschfeld's institute in Berlin. They destroyed the greater part of his collection and data and removed books from the library and publicly burned them. Hirschfeld was traveling at the time and learned of the destruction in Paris, where, in a cinema, he saw with his own eyes the destruction of much of his life's work. He tried to start again in France, but he died in Nice on May 14, 1935 -his sixty-seventh birthday.     This portrait of Hirschfeld hints at the disputes in the sexological field of the time, but there is not enough space to amplify all the differences. Distinctions were strong and Moll in particular was quick to counter almost every move that Hirschfeld made. When Hirschfeld organized his Society of Physicians for Sexual Science and Eugenics, Moll offset it with the formation of his International Society for Sexual Research. When Hirschfeld organized the first international conference on sexology in Berlin, Moll planned another one. Economic conditions in Germany postponed Moll's conference until 1926, when the International Congress of Sex Research was held in Berlin, to which Hirschfeld was pointedly not invited.24 Moll claimed that if he had invited Hirschfeld, many of the others would not have attended, because, he stated, that Hirschfeld was seen as an apologist for homosexuality. Most of those who attended the Moll conference did not know until after they arrived that Hirschfeld had been left out. Moll and Hirschfeld were on opposite sides of almost every issue. Hirschfeld himself, however, frequently appealed to Moll to lay aside their personal differences and asked Moll to Join him in the search for the scientific truth, which Hirschfeld felt could be found. Hirschfeld could never understand why Moll was so opposed to him. He knew they disagreed, but felt that ultimately science would give the answers.     Hirschfeld was erratic, was sometimes extravagant in his claims, and did not always think through his actions; he was left wing, very close to the Communist Party, and homosexual. Moll was cautious and conservative, a German nationalist, heterosexual, and very much concerned that homosexual researchers such as Hirschfeld would "infect" sex research. Moll challenged Hirschfeld's belief that he could diagnose homosexuality in children, was critical of his theory of sexual intermediaries, and could not abide Hirschfeld's belief that homosexuals had special virtues and were more democratic and more altruistic than heterosexuals.25 Moll was particularly irked by Hirschfeld's claim that the science of sexology had been founded by Bloch and instead insisted that Krafft-Ebing deserved to have the credit.     Haire, who had studied briefly under Hirschfeld in Berlin and who served later as co-president of the World Congress, was fond of Hirschfeld. Still he found that Hirschfeld was often hard to take. He wrote, "As the rest of us, he had his imperfections. He was not always tactful. He didn't always stop to think how his actions might be interpreted by persons of ill will. He could be very selfish and exigent in small matters. His appearance was, I think, unprepossessing."26     Hirschfeld's ultimate importance to sex research is not so much his theory, although he had important insights, but his data collection and his organizing ability. Though many of the sources for his data were destroyed by the Nazis, he had published significant amounts of his data, and later generations of researchers have found his cases to be Invaluable. So-called research on sex had started out mainly as learned opinions and theories, based on historical and cultural data and a few clients, but the growth of case studies and the ability to compare backgrounds of different peoples (as both Moll and Hirschfeld did) opened up new horizons in sex research and led to challenging and modifying traditional ideas. For the most part, however, the state of knowledge in the biological nature of humans was not yet advanced enough to go beyond this. The fact that some researchers, such as Hirschfeld, were openly challenging societal attitudes and threatening to undermine traditional ideas was a major factor in the opposition to Hirschfeld as expressed by Moll and others. HAVELOCK ELLIS More successful and much less dogmatic and antagonistic was the English sexologist Havelock Ellis, whose Studies in the Psychology of Sex (1896-1928) popularized the concept of the individual and cultural relativism in sex. In a sense, Ellis was a naturalist, observing and collecting information about human sexuality instead of judging it. Always cautious, he avoided unitary theories. Faced with the question of whether homosexuality was inborn or acquired, physical or psychic, he felt there was perhaps some truth in all views. Although he tended to believe that sexual differences were inborn and nonpathological, he was willing to grant that perhaps there was a higher number of neurotics among deviants than among other groups. This, however, he also qualified, by stating that the neurosis may be due to societal rather than biological factors.     Essentially, Ellis's work was a plea for tolerance and for accepting the idea that deviations from the norm were harmless and occasionally perhaps even valuable. He, like Hirschfeld, was a sex reformer who urged society to recognize and accept sexual manifestations in infants and to realize that sexual experimentation was part of adolescence. Ellis held that it was important to repeal bans on contraception as well as laws prohibiting sexual activity between consenting adults in private.27     We know a great deal about Ellis from his autobiography, including the fact that he had a fascination with the act of urination, which he called urolagnia. This fascination he believed resulted from observing his nurse urinate in a public park in his presence. She was pushing his perambulator when she suddenly stopped, a pause followed, and then he "heard a mysterious sound as of a stream of water descending to the earth."28 This was in the days when there were no public toilets and women wore long skirts and no underpants; park walks were made of crushed stone to enable them to answer the call of nature.     His sea captain father, Edward P Ellis, was absent during much of Havelock's youth, and he was raised primarily by his mother, Susannah Wheatley Ellis, who at the age of seventeen had undergone conversion to the evangelical principles of John Wesley. She made great efforts to protect him and her other children from the ever-present dangers of evil, packing them off regularly to religious services. Ellis's means of escape from his rigidly circumscribed life was through reading in the library of his grandparents, who allowed him to choose what he wanted to read. He seems to have been somewhat feminine as a boy with what were called "overfine sensibilities," and he was the subject of considerable bullying by his classmates.     At sixteen, he accompanied his father on part of a long sea voyage that ended for him in Australia. He had been seasick for much of the voyage, and when he went ashore in Sydney, he was diagnosed as too weak to continue on with his father to Calcutta. Instead, Ellis stayed behind, supporting himself as an assistant schoolmaster, a job at which he was not particularly successful. Away from his family for the first time, he found himself much troubled by sexual impulses that he did not understand. To come to terms with them, Ellis thought it necessary to "explore the dangerous ocean of sex."29 While browsing in a Sydney bookshop, he came across an anonymously written book, The Elements of Social Science; Or Physical, Sexual and Natural Religion, which greatly influenced him.     The author was the physician George Drysdale (1825-1904), who was a pioneer in pointing out the joys of sex in a manner that could avoid the Victorian censors. Drysdale, however, true to the standards of his day, held that immoderate amounts of sexual activity were dangerous, and he expressed horror at the variant forms of sexuality. Still, he emphasized that sexual intercourse could and should be a delightful thing. He held that the main obstacle to enjoying sex was the ever-present possibility of children, and it was this fear that caused men to turn to prostitutes and other forms of sexuality and women to become sexually inhibited. A neo-Malthusian, he also believed that overpopulation was a cause of poverty. All of these problems could be overcome by the use of contraceptives.30     Drysdale was very un-Victorian in believing that sex itself was to be a central issue in the future. Love, for him, was a necessity rather than a luxury, and moral virtues were, in the last analysis, simply matters of mental hygiene. Though Ellis later was critical of much of the book, at the time it influenced him. In the introduction to his series on the psychology of sex, he wrote:
	The origin of these Studies, dates from many years back. As a youth I was faced, as others are, by the problem of sex. Living partly in an Australian city where the ways of life were plainly seen, partly in the solitude of the bush, I was free to contemplate and to meditate many things. A resolve slowly grew up within me: one main part of my lifework should be to make clear the problems of sex.31
After his retuä to England, Ellis continued to teach, but proved less successful at each job. He remained troubled by sex, and in his soul searching he vowed to devote himself to a life of science. He set out to become a physician, the only profession through which he felt he could safely devote himself to the study of such a forbidden topic. In this, he was also strongly influenced first by the writings of and then by friendship with James Hinton, who, like Ellis, had been troubled about what to do with his life and had followed medicine. Hinton had also begun to study sexual behavior. Helped financially in part by an inheritance from his mother and a loan from Hinton's sister (women were continually coming to Ellis's rescue), Ellis began his medical studies. To help support himself, he turned to writing, an occupation that gave him a livelihood for the rest of his life. Though he completed medical school, he never really practiced medicine, and he used his training primarily to give him authoritative status for his sex writings. In December 1891, Ellis married Edith Lees, and though the marriage was consummated, sex thereafter did not play a significant role in it. His wife had strong lesbian tendencies, and neither Ellis nor she wanted any children. After a few years of marriage, the couple agreed not to engage in sexual intercourse, although both embarked on extramarital affairs. For a time, Ellis was impotent. His mistress, Françoise Delisle, with whom he finally found himself potent, wrote an account of her relationship with him in which she told about some of the sexual difficulties he had.32     As his success as a writer and editor grew, he began his first efforts toward a study of sex with the publication of Man and Woman (1894), in which he set out to investigate to what degree sexual differences were artificial or biological. He concluded that men were designed to make history and women to make children, a relationship that he said maintained a "perfect equipoise."33 This was because civilization was the creation of mentally and physically "abnormal" persons, and as more men than women fit that description, civilization drew its inspiration from men. This conservative view of the importance of women was strongly criticized by the eugenicist and statistician Karl Pearson. Others criticized the book for, among other things, its lucid description of menstruation.     Nonetheless, his study on male-female relationships aroused enough attention that he gained the courage to proceed further with his study of sex, although he continued to write on a variety of other topics. Ellis was most impressed by the way in which sexual topics had been treated by writers such as Nietzsche, Émile Zola, and Giacomo Casanova. Increasingly in his general literary efforts, he began making gentle attacks on the hypocrisy of modern morals, a theme that appeared throughout his sexual studies as well. Homosexuality seemed to him to be a key to understanding the nature of human sexuality, and as he began investigating the topic, he realized that several of his acquaintances were homosexuals, most notably John Addington Symonds and Edward Carpenter.     Ellis researched his topics through literature and history, supplemented by a rather haphazard collection of individual sex autobiographies, what might be called case studies. Many of his friends not only wrote their own sexual autobiographies for him but solicited their friends and sexual contacts to do so as well. He asked his wife about her homosexual friends, and though this upset her, she complied with his request to solicit biographical information from them.     Others before him had gathered information in the same way, particularly his friend Symonds (1840-93), best known for his studies of Renaissance Italy. Symonds, a homosexual who was married and the father of four children, had written two anonymous books on homosexuality: One was a long essay on homosexuality in ancient Greece called A Problem in Greek Ethics (1883), and the other, a historical overview titled A Problem in Modern, Ethics (1891). He had done much research on the topie.34 When Ellis realized the extent of Symonds's research, he proposed they collaborate on a study of homosexuality.35 Symonds had used the term inversion to describe homosexuality in his published studies, as did Ellis for a while; however, Ellis ultimately discarded it for the term homosexuality. HOMOSEXUALITY     The collaboration was an uneasy one, because the two men disagreed with each other, perhaps because Symonds, who was far more emotionally involved in the subject than Ellis, held such strong views. Symonds denied both that masturbation was a cause of homosexuality and that homosexuality might be inborn. Instead, he had romantic notions about male bonding similar to those of Frledländer, Brand, and Blüher, discussed earlier in this chapter. While Ellis agreed with Symonds about the harmlessness of masturbation, he was doubtful about the romantic notions of male bonding and instead held that heredity played some part. Symonds also did not believe that homosexuality was either a morbid or perverted condition, and although Ellis could accept this, he held that inverts were often neurotic.     Neither man's method was particularly scientific. Ellis himself rarely conducted in-depth interviews of the subjects of his case histories, unless they were close, personal friends. Instead, much of his material was secondhand written accounts given to him by the individuals themselves or by intermediaries, and Ellis did no further investigation. Moreover, a disproportionately large number of the cases he used had been gathered by Symonds, who was not always the most dispassionate observer or chronicler. To further complicate the data, Ellis, to disguise his subject's identities, sometimes deleted details and changed facts. The case history of his own wife, for example, is listed under the title "Miss H.," and it neglects to mention crucial factors in her life.     Though the agreement made between Ellis and Symonds stipulated that Ellis write the introduction and the case studies, and Symonds, the historical background, Symonds died before the project was completed. Ellis, however, gained permission to use much of Symonds's material, and it formed a significant part of the book.36 The book appeared in 1896 in German, Das Konträre Geschlechtsgefühl (to avoid problems of British censorship) under the names of both authors, and it was scheduled for an English version in 1897. Before the English edition was distributed, however, Symonds's family, to the surprise of Ellis, sought to remove his name from the publication, since they did not want any public association of the family name with homosexuality. Because the book had already been printed, the family was allowed to purchase all the copies of the first English edition and have them destroyed. They also secured an agreement with Ellis that if any further editions were published Symonds's name would be removed from the title page.     While Ellis accepted these conditions, he found he had trouble getting a publisher for his revised work in England. His book was finally accepted by Watford University Press. This new English edition, published under the title Sexual Inversion, soon ran into censorship problems, not so much for its content but because of its publisher. This was because Watford University Press was also the publisher for the Legitimation League, a group that advocated divorce by mutual consent as well as the removal of any stigma of illegitimacy on children born out of wedlock. The London police believed that such advocacy was an indication of a conspiracy by anarchists to undermine British morals, and they kept careful watch on a bookstore run by the league. An undercover agent saw Ellis's book on the shelves of the store, and the police decided to use what they felt was an indecent book to stamp out the league, the publisher, and the anarchists who were encouraging divorce. In spite of considerable support by literary figures such as George Bernard Shaw, Frank Harris, and Edward Carpenter, the bookseller pleaded guilty and was fined £100. Ellis, anxious to rid himself of his controversial publisher, took back his rights, transferred publication to the United States, and only later released the book in England.     This discussion of Ellis's early publication difficulties emphasizes what might be called much of the theme of Ellis's life and work: a desire to compromise, to avoid association with dogmatists, and to avoid unnecessary controversy. Unlike Hirschfeld, who pushed his way through obstacles at full speed, Ellis tried to win people over to his view. When he had to choose between stating that homosexuality was inborn or acquired, he said there was truth in both views. Ultimately, however, he tried to distinguish between homosexuality, which involved any physical or sexual relation between two people of the same sex, and inversion, which had definite congenital origins. He held that inborn homosexuality was inescapable and, therefore, socially acceptable, whereas acquired homosexuality might be open to cure and thus not acceptable. After admitting this, he concentrated on congenital inversion and so avoided the issue of dealing with acquired homosexuality.     He concluded his study on homosexuality by discussing what the attitude of society should be toward the congenital sexual invert. Typically, he believed That the correct answer lay in avoiding two extremes.
	On the one hand, it cannot be expected to tolerate the invert who flouts his perversion in its face and assumes that, because he would rather take his pleasure with a soldier or a policeman than with their sisters, he is of finer clay than the vulgar herd. On the other, it might well refrain from crushing with undiscerning ignorance beneath a burden of shame the subject of an abnormality which, as we have seen, has not been found incapable of fine uses. Inversion is an aberration from the usual course of nature. But the clash of contending elements which must often mark the history of such a deviation results now and again -by no means infrequently- in nobler activities than those yielded by the vast majority who are born to consume the fruits of the earth. It bears, for the most part, its penalty in the structure of its own organism. We are bound to protect the helpless members of society against the invert. If we go farther, and seek to destroy the invert himself before he has sinned against society, we exceed the warrant of reason, and in so doing we may, perhaps, destroy also those children of the spirit which possess sometimes a greater worth than the children of the flesh.37
Though Ellis used the terms aberration and deviation in this passage, he, for the most part, struggled to avoid any language of pathology. Though he often used the word abnormal, he did so in the purely statistical sense of "not average." He also used the term anomaly, sometimes sport (dalliance), and at other times variation. To emphasize the biological nature of homosexuality, he reported that inversion seemed to reappear in different members of the same families and implied that it might well be inherited. He also, unlike the author of any study that had yet appeared, attempted to emphasize the achievement of homosexuals. Here, using materials gathered by Symonds, he identified a large number of historical individuals, including Renaissance humanists whom Symonds had studied in detail, such as the Frenchman Marc-Antony Muret (1526-25), the "Prince of the Humanists" Desiderius Erasmus (1466-1536), the artist and poet Michelagniolo Buonarroti (Michelangelo) (1475-1564), the polymath Leonardo da Vinci (1452-1519), and a whole series of British men of letters from Christopher Marlowe to Francis Bacon to Oscar Wilde. Included in his list were also scientists such as Alexander, Baron von Humboldt (1769-1859).     Ellis insisted that homosexuality was not a disease but that sexual ambivalence, what is now called bisexuality, persisted in some degree in almost everyone. He held that an awareness of our shared hermaphroditic constitution helped render homosexuality comprehensible. Like Hirschfeld, he went beyond embryology and argued that internal secretions might eventually furnish the key, but, ever cautious, he felt scientists did not yet have the final answer.38 He rejected the possibility of a cure for homosexuality and disagreed with Freudian analyses of psychic mechanisms, such as the Oedipal complex, as being factors in homosexuality, but he agreed that there was a tendency for homosexuality to arise in heterosexual persons who are placed under conditions in which the exercise of normal sexuality is impossible.39 He simply concluded that the doctrine of acquired inversion was difficult to document, since it might only be a case of retarded differentiation.     Ellis paid more attention to female homosexuality, lesbianism, than others had before him, but he confined his discussion to a single chapter. Interestingly, in his discussion of male homosexuality, he did not assert that congenital homosexuals were always effeminate, but he did note that female homosexuals had more virile temperaments than other women.40 He also felt lesbianism was specially fostered by those conditions that kept women in constant association, not only by day but often by night, without the company of men. Though he emphasized that homosexuality was as common in women as in men, its pronounced forms were less frequently met with in women than in men. He also seemed to assume that dildos were in common use among lesbians, and he deemphasized the importance of the clitoris.41 Ellis stated that homosexual
	passion in women finds more or less complete expression in kissing, sleeping together, and close embraces, as in what is sometimes called "lying spoons," when one woman lies on her side with her back turned to her friend and embraces her from behind, fitting her thighs into the bend of her companions's legs, so that her mons veneris is in close contact with the other's buttocks, and slight movement then produces mild erethism. One may also lie on the other's body, or there may be mutual masturbation.42
He emphasized, however, that mutual contact and friction of the sexual parts seems to be comparatively rare.     Much of this work is similar to what Hirschfeld said but without Hirschfeld's excesses and with much more caution. His homosexual study is much less detailed than his later volumes and marks an uncertainty in Ellis about his real object. This study does set the pattern for his later writing, in trying to avoid some of the major controversies of his time, all the time arguing for tolerance and understanding. MODESTY AND OTHER STUDIES     It is in the second volume, later to be listed as volume one in the revised complete series, that Ellis hit his stride. This volume is devoted to the study of modesty, sexual periodicity, and autoeroticism, and Ellis followed the same pattern as he did in his study on homosexuality, turning to history, anthropology, literature, and biology for answers. Again he tried to remove stigma surviving in the use of earlier terms by seeking more neutral ones. Perhaps the key to the volume is his study of masturbation, to which most of the volume is devoted. Ellis believed that if he could eliminate the fear and anxiety that pervaded much of the scientific writing on sexuality when it came to masturbation, he could set the study of human sexuality on a new course.     To describe the phenomena that he grouped under masturbation, Ellis invented the term autoeroticism, which he defined as
	the phenomenon of spontaneous sexual emotion generated in the absence of an external stimulus proceeding, directly or indirectly, from another person. In a wide sense, which cannot be wholly ignored here, auto-eroticism may be said to include those transformations of repressed sexual activity which are a factor of some morbid conditions as well as of the normal manifestation of art and poetry, and, indeed, more or less color the whole of life.43
In defining masturbation as autoeroticism, he managed to bring together a number of different psychosexual phenomena, including erotic dreams, daytime fantasies, narcissism, hysteria, and masturbation, and held that the most typical form is "occurrence of the sexual orgasm during sleep."44 In the words of Paul Robinson, thus "by means of an inference that might be called innocence by association, masturbation was transformed from a malignant vice into a benign inevitability."45 Ellis, however, did not dismiss the possibility that masturbation might result in some slight nervous disorders, and he felt that in its extreme form it marked the divorce of the physical and psychological dimensions of sexual expression. Still, he removed it from the category of illness.     What is interesting in the developments of sex research in this period is seeing how each of the researchers interacted with the others' findings. Freud, for example, was working with hysteria and its association with sexuality, and so was Ellis; each was familiar with the other's work. The researchers of the time -Hirschfeld, Ellis, Freud, and others- also were extremely pleased when others cited them favorably.46 Moreover, each borrowed from the others.     One of the keys to Ellis's physiological concepts was the theory of tumescence and detumescence, which he had adopted from Moll. For Ellis, however, tumescence described the "accumulation" of sexual energy during arousal and detumescence, the "discharge" of that energy at the moment of climax.47 The idea is similar to Freud's libido theory, because Ellis recognized that the detumescence could discharge its force in other than sexual ways.     What made Ellis different from the other sexologists of his time was his much greater emphasis on love and courtship. He himself held that his studies differed from those of earlier investigators primarily in the attention he devoted to normal sexuality as distinct from abnormal. Moreover, he consistently tried to relate that which might be abnormal to the normal. For example, in his analysis of sadism and masochism, Ellis argued that the principal element in both was the association of love with pain, something he also observed in animals.48 For this reason, he sought to eliminate the two categories, combining them into sadomasochism, using the term algolagnia. He ended up arguing that the whole of sexual psychology, including its various deviations, derived from the exigencies of courtship.49 Similarly, he ultimately included other forms of sexual variation -fetishism, exhibitionism, bestiality, transvestism (which he called eonism), urolagnia, coprolagnia, and others- into the same scheme. He regarded most of these anomalies as congenital, and he could relate each to some aspect of normal sexual life. Coprolagnia, for example, was related to the attraction of the female buttocks; exhibitionism, to the pride of the male in his genitals; bestiality, to the primitive belief that animals were really disguised men, and so on. Even so-called normal men and women had unusual fixations. In Erotic Symbolism, he argued that all sexual deviations involved an imitation of both the actions and the emotions of normal sexual intercourse.50     Ellis emphasized that women were sexual creatures and demonstrated that the Victorian belief that women lacked sexual emotions was mainly a nineteenth-century idea without empirical foundation. He argued that women had sexual desire no less intense than men and that women's capacity for sexual enjoyment was comparable with men's.51 He concluded, however, that the sexual impulse in women differed from that in men, because in women (1) the impulse was more passive, (2) the impulse was more complex and less spontaneous, (3) the impulse grew in strength after sexual relationships had been established, (4) the threshold of excess was less easily reached, (5) the sexual sphere was larger and more diffused, (6) there was more periodicity, and (7) there was greater variation -both among women and within a single woman.52 Much of this was due to the fact that sexual excitement in men was wholly contained in a single event, penile erection. Though clitoral erection occurred in women, Ellis felt that behind the clitoris was the much more extensive mechanism of vagina and womb, both of which demanded satisfaction. He ridiculed Freud's idea that female sex was exclusively vaginal and held that it could have been advanced only by someone who lacked any direct knowledge of woman's sexual experience. Whereas all erotic sensitivity in the male was concentrated in the penis, it spread in women to several non-genital areas such as the breast. Ellis concluded that women were far more sexual beings than men. It was this diffuse nature of women's sexuality that made courtship necessary and essential.     In general, Ellis's goal was to study and identify various forms of sexual expression without stigmatizing them. When he studied cross-dressing, he found that Hirschfeld's term, transvestism, was both too narrow and too stigmatizing and urged the use of the term eonism, after the Chevalier d'Éon, although this term never caught on. Following Hirschfeld, however, he recognized transvestites were different from homosexuals, and that many could be heterosexual. He concluded, however, that the ultimate causal explanation might lie in an imbalance of the endocrine system, something he, as did Hirschfeld, more strongly supported as he grew older.53 ELLIS'S AND HIRSCHFELD'S STRENGTHS AND WEAKNESSES     Ellis essentially was empirical, pragmatic, and tolerant. Though he was trained as a physician, his methods were really more closely tied in with the humanities than with the sciences. Historical data furnished a significant part of his database, as did cross-cultural data. At heart, he was a sex reformer, and he strongly supported the struggle to gain greater contraceptive information, marriage reform, and rights for women and sexual minorities.     As indicated at the beginning of this chapter, one of the difficulties both Ellis and Hirschfeld posed to the medical community was that because they put so many forms of sexual behavior within the normal range of possibilities for all humans, they offered little for the physician. Ellis and Hirschfeld could enable the physician to make a better diagnosis and give explanations for sexual variations, but they provided no role for treatment. Physicians, even liberal ones, were reluctant to tell their troubled patients that their sexual behaviors were more or less part of being human.     It might well be that one of the barriers to the acceptance of Ellis and Hirschfeld by the medical community was their willingness to go beyond the medical audience, although Hirschfeld did sometimes write specifically for physicians. Hirschfeld also maintained a medical office and retained more of a belief in a medical model than Ellis, at least for treatment purposes. Ellis was a physician who never practiced medicine, and he wrote for the general public, despite the necessary legal claims to the contrary in those geographic areas in which censorship would allow sex books to be distributed only to professionals.     This appeal to the public at large was Ellis's and Hirschfeld's strength and weakness. Neither developed the kind of disciples that were so common among major medical figures of their time, and neither, since they were not associated with a university, developed a group of student followers. Hirschfeld certainly was more conscious of the need for continuity than Ellis, but he was unable to put into practice his ambitious plans. Ellis felt that his writings would be enough.     It was Freud who most effectively maintained the medical model, and this gave him an advantage in the professional community. He also carefully cultivated disciples who believed in his work and in his treatment modalities. He claimed that those who adopted his viewpoint could cure their patients, and although Ellis could be easily read and was widely available (Hirschfeld less so), it was Freudian ideas that dominated the treatment world of the first part of the twentieth century. Ellis, Hirschfeld, and others might well have been the permission givers, but it was Freud who pushed the theory and the treatment. This is something the organized medical community could accept, even if the treatment ultimately lay in the hands of a specialist rather than a generalist. SIGMUND FREUD Unlike Ellis and Hirschfeld, Freud did not set out to be either a sex reformer or a sex researcher, although he ended up as both. Born in Moravia, Freud moved with his father to Vienna in 1859, where he spent much of the rest of his life. A brilliant student in grammar school, he went on to study at the University of Vienna, where he became particularly interested in physiology. For a brief time, following his graduation in 1881, he continued his research work in physiology, but when he became romantically involved with his cousin, Martha Bernays, Freud decided to turn to the practice of medicine to support himself and his hoped-for family. He then interned at the Vienna General Hospital, spending part of his time in the psychiatric division. In 1885, the university awarded him a traveling fellowship that enabled him to study in Paris under the famous neurologist Charcot, who had demonstrated the value of hypnosis in treating patients. In 1886, Freud began practicing in Vienna as a specialist in nervous diseases and a few months later married Bernays.     In the 1880s, specialists in nervous diseases who had private practices generally treated patients who were neurotic and only occasionally some who were psychotic. The psychiatrist looked on patients with nervous diseases as suffering from hereditary degeneration or from lesions in the central nervous system. This meant that the practitioner was more or less helpless, because treatment, such as the then-popular brain surgery, often resulted in the death of the patient. Freud, impressed by Charcot, made tentative steps toward using hypnosis as a treatment technique and originally was pushed further in this direction by the experiences of Josef Breuer (1841-1925). Breuer held that neurotic symptoms were physical expressions of repressed emotions and that such symptoms would vanish if the painful experience were recalled and the emotion belated expressed. The result of this initial collaboration was Studies on Hysteria,54 which took the term unconscious from German Romantic literature and philosophy and tied it in with repression, conversion, and abreaction, a term employed by psychoanalysts for the process of releasing a repressed emotion by reliving the original experience in the imagination.55 PSYCHOANALYSIS AND SEXUALITY     There is a vast literature on the development of Freud's thought, much too vast to cover in a brief overview. The focus here is on psychoanalysis and sexuality, and not on Freudian concepts in general. Freud's sexual theories gradually emerged and changed over time. Early in his practice, for example, he adopted the belief that those individuals suffering from neurasthenia (nervous anxiety) were masturbators. For a time, he even believed that nocturnal emissions were as damaging as masturbation. Gradually, he changed his mind,56 influenced by the work of Moll, Ellis, and others who demonstrated that masturbation was part of the experience of childhood sexuality. His most important work in this respect was his 1908 paper titled "Civilized' Sexual Morality and Modern Nervousness," in which he criticized Beard's theory of neurasthenia (discussed in chapter 1) as well as downplayed the exaggerated dangers of masturbation. He further emphasized that the sexual instinct in humans served the purpose of procreation and that pleasure and pleasurable gratification were natural aspects of child development.57 About the same time, Freud had also abandoned his ideas about the influence of childhood seductions on the development of later behaviors such as homosexuality.58     Increasingly, in fact, sexuality emerged as the key to much of Freud's thinking, and he went so far as to claim that every neurosis had a specific sexual cause. Sexuality, in the words of Frank Sulloway, became for Freud the indispensable organic foundation for the scientific explanation of mental disease.59     The transition in his theoretical approach can be dated from 1899, when he began exploring the stages of sexual development. He held that the autoerotic was the first stage of development and that it preceded alloeroticism (homoeroticism and heteroeroticism) but that it survived as an independent tendeney.60     Much of the change of ideas resulted from his own intense self-analysis. At the close of this experience (about 1902), he emerged with the conviction that he had discovered three great truths: that dreams are the disguised fulfillment of unconscious, mainly of infantile wishes; that all human beings have an Oedipus complex in which they wish to kill the parent of the same sex and possess the parent of the opposite sex; and that children have sexual feelings. He later added two ideas to these emerging principles of psychoanalytic thought, namely the division of the human mind into superego, ego, and id and the concept of the death instinct (thanatos).     Freud was no advocate of sexual freedom, although he eventually believed that sexual energies had to be directed, not repressed. This led him to postulate that variant sexual behavior came from sexual drives that were misdirected in their aim or object. The cause of this misdirection lay in the nervous system and the mind through which the instinctual drive operated. Though Freud paid comparatively little attention to most forms of variant sexual behavior, his followers seized on his concepts to emphasize, far more than Freud himself did, the environmental and accidental causes of variant impulses. Later behaviorists, who stressed learning and conditioning of animals and humans, carried these environmental and accidental determinations to the extreme, but the practical result of both Freudianism and learning psychologies was to suggest that everyone had the potential to channel his or her drives toward any form of gratification and with any object. The major effect of such a conclusion was to undermine the assumption that certain forms of sex were against nature, for nature itself -the instinctual drive- was visualized as being able to express itself in many ways.     Freud came to endorse the belief that all human beings are bisexual, and he emphasized the importance of this in human psychosexual development. He also extended a more general phylogenetic paradigm of sex to encompass numerous other "component impulses" of the human sexual instinct, such as sadism, masochism, and coprophilia (love of excrement). As a result, Bloch described Freud as having "gone further than any other writer in biologico-physiological derivation of sexual perversions."61     He also emphasized the role of the environment, accepted the ubiquity of perverse sexual drives, and enthusiastically welcomed the efforts of anthropologists and cultural historians in the collection of data on various forms of sexual behavior. It was not only the social and cultural environment that influenced sexual behavior but also the individual's environment as he or she grew up. Freud noted how pathogenic fantasies developed out of the germs of infantile sexual fantasies. His hypothesis of the effect of infant or childhood repressed or unconscious erotic experiences proved to be a major breakthrough in explaining certain forms of sexual behavior. This was because it clarified why a particular form of fetish, for example, a shoe fetish, might develop in some individuals, whereas a rubber fetish or a leather fetish would develop in others. The influence of chance events in childhood on possible fetishism had already been put forth by Binet and developed by others, but the theory had been criticized by Moll because it remained unclear to him why one kind of behavior developed and not another or why similar experiences did not effect everyone in the same way. Freud's concept of unconscious repression and conversions offered a logical way out of this impasse.     Freud was an advocate of nature and of nurture, relying on both to explain psychosexual pathology. He acknowledged the possibility of heredity predisposition but also recognized environmental determinism. His approach allowed him to adopt and exploit the best theoretical ideas advanced by the two opposing camps.62     Exclusive homosexual orientation, for example, was conceived by Freud as a complex blend of the biological (bisexual potential) and psychical factors. He strongly opposed a strict distinction between inborn and acquired characteristics, since, in practice, he found a mingling and blending of both.63 In addition to the idea of inborn homosexuality, Freud considered a number of other potential causal factors, including the Oedipal complex, fear of castration, regression to a primary autoerotic state, obstacles put in the path of ordinary sexual satisfaction, hatred of a father or a sibling, and fixation on the notion that women have a penis. He also tried to distinguish among manifest, latent, aim-inhibited, and sublimated homosexuality.64     Later, he stated that psychoanalysis had established two factors in the etiology of male homosexuality. The first factor was the fixation of erotic needs on the mother. The second was that even the most normal individual is capable of making a same-sex object choice and if he had done so at some time in his life, he either still adheres to it in his unconscious or else protects himself against it by vigorous counterattitudes.65 In short, in some individuals, inversion is possible simply because human beings have the capacity to be attracted to objects of the same sex under certain psychical or social circumstances.     Freud rejected the idea of a third sex. although he recognized the possibility of biological or genetic factors. The problem, he felt, was to explain why homosexuality prevailed over the heterosexual potential of human bisexuality.66 Freud was opposed to any effort at separating homosexuals from the rest of humanity as making up a special class, since all human beings are capable of a homosexual object choice. At least twice in his career, Freud emphasized that homosexual persons were not sick. The first time was in 1904, when he was interviewed by the editor of the Vienna newspaper Die Zeit, to whom he stated that the homosexual did not belong before the court of justice and that he or she was not sick.67 Later, in 1935, he wrote to a mother whose son was homosexual, indicating to her that he could not eradicate homosexuality in a person and that it was a great injustice to prosecute such behavior in individuals. He advised her to read Ellis on the topic.68     Freud's belief in the underlying biological forces involved in forming sex-specific behavior was a major factor in his concept of latent homosexuality. This led him to equate femininity with passivity, gentleness, and timidity and to imply that females who were ambitious, athletic, aggressive, or in other ways masculine were showing latent homosexuality and losing their femininity. Such assumptions have been heavily criticized by some modern feminists, most notably and uncharitably by Kate Millet69 but the difficulty with criticizing Freud is that he said different things at different times in his career. MEGA THEORY     As his theoretical thinking matured, Freud moved from specific to grand theory. Ultimately, he concluded in Civilization and Its Discontent that the problems in sexual development were attributed to the development of civilization. Expanding on Krafft-Ebing he came to hold that the deepest roots of sexual repression that advanced along with civilization, lay in the human effort to overcome an earlier animal existence.70 Freud seemed to be subscribing to a kind of organismic theory of history, in which there was only a limited amount of vital energy in every culture and the losses suffered through sex could not be replaced. One aspect of this line of thinking was the need to control sexuality and especially female sexuality. Freud believed that the female held great feelings of inferiority over the lack of male genitalia, while the male, conscious of his possession of such an important body part, feared that women wanted to castrate him. In brief, the narcissistic rejection of the female by the male is liberally mingled with fear and disdain.71 This aspect, however, was further developed by some of Freud's followers, who put the need for female subjugation in the extreme.72 SEXOLOGY     Freud, however, cannot be blamed for the excesses of his disciples, and the theories he developed seemed able to answer many of the questions facing society. They proved particularly attractive to those involved in the study of literature, anthropology, and some of the other social sciences. Like Marx and Engels, or for that matter John Locke, Freud posited an original state of nature in which the sexual assumed great importance. He suggested that civilization developed as it learned to control the sexual. This was a radically different formulation from those advanced by Ellis and Hirschfeld, who were less ambitious in their explanations. It was the grandiose nature of the Freudian answer -which, of course, was not subject to any kind of empirical verification- that appealed to so many. Although he had strongly grounded his ideas in biology, he :gave free range to his imagination when he left it.     During much of his early career, he depended heavily on many of the early sexologists, but over time he tended not to cite them, ignoring or denigrating Hirschfeld, Moll, and other sexologists, including many on whom he had relied in his early writings. What he did was to seize on selected and historically transient evidence and generalize it into universal law. He shifted from proximate causal to ultimate causal theory in his efforts to attain a synthetic, psychobiological solution to the problem of the mind. In the process, he began to ignore later research findings of some of his sexologist colleagues and went on his own to base his whole theory of psychoanalysis on sexuality, his "indispensable premise." Freud himself made important contributions to sex research, and his concept of the unconscious was a major breakthrough. His emphasis on both biological and psychological factors is also important, although some of his disciples tended to ignore the biological. Perhaps his greatest significance is that he made an understanding of sexuality a key to the understanding of human nature. His writings, far more than those of any of his contemporaries, broke down the barriers against the discussion of sex, thus encouraging others to look seriously at human sexuality.     As he aged, Freud grew more insistent that he was correct, bringing along a coterie of individual disciples who generally accepted what he said without looking at what was being said outside of the psychoanalytic arena. The rise of the Nazis dispersed these disciples to other countries, where they promoted the ideas of Freud, not those of the other contemporary German sexologists. In the English-speaking world, and particularly in the United States, much of the sexological research preceding Freud and contemporary with Freud was neglected or overlooked by Freudian-oriented psychoanalysts, who dominated the therapeutic and scholarly writing on sex.     With the death of Freud and Hirschfeld and particularly with the rise of Nazism, German-speaking areas lost their preeminence in sex research. Ellis in England had been increasingly isolated by his ill health, and no one of his stature rose to carry on his tradition. Instead, the leadership in sex research passed to the United States, and it is the beginning of such research in the United States that forms the topic of the next chapter.
4 THE AMERICAN EXPERIENCE So far in this book, there has been an emphasis on homosexuality as a major factor in sex research. Krafft-Ebing, Hirschfeld, and Ellis all were concerned with variant sexuality, and the first works of each of them dealt with it, although Krafft-Ebing did so in less detail than the others. Freud was not so concerned with homosexuality per se, but many of his psychoanalytic followers devoted considerable attention to it. One reason for this attention, as indicated earlier, was a growing public awareness of the existence of individuals who loved members of their own sex more than those of the opposite. Another reason for the concern with homosexuality was the rapid growth of cities and the challenges this posed to traditional patterns and assumptions of living. Some of this concern by sex researchers with homosexuality, as in the case of Hirschfeld, was probably also to get a get a better understanding of themselves. MEDICAL RESEARCHERS American medical observers were conscious of some of the research taking place in Europe, but for the most part, they did not do any major research oil sexual topics in the nineteenth century, although toward the end of the century, they did contribute case histories and discussions of various "deviant" sexual practices, including homosexual behavior.1 Probably the best informed American medical writer on the subject was Lydston of Chicago (discussed in chapter 2). He recognized the complexity of the phenomenon of "perversity" and the difficulty In determining cause. He believed it was possible that a person might be born with a tendency toward perversion because of a physical deformity of either the brain (Idiots, for example) or the genitalia (such as hermaphrodites) or because of congenitally misdirected impulses. He remained a believer in the dangers of masturbation, holding out the possibility that homosexuality was a result of "overt stimulation of sexual sensibility and the receptive sexual centers, incidental to sexual excesses and masturbation."2     Lydston, however, was an exception. Generally, in fact, most American physicians who did look at sex did so to emphasize its dangers, as Beard did with his concept of neurasthenia (see chapter 1). One reason for this is that American physicians in the last part of the nineteenth century were striving to professionalize themselves and to upgrade their standards to match those in Western Europe. In such a setting, the investigation of sexual activity was not seen as respectable. Instead, the respectable physician strove to be as much a guardian of traditional morals as he or she was a medical practitioner. One result was the enforcement of a more or less official prudery among the members of the increasingly powerful American Medical Association (AMA). Symbolic of this was the reaction to Denslow Lewis's paper "Hygiene of the Sexual Act," which was presented at the 1899 meeting of the AMA. Although Lewis was allowed to read his paper, the famous Johns Hopkins University gynecologist Howard Kelly objected to such a presentation on the grounds that the "discussion of the subject is attended with filth and we besmirch ourselves by discussing it in public." Later, the editor of the Journal of the American Medical Association refused to publish the paper because he was opposed to publishing "this class of literature."3     One way would-be physician researchers into sex could cope with such demands for respectability was to make negative judgments about what they observed, thus enforcing standards of morality, which in a sense is what Lydston did. Another way was to express shock and surprise that various unusual sexual phenomena could exist. Thus the following comment by the St. Louis physician C. H. Hughes, a specialist in nervous and mental diseases who apparently was aware of some of the European sex research at the time. In 1893, he published a brief description titled "An Organization of Colored Erotopaths," in which he wrote, I am credibly informed that there is, in the city of Washington D.C., an annual convocation of negro men called the drag dance, which is an orgie of lascivious debauchery beyond pen power of description. I am likewise informed that a similar organization is lately suppressed by the police of New York City."4 Hughes, in short, not only managed to express surprise but, by emphasizing that it was only "colored" who were involved, managed to shift the stigma of such conduct to what he clearly regarded as an inferior race.     Another example of the reluctance of the American medical establishment to deal with sexuality in any serious way is emphasized by the anonymous American reviewer in 1902 of Ellis's study on sexual inversion. While complimenting Ellis for pursuing his studies of sex on a scientific level, the reviewer concluded that Ellis was too inclined to fill his books "with the pornographic imaginings of perverted minds rather than cold facts, and the data which are collected are seemingly of little value. Whether any practical results can come from such labor is doubtful."5     Earlier, William Noyes had reviewed the first German edition of the same work by protesting
	against the appearance of such a work as this in a library (series) intended primarily for popular reading. Even Krafft Ebing [sic], although writing solely for the profession, has been severely and justly criticized for unnecessary emphasis and importance he has given this subject by his articles on the perversions of the sexual sense, and nothing but harm can follow if popular literature is to suffer a similar deluge.6
Noyes claimed that publicity given various kinds of nonprocreative sexual activity only allowed perverts to recognize their condition, and since understanding failed to lead to amelioration, it was best if it had not been mentioned at all.     Still, discussion of variant forms of sexuality appeared occasionally in the medical journals, usually of isolated cases among a physician's patient population, and were reported in the hope that the gathering of as many facts as possible might lead to scientific conclusions. By and large, the American medical establishment believed "degeneration" was congenital and probably caused by a hereditary physical weakness of some sort. Case reports highlight the peculiarities of the brain and genitals, both before and after death. Undoubtedly, this kind of reporting served to confirm the tendency to think of the individuals involved as being perverts who were isolated cases as well as physically handicapped.     There were exceptions. For example, Randolph Winslow reported on an outbreak of gonorrhea spread by rectal coition at a boy's corrective institution in 1886 Baltimore. He found anal intercourse to be common in such institutions and emphasized the difficulty in eliminating such activities. Younger boys, he said, sold their favors to older ones for economic gain, and when questioned about it, the boys justified their conduct by the existence of prostitution in the outside world.7 Though Winslow and others knew that European investigators had reported a tendency among homosexuals to group together, observers generally ignored the real life around them and rarely went beyond the facts of a particular case before them.     The psychologist G. Alder Blumer, who had read the Continental literature, reported a case of "perverted sexual instinct," but he classified his patient as insane and possibly epileptic. This description was frequently applied in the American medical literature to those departing from the accepted norms in sexual behavior. He added that his homosexual patients told him they were "able to recognize each other," but he did not explain how this came about.8 Lydston again was the exception, writing,
	There is in every community of any size a colony of sexual perverts; they are usually known to each other, are likely to congregate together. At times they operate in accordance with some definite and concerted plan in quest of [a] subject wherewith to gratify their abnormal sexual impulses.... The physician rarely has his attention called to these things, and when evidence of their existence is before him, he is apt to receive it with skepticism.9
It was not only physicians who were reluctant to accept the existence of variant sexual behavior but other professionals as well. Such behavior to them was morally wrong. A member of the Philadelphia Bar, for example, told J. Richardson Parke that he would refuse to defend anyone accused of inversion on the grounds of social and professional decency. Parke himself had no such qualms and held that sexual inversion had "been perceptibly stimulated in our larger cities, and in our native born population, particularly, by the ever-growing desire to escape having children."10     John Burnham argued that American physicians of this period refused to recognize the social aspects of behavior,11 and until they did, he noted that homosexuality as well as other variant forms of sexual behavior would remain merely a series of case studies. Allan Mane Hamilton was one of the leading psychiatrists at the turn of the century, and he pointed out, as had his Continental counterparts fifty years earlier, that the lack of such studies severely handicapped the court in dealing with cases that came to its attention. The result was that the court dealt with these individuals by classifying them as mentally unsound and grouped them with the insane.
	The attitude of the law so far is very harsh regarding punishment of offenders of this kind when detected, when they happen to be distinctly responsible, and it rarely recognizes any extenuating circumstances, and while possibly this restriction is best for society, there is no doubt that in cases where a congenital taint exists, some degree of protection should be afforded the possessors of mental weaknesses who are apt to be the prey of persons of their own sex.12
There were just some things that Americans did not want to think about. For example, in 1889, A. B. Holder, who had lived and practiced in Montana, writing), in a medical journal, described the custom of berdache among the Crow Indians where the men adopt the role and clothes of women and even took another man as husband.13 Yet twenty years later a Zuni Indian healer, a berdache, could be taken by an anthropologist to Washington, D.C., and introduced as a woman without either the anthropologist or Washington society aware of the biological sex of the individual.14 Obviously Americans had difficulty in believing such people could exist and have an important role in any society. CIVILIZED MORALITY Official attitudes of American society were characterized by what has been called civilized morality, defined by Mark Connelly as the prescriptive system of moral and cultural values, sexual and economic roles, religious sanctions, hygienic rules, and idealized behavioral patterns that emerged in the Jacksonian period and influenced American middle-class life up to the beginning of World War I. In the ideal world of civilized morality, all moral values were absolute and timeless, masculine and feminine roles were sharply defined and demarcated, and sexuality was seen as a potentially destructive force.15     Believers in this civilized morality held that the code's viability depended on an
	unremitting effort to root out all opportunities for moral lapse. This understanding fueled the purity crusade of the late nineteenth century, particularly the shenanigans of Anthony Comstock and like-minded individuals who were determined to protect American society from salacious books, prostitutes, poker, and other forms of mental or physical licentiousness. In a sense, the purity crusade was an attempt to force the reality of social conditions into line with the dictates of civilized morality.16
Two fundamental components of this civilized morality were the conspiracy of silence17 and the double standard.18 Institutionalizing the enforcement of this morality was the American Purity Alliance, which had been formed in 1895 through a merger of local and state purity groups.19 Inevitably, such attitudes gave Americans doing sex research a different perspective from the one researchers had on the Continent. To put it simply, Americans were more prudish in their public discourse. Though they read Ellis, and Freud's works were gradually reaching an American audience, attitudes toward public discussion were changing only slowly. Most Americans publicly writing about sex in the pre-World War I era remained prisoners of the assumptions of civilized morality; that is, they viewed public discussion of sexual matters as not quite respectable. Still, to come to grips with what they believed to be the evils brought on by sexual activity, American investigators thought it necessary to study and understand such topics. It was with this kind of Justification that the serious analysis of sexuality began in the United States. WOMEN AND PROSTITUTION Basic to much of early-twentieth-century American sex research was prostitution, because so many evils seemed related to it: exploitation of children, pornography, disease, and crime.20 Prostitution was called the "great sin of great cities,"21 but as William E. H. Lecky wisely noted in his History of European Morals (1869), it was the prostitute, the very symbol of degradation and sinfulness, who ultimately proved to be "the most efficient guardian of virtue."22 By this he meant that only by tolerating the kind of double standard that prostitution implied could the good woman -the nonsexual woman- be preserved in her chastity.     But women in the last part of the nineteenth century were beginning to challenge some of the traditional male assumptions. Their weapon was their very weakness, the assumption that somehow they were less sexual than men (unless some evil force so aroused them that they fell from gentility) and, therefore, purer; as such, they were considered the designated guardians of family virtue. chastity was the mark of gentility, and though chastity or its lack might be difficult to prove, the assumptions of chastity were not. Once women were married, however, it was motherhood that counted.     Women, or at least proper women, were taught to think of themselves as a special class, and having become conscious of their unique sexual identity, they could no longer accept uncritically the role definitions drawn up for them. Motherhood came to be elevated into a mystique, which Freud made into a pseudoscientific basis of existence. Even though the Victorian conception of women as wan, ethereal, and spiritualized creatures bore little relation to the real world in which women operated machines, worked the fields, hand washed clothing, and toiled over great kitchen stoves, this view was endorsed by both American science and religion. Even fashion conspired to the same end, for the bustles, hoops, corsets, and trailing skirts in which women were encased throughout much of the nineteenth century can be seen, in retrospect, to have been designed to prevent them from entering the world of men.23     At one level, prostitution preserved this official female innocence, but at another level, it threatened to destroy the innocence because of the dangers of disease. It was this issue that caused so many people to condemn prostitution. The use of prostitutes as sex partners was fairly widespread in the last part of the nineteenth century, and patrons came from all classes. A good illustration is the case of the Reverend William Berrian, pastor of New York City's Trinity Church, probably the wealthiest parish in the United States, if not in the world, at that time. In a sermon preached in 1857, he virtuously proclaimed that during a ministry of more than fifty years, he had been in a house of ill fame not more than ten tims.24 If such a guardian of morals could somehow visit a prostitute, one has to conclude that large numbers did so, at least at some time in their lives. In fact, so widespread was prostitution during the last part of the nineteenth century, that Ellis thought prostitution to be a necessary product of civilization and urban life.25 SEXUALLY TRANSMITTED DISEASES The trouble with prostitution went beyond the moral because of its close association with disease. Though Ricord had plotted the three stages of syphilis shortly after the middle of the nineteenth century, the full impact of the disease began to be realized only at the end of the century. By then numerous pathological conditions were recognized as being the result of syphilis, including the appearance of gummas on the skin, on the bones, and in vital organs; the weakening of blood vessels; and the destruction of various parts of the nervous system. Though the knowledge of the sequelae of the disease was itself important, it was the realization that the disease could be passed on to innocent wives and children that proved a major challenge to civilized morality.26 The difficulty was compounded by the fact that, until well into the twentieth century, physicians could offer little therapeutic hope for those afflicted with syphilis. Most physicians treated syphilis with mercury, either orally, in vapor baths, or topically. Mercury was used as much for magical reasons as for any evidence of cure, because the justification for its original use had been based on ancient theories of humor and health, which by the end of the nineteenth century had been discarded in other areas of medicine. The mercury treatment was widely used, and the element was given in such doses that the therapy itself was often lethal. In fact, many of the symptoms then attributed to syphilis are now believed to have resulted from mercury intoxication.27     The other major venereal disease being diagnosed at that time was gonorrhea. Treatment for it depended in large part on oral medications, and it was believed that when the medications were taken in sufficient quantity, they had an antiseptic effect as they were excreted through the urethra. Ricord, however, had emphasized how little the physician could help when he noted: "Gonorrhea begins and God alone knows when it will end."28     Inevitably, venereal infections were high, although estimates of the numbers range widely. Perhaps the most accurate determination of the prevalence of the venereal diseases among young males in the United States is one from 1909 based on U.S. Army physicals; the army found a rate of one out of every five. Some medical groups set higher rates of infection based on their own practices. One committee of New York physicians estimated that as many as 80 percent of the men in the city had been infected at some time in their lives with gonorrhea and from 5 to 18 percent had suffered from syphilis. A Boston physician during the same period found that more than 33 percent of a sample of male hospital patients had gonorrheal infections.29 Prostitution was inevitably blamed, and fears grew, especially as it was realized that gonorrhea could lead to sterility in women and blindness in infants and that syphilis could cross the placental barrier. The military was also concerned because gonorrhea in particular was temporarily so disabling in males, and it made them unfit for battle for ten days to two weeks, and occasionally even longer. Some of the estimates of the rate of infection are just guesses.     In 1904, Fritz Schaudinn and Erich Hoffmann identified the causative agent of syphilis. Soon after, August Wasserman, Albert Neisser, and Carl Bruck developed diagnostic tests that relied on a complement-fixation reaction; these tests allowed physicians to make accurate diagnoses. Theoretically gonorrhea could be diagnosed much easier by examining under the microscope a slide smeared with the exudate, but few physicians had the technical facilities to do this until well after the first decade of the twentieth century.     With the isolation of the syphilis spirochete, there was an immediate search for a cure. In 1910, Paul Ehrlich and Sahachiro Hata announced the discovery of Salvarsan, an arsenic compound, which was the first effective treatment for syphilis. It was the 606th compound Ehrlich and Hata had tested on syphilitic rabbits, and their success marked the beginning of modern chemotherapeutics.30 Although Salvarsan was hailed as a miracle drug, it had serious side effects, and many individuals succumbed to the high toxicity of the treatment, since it was a race to see whether the spirochete or the patient would be killed first, and many times the patient lost.     BritainEhrlich continued to experiment with other substances, and in 1912, he found what he called Neosalvarsan, or No. 914, a less-toxic, but lesseffective, drug than the original. This finally gave the physician a treatment modality over syphilis and emphasized further the importance of medicine to the study of sexuality. This medical control was strengthened by the discovery of the sulfanilamides by Gerhard Domagk in 1921. The sulfanilamides' ability to kill bacteria, including those causing gonorrhea, was recognized in 1936. Penicillin, which had been discovered in 1929 by Alexander Fleming, was finally produced in quantity during World War II, and by 1945 it had been shown to be effective against both gonorrhea and syphilis. PREVENTION OF SEXUALLY TRANSMITTED DISEASES     Because the new treatments did not really develop until after World War II, and Ehrlich's earlier treatment was very costly and time-consuming, many medical professionals looked to prevention as an answer. In their search for answers they looked not at the male but at the female, both as a cause of sexually transmitted diseases and as an innocent victim. It was the bad women, the prostitutes, who were the cause, and the innocent wives and children who were the victims. Inevitably, many came to believe that the best way to deal with the diseases associated with prostitution was to regulate the practice and require medical inspection and isolation of infected prostitutes. This, however, implied direct government entry and supervision of what large numbers of people believed to be immoral conduct. When this Continental practice was introduced into certain port areas of Great Britain in the last part of the nineteenth century, it ran into a storm of opposition, in part from evangelical religious figures but also from women, the very preservers of public morals. The initial intent of this opposition was to eliminate officially tolerated, medically inspected prostitutes, but in the long run, it led to a growing movement for abolition of prostitution altogether, particularly in the United States,31 and a full-fledged assault on the double standard. SEXUAL ALTERNATIVES So far in this chapter, reticence of Americans, especially the medical professionals, about sexuality has been emphasized. This emphasis is somewhat misleading, because not all Americans were as reticent as the medical professionals in discussing sex issues. Many had quite different attitudes, and there were a number of fringe movements that set out to challenge the hypocrisy surrounding sex. One such movement was the free-love movement, which had as its goal the abolition of traditional marriage and the establishment of a new and better kind of relationship, based on passionate attraction. In one free-love community, couples signified their union by tying strings of the same color on their fingers; when the passion fizzled, they simply removed the strings. Many of the free-love communities were founded by religious prophets, a fact that allowed the adherents to claim that both God and morality were on their side.     In Oneida, New York, John Humphrey Noyes and his Christian Perfectionists promoted his theories of "complex marriage," and "marital continence" as well as the use of coitus reservatus in intercourse. This involves putting a finger at the base of the penis to create pressure on the urethra, which prevents ejaculation, or simply ceasing motion before ejaculation, or using both techniques. Though coitus reservatus is not 100 percent effective as a contraceptive, it certainly cuts down the probabilities. The Mormons instituted polygamy to keep straying husbands within the confines of marriage, and Sylvester Graham tried to establish chastity in "Grahamite boarding houses" to protect men from "venereal indulgence."32     Victoria Woodhull, one of the woman leaders of the free-love movement, taught that sex was not only central to human existence but essential to preserve one's health and vital strength. "Show me a man or a woman who is a picture of physical strength and health and I will show you a person who has healthy sexual relations," she claimed. While never condoning overt promiscuity, she remained hostile to marriage as an institution, because it inevitably led to sexual starvation and slavery for women and too often produced unloved and unwanted children. The way to combat such evils in her mind was to give people the freedom to love. "love wrought of mutual consent based upon desire."33 MANY FORMS OF REFORM Prostitution and sexual problems were just two of the many social ills that seemingly plagued Americans at the end of the nineteenth century. Alcoholism was another. Pornography was still another. Lack of rights for women was another. Slavery, an earlier problem, had been eliminated by the Civil War and the Reconstruction that followed it. Inevitably, following the abolition of the evil of slavery, solutions to other social ills were also seen to be the responsibility of government. Emphasizing this turn to government was the fact that traditional solutions of community pressure or a religious call to moral reform no longer seemed to work in the growing urban setting. Organized groups were formed to agitate for a variety of government interventions, including the prohibition movement, which dealt with alcoholism, and abolitionism, which dealt with prostitution. Giving the right to vote to women was supposed to raise the moral level of America. What ties the various social movements together in American history is the demand for the state to intervene in the country's social and economic life. The result was the Progressive movement, a movement that embodied conflicting impulses, ranging from social justice to efficiency and from the power of education to change behavior to a belief in the need for greater coercion to force the recalcitrant to conform. ANTHONY COMSTOCK     An early forerunner of this felt need for coercion had been the so-called Comstock Law passed by Congress in 1873, signed into law by President U. S. Grant, and titled "An Act for the Suppression of Trade in, and Circulation of Obscene Literature and Articles of Immoral Use." The articles of immoral use were specifically aimed at contraceptives, emphasizing just how much the fear of sex played in the various reform movements. Comstock, the founder of the New York Society for the Suppression of Vice, supervised the enforcement of the law from his position as an unpaid U.S. postal inspector in New York City (see also chapter 2). He almost singlehandedly prosecuted those who wrote, published, and sold literature or art that he considered obscene.34     Comstock was motivated by his belief in the absolutes of civilized morality, which necessitated that sexuality be restored to the private sphere and that any public expression of sexuality was by definition obscene. He also believed that lust itself was dangerous, and he and his allies attacked not only sexual literature sold for profit but also any dissenting medical or philosophical opinion that supported the belief that sexuality had other than reproductive purpose.35 The result was censorship of the mails and a curtailment of the public discussion of sexuality. There was open war between those who thought that sex was best regulated by restricting its public discussion and those who held that public education and information were the keys.     Comstock's success depended on public support, and for a time a sort of self-censorship was imposed by the publishers themselves. Increasingly, however, many of his allies broke away from his campaign of entrapment and intimidation. Undeterred, he expanded his attack to include suffragists, whom he felt threatened traditional family morals. Ultimately, it was Comstock's inability to compromise and his willingness to extend his net ever wider that weakened his movement and led to him becoming an almost ludicrous figure. PRINCE A. MORROW     Replacing Comstockery as a major factor in determining American views of sexuality was the growing public health movement. Many of those in this emerging coalition were concerned with sexually transmitted diseases, and they were handicapped by the activities of Comstock in carrying out their felt need for public education. Giving leadership to this new focus was the New York dermatologist Prince A. Morrow (1846-1913).     Morrow had spent a year in Europe after completing his medical training, and while there, he had made contact with some of the leading figures in the study of sexually transmitted diseases. On his return to the United States, he translated Jean-Alfred Fournier's discussion of syphilis and marriage into English and wrote his own manual about syphilis, which was geared to both students and practitioners.36 Morrow's interest was reinforced in 1899 when he attended the first of two international conferences, both held in Brussels, to consider the public health aspects of sexually transmitted diseases. At this first conference, those in attendance, mainly physicians and public health officials, concluded that sexually transmitted diseases were more prevalent than generally believed and that medical inspection of prostitutes, the standard European practice, was not effective.37 After the conference, Morrow made a moving appeal to the New York Medical Society emphasizing that among the major sufferers of sexually transmitted diseases were innocent women and children and unwitting youngsters who had no idea of the dangers to which they exposed themselves.     Morrow helped organize the second international conference, which was held in 1902. There, delegates heard about the success of a French educational campaign to warn youth against the dangers of venereal disease and to urge infected persons to seek treatment. Morrow returned to the United States committed to founding an American group to educate professionals and the public about the dangers of the venereal peril. The first step was to write a full exposition of the disastrous implications of introducing venereal disease into marriage.     In 1904 he published Social Disease and Marriage,38 which attracted a wide medical audience as well as considerable attention from lay people. Morrow attacked the double standard of sex morals and believed and preached that the male should be held as guilty as the prostitute he patronized. He argued that sexually transmitted diseases should be reportable, and urged women, as the principal sufferers of the silence about sexually transmitted diseases, to take a leading part in the struggle against disease and sexual vice. Morrow also thought that sex education was the best answer to the problem.     One result of Morrow's efforts was the establishment of what were called social hygiene societies, the first of which appeared in Chicago in 1904. These groups quickly took root and formed the basis for a national campaign to wipe out the ignorance and prejudice that allowed venereal disease to infect the nation. In 1905, Prince himself established the Society of Sanitary and Moral Prophylaxis (soon renamed the American Society for Sanitary and Moral Prophylaxis), which took as its mission the education of the public about sex and sexually transmitted diseases. Morrow believed that although sex instruction should be given at home at an early age, the ma'ority of parents were not qualified to give it. Thus, he contended, the duty fell to teachers and sex education should be an integral part of the course of study in all teacher training schools. This idea appealed both to the American medical profession and to the leaders of the American Purity Alliance, who in 1908 announced that sex education would become one of their objectives.     The main purpose of sex education was to emphasize the importance of sexual purity for both sexes and to eliminate the false impression often held by young men that sexual indulgence was essential to health and that chastity was incompatible with full vigor. Though it was recognized that sexual activity could have nonprocreative purposes and even pleasurable purposes, sexual intercourse was to be reserved for marriage, in which only husbands and wives were to enjoy such pleasures. These pleasurable aspects of sex did not enter into the public discussion.39     The purity movement gained further impetus in 1911, when the two major purity organizations -the American Purity Alliance and the American Vigilance Committee (founded by Jane Addams, Grace Dodge, David Starr Jordan, and others in 1906)- elected the same officers. This was the first step to the organizations' consolidation as the American Vigilance Association, which was dedicated not only to fighting prostitution but to educating the young about the dangers of immorality. In 1910, many of the medically oriented groups that were supportive of Morrow's ideas had met and elected him the president of a new national organization, the American Federation for Sex Hygiene. In 1913, after Morrow's death, the two forces, medical and purity, merged formally and symbolically to form the American Social Hygiene Association.40     To be successful required the education not only of the young but also of the general public. This was a more difficult task than many of the reformers envisioned. In 1906, when Edward Bok, the editor of the Ladies' Home Journal, published a series of articles on venereal disease, he lost some seventy-five thousand subscribers.41 This reaction took place even though the advocates of sex education in that period carefully emphasized the themes of chastity and abstinence, reinforcing this by portraying the horrors of disease. Attitudes began to change only after World War I, when the influence of Ellis and Freud began to be felt, but the American public did not significantly change its view of either sex education or sex in general until after World War II.42
CONTRACEPTION     If public discussion of sexually transmitted diseases aroused such public reaction, the discussions in the United States of contraceptives was even more controversial. Generally, medical professionals in the last part of the nineteenth century and first part of the twentieth century had turned their backs on both contraception and abortion, regarding them as something that poorly trained or irregular medical practitioners got involved with. Physicians in the increasingly powerful American Medical Association were not only active in campaigns to outlaw abortion but, in keeping with their view of their moral guardianship, refused to deal with contraceptives. Some of these actions derived from the prevailing medical belief that women had a special sphere and were designed for the maternal role, thus any attempt to avoid this role was dangerous to their health. Though individual physicians might ignore these publicly stated assumptions, contraceptives and information about them went underground in America in the last part of the nineteenth century, just as effective birth control devices were reaching the market. The newly invented latex rubber condoms were being sold in the United States as early as 1860 as effective prophylactics; they were available in barber shops and other places where men congregated. Though pushed as a prophylactic against venereal infection, its contraceptive value was also recognized.43     More widely available to women were various devices that were advertised to deal with prolapsed uterus or "female complaint"; in one way or another, they formed a barrier over the cervix. Many of these pessaries were patented by the U.S. Patent Office, even during the period when Comstock was most active, although their alternative use was never specified in patent applications. The most effective of these pessaries in terms of contraception was that developed by W. P. J. Mensinga (C. Haase). Most of the early pessaries had used a hard rubber ring, but after the vulcanization of rubber, it became the favored material. What made Mensinga's diaphragm, dating from the early 1870s and made of latex, more effective than earlier models was the incorporation of a flat watch spring in the rim to keep it in place. Later, a coiled spring was used.44     In the 1860s, Edward Bliss Foote had introduced in the United States something he called "The Womb Veil," a device very similar to the Mensinga diaphragm. Unfortunately, the pamphlets recommending its use were seized and destroyed under the Comstock Law of 1873, but clear descriptions of it exist in earlier editions of his book.45 The Mensinga diaphragm was popularized by Mensinga's student Aletta Jacobs, who, in 1882, opened the first contraceptive clinic in the world in the Netherlands and taught women how to use the Mensinga diaphragm. It was the device used by Planned Parenthood clinics in the 1920s, and it was probably the birth control device most widely used by women up through World War II.     A number of effective spermicides had also appeared on the European market by the end of the nineteenth century. Usually regarded as the first person to become active in manufacturing and selling spermicidal suppositories is the English chemist W J. Rendell, who in about 1880 first put his quinine and cacao pessaries on the market. Cacao, or cocoa butter -a yellowish, hard, and brittle vegetable fat that is obtained from the seeds of the plant Theobroma cacao- contains about 30 percent oleic acid, 40 percent stearic acid, and various other fatty acids. It is a fairly effective material for a suppository because of its low melting point, and it probably worked as a contraceptive by blocking the cervix with an oily film. On the other hand, the quinine served as a spermicide, because it is a general protoplasmic poison; unfortunately, many individuals have a toxic reaction to it. Other chemical spermicides also began to appear on the market, and some news of them reached the United States, more by word of mouth than by any references in the medical literature.46 HOSTILITY     So strong was the official American attitude of hostility to sex that it even carried over into the treatment of soldiers in World War I. The international moral order visualized by President Woodrow Wilson led to the portrayal of the American soldier as a knight crusading for democracy who kept himself pure for his lady fair by abstaining from alcohol and sex. Such emphasis on ascetic dedication might have lessened the fears and anxieties of the mothers and wives left behind, but a most unfortunate side effect was that the government planners believed their own propaganda, and as a result did not make any plans to deal with venereal disease.47 Wilson himself lent his authority to antivenereal fervor: "The federal government has pledged its word that as far as care and vigilance can accomplish the result, the men committed to its charge will be returned to homes and communities that so generously gave them with no scars except those won in honorable conflict."48     Though military-controlled prostitution had been part of the American tradition in early wars, no such activity could be contemplated under the new moral tradition so associated with the Progressive Era. The result was almost a total failure in planning on how to deal with millions of young men at the height of their sexual urges. Pulled off the farms and out of the small towns and tossed together in mass camps without women and without the moral constrains of their families, communities, and churches, these men were victims of sexually transmitted diseases, which had become endemic. The War Department chose to emphasize abstinence to the troops, although as the last step of its six-point program, it had suggested the distribution of prophylactic packages when other solutions had failed. Inevitably, the American policy proved a total failure in Europe, and the major successes against venereal diseases came from those commanders who ignored official policy, which was finally changed by orders of General Pershing in 1918.49 One result was a vast number of Americans who suffered the sequelae of third-stage syphilis and were confined to Veterans' Hospitals in the 1930s and beyond. CLELIA MOSHER     In spite of such official attitudes, there was a vast outpouring of information, or rather misinformation, about sex in the popular literature and in the professional Journals. There was also the beginnings of serious sex research, much of it by women, that went beyond the simple reporting of individual case studies so common in medical writing. Several of the researchers might be called closet researchers, as the results of their early work was not published until much later. For example, the work of Clelia Mosher (1863-1940) did not reach print until 1974, more than eighty years after she had originally started it. Her story might be regarded as symbolic of the ambivalence about sex that most Americans held at the turn of the twentieth century.     Mosher's research grew out of an 1892 questionnaire that she designed for married women. Mosher used the survey to help her prepare a lecture on the marital relation, which she gave to the Mothers' Club, the members of whom were mostly faculty wives at the University of Wisconsin, where she herself was a graduate student. Her motivation for the research was to give better sexual advice to young women who came to her for counseling before they married. Of course, many of her survey questions dealt with sex; she was trying to determine the extent of women's knowledge of sexual physiology before they married, whether they habitually shared the same bed with their husbands, whether they had a venereal orgasm, and what in their minds was the true purpose of sexual intercourse. A total of forty-seven women filled out Mosher's questionnaire over the years. After the first batch of interviews, it seems that others were conducted only sporadically from among her patients. Mosher became a physician and practiced in Palo Alto from about 1900 on; she joined the faculty at Stanford in 1910.     Mosher found that the majority of women had known little about sex before they were married, and one women said that until she was eighteen she did not even know where babies came from. These women learned about sex in marriage, and most shared the same bed with their husbands. Thirty-five of the forty-four who answered the question said they felt a desire for sexual intercourse, and one wrote that sex was not only agreeable to her but delightful. Thirty-four of the women regularly experienced orgasm during sex. One said when she did not have an orgasm it was depressing and revolting, another said the absence of orgasm was "bad, even disastrous, nerve wracking." The most detailed and personal responses were elicited by a series of questions on the "true purpose of intercourse," and though nine believed that intercourse was a necessity for men, thirteen claimed it was a necessity for both sexes. The other fifteen who answered this question did not believe it was a necessity to either sex. While reproduction might be the primary purpose of sex, twenty-four women believed that the pleasure exchanged was a worthy purpose in itself. At least thirty of these women used some sort of contraceptive -withdrawal, douching, condoms, and cocoa butter- and two used a rubber cap over the cervix. Some felt that intercourse once a month was probably enough, but most thought it should be more often. Several of the postmenopausal women still enjoyed and desired intercourse.     Mosher's last interview was dated 1920, and all but one of her respondents had been born before 1890. Thirty-three of the women were born before 1870, and of that number, thirteen were born before the Civil War. Though the sample is fairly representative geographically of late-nineteenth-century America, socially and economically it was not. Of those whose education is known, 81 percent had attended college or normal (teacher training) school, and the remainder had at least attended secondary school. Most were married to college graduates.50     Though Mosher undoubtedly used her data to advise her women patients and students, few others knew about it. This makes the data interesting to us but not particularly helpful to her contemporaries who sought information about sexuality. For her time, Mosher was a feminist, and early in her career, she did publish a paper on normal menstruation in which she demonstrated four factors contributing to disabilities then believed to accompany menstruation: constricting clothing, inactivity, chronic constipation, and the general expectation that discomfort was inevitable. Each of these, she noted, was reversible and not physiological. She earlier had challenged the widespread myth of the time that women breathed costally (using only the upper chest) because of the physiological requirements of pregnancy, while men breathed diaphragmatically (using the diaphragm). Mosher found that while most women she examined did breathe costally, she believed that physiology was not the cause but constrictive clothing and a sedentary life; when the restrictive clothing was not present and women exercised normally, they breathed diaphragmatically. These data served as her master's thesis at Stanford.51 ROBERT LATOU DICKINSON     Another, and more significant, closet researcher was the physician Robert Latou Dickinson (1861-1950), who conducted studies between 1890 and 1920 and published them in the 1930s. Dickinson, an innovative specialist in obstetrics and gynecology, began practicing in 1882. He introduced the use of electric cautery in the treatment of cervicitis, was among the first to use aseptic ligatures for tying the umbilical cord, and gained widespread prominence for his innovative teaching methods for medical students -particularly for his use of rubber and sculpted models to teach female anatomy and to show fetal growth from fertilization to birth.52 Dickinson became active in the campaign for better sex education and especially birth control, but both of these public roles were assumed when he was in his sixties and his professional reputation was secure. He has to be regarded as the most prominent American physician associated with the campaign for birth control in the immediate post-World War I period as well as the most significant sex researcher during the first three decades of the twentieth century. In 1923, he founded the Committee on Maternal Health, which began compiling data on contraception.53 He tried to persuade Margaret Sanger to allow accredited physicians to have more control in her New York clinic and do more active research in contraceptives, but she did not take his advice. He broke new ground in the medical profession in 1920 with his presidential address to the American Gynecological Society, in which he urged his fellow physicians to do more work in the fields of contraception, infertility, artificial impregnation, and voluntary sterilization.54     Dickinson's most significant contributions were to the study of female sexuality, and though he had written scholarly articles on some of his data during the course of his active career, most of his data were published late in his life. Dickinson strongly believed that the key to effective medical practice was a good patient history, and during the years of his most active practice, 1890-1920, patients were not received by him until they had filled out a four-page questionnaire that accounted for general and family history. As he examined the patient, he also made at least five drawings: one each of the uterus, cervix, and vulva and two of the pelvic difficulty for which the woman had sought his assistance. The maximum number of drawings for any one patient was sixty-one. Later, as photography became easier to do, he supplemented the drawings with photographs. His standard practice was to read the patient's answers to the questionnaire and use them as a basis to question her further. He found that his patients often confided in him information about sexual problems, which he recorded and treated, if possible.     By 1923, Dickinson had compiled data on more than five thousand cases, which he turned over to the Committee on Maternal Health, after they had agreed to help him publish it. Lura Beam, a writer with a background in education and applied psychology, was called in to make a preliminary review of the data, and she proposed publication of three books, two of which were actually published. The original fifty-two hundred case histories were divided into two groups: one consisting of four thousand married women and the other of twelve hundred single women. These data served as the source material for A Thousand Marriages, in which he described the analysis of one thousand cases; data from other researchers were used as a control group. In The Single Woman, Dickinson analyzed three hundred fifty of his case histories, comparing them with information from other groups of women used as two control groups.55 A third volume that he wanted to do on lesbianism was never finished, although he contributed his data to other studies.     One of the advantages of Dickinson's data was that he often saw his patients at different points in their lives and could plot the changes in their attitudes on sexual issues. For example, he illustrated with twenty cases how "passion and frigidity" could appear and disappear. At age thirty-four one of his patients became disgusted with coitus, but her husband did not. Later, the husband lost interest, but after six years without an orgasm, the woman again became orgasmic and the husband and wife found it difficult to remain apart from one another.56     All kinds of data are available from the Dickinson studies, including information on frequency of intercourse (two to three times a week in his married sample). Some 11 percent, however, had intercourse once a year or less. He has information on length of intromission before ejaculation and the attitudes of brides. Dickinson also collected data on more treatment-oriented issues, such as frigidity, dyspareunia, minor menstrual disturbances, sexually transmitted diseases, and fertility, as well as on such psychological issues as anxiety and fear. One in twelve of his patients in the married sample had venereal disease, usually gonorrhea, emphasizing just how widespread the disease was among his upper-middle-class patients.     In comparing single women with married women, he found that relatively more wives than single women reported masturbating. Twenty-eight of his sample of single women had been involved in same-sex relations, but he found no evidence of maleness of feeling, in his subjects (i.e., lesbians were believed to have masculine qualities), some of whom he examined in the period before 1900. He reported that seventeen of those who had lesbian experiences later married and had ordinary fertility.     Dickinson's work has often been overlooked by later generations, but he proved to be innovative in his research in almost every way and in many areas. Very much interested in the physiology of intercourse, a subject that had been first studied by Felix Roubaud in the 1870s,57 Dickinson preceded William Masters and Virginia Johnson in trying to observe what happened in the vagina during Intercourse. To do so he used a glass tube resembling an erect penis in size and shape while women masturbated to orgasm; in the process, he proved once and for all that women did have orgasms involving physiological changes.58 One of Dickinson's major contributions was a definitive summary of human sex anatomy, based on his work and on that of others.59 From his discussion and references, it is possible to follow the growing knowledge about sex. He indicates, for example, that it was Ernst P Boas of Mount Sinai Hospital in New York City who plotted the pulse rate of a couple during sexual intercourse in 1928 and 1929, demonstrating the rise at intromission, gradual increase, and then drop after orgasm.60     Along with W. F. Robie and LeMon Clark, Dickinson was responsible for the introduction of the electrical vibrator, or massager, into American gynecological practice. This device produced intense erotic stimulation and even orgasm in some women who previously had been unable to reach a climax. Dickinson and collaborators theorized that once a woman had achieved orgasm, even with a vibrator applied to her genitals, she was more likely to proceed to orgasm during coitus or through digital masturbation. MAX J. EXNER     That either the Mosher or the Dickinson studies could have been published in the United States before World War I is extremely doubtful. Evidence of this is Max J. Exner's prewar study of the sexual activities of 948 college men, which was based on questionnaires. Exner, a physician associated with the Young Men's Christian Association (YMCA), was a leading sex educator of the time and a strong upholder of the importance of chastity. He believed that sex education should be designed to curb "morbid curiosities" and erase sexuality from consciousness.61 Although he later modified some of his ideas, Exner was one of the leaders in the struggle to keep the American army pure during World War I. Even before the United States entered that war, he had conducted, in 1916, inspections of troops involved in the war against Pancho Villa and reported that the character of the camps was "sensualizing," with the coarse elements prevailing. In his mind, venereal disease merely represented the physical repercussions of a far more dangerous moral decay. Exner's solution was to urge the military authorities to raise the moral environment of the camps by removing the temptations; they were to cut down on the sale of liquor and eliminate prostitution.62     Thus even though Exner's study is the pioneer attempt to secure statistical data on the sexual behavior of American college men, it is badly flawed because of the researcher's biases. Exner asked a small group of men who were primarily from the Northeast and another more national group based on mall questionnaires to respond to thirteen questions, which were not particularly well designed.63     He analyzed the data by simple tabulation, and since the population was homogeneously college male, the data should have been significant, but they are not now so regarded, partly because of the content of the questions.64 Exner tended to give the impression in most of his questions that sex outside of marriage was wrong. Still, in his sample, 518 men responded that they had engaged in sexual practices of one kind or another, 62.5 percent having practiced "self-abuse," 17 percent having practiced both "self-abuse" and intercourse, and 2 percent having practiced "various perverted practices," which remained unnamed.     The goal of Exner's research was to document the need for effective sex education, which he felt had to begin early, in the elementary schools. He found that most individuals had bad sources of sex information, having been told about sex by boy associates (544 of the 676 who answered this question), girl associates (33), or hired men or older men (22). The rest had received information about sex from their parents or reliable sex educators. He argued that the facts were learned too late in these men's development and that only by creating "an inspiring atmosphere with reference to sex, through a true and full interpretation of its meaning" in a classroom could boys learn the basic importance of chastity.     The importance of the Exner study is more symbolic than significant. fle did his work publicly, demonstrated that individuals would respond to questions about sex, and made an early attempt to quantify replies. Interestingly, in spite of his assumptions and limitations, Exner turned out in the end to be a major force in bringing about organized sex research in the United States. KATHARINE BEMENT DAVIS AND JOHN D. ROCKEFELLER JR.     The story of how organized sex research came about is somewhat complicated, and the key was the involvement of John D. Rockefeller Jr. In 1910, Judge Thomas C. 0. O'Sullivan of New York City charged a grand jury chaired by Rockefeller with determining whether white slavery rings existed in the city. Rockefeller later stated that he never worked harder in his life and added that he "was on the job morning, noon, and night."65 Scheduled to sit for a month, the committee sat for six, and though it found no evidence of a formal organization of white slavers, it did find informal associations of brothel owners and even prostitutes. It also stated that recruitment to prostitution took place on a national level, that prostitution was linked to criminal elements, and that there were mutually beneficial ties between those engaged in trafficking in prostitution and the police.66 One of the recommendations of the commission was the establishment of another commission to study the laws relating to the methods of dealing with prostitution in the leading cities of the United States and Europe.     When the mayor of New York City refused to set up such a commission, Rockefeller decided to do so himself, and in 1911, he established the Bureau of Social Hygiene, with an advisory board of Paul N. Warburg, Starr J. Murphy, and Katharine Bement Davis (1860-1935). Rockefeller served as chair, and Warburg and Murphy were chosen because they were friends of Rockefeller.     Davis was a different matter. She had been chosen because she was warden of the new Reformatory for Women at Bedford Hills in New York, many of whose inhabitants had been prostitutes. Davis had been appointed warden shortly after receiving her Ph.D. from the University of Chicago in 1900, and in her new position, she emphasized education and rehabilitation. Concerned that employment opportunities for poor and working-class women were too often restricted to domestic service, Davis believed part of their rehabilitation was to enable them to get better jobs. Because the state budget often proved to be erratic as well as insufficient, Davis put her female charges to work renovating the grounds and running the physical plant, to save money that could be used to better educate them. Inmates mixed concrete, laid foundations, graded lawns, cut ice from the river in winter, and even slaughtered pigs.67 Davis believed that with respectable employment and adequate learning, the women could return to society without further danger of law breaking. She likened her reformatory to an educational institution and often referred to the prison's former Inmates as graduates.68     To better manage her reformatory, she had developed a program that tried to identify different types of offenders and to separate the potentially reformable from the more hardened or irreclaimable. This program led her to recommend that an offender be studied by experts after being convicted but before being sentenced, a subject on which she wrote a pamphlet, a sort of forerunner to the presentencing report now commonly used in most courts.     Cervical capsIn 1911, Davis's pamphlet came to the attention of Rockefeller, who, after conferring with Davis, bought land adjacent to the Bedford Hills Reformatory and set up the Laboratory of Social Hygiene under her direction in 1912.69 Her success and work there led Mayor John P Mitchell to appoint her commissioner of corrections for all of New York City's prisons in 1914, a first for a woman. Among other things, she lobbied for creation of a parole commission, the use of probation and parole, and indeterminate sentences. When the Parole Commission was created in December 1915 she was appointed its first chairman. Though her administration was often the center of controversy, she proved extremely successful. She ultimately lost out, however, when Mitchell was turned out of office, and her career as a city official came to an end in 1917, after which she became the salaried secretary of the Bureau of Social Hygiene.     Like his father, Rockefeller was convinced that the solution to any problem required the gathering of data and then the establishment of a plan of action. What was needed first were the data, and the plan for gathering these data was provided by Davis. Data were collected at the new laboratory from examination and testing of women, particularly prostitutes, and she also examined prostitution as an institution. Beginning in 1912, and for the next six years, the bureau undertook the most significant studies of prostitution undertaken up to that time. The bureau hired George J. Kneeland, who had directed the Chicago Vice Commission, to undertake a study of prostitution in New York City.70 This was followed by studies of prostitution in Europe by Abraham Flexner, a study of European police systems by Raymond B. Fosdick (including how they dealt with prostitution), and a study of prostitution in the United States by Howard Woolston.71     Davis was involved in all of these, although in some more than in others. She wrote a chapter in Kneeland's book about the prostitutes committed to her reformatory, and she delayed publication of the Woolston book for several years while she made revisions. She actively maintained contacts in Europe to assist with the European studies.     Usually, Rockefeller acted behind the scenes, but on the issue of prostitution and vice, he was very public, not only because of his grand jury experience but also because he served as a member of a Blue Ribbon Committee sponsoring Eugène Brieux's play Damaged Goods, the theme of which centered on the effects of venereal disease. The success of the play was the final death blow to Comstockery in the United States, and Comstock died shortly after, a figure more of derision than respectability. Rockefeller attended the opening performance of the play and emphasized that the key to understanding the "evils" springing from prostitution was frank public discussion.72 Rockefeller also wrote the introduction to Kneeland's book.     Under Davis's impetus, the Bureau of Social Hygiene gradually became interested in other areas of sexual behavior, and Rockefeller became less noticeably involved, perhaps because it soon became evident that there was no easy solution to the problems of prostitution. Early in the spring of 1920, Exner, who was then the director of the Department of Educational Activities at the American Social Hygiene Association., tried to persuade Davis to serve as coordinator of a proposed study of the sex life of women. Davis agreed on the desirability of such a study but believed she needed to consult women physicians about the feasibility. Her correspondents agreed that such a study was needed, but they opposed the involvement of the YMCA and YWCA in the project, an involvement that had been suggested by Exner. As a result, Davis agreed to form a committee to study the sex lives of five thousand women, subject to the approval of Rockefeller.73 Rockefeller not only agreed to this but made an initial appropriation of two thousand dollars toward the project at a bureau meeting74 and gave additional financial support in succeeding years.     This marked a departure from the earlier activities of the Bureau of Social Hygiene, but one that was a logical extension of its endeavors and one that threw the bureau more clearly into the field of sex research. Davis eventually extended her study to include a section on lesbian women,75 a fact that is specifically mentioned in the minutes of the bureau and that indicates the basic change in attitude among the advisory members toward sex. Prostitution and other sex-related problems were increasingly being seen as related, and to deal with such problems successfully, it was necessary to better understand sexuality itself.     The data in the Davis report were drawn from responses to questionnaires -eight pages for married women and twelve pages (two of which were taken up with definitions) for the unmarried women. Names of the women were drawn primarily from the alumnae registers of the leading women's colleges. To obtain the required number of subjects, nearly equally divided into single and married women, a preliminary letter asking for cooperation was sent to twenty thousand women, and the final questionnaire was sent only to those who responded as willing to answer the questions.     The answers from the twenty-two hundred respondents were tabulated, and to interpret them, Davis undertook explanatory studies into the following topics: contraceptives, frequency of intercourse, happiness of the married women in terms of both general factors and sex, backgrounds of the unmarried sample, autoerotic practices among both married and unmarried women, periodicity of sex desire among both married and unmarried women, and prevalence of lesbianism in both married and unmarried women. About 50 percent of all women in the study reported experiencing "intense emotional relations with women," but the number giving these feelings overt sexual expression was less than two hundred. This is a higher percentage than Alfred Kinsey later found, although the difference might well be one either of class or of definition. Davis remained, however, very much a woman of her time in many ways. She found it "probably not surprising" to find that a large number of her subjects had "engaged in various erotic practices," although she did not bother to explain what these might be.76 She did, however, discuss masturbation as an erotic practice and not as self-abuse. Some 64.8 percent of her unmarried college women admitted to masturbating at some time, although only 40.1 percent of her married sample did.77     Among Davis's married sample, only 71 women had sexual intercourse before marriage. The vast majority of these women used some form of contraceptive after marriage (730), and most of those who did not use one themselves approved such use in principle. Some 9.3 percent of the married women had at least one induced abortion, and one had eight such abortions.78 Davis also found that of the women she classed as highly erotic, a much higher percentage had received sex instruction from what she called responsible sources before they were fourteen years old. She discovered that women who desired intercourse more frequently than they engaged in it with their husbands were more likely to be unhappy than were the wives who had husbands who agreed on the frequency of sex. The mode of greatest frequency was once or twice a week.79     Although she had not done the kind of study that Exner had suggested, Exner remained friendly with her and encouraged Davis to push the bureau even deeper into the kind of serious sex research that she was doing. Encouraging Exner was Earl F. Zinn, a young psychology graduate student from Clark University, whom Exner had hired in 1920 as coordinator of questionnaires on research projects at the American Social Hygiene Association.. Zinn, after some preliminary work, made a series of proposals to Exner about sex research, which Exner took to Davis in 1920. After Davis made some modifications, she and the bureau were persuaded that a large-scale study of human sexuality should be undertaken. Conscious of the possible consequences of such a study to the social hygiene movement with which the bureau was associated, Davis and others felt more "scientific backing" for such a study was needed. It was therefore suggested to Rockefeller by his advisers that the study be conducted by an independent agency, specifically the National Research Council (NRC).80     Established in 1916 by the National Academy of Science to coordinate research funding during World War I, the National Research Council continued to function after the war as a conduit for research funds and projects. Since the Rockefellers supported projects of the NRC in other areas, it seemed natural to turn to the NRC to obtain the necessary respectability for the new kind of sex research that Zinn and Davis now proposed. What the two advocated was a systematic and comprehensive research into all aspects of human sexuality in its individual and social manifestations, the prime purpose being to evaluate conclusions now held and to increase our body of scientifically derived data.     Included in the proposal would be studies of physiological and psychological aspects of continence, masturbation, intercourse, and "aberrations" and investigations into prostitution, venereal disease, the family, marriage, divorce, family planning, and sex education.81 Though Simon Flexner, one of the advisers to Rockefeller's father, originally opposed the proposal, he later, perhaps after some discussion with the younger Rockefeller, thought the project might well be worth attempting. Before going further, Flexner suggested that a group of scientists should be brought together for a conference and then action should be "based on the way the project appeared to them." As a result, in 1921, Rockefeller authorized the employment of Zinn to work under Davis's direction in an effort to secure the support of the National Research Council for such a conference. A budget of ten thousand dollars was allocated by the bureau for Zinn's expenses and proposed conference.82     Robert M. Yerkes, the resident salaried officer of the National Research Council, was supportive of the proposal but believed many of the council members would not be. Initially, the proposal was presented to the newly formed Division of Anthropology and Psychology but that division refused to deal with sex research, even if funds were available. Because there was no social science division, Yerkes then tried the Medical Sciences Division, where he also encountered an unwillingness to have anything to do with sex. Fortunately, there was a serendipitous change in the division chair, and the new chair was able to overcome the qualms of the committee; a special conference on sex research was held under the sponsorship of the division on October 28, 1921.83     The twelve invited participants at the conference (including Davis and Zinn) voted in favor of establishing the Committee for Research in the Problems of Sex (CRPS) within the Division of Medical Sciences and issued a statement to that effect. Included in the statement were perceived impediments to research into sex, including both the lack of data and the reticence and shame associated with such research. The committee reported, nonetheless, that it was convinced that through the use of methods employed in physiology, psychology, anthropology, and related sciences problems of sexual behavior could be subjected to scientific examination. The committee also listed a number of possible research topics, including sex and internal secretions, sex habits of primitive peovpes, race and sex, variations in sexual impulse, attitudes toward sex, physiological and psychological effects of masturbation, continence, a better understanding of sexual intercourse, and birth rates in a variety of different groups.84 GILBERT V. HAMILTON     An initial budget of fifty thousand dollars was proposed,85 and with this action, the nature of sex research changed. Inevitably, Americans, with the availability of research funding, quickly rose to preeminence in the field. An early version of peer review of sex research, which was beginning to exist in other fields, was also established in at least some aspects of sex research. The results will be discussed in the next chapter, but everything did not necessarily progress smoothly. One of the first studies considered by the council, one that had been solicited by Yerkes, was not approved for funding by the National Research Council itself even though the Committee for Research in the Problems of Sex had recommended it. This serves to again emphasize the stigma. Involved in the turndown was Gilbert V Hamilton, a physician who had taken special training in psychology under Yerkes. His research was ultimately funded by the Bureau of Social Hygiene, to which Davis had taken it after it was rejected by the NRC.     Hamilton studied two hundred married persons -one hundred men and one hundred women, including fifty-five married couples- most of whom were either patients of New York City psychiatrists or friends of such patients. Each subject was examined privately in Hamilton's consulting room and were presented with questions on typed cards, 372 for women who had been pregnant, 357 for those who had not been pregnant, and 334 for all men. Though the questions were presented in typed form, the subjects were encouraged to talk out their answers in a give-and-take conversation; these were taken down word for word without comment. The interviews varied in length from about 2 hours to more than 30. Among other findings, Hamilton reported the occurrence of multiple orgasm in some females.86     Hamilton's results, however, were judged so controversial by the Bureau of Social Hygiene that it refused to be identified in any way as supporting what he wanted to publish. Davis had retired from the bureau and from the CRPS by this time, and Hamilton's failure to gain permission to list his granting agency gives some indication of the influence she had wielded. Hamilton had to agree that he would neither state nor imply that he had received financial or moral support from the bureau. The only thing permitted to him was to refer to a "group of scientific men" who had acted as advisers to his project.87     Hamilton reported a wide range of sexual activity among white, married, college-educated men and women, far more than was generally assumed at the time. Interestingly, his findings were more or less ignored by the scientific community, in part because of the "undue" proportion (21 percent) of his subjects who sought psychiatric help before their participation in the study. Though the small size of the sample also limited its usefulness, the results more or less matched the later data collected by Kinsey for urban, white, college-educated males and females between the ages of thirty and thirty-five.88 The findings differed somewhat from Davis's conclusions, though Hamilton's questionnaire was modeled on hers. Hamilton's subjects seem to reflect far more marital unhappiness than Davis's subjects. His subjects also demonstrate greater sexual variety, but this might be because the interview allowed more information to be gathered than Davis could acquire through a mailed questionnaire. SUMMARY Ellis, in surveying American sex research in 1931, held that the investigations of Davis, Hamilton, and Dickinson (he did not know about Mosher) represented breakthrough research in that they treated on a fairly large scale the sex activities and "sex relationships among fairly normal people, on a sufficiently large and systematic scale to be treated statistically."89 He added that he had long ago realized that there was no rigid rule of normality and that in reality there was a wide range of variation, all of which legitimately should be admitted within the limits of normality. It was this wide range that the American investigators found. It was on just such studies that Kinsey and his collaborators built.     Although Dickinson once calculated that each interview compiled by Hamilton cost an average of three hundred and fifty dollars -far more than either he or Davis or, for that matter, Kinsey himself spent (the Kinsey interviews cost about two dollars each)- all these early studies emphasized that good sex research could be done and that it needed and deserved support. Though Dickinson's interviews were part of his patient load, he himself later received considerable financial support, some from Rockefeller sources, which enabled him finally to publish his studies. With these studies, the emphasis on purity and chastity -which had been such an important factor in what passed for sex research in the United States- was being replaced by a more realistic portrayal of what took place. It is worthy of comment that Exner, the exemplar of these traditional ideas, helped usher in the new age, but it is even more important to note that it was women such as Mosher and Davis who brought the new realism to American sex research.
5 ENDOCRINOLOGY RESEARCH AND CHANGING ATTITUDES Whatever the original intent of Davis, Zinn, and Rockefeller had been in turning to the National Research Council to front serious research into human sexuality, once the formal scientific establishment was involved, the nature of sex research changed. It became university based, and the traditional physician was increasingly replaced by the Ph.D. trained in research methodology. As evidenced by the rejection of funding for Hamilton by the National Research Council, most scientists were not entirely comfortable with actual sex research conducted on humans. Because those at the NRC were laboratory scientists, they felt that the best science was done in a laboratory where conditions could be controlled. Inevitably, the Committee for Research in the Problems of Sex (CRPS) concentrated on what might be called "safer" subject areas (namely the kind of research that could be conducted in a laboratory), and consciously or unconsciously this allowed the committee to avoid the real "problem" areas (namely human sexuality, which was outlined in the original committee report).     Still the committee periodically gave lip service to the problem areas. For example, it sent an invitation to Ellis to visit the United States in the hope it could consult with him. Ellis, however, fell ill shortly after the receiving the invitation and never came. Zinn was sent to Europe to survey the research taking place there, and Davis coordinated his briefings. It is known he consulted with psychiatrists such as Freud, Eugen Bleuler, and Paul Schilder, but who else is not clear, although he made a report on his return.1 The committee also consulted with various American experts on possible topics of interest to it. Clark Wissler, curator of anthropology at the American Museum of Natural History, was asked to consider the possibility of studies of sex In primitive cultures; Helen B. Wooley, director of the Bureau for Child Development at Teachers College, was asked whether the CRPS might give support to some of the bureau's studies of sex problems in children; and Dickinson met with the committee in 1925 to discuss the possibility of research in urological, gynecological, and obstetrical clinics. Little came out of any of these contacts, and Dickinson eventually was funded by other sources, some of which came from other wings of the Rockefeller Foundation. There was some discussion of a journal devoted to sex research, but this, too, was voted down.     These initial explorations and difficulties further emphasize the ambivalence that many in the scientific community had about being labeled sex researchers, even though their research might be supported by a committee set up to deal with sex problems. The answer is more complicated than simple fear of being labeled, however. Many of those interested in expanding the understanding of human sexuality argued that for findings to be meaningful they had to be accepted by their contemporaries in various specialty areas of science from which they came, something that might not happen if they were ghettoized as sex researchers.2 The scientists involved wanted to publish in their own journals and to be judged by their peers. It was from their colleagues that they received their academic appointments, promotions, and recognition, and there was no department of human sexuality. The problem was that the study of sex was an interdisciplinary and interprofessional activity, and though the CRPS might coordinate grants, the researchers went off on their own. The committee was clear, however, about some of the minefields that were feared to exist, and even though it worked under the auspices of the medical division of the National Research Council, comparatively few grants were given to physicians. In addition, those physicians who did receive grants were essentially researchers and not practitioners, further weakening their influence on sex research. It also meant that the committee was not particularly motivated by a medical emphasis on diagnosis and treatment.     An old-boy network (few women were involved) of sex researchers quickly emerged, and the research most likely to be funded was that of interest to the committee members or their friends. After the retirement of Davis from the committee, most of the committee members either received significant grants of their own or gave such grants to their students or colleagues. Even Hamilton was well connected in this respect, since he had studied with Yerkes. At least one of the committee members became utterly self-serving, and Rockefeller Foundation officials were quite embarrassed by his special pleading. FRANK R. LILLIE In spite of such criticisms, what the CRPS concentrated on, it did well. It was also focused. Members of the committee had been requested to give suggestions of possible projects, and two such proposals dominated much of the early efforts of the committee. A key program was that put forth by Frank R. Lillie (1870-1947), one of the CRPS's original members, who prepared an outline on potential research areas in biology. The other was prepared by K. S. Lashley, a member of the psychology department at the University of Minnesota. At the request of Yerkes, chair of the committee for the first twenty-five years of its existence, Lashley drew up a program for research in sex neurology and psychobiology, areas of interest to Yerkes himself. Both proposals received important financial support from the committee, although it was Lillie's outline that served as the main guide.3     Lillie was one of the great entrepreneurs of early-twentieth-century biological sciences. He was Canadian; received his Ph.D. from the University of Chicago in 1894; returned to Chicago in 1900, where he spent the rest of his career; and was important in the development of several areas of biology. He was early associated with the development of the Marine Biological Laboratory at Woods Hole, Massachusetts, and from 1910 on was director of that lab as well as the biology department at Chicago. Lillie married into the wealthy Crane family of Chicago, and through his family contacts he was able to raise funds to help him establish many of his research programs. It was under Lillie that the Woods Hole Oceanographic Institution was formally incorporated. Among other things, he served as president of the National Academy of Sciences and during part of that time was also chair of the National Research Council.4     Lillie, however, was more than an entrepreneur, he was also a major researcher in his own right and expanded our knowledge of the factors that went into sex determination. Each new discovery about sex determination led to new questions. In 1902, the American investigator Clarence E. McClung found that the accessory chromosome, what is now called the X or Y chromosome, determined the sex of the fetus.5 But complications arose with such a simple answer almost immediately. One such contradiction was resolved by Lillie in his study of freemartins. A freemartin is the female twin of a male calf who is born sterile, because it has been partially masculinized before birth by the male's testicular hormones, which are transferred to the female by the fusion of the two placentas. Hormones had not yet been isolated, but Lillie concluded that some internal secretions produced by the male's fetal testes entered into the female's embryonic circulation and inhibited the development of her gonads into ovaries, stimulated the development of mesonephric ducts and tubules into male-type sperm passageways, and inhibited the development of the müllerian ducts into the components of the female reproductive system.6 To put it succinctly, Lillie demonstrated that in utero developments could effect the development of the visible sexual organs of individuals. It was the investigation of these internal secretions that occupied much of the CRPS's concern.     As of this writing, there is a debate in scientific circles over the growing inclination of the government granting agencies to prioritize areas of research instead of relying on investigator-initiated research.7 Such prioritization has become the norm in many of the health-related agencies, such as the National Institutes of Health and National Institute of Mental Health, and it is becoming so in the National Science Foundation, which is being urged to do more applied research aimed at improving life and standards in the United States. Though there are arguments on both sides, because so many potential breakthroughs in science seem to have resulted from the serendipitous results of trying to answer basic questions rather than a deliberate attempt to deal with any so-called technical or social problem, the experience of the CRPS is perhaps the first major long-term example of the results of directed research. Sophie Aberle and George Corner, in their comments on the research efforts of the CRPS in sex and reproduction, claimed that more was learned about sex and reproduction in mammals in the first twenty-five years of CRPS than in any other similar quarter century in history.8 This, however, is attributing too much to the CRPS, because although almost every American researcher in the field was sponsored by CRPS, there were also major breakthroughs in Europe, simply emphasizing that this period in time was one of those most ripe for contributing major additions to such knowledge. The general history of these developments has been outlined by others,9 but it is important to summarize the breakthroughs here. Though it is difficult to separate these findings into categories, major discoveries concerned the female cycle, biochemistry, and reproduction, all of which overlapped. The result of this research not only led to a more complete understanding of the menstrual cycle and of fertility but finally led us to understand what happened at puberty. One of the more practical results was the development of oral contraceptives, a development that will be recounted in a later chapter. ENDOCRINOLOGY Both Ellis and Hirschfeld believed that what came to be called endocrinology would provide the answers to their questions. Some aspects of endocrinology, however, such as the effects of castration on animals, had long been known to science. Aristotle, for example, described the castration of birds, boars, stags, and cattle and gave precise directions for removing the ovaries from sows. He also described the effect of castration on the human male.10     The first modern report of the effects of castration was published in 1849 by the German zoologist by A. A. Berthold (1803-61). He had performed experiments on four young roosters. In two of them, he completely removed the testes, after removing the testes in the other two birds, he made an inch-long incision into the abdomen of each and inserted one testicle. He observed that the castrated roosters showed all the typical capon characteristics, behaving more like hens than roosters and having small combs, wattles, and heads. The roosters with the transplanted testes, however, behaved like other roosters. When he killed the birds, Berthold found that the testes he had inserted had become attached to the intestine, where they had acquired a good blood supply and were in good condition. He concluded from this that there must be some substance within the testes, other than sperm, which affects the temperament of the male chicken and which influences the development of the secondary sex characteristics. He also theorized that this substance was carried through the body by the bloodstream, because the blood vessels were the only channels connecting the transplanted testes to the rest of the body.11     What was true for the male gonads was also true for the female. In 1896, the Viennese gynecologist Emil Knauer (1867-1935) proved the existence of female internal sex secretions by transplanting the ovaries of fully mature animals into immature female animals who quickly displayed mature sexual characteristics.12 These findings were more or less ignored until 1910, when Artur Biedl (1869-1933) published the first comprehensive study on glands and their secretions.13     Some ideas of the possibility of biochemical reactions in the body had been realized much earlier by researchers not particularly interested in sexuality. A pioneer in this was Thomas Addison (1793-1896), who had a patient who, for some reason, grew more and more emaciated until he finally died. Addison soon noticed other patients suffering from the same symptoms. He did an autopsy on the second patient and found that every organ was seemingly normal except for the adrenal glands, which lie above the kidneys. These had become withered and shrunken into tiny fibrous beads. Before publishing his findings, Addison gathered evidence over a period of five years on eleven such patients and concluded that the adrenals helped maintain normal function of the heart, digestive organs, blood, and skin.14 Addison, however, did not know how the adrenals exercised their tremendous power and hesitated to guess.     At about the same time that Addison was writing, the French scientist Claude Bernard (1813-78) realized that the liver secreted a sugar-forming substance, which he called an "internal secretion." Later, he isolated the secretion, which he named glycogen, and went on to show that both the thyroid and adrenals similarly produced internal secretions.15     Up to this point, scientific caution had prevailed in unraveling the secrets of internal secretions. Changing this cautionary roll was Bernard's successor in experimental medicine at the Sorbonne, Charles-Èdouard Brown-Séquard (1817-94). He jumped to the conclusion that the male sex glands secreted some substance that controlled not only sexual vigor but many other bodily functions. This is a valid assumption, but anxious about his own waning sexual power, he then reasoned that all he had to do was to extract this powerful secretion from animal testicles, inject it into himself, and thereby renew his sexual vigor.16 This he proceeded to do, and though he reported much benefit, his advocacy of this method evoked skepticism and criticism, since others who tried it did not report the same results. Unfortunately, the experiments of Brown-Séquard led some of the more "respectable" scientists to avoid the study of internal secretions, because of its association with sexual rejuvenation, a topic that they felt might impair their academic integrity.     Brown-Séquard, however, was on the right track, and in 1891, George Redmayne Murray (1865-1939) demonstrated that it was possible to cure myxedema (a disease attributed to hypothyroidism) by injections of a glycerin extract of sheep's thyroid, although it was not clear what was contained in the extract.17 It was not until 1902, however, that the science of endocrinology moved from speculation to reality. In that year, William Maddock Bayliss (1860-1924) and Ernest Henry Starling (1866-1927) demonstrated the existence of a substance that they called secretin in the duodenal secretions of the pancreas. They demonstrated the secretin activated the pancreas to secrete pancreatic juice.18 With the discovery of glycogen and secretin, it was readily apparent that internal secretions were extremely important in regulating body functions.     Though others continued to work on internal secretions, it was the example of Brown-Séquard that caught the public's imagination. Adding to the Public's imagination were the experiments of Eugen Steinach (1861-1944), who by 1912 had experimentally masculinized the mating behavior of female guinea pigs and feminized the mating behavior of males by castrating them at birth and transplanting heterotypic gonadal tissue into them.19 By doing this, he demonstrated, for the first time, the prenatal hormonal control of the adult behavioral outcome of the male-female bipotentiality that exists in us all. Steinach, like Brown-Séquard, immediately sought to apply his findings to humans. He came to believe that by ligating the vas deferens (a method now used to bring about male sterilization) he could bring about sexual rejuvenation. The reason for this rejuvenation, be argued, was because the secretions associated with ejaculation would then flow back into the body.20 Actually, as we later learned, this does not happen, since instead of flowing back it is secreted in the urine. Like Brown-Séquard, he initially reported success in his operations, a success apparently due to a placebo effect. His method was soon discredited. QUACKERY AND ENDOCRINOLOGY     In the United States, however, in spite of the failures of Brown-Séquard and Steinach, a minor industry grew out of the promise to restore potency to the aging male. For example, the Packers Product Co., run by a Fred A. Leach out of Chicago, sold something called "Orchis Extract," imputed to be made from an extract of ram's testicles. The U.S. postal authorities put Leach out of business for fraudulent use of the malls, in part because of false advertising, because he implied he obtained his product from Armour & Co., one of the major American meat packing companies, and Armour wanted no association with him. He quickly returned to the market under a new name for the same product, this time the Organo Product Co., without any references to Armour. Postal officials, nonetheless, accusedS him of fraud in 1919, and their refusal to deliver mail to him again put him out of business.21 Even Magnus Hirschfeld got into the act with a concoction labeled Titus Perlen to encourage sexual stimulation, an action that was used by his critics to discredit him.     Perhaps the ultimate salesman of the new potency products for males was John J. Brinkley (1885-1942), popularly known as "Goat Gland" Brinkley, who promised to restore virility to the weakened male by implanting goat testicles and to reinvigorate females by treating them with the royal jelly of the honey bee. Brinkley carried news of his operations and elixirs on the newly developed radio and owned his own radio station in Kansas through which he blanketed much of the Midwest. When the government revoked his medical license and moved to close his station, he ran for governor of Kansas in 1932 as a third party candidate. He received 244,607 votes, running third behind the winner, Alfred M. Landon (who received 278,581 votes), who ran for president in 1936 against Franklin D. Roosevelt. Brinkley then moved to Mexico and opened another radio station, which for a time was said to have reached one-third of the radio listeners in the United States and from which he pitched his secret remedies and his goat gland operation. He also sold advertising time on his station to other health hucksters. Eventually, the Mexican authorities closed the station because he was not properly registered in that country.22     Undoubtedly, the misleading claims of Steinach and Brown-Séquard, even Hirschfeld, made researchers in endocrinology cautious in their claims, and the examples of Brinkley and Leach worked as factors in the reluctance of many of the sex researchers of the 1920s and 1930s to have any identification with them. Still there were breakthroughs in understanding the importance of human internal secretions. One of the major breakthroughs, made at the University of Toronto, was the 1921 discovery by Frederick G. Banting (1891-1941), Charles H. Best (1899-1978), and John J. R. Macleod (1876-1935) of a way to extract insulin from the islets of Langerhans in the pancreas. This discovery provided a life-saving treatment for diabetics.23 It WaS in such a setting, one of great potential and yet one that, as far as sex was concerned, could easily lead to exaggerated claims, that the Committee for Research in the Problems of Sex decided to give major support to the developing field of internal secretions. FEMALE HORMONES     It was not in the study of males but in the study of females that the first major breakthroughs occurred. By 1920, after several false starts and assumptions, a theory of menstruation was beginning to develop. The essentials were that menstruation occurred because the lining of the uterus, after being prepared for implantation of the ovum, would degenerate if fertilization of the egg did not occur. This theory required that ovulation and the corpus luteum formation precede the premenstrual change. Still there were many unanswered questions, and the 1920s saw a number of researchers investigate problems that led not only to better understanding of the cycle but to isolation of female hormones. One of the first researchers to be supported by the CRPS was Edgar Allen (1892-1943) of Washington University in St. Louis (later he moved to the University of Missouri and ultimately to Yale University). In 1923, Allen and his colleague Edward A. Doisy (1893-96), who later won a Nobel Prize, injected a somewhat crude ovarian extract into immature female rats and found that within 48 hours the rats went into estrus (heat) just as if they possessed fully mature ovaries.24     They had been aided in their study by the earlier discovery of Charles R. Stockard (1879-1939) and George N. Papanicolaou (1883-1962) that in some laboratory rodents (guinea pig, rat, and mouse) the cycle of the ovarian function could be followed and ovulation detected by taking vaginal smears.25 (Papanicolaou later developed the Pap smear test for cervical cancer.) The, use of vaginal smears made it possible to test exactly what was happening in the female reproductive tract without killing or operating on the experimental animals. Allen and Doisy tried to develop more concentrated active estrus stimulating extracts from ovaries but were initially unable to do so.     Their problem was solved serendipitously by Selmar Ascheim (1878-1965) and Bernhard Zondek (1891-1966), who in their search for simple test of pregnancy found that if they injected a patient's urine into an immature laboratory mouse or rat, they could get an accurate yes or no answer about the patient's pregnancy. If the patient was not pregnant, the test animal showed no reaction; if the patient was pregnant, the animal displayed an estrous reaction, despite its immaturity.26 This came to be called the Ascheim-Zondek test for the diagnosis of pregnancy. It also implied that with the onset of pregnancy there was such an increased production of hormones by the ovaries that substantial quantities of estrogenic substances were excreted.     When Allen and Doisy heard about the test, they realized there was a rich and easily handled source of hormones in urine from which they could develop a potent extract. In a sense, the scientific race for the isolation of a female hormone was on, as scientists in other countries -notably in France, the Netherlands, and Germany- were also active. Allen and Doisy's research was sponsored by the committee, while that of their main rival, Adolf Butenandt (b. 1903) of the University of Göttingen was sponsored by a German pharmaceutical firm. In 1929, both teams announced the isolation of a pure crystal female sex hormone, estrone, in 1929, although Doisy and Allen did so two months earlier than Butenandt.27 By 1931, estrone was being commercially produced by Parke Davis in this country; and Schering-Kahlbaum in Germany.     Interestingly, when Butenandt (who shared the Nobel Prize for chemistry in 1939) isolated estrone and analyzed its structure, he found that it was a steroid, the first hormone to be classed in this molecular family. Steroids, from the Greek steros (meaning "solid"), are members of the alcohol family but they differ from the common alcohols in that they are subject to crystalline solidification. All steroids have one thing in common: a group of seventeen carbon atoms arranged in four rings. ISOLATION OF HORMONES     This discovery was important, because chemists had already learned to manipulate and alter steroid molecules, so there was a good possibility the substances could be duplicated by chemical synthesis. It also emphasized the possibility that since estrone was a steroid the secretions of the testes may be as well.     The result was a rapid spurt in isolating various internal secretions, now generally called hormones. In 1930, Guy E Marrian (1904-81) of London isolated another substance from pregnant women's urine called estriol, which differed only slightly from estrone but was milder in its activity. The two substances are the excreted metabolites of estradiol, the active hormone produced in the ovaries. The estrogenic substances turned out to be responsible for the development of secondary sexual characteristics and for the cyclic changes in the vaginal epithelium and endothelium of the uterus.     Estrogens, however, are not the only female sex hormones. As early as 1903, Ludwig Fraenkel of Breslau had discovered that once the ovaries released an egg, a yellow substance formed within the ruptured egg sac. He had also found that if he removed this yellow body (corpus luteum) from a rabbit doe shortly after she mated with a buck the embryos would not develop. The American researchers George W Corner and his then student assistant, Willard M. Allen, at the University of Rochester, were sponsored by the committee and succeeded in producing a corpus luteum extract in 1930. Corner later described it as a "few spoonfuls of a thick greasy semifluid material looking like a poor grade of cylinder oil."28 Because it favored the process of gestation, this second female hormone was called progesterone, and by 1934, several scientists working independently isolated the pure hormone.     Fred C. Koch at the University of Chicago was another scientist supported by the committee. Koch had started by grinding up bulls' testicles and preparing extracts from them, which he injected into capon chickens to see how they influenced comb growth. His initial results were not very good. In 1929, he Joined with T E Gallagher, another scientist supported by the committee, and they developed a many-staged extraction process that yielded a more active mixture than any Koch had seen before. Just 0.01 milligram of the new substance produced an upstanding red comb in five days.29     Again there was a concentrated effort to isolate the substance, and Butenandt managed to isolate a few grains of crystalline hormone in 1931 but from urine rather than testicles. Because it stimulated comb growth and because it was a steroid, he coined a Greek name for it: androsterone.30 Though the substance was biologically active, it was found not to be the male hormone itself but a metabolically changed or degraded form. It was not until 1935 that a Dutch team, improving and modifying on Koch's method of extracting a substance from crushed bulls' testes, succeeded in extractine the true male hormone. which was called testosterone.31 Within a year, the Yugoslavian chemist Leopold Ruzicka, working in Switzerland, managed to make a synthetic duplicate of natural testosterone.     The availability of injected hormones allowed a large number of investigators to carry out extensive studies with sex hormones in all sorts of animals from fish through amphibians to birds to mammals. The result was to demonstrate the idea first put forth by Lillie that the differentiation of the organs of the two sexes in utero was determined by hormones. Was there not then a second hormonal onset that was involved with developments at puberty and that changed girls into women and boys into men? Again, one of the researchers sponsored by the committee, Herbert M. Evans, found that when he injected female rats with fluids from the anterior part of the female glands, they produced abnormally large quantities of corpus luteum.32 The substance was called a gonadotropin because it stimulated the ovaries and testes. Ultimately, one of these substances was identified as follicle-stimulating hormone (FSH), because it was at first thought to cause only the secretion of estrogen by the ovaries. This in turn led to the maturation of an egg cell in its follicle.33 FSH was later found to stimulate the development of the ovaries and the production of sperm cells.     A second gonadotropin was also found by the same team: interstitial cell-stimulating hormone (ICS),34 so called because it stimulated the secretion of testosterone by the interstitial cells of the testes, which in turn led to the growth of the penis and prostate and the development of secondary sexual characteristics. Later the name was changed to the luteinizing hormone (LH), because in females it triggered the formation of the corpus luteum and brought about ovulation.     Both gonadotropins need to be present to accomplish their effects on the sex organs. This is because there is a feedback action regulating the pituitary output of these hormones (hormones are also produced in the pituitary). This output depends on the level of testosterone, estrogen, or progesterone in the blood, and the pituitary either steps up or reduces the output of FSH or LH accordingly. MENSTRUAL CYCLE     The result of such discoveries was a much better understanding of the whole physiology of reproduction, including the workings of the menstrual cycle, the period of female fertility, and the nature of conception.35 One of the key breakthroughs was by G. W Bartelemez and J. E. Markee, who explained the role of the blood vessels in the uterus during menstruation". The two researchers found that the endometrium is fed by arteries that come up into it from the underlying muscle. These arteries have two kinds of branches. One kind is unique: Such arteries are wound into coils and make their way rather tortuously toward the surface, where they break up into capillaries, which supply the inner one-third of the endometrium. The other kind is the standard artery: They run a rather straight and short course directly to supply the basal two-thirds of the endometrium.36 As the endometrium thickens, additional coils appear in the coiled arteries, and this leads to a retarding of the circulation of the blood through them and their branches. Thus the immediate cause of menstruation was conjectured to be the injurious effect of the lack of blood supply to the endometrium brought about by the mechanical compression of the arteries.37 This conjecture of mechanical causes of ischemia was discarded when the whole process was found to be hormonally mediated.     The menstrual cycle can be divided into phases. Some researchers have used the following five phases: (1) follicular, (2) ovulation, (3) luteal, (4) premenstrual, and (5) menstruation or pregnancy. Others have used four phases: (1) proliferative (or follicular), (2) ovulatory, (3) progestational (luteal), and (4) menstrual. Those writing for the general public tend to use five, because it seems to be more descriptive of what women go through, and some women are very conscious of their oncoming menses or the premenstrual phase. The premenstrual phase is not usually used in scientific writing, perhaps because much of the research on the menstrual cycle was conducted on nonhuman primates, particularly rhesus monkeys, who could not communicate with the researchers. Corner found that progesterone and estrogen had menstrual suppression properties and the discontinuance of progesterone brought on bleeding. He theorized that in the normal cycle the uterus would not bleed during the first half of the cycle (the follicular phase), because the ovaries are furnishing estrogen; it would not bleed during the second half of the cycle (the luteal phase), because the corpus luteum is furnishing progesterone. Demonstration of this hypothesis is essentially what made the oral contraceptive possible.     During the follicular phase, which lasts from six to fourteen days, several follicles (from which the phase gets its name) begin to ripen and mature within an ovary. This process is mediated by a hypothalamus decapeptide that was originally called gonadotropic-releasing hormone (GnRH) but is now usually called luteinizing hormone-releasing hormone (LH-RH) or luteinizing hormone-releasing factor (LH-RF). The release of LH-RH is in response to low levels of estrogen in the bloodstream. LH-RF in turn stimulates the pituitary to secrete FSH38 and LH. FSH stimulates the follicle to produce and secrete estrogen into the bloodstream (the follicular phase). As the level of estrogen in the bloodstream rises, it signals the pituitary to stop releasing FSH. This then leads to ovulation which involves the rupture of a mature follicle from the ovary. When the egg is released from the follicle, it begins its journey to the fallopian tube, where it may or may not be fertilized by a sperm. Some women are able to feel the rupturing of the egg (middleschmerz), but most do not. The result is the luteal phase, since the empty follicle, now referred to as the corpus luteum (yellow body), secretes progesterone.39 Progesterone leads to an increase in the growth of the endometrium (uterine lining) in preparation for the egg in case it is fertilized (premenstrual phase). After four to six days, the corpus luteum begins to disintegrate, leading to a decrease in the levels of both progesterone and estrogen and, finally, to menstruation, the disintegration and discharge of the uterine lining.     There are also variations in body basal temperature during the cycle, with the temperature rising slightly during the later part of the menstrual cycle. The temperature begins to rise one to two days after ovulation in response to rising levels of progesterone, and it is on this fluctuation in body temperature that some individuals used to chart their fertility cycle.40 Other changes take place in cervical mucosa, which have also been used to plot safe periods for sexual intercourse.41     As estrogen levels drop, the cycle starts over again. If, however, pregnancy takes place, the placenta begins to produce human chorionic gonadotropin (hCG) at rapidly increasing levels for the first six weeks; this hormone delays the onset of menstruation and replaces LH.42 The placenta also produces estrogen and seems to be the chief source of estrogen during pregnancy. Progesterone is also present in the placenta. The ability to detect hCG was the explanation for the success of the first pregnancy tests. Essentially, the key to the cycle was Corner's discovery that menstruation was not brought about by the positive action of the corpus luteum but by its decadence. The proof of this was a key to understanding the cycle of the human female, although our ideas on this continue to be refined.43 Though not all of the researchers involved in such studies were supported by the CRPS, most of them were, and it enabled American science to move into a more or less dominant role in sex research. This move was undoubtedly assisted by the rise of the Nazis and the destruction of the German scientific enterprise, but the full effect of these discoveries depended on the effective and inexpensive production of the hormones, something that was not immediately possible. GREGORY PINCUS Generally, the research remained noncontroversial, but occasionally it received the kind of notoriety the committee tried to avoid. One of the researchers who received such notoriety was Gregory Pincus. Pincus picked up where another Rockefeller-supported scientist, Jacques Loeb (1859-1924), had left off. Loeb, who immigrated from Germany in 1891, taught at the University of Chicago and the University of California; and from 1910 on, he was affiliated with the Rockefeller Institute in New York City. In large part because Sinclair Lewis used Loeb as the model for the altruistic scientist in his novel Arrowsmith (1925),44 Loeb in death became the symbol of the scientist as a lonely searcher after truth, immune to the temptations of the "Bitch God of Success." Earlier Loeb was also praised by Thorstein Veblen and H. L. Mencken for his willingness to stand against prevailing American orthodoxies, since he was not only a mechanist in science but a socialist in politics.45     As a mechanist in science, Loeb sought to treat living things as "chemical machines" whose behavior could be explained by the laws of physical science. To test his hypothesis about chemical machines, he immersed fertilized sea urchin eggs in saltwater with an osmotic pressure that had been raised, by the addition of sodium chloride, above that of seawater. When replaced in seawater, they underwent multicellular segmentation. Later, he subjected unfertilized eggs to the same process, and by 1899 had succeeded in raising larvae by this technique, the first notable triumph in achieving artificial pathogenesis.46 The possibility of living things as chemical machines challenged the traditional assumptions of science, and in Donald Fleming's words was an "assault upon the crux of biological mysticism, the process of fertilization where so many ingenious theologians through the ages had seen their chance to slip a soul in while nobody was looking."47     Picking up on this was a young assistant professor at Harvard, Pincus, who was establishing himself as an authority on mammalian sexual physiology and was specializing in delicate work with rabbit eggs. His research was supported by the CRPS. Pincus received national publicity in 1934 when he announced that he had achieved in vitro fertilization of rabbit eggs (that is, inside a test tube). Unfortunately, in the aftermath, the New York Times portrayed him as a sinister character bent on hatching humans in bottles, similar to that of Professor Bokanovsky, created by Aldous Huxley in the novel Brave New World (1932), which was then being widely read.48     By 1936, Pincus had shown that rabbit ova could be artificially activated by a number of techniques, including exposure to salt solutions and to changes in temperature. He had also successfully transplanted many developing ova into female rabbits and shown that the ova had grown into embryos before the host does were sacrificed to check the progress of the experiment.49 His "immaculate conceptions," as they were called, made good copy for journalists even though many of them were hostile to what he was doing. Collier's magazine, then one of the most widely sold magazines in the United States, ran an article titled "No Father to Guide Them," which was both antifeminist and anti-Semitic (Pincus was Jewish) and held that biologists were playing with nature. The article concluded that Pincus was threatening the American male, whose virility, already called into doubt by the Great Depression and the declining birth rate, was now threatened by a fate worse than simple castration, namely the very reason for his existence50     Shortly after this, Pincus was denied tenure at Harvard, an action that served as a further warning to those engaged in sex-related research to keep a low profile. Harvard did give him a research grant that enabled him to go to Cambridge University in England for a year. But on his return, he was unable to get an academic position. Hudson Hoagland at Clark University (in Worcester, Massachusetts) came to his rescue by offering him a courtesy appointment as a visiting professor of zoology, but such a position had no salary and lacked faculty privileges. With financial support from Nathaniel, Lord Rothschild, Pincus was able to move to Worcester, and some of his research there was eventually supported by the CRPS, although not until 1940. His move to Massachusetts, however, did not isolate him from media attention, and periodically, they gave new publicity to the birth of the parthenogenetic rabbits.51     Still unable to get Pincus a regular academic appointment at Clark or elsewhere, Hoagland joined with Pincus in 1944 to set up the Worcester Foundation for Experimental Biology, a nonprofit corporation supported by local philanthropists and various foundations and agencies, including the CRPS. Pincus went on to conduct research about steroids. Much of the money eventually came from the G. D. Searle pharmaceutical company, since Pincus and his colleagues were interested in developing a process for the commercial production of cortisone, a secretion of the adrenal cortex.52 By that time, however, Pincus was no longer supported by the CRPS.     In terms of practical application to sexual practices, perhaps the most significant result of the new endocrine discoveries was the development of more effective contraceptives. In the 1920s, Davis demonstrated that contraception was known and widely practiced by the majority of married women she studied. The problem was not a lack of effective contraceptives but dissemination of information about them and making them affordable to the average person. Physicians themselves were often reluctant to deal with contraceptives. When Sanger originally asked Dickinson to give his public support for her early campaign on contraception, he turned her down. He believed his career as a physician came first, and that his association with Sanger would end his influence among other medical men. Dickinson had even told Clarence James Gamble (1894-1966) -heir to the Ivory soap fortune as well as a pharmacologist interested in dissemination of contraceptive information- that first-class scientists neglected contraceptive research because of the belief that birth control was illegal and was associated with immorality.53 Though Dickinson later changed his mind about working with Sanger (he was already an advocate of birth control and prescribed it for his clients), as did many other physicians, the reversal was brought about by changes in American society as much as it was by new scientific breakthroughs.     In fact, in spite of the studies by Davis and Dickinson, American researchers remained hesitant about studying sex in humans in any direct way through much of the 1930s. Animal studies, as has been emphasized, seemed safer, and though many of these had implications for human sexuality, such implications were usually never directly drawn. This was unfortunate, because in Europe studies in human sexuality reached an ebb. Germany, the center of most of the early-twentieth-century studies of sex, was under Nazi control and the Nazis, who were extremely prudish in discussions about sex, mounted campaigns to eliminate pornography, imprisoned homosexuals to cure them, sent off into exile many of the those engaged in sex research, and either destroyed or dispersed valuable collections of materials such as those of Hirschfeld.     Outside of Germany, many of the pioneer generation of physicians who had dominated sexology were dying off, and the younger generation of medical practitioners were not interested in studying sex. The major exceptions to this generalization were in the field of contraceptive research and in the area of sexually transmitted diseases, then called venereal diseases. Still there were difficulties even here. Many respectable scientists were unwilling to do research into contraceptives, and even the Rockefeller-funded CRPS was unwilling to investigate the topic. The Rockefeller Foundation remained interested in it, however, and when it decided to fund studies into the chemical composition of spermacides, the foundation could find no American scientist willing to do the work. Instead, they went to England, but after some preliminary finds had been made there, the English group refused to go further.     Human sex research in the eyes of much of the scientific community was simply too controversial to investigate directly. Following their own interests, these scientists concentrated on much narrower studies in nonhuman species. Even the topic of venereal disease was handicapped by an unwillingness to discuss the issue publicly. For example, when Thomas Parran Jr. was made head of the Venereal Disease Division of the U.S. Public Health Service in 1926, one of his goals was to tackle the problem of syphilis. He found it much more difficult to do so than he anticipated, because he was unable to discuss the topic publicly. As late as 1934, when he was scheduled to give a radio talk for the Columbia Broadcasting System (CBS) that was to review the major public health issues, he was told he could not use the words syphilis and gonorrhea on the air. It was not until 1936, after he was appointed U.S. surgeon general, that federal funds were finally appropriated for public clinics to carry out Wasserman testing for syphilis and to treat the disease.54     Sex education in the schools theoretically had been growing, but in most schools where it was taught, it was regarded as an adjunct to physical education (which supposedly included health education). The goal of such education was to emphasize abstinence, which was often done by focusing on the dangers of disease and infection. Though some anatomy and physiology was included, it was usually better taught in the girl's classes than the boys, since menarche and menstruation were deemed more important to them.     At the college level in the United States, however, particularly in the state universities and the private women's colleges, courses began to be offered in marriage and family, often in home economics departments. Such courses also included discussions of the anatomy and physiology of sex, although most of the students were female.55 This movement for some sort of education in marriage and family continued to grow and was formalized in 1939 with the organization of the National Council on Family Relations and the establishment of the journal Living, which later changed its names to the Journal of Marriage and the Family.56 One effect of the foundation of the NCFR was to encourage exploration into various aspects of dating and courtship as well as sex. It was in just such a course that Kinsey started his research. MARRIAGE MANUALS AND THE SEXUALIZATION OF LOVE The changing ideas about marriage and the place of sex can most easily be traced in the appearance of new types of advice manuals, which came to be popularly known as marriage manuals. They differed from earlier ones not only in accepting women as sexual creatures but in insisting that sexual satisfaction was part of their marital right. Many of these manuals were written by women, and even those that were not seemed to be aimed more at women than men, since the emphasis was often on having husbands (sex was still permissible only in marriage) learn the sexual needs of their wives. A major consequence of such manuals was the increasing sexualization of love. Using the writings of Ellis, Freud, and others as a base, the marriage manuals, offered advice and help, of types not previously available, to the newly marrieds of the 1920s and 1930s.     A major reason for the appearance of these new manuals was the widespread popular belief in Western society that traditional marriage was failing. One source of fuel for this belief was the changing status and influence of women, which led to demands for greater equality in marriage. Though women had finally gained the right to vote at the end of World War I in the United States, the United Kingdom, and other countries, this had not led to anything like equality between the partners in marriage. Such a demand had already appeared in the last part of the nineteenth century, and it grew more influential as the twentieth century progressed.57 One of the early symbolic representations of this unrest were the plays of the Norwegian dramatist Henrik Ibsen (1828-1906). The heroine in A Doll's House (1879) came to believe that her domestic happiness was specious and that her whole personality had been circumscribed and smothered by society's conventions. Her solution was to explore the world alone in search of selfhood, and though this seemed daring and attractive to many of the women of the time, few were willing to go quite that fan In his Ghosts (1881), Ibsen portrays the horrible hereditary effects that result from an unfit father who, in spite of his defects, continued to fulfill his procreative obligations to society.58     There was a growing plea (not yet 5 demand) to change laws and customs so that the woman would not feel forever chained to a partner in a repulsive relationship. Ibsen's ideas were not isolated ones but were carried over into feminine protest novels by such authors as Ellen Key (1849-1926), who urged that women must be faithful to their own personalities rather than conventional morality. Some of the same kind of message was conveyed in the works of Ellis and Edward Carpenter, and in fact, the whole European sex movement was strongly influenced by the need for reform in marriage, including the right of divorce. Divorce, in fact, was becoming much more common, and as early as 1908, Shaw, in his introductory remarks to his play Getting Married (1908), wittily proclaimed that divorce was a necessary condition for the maintenance of marriage.59     Obviously, there were literary counterparts to Ibsen, Key, and others who argued on the other side. Most notorious was Otto Weininger, whose Sex and Character (1903) is a misogynist tract emphasizing that women are heartless, shameless, and amoral.60 August Strindberg (1849-1912) dramatized sex as a conflict between two well-armed antagonists. Though women, he wrote, were normally inferior combatants in most battles, in marriage they were stronger because they were more realistic and more unscrupulous. He said that though the world contained only one disagreeable woman the problem was that she was universal and each man drew the same woman for his companion. The American author Robert Herrick (1868-1938) added that the trouble with middle-class women was that they married to became queens and they wanted to rule and not to work.61 Much of the psychoanalytic writing of the time, in fact, is devoted to attempting to explain female neuroses as due to repressed sex desire.     Various solutions were proposed. Among the popular American advocates of change were Judge Benjamin B. Lindsey and Wainwright Evans, who advocated what they called companionate marriage. This included the use of birth control, divorce by mutual consent for childless couples who were incompatible, education of the young in the art of love and successful marriage, and a reform in laws regulating allmony.62     Another way of dealing with the issues was to redefine marriage by emphasizing the sexual and affectional basis of intimacy and the importance of companionship in marriage. This change in emphasis is most reflected in the change in the nature of marriage manuals that began to appear in the United States. Interestingly, though Americans such as Sanger and Robinson wrote on sex and marriage, the two most widely read authors were Europeans: the British botanist Marie Stopes and the Dutch gynecologist Theodoor van de Velde. MARIE STOPES     Marie Charlotte Carmichael Stopes (1880-1958) was one of the pathbreaking women who were so important in the development of a better understanding of human sexuality. Born to a well-to-do family in Scotland, she was tutored at home by her parents until she entered boarding school in London at age twelve. After graduating from University College in London in 1902, where she studied botany, geology, and physical geography, Stopes went on to receive a doctorate at the University of Munich. She then joined the science faculty at the University of Manchester, the first woman to do so. In 1911, she married, and leaving Manchester, she moved to London where she became a lecturer on paleobotany at the University of London from 1913 to 1920. During this time, Stopes published a textbook on ancient plants as well as a catalog of Cretaceous flora in the British Museum collection. During World War I, she engaged in research on coal with R. V Wheeler. In short, Stopes was a first-class scientist and researcher.     Stopes's interest in sexuality came from the failure of her 1911 marriage to Reginald Ruggles Gates. In 1916 the marriage was annulled on the basis of noncon summation, and in 1918 she married Humphrey Verdon Roe, an aircraft manufacturer. He was already interested in birth control, and shortly after their marriage they founded the Mothers' Clinic for Constructive Birth Control in London, the first of its kind in England.63 After this, Stopes (who kept her maiden name) relinquished her lectureship at the University of London and devoted herself to family planning and sex education for married people. She also wrote fairy tales under the name of Erica Fay. Among her other pseudonyms were Mark Arundel, Mane Carmichael, and G. N. Mortlake.     Strongly supportive of the concept of marriage, she also emphasized the rottenness and danger of the unhappy marriage, which she said came about when love was separate from sex. She believed that both were key to a happy marriage. Her first book on the subject, Married Love, was published in 1918, although she had originally drafted it in 1914 to crystallize her own ideas. It became an immediate success and was translated into numerous languages, causing a sensation at the time of its publication. Although the first edition dealt scarcely at all with birth control, she received so many requests for instruction on the subject that this was followed up by the short book Wise Parenthood, which was also an immediate success. Within nine years it had sold half a million copies in its original English edition. Stopes published a number of other books more or less dealing with same subject with titles such as Radiant Motherhood and Enduring Passion; many of these sound somewhat overromantic to later generations of readers.64     Her great achievement was to move the topic of birth control in much of the English-speaking world from the confines of the physician's office to public discussion. But equally significant was her emphasis on the importance of sex in the life of a woman. Stopes believed that both love and sex were essential parts of marriage. Because the sexual discontent so dangerous to marriage was something that she thought could be remedied, she took to writing marriage manuals on how to renew love through sex. Her general theme, as it was of several other contemporary writers on love and marriage,65 was that in the past marriage had been held t ogether by the economic dependence of the wife on the husband, by the sense of duty of the husband to his family responsibilities, and by law. She felt that in the new day and age there had to be a new basis for holding together a union of equals who chose to Join their lives for companionship. This new force that was to bind love and marriage was sexual compatibility.
	Where the acts of coitus are rightly performed, the pair can disagree, can hold opposite views about every conceivable subject under the sun without any ruffling or disturbance of the temper, without any angry scenes or desire to separate. They will but enjoy each other's differences. Contrariwise, I am sure that they can have ninety-nine per cent of all their other qualities and attributes in perfect harmony, and if the sex act is not properly performed; if they fall to adjust themselves to each other; if they are ignorant of the basic laws of union in marriage, all that harmony and suitability in other things will be of no avail, and they will rasp each other apart in sentiment, until they but endure each other for some extraneous motive, or they desire to part.66
Sanger, perhaps better known to American readers today than Stopes, was not quite so explicit, but Sanger also emphasized the importance of sex, holding that the bedrock of lasting happiness in marriage "1ies in a proper physical adjustment of the two persons, and a proper physical management of their mutual experiences of [sexual] union."67 The cornerstone of a proper physical management for Sanger was built on the use of effective contraceptives so the life of the woman would not be governed by frequent unwanted pregnancies.     It was believed and taught that once women's sexual needs were accorded an equal status to those of men, the norms of companionship and mutuality in marriage would inevitably extend into the domain of sex and become the seal of love. Hannah Stone and Abraham Stone, who also wrote marriage manuals, said that the sexual embrace should become the expression of mutual desire and passion. The joy of sex could only increase when it was mutual.68 Isabel Hutton emphasized that "no matter how ideal the partnership in every other way, if there is want of sex life," the marriage cannot be a success.69 Stopes had added a strong second to that: "In these modern days when friendship, mutual occupations, businesses, almost every phase of our civilized life, bring men and women together in innumerable ways, the only justification of marriage is the mutual need for and the mutual enjoyment in sex union."70 THEODOOR VAN DE VELDE     Some writers seemed to caution against quite so much emphasis on sex as a cure for all marriage problems. Theodoor Hendrik van de Velde (1873-1937), for example, whose marriage manual was the most popular one in United States, emphasized that marriage depended on a range of factors, including the emotional and social compatibility of the husband and wife, a sharing of interests, and an agreement on family.71 Still, even he held that vigorous and harmonious sexual activity was the key to the temple of marriage: "It must be solidly and skillfully built, for it has to bear a main portion of the weight of the whole structure. But in many cases it is badly balanced and of poor material; so can we wonder that the whole edifice collapses."72 In effect, almost all the manual writers, including van de Velde, agreed it was good sex that made marriage a success.     Van de Veldes's first book, Ideal Marriage, was published in 1926 in both Dutch and German. Though van de Velde anticipated he might be ostracized for publishing the kind of sex information he included in his book, this was not the case. The book went through forty-two printings in Germany before it was suppressed when Hitler came to power in 1933. The London edition went through forty-three printings, and while figures are not available for the American edition, it went through six printings in the first two years of publication. Random House, which later purchased the rights to publish it, reported that it sold half a million copies between 1945 and 1965, when it again was revised and republished.73     Van de Velde had first married in 1899 when he was twenty-six, but the marriage was not a happy one. After ten years, he left his wife for Martha Breitenstein-Hooglandt. This act, he said, forced him to give up his practice and live in sin until his wife finally divorced him in 1913, and he could marry Breitenstein-Hooglandt. The couple settled near Locarno, Switzerland, and it was there that van de Velde began writing his marriage manual based on his own experience as well as his friends' and patients' experiences.     Though there is considerable anatomical and physiological data in the first part of the book -some of it inaccurate even for the time- the key to the book is its discussion of sexual intercourse. For him, however, the only normal intercourse was between two people of the opposite sex. Having said this, he went on to emphasize the importance of foreplay, including kissing and touching the erotic parts of the body: the nipples, clitoris, and penis. Though he said an orgasm by cunnilingus or fellatio was pathological, such activity was perfectly permissible in foreplay. He saw no reason why, if they wanted to, a couple should not copulate during menstruation and that intercourse during pregnancy is permissible if the woman was willing and desired it, although the positions might have to change. Only "the menace of miscarriage, and the eminence of birth" would preclude it.74     Van de Velde reported that though some of the Oriental encyclopedias of love described a hundred different positions, there was no need to know them all. Still, knowledge of a variety of positions was important and had practical value, because it increased sexual pleasure, sometimes prevented hygienic dangers or injuries, and could promote or prevent conception. He erroneously believed that the most intense orgasm possible occurred when both partners reached climax simultaneously or almost simultaneously. Similarly erroneous was his belief that such an orgasm increased the probability of conception, although it was just such beliefs that allowed him to argue the necessity of experimenting with any positions that might promote simultaneous climaxes.75 He listed ten different positions, six in which male and female are face to face and four with the male behind the female. He included a summary chart that indicated when such positions should not be used (for example, in pregnancy), the type of stimulation afforded (such as clitoral stimulation), and whether it was more likely or less likely to lead to conception (here he was in error).76 He also felt that by exploring and engaging in these various coital positions, the desire to achieve variety by a change in coital partners would be curbed and marital fidelity fostered. Van de Velde, in fact, was often in error not only in terms of today's knowledge but in terms of the knowledge of his own time. He taught there was danger in the male thrusting too much, since it might rupture the vagina. He also believed that the human penis could become locked in the human vagina, a somewhat common occurrence for dogs but an extremely rare occurrence for humans. His belief in the importance of simultaneous orgasm was probably the belief that caused the most difficulty to his readers, at least according to modern sex therapists. EMANUEL HALDEMAN-JULIUS     Collectively, the writers of marriage manuals were changing attitudes toward sex, particularly those held by and about women, and in the process eliminating some of the stigma associated with sex research. The new concepts about sex were not confined to members of the middle class who could afford a hardcover book by Stopes or van De Velde; they also appeared in pamphlets and books aimed at a larger public. Probably the major American disseminator of information aimed at the working classes was Emanuel Haldeman-Julius, a publisher from Cirard, Kansas, who issued more than three hundred million copies of volumes in the series Little Blue Books, initially selling at five and ten cents apiece, and later for twenty-five and fifty cents. Sex books furnished a significant portion, perhaps as much as 20 percent of Haldeman-Julius's business. During 1927, for example, some sixty-six thousand copies of Sanger's What Every Girl Should Know were sold. Similar titles were aimed at boys, newly married couples, married women, married men, expectant mothers, and so forth. Most of the books for males were written by William J. Fielding, while Sanger wrote many of those for women. Some rather esoteric books by A. Niemoller were also included in the series, including translations of some of the Islamic and Hindu classics. Haldeman-Julius was eclectic in his sex titles and published books about homosexuality, transvestism, incest, rape, and prostitution. There were six titles by Ellis available in 1928 as well as two books on contraception, others on venereal disease, and some on sexual hygiene. In most cases, Haldeman-Julius published the best available information in English on many of these topics, and in his miscellaneous topics book he included discussions of such topics as homosexuality and transvestism, which made his publishing company often the only popular source available.     The Little Blue Books had started out as offshoots to the socialist newspaper Appeal to Reason but soon dominated the business. In addition to the sex pamphlets, Haldeman-Julius published works on socialism, free thought, and vast quantities of the literary classics, including all of Shakespeare's plays in individual booklets. His business began to decline in the early 1940s with the advent of large-scale paperback publishing in United States, but during the height of his activities (from the late 1920s through the 1930s), he was perhaps the leading disseminator of sex information in the United States.77 CENSORSHIP AND SEX CensorshipThe battle to bring sex information to the American public had not easily been won. In fact those disseminating sex information were able to do so only with the aid of a series of decisions by the U.S. courts.78 One of the key cases dealt with whether the public had the right to read about lesbianism. Edouard Bouret's play The Captive, which dealt with lesbian love, opened in New York in 1927 and was closed down by city officials as obscene. This action was quickly followed by the passing of a law in the New York State Legislature prohibiting the performance of any drama that dealt with sexual perversion. The immediate question was whether such a law also applied to a novel, particularly to The Well of Loneliness by Marguerite Radclyffe Hall. This early classic of lesbian love had been published in England in 1928 where it had been denounced as obscene by a reviewer in the Sunday Express, in part for what was regarded as special pleading for lesbians as victims of nature as well as an appeal to God for justice and recognition. The home secretary responded to the review by requesting the publisher to withdraw the book from circulation. An English edition was quickly published in Paris and sent to England, but customs seized a shipment of this printing and, after getting a court order, destroyed it.79 Fearful that such events would also occur in the United States, the original American publisher decided to drop the book, and its publication was quickly taken over by Donald Friede of Covici. Friede was determined to fight the case through courts if necessary, even if it meant his conviction for publishing pornography. Inevitably, the book was seized, and in the magistrate's court, the judge ruled that the novel "tends to debauch public morals, that its subject-matter is offensive to public decency, and that it is calculated to deprave and corrupt minds open to its immoral influences and who might come in contact with it." Oil appeal, however, in the appellate court on April 19, 1929, the court ruled the book was not obscene, and it was given American publication.80 The importance of the decision is that because the book was allowed open circulation, no theme in itself could be declared obscene. Censors had to find other reasons for suppressing the written word rather than the topic with which it dealt.     This decision by no means ended attempts at censorship of sex-oriented books. In 1930, Mary Ware Dennett, an activist in the legal battles for contraception, had been convicted of mailing obscene material, namely a pamphlet she had originally written for her two sons (aged eleven and fourteen) to read; it was titled Sex Side of Life. She had allowed some of her friends to read the pamphlet; one of them brought it to the attention of the owner of the Medical Review of Reviews, who asked if he could read it. He found the pamphlet informative and proceeded to publish it in his journal without any interference from legal authorities. About a year later, Dennett decided to publish the article in pamphlet form herself and sell it through the mall for twenty-five cents a copy to anyone who wrote and asked for it. It was this for which she was prosecuted.     At the beginning of the pamphlet, Dennett had what she called an introduction to elders (parents and others), in which she says that she had been unable to find a pamphlet on sex matters that she would willingly put into hands of her sons without warning them about the misinformation that was contained in it. She then said her pamphlet contained material "far more specific than most sex information written for young people. I believe we owe it to children to be specific if we talk about it at all." In the pamphlet, Dennett emphasized that sex involved both physiological and emotional responses. She described the sex organs and their operation, the way children are begotten and born, and masturbation. In her mind, the greatest danger of masturbation was the guilt feeling built up about it, since the act itself was not particularly harmful. She also said that venereal disease was curable and noted that the sex impulse was not a base passion but a normal one and that its satisfaction could bring about great and justifiable joy, especially when accompanied by love between two human beings. Dennett warned against perversion, venereal disease, and prostitution and argued for continence and healthy mindedness until marriage and spoke against promiscuous sex relations.81     It was such frankness that led to her prosecution. In what turned out to be an extremely important decision, Dennett was acquitted of disseminating obscene material by the U.S. Court of Appeals for the Second Circuit on March 3, 1930. The opinion written by Augustus N. Hand proved to be extremely influential, because it made sex education materials legal, even if those aimed at children dealt with sex in a positive way.     Stopes also added to American case law. She early had been involved in a notorious trial in England over her establishment of a birth control clinic in London in 1921.82 In this case, she herself had brought suit when an English writer had denounced her as teaching a "harmful method of birth control" and being one of the leaders in a "monstrous campaign" for birth control. Though her attorneys advised her against suing, as nothing came of the review except disparagement of her views, sue she did. She lost, but her loss was more to her pride than to the birth control movement. The American cases came about in 1931 when her book Married Love had been seized by customs officials in two different ports of entry, New York City and Philadelphia. In both cases, however, the courts found the book not to be obscene.83     It is worthy of note that all of these cases involved women, and two of them were active in the movement for contraception and better sex education. Though these decisions dealt with scholarly or scientific discussions of sex, they set the background for the most important censorship case in ,American history up to that time, namely that of James Joyce's Ulysses, which had been published in English in Paris to avoid British censorship problems. Bennett Cerf, president of Random House, wanted to print the book and devised a stratagem to have the courts rule on the book before he published it. After consultation with his attorney, Morris Ernst, he imported a copy of Ulysses, which was then duly seized by the customs inspectors. Cerf brought action in federal court for its release and asked that the action be heard without a jury and before a single judge. The judge turned out to be John Munro Woolsey, the same judge that had been involved In one of the cases involving Stopes's Married Love. In December 1933, the judge ruled that the book was not obscene, and Cerf immediately began publication of the book, which appeared early in the next year. One of the key elements in Woolsey's decision was that a book must be judged not by its effect on the abnormal or the young but rather on the average man (or woman). The government appealed the case to the next highest court, the circuit court of appeals, where the decision supported Woolsey two to one. The government decided not to appeal to the Supreme Court. The decision in the circuit court, written by Learned Hand and Augustus Hand, who were brothers, emphasized that a book had to be taken as a whole and could not be banned because it contained some obscene passages. The Hands added that it was settled, as far as the circuit court was concerned, that works of physiology, science. and sex instruction could not be judged obscene, even though some persons argue they promote lustful thoughts.84 CONTRACEPTION Gradually, a growing number of scientists became more willing to examine aspects of human sexuality, instead of just that of animals. Because so much of the popular writing about sex had been aimed at women, and much of it written by women, contraceptive research was one of the beneficiaries. Originally, Sanger fit her patients with cervical caps, simply because she had an available supply in her clinics (started in 1916). Later, she was able to get supplies of the Mensinga diaphragm and quickly turned to them, because they were easier to fit and insert. Still, the contraceptive industry was a clandestine one, with little regulation or quality control, since contraceptives were outside the purview of the various government agencies.     The Birth Control Clinical Research Bureau of the American Birth Control League (after 1942 collectively known as the Planned Parenthood Federation of America) filled in the gap and began to conduct clinical experiments in contraception. They gathered individual case histories of use and attempted to determine the success rate of the users. The first report was published in 1924, but it was essentially a preliminary one. A second report was issued in 1928 based on 1,655 cases; it showed that the use of a modified Mensinga diaphragm -known then as the Ramses pessary (it had a coiled spring)- In combination with a spermicidal jelly was most effective, with a success rate of 96 percent.85     Although such information was available to medical specialists and was even available in some libraries, most of the general public remained ignorant. Still, a central goal of the birth control movement had been getting medical acceptance of contraception, and the publication of such data was important. One of the first widely available sources of public information about effectiveness was the 1937 report by Consumers Union, the publisher of Consumer Reports. It was a sign of the times, however, that rather than publish the information openly in the magazine, it notified subscribers that a report was available to those who signed an application saying they were married and had been advised by a physician to use contraceptives. Even this method of dissemination ran into difficulty, and in 1941, the Post Office Department barred the report from the malls. Though the action of the post office was upheld by a U.S. district court, the decision was finally reversed by the court of appeals in September 1944.86 Planned Parenthood officials remained leery of legal action, however. Although an increasing number of physicians were providing contraceptive information, the Planned Parenthood Federation was reluctant to support any widespread public education in contraception outside of the confines of its clinics, because of local and state government action against them.     In 1934, Gamble established a research program under the auspices of the National Committee on Maternal Health that was directed toward the "discovery of better, cheaper and more generally available contraceptives for the underprivileged masses."87 The committee itself, as mentioned earlier, had been set up Dickinson in 1924 to sponsor medical investigation of contraception, sterility, abortion, and related issues. It had been funded mainly by a group of society women led by Gertrude Minturn Pinchot,88 although part of its research program also received funding from the Rockefeller-sponsored. Gamble's support appeared at a critical time, because the Bureau of Social Hygiene was being closed down, and its funding was being withdrawn; furthermore, the CRPS was not interested in such research.     Later, another Rockefeller-funded agency also put a strong Rockefeller imprint in this area. This time the money came from the third generation of Rockefellers, when in November 1952, John D. Rockefeller III, following the example of his father in supporting sex research, started the Population Council with his own funds. Through its Demographic and Bio-Medical Division, the council continued the research that had been done on a small scale by the National Committee on Maternal Health and in 1958 took over the committee itself.89 Included in the council's research program were demographic studies. The early ones showed a decline in the number of children per family through the 1930s among cohorts of women (aged fourteen to forty-nine) grouped into twelve-year intervals from 1897 onward. The 1940s, however, saw an increase in family size and the subsequent rise in birth rate that produced the so-called baby boomers.90 The effect of such studies was to give accurate indicators of the use of contraceptives, the existence of abortions, and other factors so important in long-range planning for a variety of issues. SUMMARY The 1920s and 1930s saw significant breakthroughs in the understanding of the physiology of sex. This understanding was primarily based on animal models and resulted from the efforts of the CRPS funded by the Rockefellers. It also saw a growing public willingness to learn more about sex, particularly by women, many of whom took on the role of sex educator in the family for both their children and their husbands. This growing public receptivity led to more scholarly and scientific research, as academic researchers, mainly in the sciences but also in anthropology, gingerly began to explore human sexuality within their own disciplines. It is this subject that is explored in the next chapter.
6 FROM FREUD TO BIOLOGY TO KINSEY A major factor in bringing about a change in attitudes toward sexuality in the United States was the growing importance of Freud and Freudian ideas. Though Ellis was widely read, as were the writers of marriage manuals, it was Freudian ideas that captured the interest of the intellectual community. Freud's concept of sexuality was widely adopted by anthropologists, psychologists, literary critics, and others who carried his message to a larger audience. His ideas were also important in treatment. While there were some psychiatrists who did not adopt the Freudian viewpoint and others who belonged to variant schools of psychoanalytic thought, it was Freudian-based concepts that dominated American writing on variant sexuality and exercised great influence over American ideas about sex, in general, and about the diagnosis and treatment of patients' sexual problems, in particular. Psychiatrists saw both private patients and those sent to them by the courts. There was, however, a difference between Freud himself and most of his American followers, because where Freud had emphasized nature and biology as much as nurture, the American psychoanalysts put much more emphasis on nurture.     The historian John Burnham argued that in the 1920s and 1930s
	enthusiasts of dynamic psychiatry and psychoanalysis, like the Menninger brothers, were asserting that they and their colleagues could contribute to a better world because they knew the causes of human unhappiness. Later a conservative cult of contentment... may have been important, but for decades coinciding with the high tide of psychoanalytic influence in America, the analysts, the deviant analysts, and many of their psychiatric and lay followers persisted in describing the benefits of psychoanalytic treatment and applied psychoanalytic psychology in terms of glowing promises.1
A major result of this rising influence of Freudian ideas to the development of sex research was to make Americans more conscious and less reticent about sexuality, since simply to read Freud was to become aware of sexuality. For a time, in fact, some American journalists argued that it was impossible to describe Freud's theories in magazines that circulated in the home, because the theories included so much about sex.2 Gradually, however, discussions of sex, which previously had been limited to the topics of prostitution and divorce in most popular magazines, began to be more open. As early as 1915, Floyd Dell, an author and later publisher, wrote that psychoanalysis gave an air of "ponderous German scientific propriety" to subjects that a few years before would have been deemed "horrific."3 Psychoanalytic talk, he said, spread from Greenwich Village to the suburbs, although there still remained a tendency to avoid mentioning directly pertinent body parts and circumlocutions abounded. Though articles in the popular media about psychoanalysis remained unfavorable through the 1920s, knowledge of Freudian ideas was increasingly widespread. By World War II, the impact of Freudian ideas was widely accepted in popular culture. His ideas had become fundamental in psychiatry and psychology and had spread over into sociology, anthropology, history, and various forms of literary and other criticism. FREUD AND SCIENCE The critics of Freud, and there were many, served only to disseminate further the knowledge of Freudian ideas and concepts. As president of the American Association for the Advancement of Science in 1925, J. McKeen Cattell stated that "psychoanalysis is not so much a question of science as a matter of taste." He went on to add that Freud was an artist who lived in a fairyland of dreams among the ogres of perverted sex.4 One of the reasons for criticism is that Freudian psychoanalysis became a self-justifying system, not subject to scientific verification by the uninitiated.5 Freud also either suppressed or ignored information about his patients that did not fit into his theories.6 Even some of his closest sympathizers, such as Wilhelm Fliess, went so far as to accuse Freud of reading his own thoughts into the minds of his patients.7 This absence of data, lack of intuitive insight, and even deliberate suppression led Sulloway to question why Freud published even the case histories he ,did if he did not cure most of his patients or, for that matter, apparently did not believe them generally curable. He argues that Freud's purpose was to establish a way of thinking, that he was involved in what might be called the social construction of psychoanalysis. If this was the case, the American version of Freudianism was a great success.     Freud's influence in the United States went beyond his own ideas and concepts and included the views of those who started as his disciples and theii broke with him about various parts of his system. In fact, his very system encouraged the development of rival systems, and in the United States, this aroused even greater interest. Freud's ideas, as indicated earlier, originally had been disseminated through a small coterie of believers. Unable to sell his concepts to the medical establishment in Austria, he created his own education institutes, more or less abandoning the established medical apparatus designed to train neurologists and psychiatrists. Later, he deliberately discouraged his followers from trying to establish medical school ties or to set up training institutes within medical schools. The ultimate result was that Freud, sometime after 1900, either consciously or unconsciously abandoned the methods of science, namely the need to replicate theories and practice not only within one's own immediate social group but outside as well.     Training scientists, however, was not his aim, because Freud wanted practitioners who operated within a relatively fixed system of ideas. As Sulloway put it, "Instead of trusting that his methods would withstand critical scrutiny and flourish independent of opposition, Freud privatized the mechanism of their dissemination and trained a movement of loyal adherents. His most talented followers naturally tended to rebel under this totalitarian regimen."8     The history of Freudian thought inevitably becomes the histories of heresies and schisms, but the net effect was to disseminate more widely a realization of the importance of sexual issues. Some of those who broke with Freud did so because of disagreement with his sexual theories, and most of them picked up American followers of their own. ALFRED ADLER     Adler (1870-1937) broke with Freud in 1911 and went on to develop individual psychology. Adler tended to downplay sexuality, using it more symbolically, as he did in his concept of sibling rivalry, than biologically.9 Closely related to sexuality was his concept of gender theory, by which Adler held that individuals generally compensate for underdeveloped or abnormal organs and occasionally achieve a higher than average achievement by so doing. Though Adler originally did not apply his theory to the sexual organs specifically, others did. They implied that organ inferiority might lead either to neurosis or to perversion, an idea that Adler himself came to accept.10     From these seeds, Adler went on to develop the idea of a drive toward masculine protest or will to power. Since society calls women the weaker sex, a masculine protest is a common compensation, and women may strive directly for power or use their sex as a device for gaining power over men. Men with feminine tendencies may become exaggerated hemen or, if they are homosexuals, try to dominate through weakness.11 WILHELM STEKEL     In 1911, Stekel (1868-1940) resigned as an officer of the Vienna Psychoanalytic Society and eighteen months later Stekel left the society over an editorial dispute with Freud. He continued to accept many of the concepts of psychoanalysis, but gave them his own interpretation. A gifted writer and an energetic reformer (in 1906, he established a branch of Hirschfelds's Scientific-Humanitarian Committee to agitate for the removal of legal obstacles to homosexuals), Stekel today is most valuable for his reports on his case studies. These empathetically describe the problems of his patients; in fact, his descriptions were so interesting that he was accused of making them up. His descriptions of fetishism, for example, make one almost feel what it must be like to be a fetishist. He continued to emphasize the importance of sexuality but he did not accept the Freudian interpretation of neuroses. Instead, Stekel claimed that all neuroses and sexual disorders rose from mental conflict, not from blocked or redirected instinct and were, therefore, potentially curable. He believed that deviants isolated their problems in their minds and chose a tortuous path through life to avoid challenges that they could not handle. Thus, once the source of the conflict is uncovered, a cure can take place, and in a dig at Freud, he claimed he could cure individuals that the Freudians found incurable.12 CARL JUNG     Carl Gustav Jung (1876-1961) broke with Freud in 1912, in large part because of Freud's emphasis on sexuality. He disagreed with Freud about infantile sexuality, the concept of a latency period, and the emphasis on childhood experiences as the essential causes of neurosis, all of which he criticized on biological grounds. Sex, for Jung, was important only in so far as it was made so through the varieties of individual experiences. Jung agreed with Freud and Adler that every person is essentially bisexual. Jung, however, developed the concept in a different way, one that fits more into the gender theory of today. The male, he wrote, frequently represses the female side of his nature, the anima, but it survives in the unconscious, as does the repressed male side of the female, the animus. The anima in men gives a receptive, nurturing alternative to soften the masculine logical, dominating, and forming features. The animus in women imparts logical, dominating, and forming features to the feminine nature. Pathologies develop when these opposites are lost in a shriveled, ineffective, unconscious representative. It is also possible, however, that the wrong nature dominates. In some homosexuals, according to Jung, the female anima dominates, as it does in excessively weak or tender men. Similarly, the woman who seeks to dominate men without love may be controlled by her animus. The healthy person is one in which the correct nature is present, but there is also a strong dose of the opposite. Jung also claimed that the Western male was afraid of the feminine within himself and the more he tried to avoid confronting this, the greater the toll for avoiding it.13 WILHELM REICH     Wilhelm Reich (1897-1957) was much more radical on sexual issues than the others discussed above. He argued that Freud did not carry his theories about sex to their logical conclusion, particularly his megatheory about the need of civilized peoples to redirect their sexual energy.14 After World War I, Reich set out to incorporate Marxism and Freudian psychoanalysis into a new synthesis based on his sexual concepts. He argued that there was a crucial interdependence of social and sexual liberation and that any political revolution was doomed to failure unless it was accompanied by abolition of repressive morality. It was this failure, he argued, that had undermined the Russian revolution.     Relch also felt that the sexual revolution needed to encompass not only adults but children and adolescents. In his mind, the sexual repression of the adolescent in society led to juvenile delinquency, neuroses, perversion, and of course, political apathy. He devoted numerous pages in his writings to the problem of providing adolescents with the private quarters and contraceptive devices necessary for the fulfillment of their sexual needs. If society followed his prescription for a revolution in the attitude toward sex, homosexuality, he said, would disappear in the wake of the revolution, as would all other forms of sexual perversity.15     Ultimately, Reich proved a failure in his endeavors to reconcile Marxism and psychoanalysis and was expelled from both the International Psychoanalytic Association and the Communist Parts.. In 1936, he was in Norway, where he founded the International Institute for Sex-Economy to study the way the human body used what he called sexual energy. Motivating this search was his attempt to find the basic physical unit of energy to replace Freud's generalized concept of libido.     In place of the libido, he developed a concept of energy, an actual physical component of humans that could be measured and harnessed, to which he spent the rest of his life trying to explain, control, and use. In 1939, Reich went to New York, where he established the Orgone Institute in Forest Hills. There, he attempted to teach others how to use the new kind of energy, which could be tapped by body massage, stored in accumulators, and used to strengthen the body against disease and particularly to increase orgastic potency. The result was the orgone box -a six-sided box made of wood on the outside and metal on the inside, a little larger than a coffin- that supposedly collected the orgone energy, transferring it to the patient sitting inside, who could then direct the energy to the genitalia, thereby restoring sexual potency. If the patient was ill, he or she could be restored to a healthy condition.     Reich held that orgastic potency -the capacity of an individual to achieve orgasm after appropriate sexual stimulation- was the key to psychological health. Orgasm, he claimed, regulates the emotional energy of the body and relieves sexual tensions that otherwise would be transformed into neurosis. His theories led not only to his denunciation by the American Medical Association but to an investigation by the Food and Drug Administration, which enjoined him from distributing orgone accumulators. Reich defied the ban; in 1957, he was sentenced to prison, where he died of heart disease.16 HERBERT MARCUSE     Starting out with the same intention of reconciling psychoanalysis and Marxism was Herbert Marcuse (1898-1979). He considered sexual repression one of the most important attributes of the exploitive social order. Under capitalism, Marcuse held that sexual love had been stripped of its playfulness and spontaneity and become a matter of duty and habit, carefully circumscribed by the ideology of monogamic fidelity. In fact, the blunting of sensuality was the inevitable by product of industrial labor and had resulted in the atrophy and coarsening of the body's organs. Sex repression itself was a major tool used to maintain the general order of repression.     Sexual repression also correlated with the performance principle, a key to capitalism, and this had resulted in the desexualization of the pregenital erotogenic zones and reinforced the genitalizations of sexuality. In short, the libido became concentrated in one part of the body, the genitals, thus leaving the rest of the body free for use as an instrument of labor. Resexualization of the body was the goal of human fulfillment.17     There were many other individuals who developed theories and schools of thought that emerged from Freudian ideas. The purpose of examining these five men is not to explain the development of psychoanalysis (impossible to do in such a short section) but to emphasize that Americans were becoming increasingly aware of the importance of sexuality, in large part through the efforts of Freudian disciples and apostates. Academics in the social sciences and humanities, especially, were intrigued by Freudian and other psychoanalytic theories and used them heavily in their own writings. Many tried to use various aspects of the theories to explain society, and from the academic community, the ideas passed into everyday use. Sex, in effect, could no longer be ignored. Moreover, the very willingness of psychoanalysts to speculate about sex made them the authority figures for sexual information for the middle years of the twentieth century, at least in terms of variant sexual activities. Even when their ideas were challenged -as they were by numerous sex researchers during the 1920s, 1930s, and 1940s- the psychoanalytic view dominated American thinking on sex until the 1960s, again because the psychiatrists, particularly the psychoanalysts, claimed a cure rate that no others could match. They helped maintain a medical dominance over sex that their research could not support.     Though the psychoanalysts dominated treatment, and case studies of individual patients or groups of patients became publishing staples, a new kind of research was emerging on the college campuses. Changing ideas about sex gradually permeated into the college curriculum, particularly in courses in child development, psychology, and cultural anthropology. One result was the growth of what today would be called gender studies, although the term had not yet been invented. Such courses emphasized the social and cultural differences between males and females. Many of the women's colleges as well as so-called women's departments, such as home economics, developed special woman-focused courses so women could better understand themselves. The American studies of sex by Davis, Dickinson, Hamilton, and others had fit into this growing tradition. Such studies continued during the 1930s, although none of the published studies at that time matched the earlier ones.     One major benefit of the developing college courses in marriage and family was that they gave the emerging social sciences potential research subjects. Increasingly, studies based on college student responses to questionnaires in psychology, home economics, and sociology classes began to appear. Some studies sponsored by the Committee for Research in Problems of Sex (CRPS) went beyond the classroom to study special groups as well. Still, it was animal studies that dominated American sex research, and in a sense, academic American sex research, once established in biology departments, gradually moved over into other areas. Initially, at least, animal studies not only were politically safe but, in many cases, had practical application for farmers and others. ANIMAL STUDIES T H. Bissonette was one of the researchers supported by the CRPS; he concentrated on the problem of light in relation to sexual periodicity. Though his studies were mainly done on birds, he also investigated ferrets, rabbits and raccoons and was able to change the breeding season of these animals by reducing illumination in the summer months and increasing illumination during the winter.18 Such findings led to increased egg and milk production but were not applied to humans, although it can be statistically demonstratet that seasons do have some influence on human reproduction (and sex life). If there were no seasonal effect on human sexuality, then an equal number of births would, on average, occur on each day of the year. This, however, is not the case, and statistics demonstrate that fewer individuals are born at certain times of the year than at others.     Studies on nutrition and sex in terms of reproduction sponsored by the CRPS demonstrated that in rats a diet of pure fats, carbohydrates, and proteins, supplemented by the then-known vitamin groups (A, B, C, and D), was enough for the rats to live well, but the females could not breed. The addition of wheat germ oil cured this difficulty -a fact that led to the discovery of vitamin E (a-tocopherol).19 Similarly, nutrition and diet affect fertility ratios in humans, but it was not until later that such studies were made.     Often the results were more immediately important. C. R. Moore found that mammalian testes could not form sperm unless they were subjected to temperatures lower than the interior of the body, hence the need for a scrotal sack. Furthermore, if a human male wanted to get a female pregnant, he should not keep his genitalia too warm by taking too many hot baths or wearing furlined Jock straps.20     It was not only on rats, sheep, and goats that experiments were carried out but also on nonhuman primates. It was in this area that Yerkes, the chair of the CRPS, was most active. Yerkes was a comparative psychologist and devoted himself from 1924 to work with nonhuman primates. By 1929, with aid from the CRPS, he had established an experimental station near Orange Park, Florida, later named the Yerkes Laboratory of Primate Biology. One of the questions Yerkes examined was whether primates had a cyclic variation in sexual response similar to that of the human female. Yerkes and his collaborators agreed there was, but they also found that several nonsexual factors were involved, namely the individual personality traits of the consorts, their past experience, and various social and environmental factors, all of which influenced the basic behavior cycle by overriding hormonally conditioned responses. In the female, preference for one male or another could completely overshadow sexual receptivity and lead to the occurrence of copulation throughout the cycle.     Yerkes found that when a male and female chimpanzee were intimately acquainted and congenial, the male, ordinarily dominant in all their competitive activities, yielded precedence to the female during her estrous period. Most important, he observed that variation in mating behavior among females was very great and that the behavior of a particular female differed in reaction to different males. Yerkes emphasized that touching and manipulation of genitals was a common pattern among nonhuman primates and a wide range of other animals and, contrary to traditional thinking, was not against nature. His study of the great apes, which he published in 1929 with Ada Watterson Yerkes, was the standard work on the biology and psychology of these animals for several decades.21     A major result of these and other animal studies was to emphasize just how many of the body systems (muscular-skeletal, circulatory; neurologic, and endocrine) were involved in sexual activity. Though much of the copulatory pattern is mediated by nervous circuits that lay within the spinal cord, these are regulated by the hypothalamus and the cerebral cortex. It was also found that various sensory-motor adjustments were involved in coitus and the stimulation of various cutaneous receptors located in the genitals and elsewhere contributed to the intensification of sexual excitement. In the primates especially, learned patterns of social interaction are also influential in forming relationships. In sum, if it was not known before, the animal studies of the 1920s and 1930s proved that sexual activity involved a whole series of neuropsychological and ociocultural factors.22 ANTHROPOLOGICAL STUDIES Giving emphasis to sociocultural factors hinted at in the animal studies were a growing number of field studies in anthropology, many of them influenced by Freudian concepts. Bronislaw Malinowski (1884-1942), the father of anthropological fieldwork, set the tone for the future study of such factors through his emphasis on the necessity of the meticulous investigation of a culture and its social organizations. He believed that it was important to determine how each specific aspect of cultural behavior contributed to the functioning of the group.     In Malinowski's mind, sex was more than a simple physical connection between bodies. He argued that understanding the sexual practices in their sociological and cultural contexts was essential to understanding any cultural grouping. Malinowski's insistence on studying sex linked the professional anthropologist with the amateurs, such as Richard Burton, of an earlier generation and the new Freudian concepts. Sex behavior was defined broadly by Malinowski, and The Sexual Life of Savages (1929), one of his major studies, dealt more with courtship and marriage and family than with descriptions of sexual behavior.23 Still, Ellis, who wrote an introduction to the book, emphasized its importance as a comprehensive picture of a society that integrated sexuality within its culture and noted that Malinowski did not stress the aberrations as many earlier studies had done. Ellis pointed out that although the Trobriand Islanders made up only a small community and lived in a confined space it was evident that these comparatively primitive people were very much like their modern European counterparts and had the same vices and virtues. Malinowski's critics, upset at his emphasis on sex as a key to life in primitive societies, accused him of generalizing from too narrow a base of experience as well as failing to catalog and describe his native informants.24 Though these criticisms are not without merit, his importance lay in institutionalizing sex and gender issues into anthropological field studies.     A number of other anthropologists sought to answer specific questions that had sexual overtones. Margaret Mead, a student of Franz Boas (1858-1942), focused on the nature of adolescence and sexuality in Coming of Age in Samoa.25 Boas and Mead, at this stage in her life, were both cultural relativists. Human nature consisted entirely of such physical needs as food, water, and sex, and how different cultures coped with these needs was seen as enormously varied. On the basis of data furnished by her informants, Mead concluded that adolescents in Samoa had complete sexual freedom and that it was the ambition of every adolescent girl to live with as many lovers as possible" before she married. The book was extremely influential in its time and was praised by Bertrand Russell, Ellis, Mencken, and others, although not all observers of Samoa agreed with her. In fact, many anthropologists as well as the Samoans themselves now argue that traditional Samoa was just the opposite of what she said, that it was a culture of strict parental controls and unbending sex taboos, a society in which female virginity was so highly prized that girls were tested for virginity before they were allowed to marry.26 Mead later went on compare sex roles among three New Guinea groups (Arapesh, Mundugumor, and Tchambuli), emphasizing that sex roles were not inborn but a product of learning, a view that even her critics never challenged.27     Whether Mead was misled by her informants, and she probably was, is important historically, but such charges came much later, too late to prevent her work from becoming part of the canon challenging traditional sex and gender roles. She was regarded as giving further proof that ethnography could furnish a catalog of information on human sexuality, illustrating the malleability and variety of human behavior.28 One source for testing this malleability, which went beyond the individual reporter such as Mead, was a collection of reports that had been gathered together at Yale University during the 1930s on more than 190 cultures; it has continued since then in what was originally known as the Yale Cross-Cultural Survey and now called the Human Relations Area Files, Inc. This compilation of information about different peoples is classified by both subject matter and geographic area and is based on thousands of books, articles, and papers by a variety of reporters and observers ranging from casual travelers to missionaries to professional ethnographers.     One of the early attempts to summarize these data in terms of sexual behavior was by Clellan S. Ford and Frank A. Beach, whose research was sponsored by CRPS. They concluded that there was such a wide variation among peoples and cultures that no one society could be regarded as representative of the human species.29 Though they found many cross-cultural similarities, they also found a number of differences. Some societies condoned and encouraged the sexual impulses of children, but others prohibited and punished such behavior. Different societies held widely different rules and attitudes about masturbation. Regardless of whether the attitude was approval or condemnation, they noted that at least some adults in all or nearly all societies appear to have masturbated. Though a number of societies reported the existence of bestiality, most such references were found only in folklore and not in everyday life. Homosexual behavior was not found to be predominant among adults in any of the societies, although some form of same-sex activity was either observed or reported in a significant proportion of societies. The data indicated that though certain social factors probably do incline certain individuals toward homosexuality, the phenomenon could not be understood solely in such terms.30     Though the summaries of Ford and Beach are accurate summaries of the data then available, it is important to emphasize that the data they used reflected the biases of the compilers of their source material. This means that such data must be used with caution, because so many of the early reports were made by missionaries or other amateurs who lacked the training of the modern ethnographer. Moreover, many of the early observers tended to approach sexual subjects with preconceived moralistic assumptions.     A good illustration appears in the findings concerning homosexuality. Ford and Beach found references to homosexuality in seventy-six societies. In forty-nine (64 percent), homosexuality was considered normal and socially acceptable, at least for certain members of the community In the other twenty-seven (36 percent), homosexual activity among adults was reported to be totally absent, rare, or carried on only in secrecy.31 Because no reference to homosexuality, either positive or negative, was reported for the majority of societies, these groups were excluded from the statistics. This leads to the question of whether the absence of either positive or negative statements about homosexuality means it was unknown in those societies or simply that the informants neglected to mention the subject or the informants felt it was something that the Western observer would not understand or sympathize with. The answer would seem to lean more toward the latter explanation, and if this is the case, the accuracy of definitive conclusions drawn from such observations is open to debate. Some of the investigators reporting the existence of homosexuality might have been looking for proof of its existence, while many of those who did not look for it were unaware of its existence.     Another problem with such studies is a definition of what constitutes homosexual activity. Balinese society, for example, was classified by Ford and Beach to be one of the societies in which homosexual activity was rare, absent, or carried on only in secret. Yet the crossing of sex roles is common among the Balinese, since their religion places a high value on the hermaphroditic figure of Syng Hyan Toenggal, also known as the Solitary or Tijinitja. Tijinitja, according to Balinese cosmology, represents the time before the gods, before the separation of male from female. Thus Tijinitja is thought of as both husband and wife.32 Obviously, the cross-dressing associated with the god represents transvestite conduct, but is it homosexuality? Ford and Beach did not think so, but then the question has to be asked as to why they classified the cross-dressing among the berdache as homosexuality since many of the early studies classified a variety of conduct under this label.33 Can the classification in the one case be any more justified than in the other? Probably the answer depends on when the data they used were reported and by whom, something they did not take into account.     Part of the confusion stems from the fact that as research into sexuality has developed there has been both a greater awareness of the sexual implications of some customs and a greater attempt at precision in definitions. New categories such as transvestism and transsexualism have been established in recent years that were once classified as homosexuality; the use of the new categories challenges older interpretations. Unfortunately, it is impossible to redo the earlier studies because many of the cultures studied have themselves changed. Since most of our past historical and anthropological data are not usually detailed or precise enough to indicate into which category ail individual should fall, whether an individual is classified as homosexual in part depends on the time and place when the data were gathered and the sophistication of the observer.     This difficulty in classification is not a unique problem for anthropologists but pervades the study of human sexuality. Modern physicians, for example, who attempt to read historical descriptions of symptoms have difficulty in determining what disease is being described, because physicians in the past looked at different things than do modern ones and had different diagnostic categories. This meant that they lumped together categories we now separate and gave great emphasis to some factors we no longer think important. The most workable and practical solution for the historical diagnostician often is to avoid analyzing an illness outside the culture in which it existed; even when the data are sufficient to permit some preliminary classifying, definite assignment in terms of current understanding can be misleading if not actually erroneous.     The same caution must be applied to labeling same-sex conduct in other societies as homosexual in the modern sense of the term, since it had a different meaning in that society from the one it has in ours. Still, after all of this has been said, the anthropological data that were being gathered in the period between the World Wars (1918-41) emphasized the variety of possibilities existing in human sexual behavior.34 HISTORICAL DATA Similarly, various historical works appeared during this same period, emphasizing that even within the Western tradition, there had been a variety of different sexual activities that had not only been tolerated but institutionalized in societies. Among the Greeks, for example, homosexual contact between adolescents and young adults were considered normative.35 Similar studies appeared about sexual life in ancient Rome and in ancient India36 as well as specialized studies dealing with references to masturbation, sexual intercourse, bestiality, and so forth in classical culture.37 Undercover editions of pornographic classical works were also translated and distributed,38 and the major value of such works is that they throw light on different attitudes from what the official sources would allow, not only in ancient times but also in modern times.     A good example is the anonymous work My Secret Life, a sexual autobiography of a Victorian gentlemen believed to be based on a real life. In such works, We find that there was widespread interaction between prepubescent young girls and older males. The author records some of the difficulties of having sex with prepubescent girls, and we know from other sources that it was not uncommon in the nineteenth century to chloroform the girls during penetration. The author said nothing about this but stated rather as a matter of fact:
	Verily a gentleman had better fuck them for money, than a butcher boy (fuck them) for nothing. It is the fate of such girls to be fucked young, neither laws social or legal can prevent it. Given opportunities -who has them like the children of the poor- and they will copulate. It is the law of nature which nothing can thwart. A man need have no "compunctions of conscience" as it is termed-about having such girls first, for assuredly he will had done no harm, and has only been an agent in the inevitable. The consequences to the female being the same, whosoever she may first have been fucked by.39
He went on to state that the youngest girl he had ever had sex with was ten years old, but he complained that she could not give the pleasure "that fully development women could." Nevertheless, he admitted he had several orgasms with her.40     The existence of such conduct emphasizes just how much the silence about sex in the late nineteenth and early twentieth centuries allowed such abuses to exist. It causes one to question seriously official histories and to challenge the pious hypocrisies of the past. But the problem with the specialized sexual histories, as with the pornographic classics, is that many of these works reflect the same kind of problems as did the anthropological literature before Malinowski. The specialized investigators into historical sex failed to integrate the sexual customs and data into the culture of the society they were examining. They tried to look at it in isolation, and the result was often a prurient, even salacious study, which though informative, probably gives a rather distorted picture of the place of sexual activities in a society.     This emphasis on the salacious and prurient was the same problem that Americans in general faced between the two World Wars. American culture was only gradually losing what could only be called a prurient view of sexuality. Americans often officially denied the existence of a wide variety of sexual activities and yet sought out, in pornography or in sex-segregated audiences, information about forbidden activities. This was particularly true of all-male groups, which gathered to watch one-reel stag films or strip tease shows, with the men becoming aroused at the forbidden STUDIES ON PREMARITAL SEXUAL ACTIVITIES Still, serious quantitative studies reflected a growing change not only in attitudes but in behaviors. Among the best of the studies of the 1930s were those by Dorothy Dunbar Bromley and F.H. Britten on male and female college students and that of Lewis M. Terman, Carney Landis, and others on psychological factors in marital happiness.     The Bromley and Britten study consisted of a questionnaire given to 1,364 college students, 43 percent of whom were male and 57 percent female. Data collecting could only be called haphazard. The two authors were journalists who visited fifteen college campuses: five men's colleges (four in the East and one in the South), five women's colleges (all in the East), and five coeducational universities (four state institutions -two in the Midwest, one in the South, and one in the West- and one private university in the Midwest). They simply walked on campus, introduced themselves to students, and then scheduled interviews with them. Authorities at one women's college asked Bromley and Britten to leave, but officials at the other institutions either did not know they were there or tolerated their existence. In total they interviewed 154 women and 122 men, all of whom were undergraduates. Then Bromley and Britten recruited undergraduates to give or send their questionnaires to other students, paying them ten cents for each returned questionnaire. Of the 5,000 questionnaires sent to forty-six additional colleges and universities, 1,088 were returned: 618 from women and 470 from men. The largest number from any one campus was 169 from a midwestern state university, and the next largest was 77 from an eastern women's college.     The statistical manipulation of the data was scant, and there is no breakdown of the sample. From what we know of other available information, responses to the questions about masturbation and homosexuality were underreported by the male respondents, although this was not necessarily the case with females. Among the questions asked was whether homosexuality was prevalent in their college and whether they knew much about it. Students were then asked if they themselves had ever engaged in same-sex practices. Many men reported knowing nothing about homosexuality, and only a few admitted having such experiences. Furthermore, those men that did report same-sex behavior insisted that it was simply a casual affair.     Probably more accurate data were given on students' self-reports of heterosexual activity. Some 25 percent of the women indicated they had engaged in sexual activities with men, but almost all said they had been in love with their partners at the time, and many said they were engaged. On the other hand approximately 50 percent of the males indicated that they had sexual experience with women, and there was less of an attempt to justify their activities with statements of love.     On the basis of their data, Bromley and Britten argued that there was a social revolution in manners and morals taking place in America in terms of premarital sexual relations, although their respondents overwhelmingly reported they still wanted to marry and settle down. Perhaps because of the pressure put on them for sexual intercourse by the men in their lives, the college women for the most part wanted to marry young, much younger than the males did.41 In fact, the unconscious pressure to engage in premarital sexual activity, which went contrary to officially sanctioned morality, might have been the reason so many women dropped out of college to marry.     Terman and colleagues examined attitudes toward sex and marriage based on 2,484 subjects, made up of 1,250 married couples, mostly living in California and mostly college educated. The mean age of their subjects was thirty-nine, and within the limits of the sample, the study illustrated changes that were taking place in the United States. Terman and co-workers found an increase in premarital sex among college-educated women, with between 35 and 65 percent engaging in premarital sexual activity, depending on their age cohort. The younger women had engaged in premarital sex more than the older ones. The authors predicted that, if the trends portrayed in their study continued, by 1960 no American girl would reach the bridal bed as a virgin. One of the more interesting findings was that 13 percent of the married women experienced multiple orgasm. Subjects, however, were not interviewed, and data were based on a questionnaire.42     Landis studied married couples, and his work was supported by the CRPS (as was Terman's). He found that beneath an "emancipated facade," and even behind "emancipated behavior," traditional attitudes still remained strongly ingrained. Many husbands reported deliberately varying sexual techniques and extending intercourse to bring their wives to orgasm, but the majority of wives either remained unaware of these efforts or felt they were unsuccessful, because the women said that their husbands cared only about gratifying themselves. Miscommunication about sexual matters seemed to be a common problem among the couples.43 A number of other studies on marriage were done, and Terman was often involved in some capacity or another.44     Terman and C. C. Miles pioneered in developing a masculinity-femininity scale, although by today's standards the measurements were very crude. Instead of beginning with a theory of masculinity or femininity as psychological concepts, Terman and Miles followed the more simple strategy of finding empirical sex differences between the responses of men and women to questionnaire items about their interests and preferences. At its most mindless, such an operational definition of masculinity equated it with men's preference for taking showers, for seeking work in business or as contractors, and for reading magazines like Popular Mechanics. Femininity was equated with a preference for taking baths, for seeking work as dress designers, and for reading magazines like Good Housekeeping.     Such an approach, Terman and most of his contemporaries seemed to believe, enabled them to discriminate between men and women as well as separating off homosexual men and lesbian women. They assumed that males and females were opposites and homosexuals were the inverse of heterosexuals. They also assumed that healthy men would be masculine and healthy women feminine. Any cross-gender activity or habit aroused suspicion.45 Many such simplistic assumptions carried over into profiles that the military, during World War II, used to reject or discharge individuals whom they identified as gay.*     Indicative of the growing awareness of sexual issues are the studies of specialized samples. Landis and M. M. Boles, for example, examined the personality and sexuality of physically handicapped women, but the study should be noted more for its intent than for its results.46 Earlier, E M. Strakosch had done a study on the sex life of seven hundred psychopathic women in the New York State Psychiatric Institute and Hospital in New York City. The data were compiled by a number of psychiatrists, raising the potential of possible variation in the standard of recording. Complicating the usefulness of the study was the fact that the ages, education levels, and social levels of the respondents fell within such a wide range, especially since Strakosch compared his data with that of Davis, Hamilton, Dickinson, and Beam, whose subjects were drawn more or less exclusively from the upper educational and social levels.47     Many of these social science-oriented studies were examined by Alfred Kinsey and colleagues, who concluded that it was difficult to generalize from such studies because of their limited or class-biased samples. Many were heavily based on material from the New York City area, while most of the others came from the eastern United States. All of those studies attempting to go beyond this limited geographical area were questionnaire studies, not interview ones, and none of the samples attempted to reach a wide range of populations or age levels. Their results were further compromised by the ambivalence the authors had in asking questions about sex, and many of the studies used circumlocutions or judgmental terms, particularly the earlier ones.48
	* Even I thought that something must be wrong with me because, during an induction examination, I said I liked baths. This was regarded as a feminine rather than a masculine characteristic and resulted in further questions about my masculinity, even though my preference for baths was because there was no shower in the home in which I was raised.
HOMOSEXUALITY AND LESBIANISM Increasingly, however, American sex researchers became ever more daring, and one of the most ambitious efforts to study sex dealt with the issue of homosexuality. This study was carried out by a self-selected group of individuals who, in 1935, formed the Committee for the Study of Sex Variants.49 Most of the research and writing for the ultimate publication were done by psychiatrist George Henry. The subjects for the study were recruited by Jan Gay, a woman who had contacts in the homosexual and lesbian community. Subjects willing to participate underwent a psychiatric interview, using what Henry called a modified free-association method. With an occasional suggestion or question subjects were led to talk freely and spontaneously about themselves and their family and a verbatim shorthand record was made of the answers. The note-taking instead of inhibiting the subject was reported to encourage the respondents that everything they had to say was of value. The notes were taken by the psychiatrist who showed no reaction to what was divulged other than interest.     After a detailed history had thus been obtained, the study, as far as the subject was aware, was at an end, although many volunteered to return if further information were desired. Two years later interviews were resumed but this time the questionnaire method was employed. This procedure was adopted for the purpose of checking on statements previously made and to supplement information already obtained.50     How many were interviewed is not clear (somewhat more than two hundred), but eighty subjects were ultimately selected to have their case histories and analyses published; half of them were female. To report his data, Henry separated lesbians from gays, but put each into the same three categories, bisexual cases, homosexual cases, and narcissistic cases, although narcissistic cases were simply another form of homosexuality for him.     Henry presumed there was a physical basis or predisposition for homosexuality, and thus in addition to the interview, there was an extensive physical examination of the subjects made by Joseph C. Roper. Furthermore, a special pelvic examination was given to the women by Mary Moench. Both Roper and Moench were physicians at New York Hospital. About 33 percent of the group were photographed in the nude, and all of them had x-ray examinations of the head with special reference to various physical features that were thought to be indicative of homosexuality or lesbianism. Males were also asked to give sperm samples. As a result of these examinations, Henry and co-workers concluded that the body-carrying angle of homosexuals of both sexes was intermediate between male and female. Lesbians often demonstrated abnormal pelvic formation and immature skeletal development.51     Henry also looked for hereditary factors and made up genealogical charts for his subjects, noting the occurrence within each family of factors such as homosexuality, bisexuality, suicide, psychosis, alcoholism, and tuberculosis as well as "artistic inclinations." He found that sex education had been an ignored subject for his subjects when they were growing up, and that many of them had been told by their parents that they had wanted a child of the opposite biological sex. In traditional psychiatric fashion, Henry and colleagues looked at the parents and found that mothers were in many cases unhappy, almost martyrs, who made their children conspirators with them against the man of the house. Some fathers fought back with angry displays of infidelity, making the mother's judgment come true, whereas others withdrew and became ciphers. In other households, fathers flaunted their sexuality and suffering to win attention. Usually only one parent won the child's solicitude. He documented a relationship between homosexuality and aggression-passivity behavior and showed that this behavior was often passed through several generations. He thought there might be a genetic basis for this behavior but that a neurotic environment made it particularly important in personality development. Henry also found that on tests of masculinity/ femininity, male and female homosexuals were intermediates,52 which he emphasized was an indicator of the existence of an intermediate sex.     Henry's conclusions were strongly influenced by the attitudes of his time and his psychiatric assumptions, but what made his study valuable then and now is the long, detailed case histories that sometimes indicate patterns to the current generation of readers that Henry did not see or ignored.53 Generally, his homosexual men and women were a varied group, some openly homosexual, some secretive; many were successful in their careers and social lives, while a few had a history of depression, career failure, and suicidal urges.     Henry had the traditional medical-psychiatric assumptions and emphasized that the sex variant could be studied best and most efficiently by a psychiatrist who had specialized in sexual pathology.54 Ultimately, his study turned out not to be the dispassionate study he had set out to do, because he became deeply involved with his clients and occasionally even expressed skepticism about standard psychiatric assumptions. During World War II, Henry was consulted by the military about the problem of homosexuals. He had the courage to tell them that far more homosexuals served with the armed services than were eliminated before or after induction. In fact, the army had in a sense encouraged homosexuality by making men aware of their sexual orientation. As a result, many men had their first overt homosexual experience while in the army.55     It was the feeling of compassion showing through his psychiatric assumptions that led a group of Quakers to approach him in 1945 to set up the Quaker Emergency Committee in New York City to deal with the problems of the young people arrested on charges of homosexuality. A network of clergy, physicians, and educators was established, but differences soon developed between Henry and the Quakers. The Quakers withdrew and set up their own group, the Quaker Read Readjustment Center, a title indicative of the conflict with Henry. The new director of the Quaker group was the psychiatrist Frederic Wertham, who was far more conservative than Henry. Under Wertham's direction, the center dealt mostly with sex offenders. The earlier committee was reorganized as the George W Henry Foundation and concerned itself with giving aid, advice, and encouragement to youths troubled with problems of homosexuality. Many of the directors of the Henry foundation became active in organized homosexual groups in New York, and following Henry's death in 1964, the foundation was reorganized into a social work agency to deal with problems encountered by homosexuals.     Henry also published a more popular and rather different version of his psychiatric experience with nine thousand clients (eight thousand men and one thousand women) under the title of All the Sexes. This was a pioneering effort to emphasize that each individual was an incalculable complex of masculinity and femininity. Henry pointed out that every man possessed feminine attributes and every woman possessed masculine ones; human beings represented an imperceptible gradation between the theoretical masculine and the theoretical feminine. Though his psychiatric explanations of imbalances were not the traditional ones of the time, his message was an important one, and in a sense, the book was an important contribution to what later came to be called gender studies.56 Henry even began to retreat from his earlier emphasis on physiological factors and realized that body form itself was not a reliable indicator of sexual competence.     Though Henry changed his mind about physical indicators, other researchers did not. Such concepts were pushed to the extreme by W S. Sheldon through what he called "constitutional psychology." Sheldon took photographs and measurements of thousands of men and women, which he then divided by physiques into three basic categories: endomorph (dominated by stomach and massive digestive viscera), ectomorph (dominated by brain and nerve endings), and mesomorph (dominated by musculature). He then went on to claim that body build and emotional disturbances were related. Sheldon implied that male homosexuals were weak, fragile, defenseless, and poorly endowed and had physical characteristics typical of women. The reverse was true of female homosexuals. He also argued for a correlation between high sexual activity and perversion.57 In light of such attitudes, Henry's studies appear to be a model of objectivity. ALFRED KINSEY In spite of the criticism made of some of the American social science-oriented studies, such studies were increasing in number and, with some exceptions, gradually becoming more sophisticated. Interestingly, they had no counterpart in Europe. In the Soviet Union, to which many of the earlier generation had looked for new breakthroughs in sex, Stalin had repressed any kind of social science sex studies. Early in the 1920s, before Stalin had consolidated his power, the Soviet Union encouraged studies on the sex lives of factory workers and college students. For a brief time, there was even the Scientific Society for Sexology and Forensic Sexological Expertise, which held a conference in Leningrad in 1928, but after this, sexological studies were more or less terminated.58     It in this setting of a growing awareness of the importance of sexuality and an ever-increasing volume of studies on human sexuality that Alfred Kinsey began to do his research. Kinsey was born in 1894 in Hoboken, New Jersey; he was at the height of his career In 1938 when he shifted from the study of gall wasps to the study of human sexuality. He probably also was going through what might be called a midlife crisis, hunting for new fields to conquer. In the summer of that year, Indiana University began to teach a course in marriage, one of the many colleges and universities to venture into this new area. Because no professor on the faculty was considered qualified to teach it singlehandedly, teachers (all men) were gathered together from the departments of law, economics, sociology, philosophy, medicine, and biology to do so. Kinsey ended up as coordinator of the course.     To add to his own knowledge, he soon began taking histories of the students, many of whom came to him for counseling. He sought information on age at first premarital intercourse, the frequency of sexual activity, the number of partners, and similar data. Gradually, he amplified his search for information by including questions about prostitutes, the age of the partner with whom the subject had his or her first intercourse, the percentage of partners who were married, and so forth. Kinsey, a compulsive data gatherer, began an extensive reading program into all aspects of sexual behavior. This led him to build up a personal library, since serious studies on sex were difficult to find in most public or university libraries (some