Westphal
Invents Sexual Inversion
Germany, 1869. Dr. Karl Westphal
invented a new diagnosis for people attracted to members of their own sex, "contrary
sexual feeling". When Westphal's new term was translated from the German, it
became "sexual inversion", first in Italian, then in English. The term
caught on among psychiatrists, and so did Westphal's idea that it is an inherited sexual
abnormality.
Contrary Sexual Feeling
From 1864 through 1868, the German lawyer
Karl Ulrichs published seven pamphlets arguing that "man-manly" love is just as
natural as the love of a man for a woman. He hoped that his prolific efforts would
stimulate a discussion among the public, but especially among doctors, about man-manly
love. Doctors were important to Ulrichs because the public increasingly believed
physicians' claims that they were the experts on sex, and Ulrichs tried to enlist their
support for his ideas.
In 1869, a Berlin based psychiatry professor
began the medical discussion that Ulrichs had hoped for. Dr. Karl Westphal, the
eminent professor and sometime editor of the German Archive of Psychiatry and Nervous
Diseases, published the case histories of a man and a woman who suffered from
sexual attraction to members of their own sex and he developed a new diagnosis.
Westphal's approach to the subject was more humane than that of predecessors like Tardieu
who would have dismissed these patients as criminals. Instead, Westphal took
careful case histories, and apparently conducted his interviews sympathetically.
In the female case history, Westphal
described a woman who would probably be called butch today. She grew up a tomboy and
preferred boys' clothes over the frilly fashions girls were expected to wear.
Instead of rehearsing for her adult role as a wife like most girls of her time, she liked
to play sports with the boys. When she grew up, she was not the least bit attracted
to men, but found intimate friendship, and sexual fulfillment, only with other
women.
Today, the case history sounds utterly
unremarkable, but Westphal thought he was on to something new. He named the
phenomenon "Contrary Sexual Feeling". His conclusion about the cause of
the disorder was music to Karl Ulrichs' ears: Westphal said that contrary sexual
feeling was probably congenital in most cases. He went even further when he wrote
that laws against same-sex practices were ill advised. But there was a dark
side to Westphal's conclusions. His reason for opposing sodomy laws was so that
"then these cases [will] certainly come in greater numbers to the attention of the
physicians in whose area they belong." Why do these people need physicians?
Because, Westphal explained, patients who exhibit contrary sexual feeling almost
always have other associated mental illness.
Westphal was writing at an exciting time for
psychiatrists. The Archive of Psychiatry and Nervous Diseases in which he
published his 1869 case studies had been founded just two years before by Wilhelm
Griesinger, the head of Berlin's psychiatry department. Griesinger was a prophet of
the professionalization of his discipline. At the middle of the 18th Century, most
psychiatrists worked at asylums where the mentally ill were locked away. The best
asylums boasted that they provided a clean, healthful environment where they kept their
patients busy, but psychiatrists were little more than custodians who tried to make their
patients comfortable while they waited to see if they got better. Most medical
doctors didn't even think psychiatrists deserved to be called physicians.
Griesinger aimed to change that. In the preface to the first edition
of the Archive Griesinger wrote: "Psychiatry has undergone a
transformation in its relationship to the rest of medicine." And what was that
transformation? "This transformation rests principally on the realization that
patients with so-called 'mental illnesses' are really individuals with illnesses of the
nerves and brain." Instead of caretakers observing diseases of the mind,
psychiatrists were to become medical doctors treating diseases of the brain.
One of the tasks of a physician is diagnosis, and under the influence of
reformists like Griesinger, an unprecedented passion to diagnose and classify mental
illnesses overcame psychiatry. When Westphal invented contrary sexual feeling he was
participating in the progressive psychiatric movement to turn psychiatry into a
respectable medical specialty.
Westphal's claim to be an expert in the disorder he named paid off
for him professionally. He was quickly recruited as an expert witness in court
cases. In the most notorious, he was asked to testify in the case of Carl Zastrow, a
man who raped and murdered one boy and slashed another. At the trial, one doctor
repeated an old idea: Zastrow had acquired his perverse passion for sex with boys
because he had masturbated as a youth. Westphal stood on the progressive side, and
argued that no, the man was not debauched, he suffered from congenital contrary sexual
feeling.
Westphal's coinage, "contrary sexual feeling" became the
standard term for his new diagnosis in Germany, but when it was translated into other
languages it was awkward. In an anonymous review that appeared in an English medical
journal in 1871, the term was translated as "inverted proclivity" then in an
1878 Italian article by a Dr. Tamassia, the German term was translated as "inversione
sessuale". Translated into English, "inversione sessuale" became
"sexual inversion", the term that ultimately stuck.
The End of Inversion
The term "inversion" spread widely in psychiatry and so did
Westphal's belief that men whose libido is directed toward other men have female
personality features. The word remained a technical psychiatric term until Havelock
Ellis published his book Sexual Inversion in 1897. The term entered the
popular lexicon partly because of the immense popularity of Ellis' book.
In 1905, when Sigmund Freud wrote Three Essays on the Theory of
Sexuality, he used the word inversion as well, but by the 1915 edition of the book,
he had switched to homosexuality. Freud wanted to distance himself from Westphal's
views for several reasons, but most importantly he believed that homosexuals are not
necessarily feminine in any way, and he did not believe that homosexuality is congenital.
As Freud's views came to dominate 20th Century psychiatry,
"homosexual" replaced "invert" as the preferred diagnosis for men who
love other men.
Sources and Further Reading
Westphal's interviewing methods and article are recounted in Ellis, 1897. The
quotation of Dr. Westphal's article on Contrary Sexual Feeling is from a citation in
Ulrichs' Critical Arrows, (Ulrichs, 1994). The quotation from Dr.
Griesinger's preface is from a citation in Shorter, 1997.
Bullough, Vern, 1994. Science in the Bedroom: A History of Sex
Research. New York: Basic Books.
Ellis, Havelock, 1919. Studies in the Psychology of Sex Volume II:
Sexual Inversion. Third Edition. Philadelphia: F. A. Davis.
Ellis, Havelock and J. Addington Symonds, 1897. Sexual Inversion. [first
edition] London: Wilson and Macmillan. Reprinted 1994. New York:
Ayer.
Foucault, Michel, 1978, Robert Hurley, trans. The History of Sexuality Volume
1: An Introduction. New York: Pantheon.
Freud, Sigmund, 1905, James Strachey, trans. Three Essays on the Theory of
Sexuality. in Sigmund Freud, 1953. The Standard Edition of the
Complete Psychological Words of Sigmund Freud. London: Hogarth.
Katz, Jonathan Ned, 1995. The Invention of Heterosexuality. New
York: Plume.
Shorter, Edward, 1997. A History of Psychiatry: From the Era of the
Asylum to the Age of Prozac. New York: Wiley.
Ulrichs, Karl Heinrich, 1994, Michael Lombardi Nash, trans. The Riddle of
"Man-Manly" Love: The Pioneering Work on Male Homosexuality. Buffalo,
NY: Prometheus Books.
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© 1998
Andrew Wikholm
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