Raffalovich admitted that he had many unisexual friends, though he was cagey about his own long-term relationship with John Gray, a former lover of Oscar Wilde.  He seems to have taken personal offense at the notion that inverts are effeminate, and he argued that congenital unisexuals are virile, often more virile than heterosexuals.  Effeminacy, he wrote, is usually a sign that a man had taken up inverted practices out of debauchery, and isn't really a congenital unisexual.  Raffalovich who lived in England at the time he wrote the book, was influenced by Havelock Ellis and introduced many of Ellis' ideas into the French medical literature for the first time.

Many German and English doctors received Uranisme et Unisexualite warmly, but Raffalovich and his work were ridiculed by the French medical establishment.