At puberty a certain change took place in the psyche of the patient. At this time, when about twelve years of age, he began to think how nice it would be if he could be changed into a girl. He never had any sexual desires for women. In stuprando manu he donned female attire, but his fancies had always women as the objects. When the patient is dressed like a man, no one would take him for a woman. There are no strongly pronounced feminine traits. The sex-organs are those of a normal man. The distribution of the hair on the body is almost the same as in any other man. The head is rather bald. On the arms there is no hair, but the hands are covered with hair. The hands are rather small, narrow, soft, well-shaped and artistic. The fingers are tapering. The legs and feet, when in dainty stockings, are rather feminine. The patient wears woman’s shoes. Otherwise when he is dressed like a man he looks like a normal man. But when the patient is in stockinet as in his photograph, “Psyche in Bath,” no one would take him for a man. When dressed like a woman, nobody would recognize a man in him. He has taken walks on streets unnoticed while so dressed. He never drew any attention, so perfectly does he look like a woman. The patient’s behavior is quiet but not effeminate. His voice is low, of uncertain timbre. He tries to cultivate a female voice without resorting to falsetto. His writing is uneven, sometimes bold; mostly, however, it is a woman’s small handwriting. The gait is like that of a woman, swaying in the hips. The patient suffers from periodical hemorrhages of the nose, which he is inclined to consider as a kind of vicarious menstruation. As far as the emotions are concerned there is a marked feminine sensibility. Tears come easily when watching emotional scenes. He smiles almost constantly when in conversation, but he rarely laughs outright. He is very sensitive to pain, but stoic enough not to complain. He blushes on the slightest pretext. He is possessed of feminine adaptability. He likes needlework and loves to do crochetting. He likes female amusements, such as “Kaffeeklatsch.” He is a freethinker in his creed. The patient possesses normal love and admiration for the other sex. He is attracted by women, although his sexual feelings are very little pronounced. He takes the greatest pleasure in contemplating pictures of the female form. His day-dreams and fancies are only of women. He has no homosexual inclinations, but rather a profound repugnance against homosexual relationship. He never longed for a male instead of a female lover. Still he seems to want a man before whom he could expose the charms of his own person and who would kiss and caress him. His sexual desires are not developed. He never was in love with any women or men. His wife proposed to him. He may have remained otherwise single. He has three children, all perfectly healthy.