The peculiar anomaly the patient is suffering from is the desire to be a complete woman. From his childhood he had the wish to be a girl. His desire now is to live as a woman absolutely. He never had any dream where he saw himself as a woman; in fact, he never had any erotic dreams. He longs for the female form. He often wished to be castrated to be more like a woman. The patient is attracted by beautiful women, but the instinctive feeling toward them is not the desire for possession, but more a feeling of envy that he cannot be one like them. The appeal of woman’s beauty to him is connected with the desire of inner or psychical or subjective identification of himself with the beautiful woman, the desire to be in her place—“Einfühlung, Miterleben,” as the Germans call it. He would do almost anything to see a girl in any condition of exposure, but he would experience only the desire of inner imitation. His desire to show himself in female attire is founded upon the impulse of being considered a full woman. [Illustration: CUT XLIV. First patient.] From a legal point of view the patient’s inversion is mainly confined to the sphere of clothing. He has a profound longing for female clothes. He takes pleasure in the sight of female attire. Woman’s underclothing exercise a greater charm upon him than the woman herself. He especially attaches great importance to the corset. The patient is always dressed in female underclothes. He wears only a man’s coat, vest and trousers, or the clothes belonging to the outward cover. He wears woman’s shoes, shirtwaists, corsets, stockings, etc. The earlobes are pierced for earings, which he wears every night. He takes breakfast dressed as a woman. When the patient is dressed as a woman, he has all a woman’s feelings and longings. For this reason he tries to dress as a woman at every opportunity. The desire to be dressed like a woman takes the form of an imperative impulse. When he cannot dress up he becomes restless. He would rather commit suicide than be without female apparel. As a literary man and brain-worker, the patient can concentrate his thoughts better when in female attire. When dressed as a woman he feels himself to be in a normal condition and is cheerful. A feeling of absolute comfort and restfulness comes over him, when in female clothes, and his behavior is in full accordance with his feelings, while in male dress there is a kind of absent-mindedness about him; he is always thinking of his female dresses.