The second case is that of a gentleman of about sixty-two years of age living in the western part of our country. As a child he was known as mother’s boy, and his mother and he were very fond of each other. He has always done his best to please her, spent as much of his time with her as possible, and took great pleasure in the tasks she would give him, such as knitting, crochet work, or plain sewing. On most of all these occasions she would first put him in girl’s clothes. The hardest tasks would then be a pleasure to him. These practices continued up to his twelfth year of age. From his earliest recollections his playmates were always girls and his playthings were dolls, ribbons, miniature housekeeping, furniture, etc. He was an expert doll maker and could cut and make doll clothes for his sisters and other little girls. At ten years of age he could cook and prepare a meal. He was known to have no lack of courage. His inclinations are always towards strong-minded, energetic women of the masculine type. He also has an admiration for other men of his type when they are dressed like women. He never had any homosexual inclination. He always had an almost uncontrollable desire to wear woman’s attire. When so dressed he can always think more logically, feel less encumbered, solve difficult problems. But for the popular prejudices he would always wear female attire. The skin of the patient is soft and clear, the hair on head and beard is soft and light. He has little hair on his body. His shoulders are square and his breasts quite large. His voice is high. He blushes readily. He could never countenance vulgarity, such as smutty stories or obscene remarks. He is receptive. He is very sensitive to pain or pleasure. He is inclined to be stubborn. His intellect is keen, and he thinks logically. When about fifteen years old his father forbade him to wear female clothes, so he kissed his mother good-bye and made his way to the far West. There he drove a team on construction work of a railroad and in the fall of the same year found himself hunting buffalo. In the five ensuing years he has done his part in winning of the West, with the result that he carries two Indian bullets in his legs. But he covers them up with petticoats, he says, as often as opportunity permits. Then he forgets all about them, as well as all other troubles. He has served as a detective in a United States marshal’s office, as a sheriff, and as a justice of the peace. He has been able to conquer almost everything except his uncontrollable passion for female attire. When the inclination to dress comes over him, he is unable, try as he may, to resist it. This last characteristic in the case shows that the desire for cross-dressing may often assume the degree of a veritable imperative idea. If the desire is not satisfied, some patients are seized with anxiety, accompanied by cold perspiration and palpitation of the heart.