But it would be erroneous for that reason to decry the course of cultural development or to look for the improvement of conditions to changes in law or in the formal code of morals. All lovers of mankind surely must fight for the abandonment of the moral opprobrium and legal persecution of homosexuals and for a greater freedom from bias in the perception of the problem of all paraphilias. But we must not fail to recognize that we are dealing here with tremendous social forces and with developmental tendencies striving, beyond all human range, for the attainment of unknown higher ideals. _The development of the race is from bisexualism to monosexualism. Even the “genuine” homosexuality as we know it today everywhere is a proof in favor of this contention._ For if homosexuality were an inborn trait, as _Hirschfeld_ and his pupils maintain, it would be the pattern-type of health and homosexuals would show no repressed heterosexuality; there would be no morphinists, no drinkers, and no dipsomaniacs[22] among them. Their number may not be large, but that is because the uranists’ homosexuality is already a compromise, an attempt on the part of nature, and of the psyche, to escape the insolvable bisexual conflict. The very fact that all neurotics represent retrogressions shows that the race is advancing towards monosexuality. The neurotic, as a bisexual being, might stand for an earlier developmental phase, if the cultural standards of morality would not hinder. When he attempts it (like, for instance, _Oscar Wilde_) he draws upon himself the deadly scorn of his fellowmen; he is ostracized as a citizen. Homosexuality leads but seldom to paranoia when associated with heterosexuality, as happens in the reverse instance,—heterosexuals trying to repress their homosexuality. That in itself shows homosexuality to be a neurosis,—the premonitory phase of the paranoiac psychosis. When paranoia breaks out, the homosexual holds to the delusion that he belongs to the opposite sex and may go so far as to disregard his genitalia and to acquire the feeling that he is physically changed. The paranoia attempts to round out physically the delusion of sexual transformation it has initiated psychically. The wish of the male homosexual: “I want to be a woman!” is fulfilled in paranoia. In that state he finds a thousand proofs that he is a woman. Many such cases have been described especially by _Krafft-Ebing_, who has called them “_metamorphosis sexualis paranoica_.” The subjects imagine that they have the monthly flow because they have the nose-bleed every four weeks (this happens also with nonparanoia _urnings_),—they have a flow from the lower parts for five days at every full moon. A patient of _Krafft-Ebing’s_ relates (Obs. 134, p. 245): “Every four weeks at the full moon I have for 5 days the _molimina_, like any woman, physically and mentally, only I do not flow,—but I have a sensation of discharging fluid, a feeling of fulness about the genitals and the lower