April Trask. German History. Volume 36, Issue 2. June 2018.
In the early 1920s, German sexual scientists championed testicular modification as the cure for the ‘effeminate’ male homosexual. This article explores how, between 1914 and 1933, sexual scientists were able to imagine that they could engineer the body to transform the soul. Joining interdisciplinary work on the social history of medicine and gender, it traces the efforts of medical practitioners to understand and discipline the transgressing of normative gender roles, so-called ‘intermediacy’, that became central to taxonomies of sexual deviancy in the twentieth century. This article examines how sexual scientists engaged war pathology, endocrinology and constitutional medicine to develop utopian treatments that promised to turn ‘effeminates’ into ideal German men. It illuminates how medical experts imagined their role in defining the healthy embodiment of militant, patriarchal manhood as constitutive of social stability and political citizenship during a time in which German masculinity was assumed to be in crisis. Medical experts cast testicular modification as a possible antidote to the ‘hysteria’ of returning soldiers and the perceived effeminacy of urban men and alleged sexual deviants. While leading sexual scientists clashed on the ethics of surgeries aimed at restoring ‘masculine’ traits to the ‘weak-willed’ and male homosexuals, they agreed that glandular modification held the key to unlocking the malleability of men and the extent—and limits—of scientific intervention.
After a 1924 visit to Berlin, American novelist Gertrude Atherton claimed that hormonal injections and a newly popularized vasectomy surgery had the potential to rejuvenate Germany’s men and restore the country’s international prestige following defeat in the First World War. In her popular novel Black Oxen (1923) and other publications, Atherton suggested not only that endocrine modification could heal war veterans plagued with ‘derangements of the ductless glands’, but also that ‘human nature might attain perfection’ through gonadal treatments. Despite ridicule by German and American journalists, who questioned whether a Berlin ministry would be ‘tasked’ with mandating testicular surgeries, Atherton’s enthusiasm reflected her immersion in an interwar discourse that celebrated the revitalization of self through endocrine procedures. The German science of glandular therapy, once associated with maligned French organotherapy, became by the 1920s integral to a holistic, so-called constitutional paradigm that sex researchers used to develop new taxonomies of gendered and sexed deviancy and treatments aimed at remaking men.
Contrary to representations of glandular therapy in other national contexts, which framed it as a potential ‘fountain of youth’ that would stave off the ravages of old age, in Germany medical experts positioned endocrine theories within wide-ranging debates on male dysfunction, homosexuality and the negotiation of gender dichotomies in the First World War and the postwar period. In particular, sexual scientists, broadly defined to include the clinical physicians, researchers and psychiatrists who produced medical knowledge (and related practices) on sex, sexuality and gender, developed endocrine experimentation in dialogue with shifting anxieties that pathologized deviant and ‘effeminate’ men. After 1914, medical experts and sexual scientists retooled a language of dysfunction and abnormality pioneered by early sexual psychiatrists such as Richard von Krafft-Ebing and Albert Moll, who had in the late nineteenth century profiled men’s failures to ‘adjust’ to industrial work and urban life while also emphasizing the perceived feminization of the ‘decadent’ upper classes. While rejecting models that linked so-called effeminate men with contagious pathology, other sexual scientists such as influential Berlin physician Magnus Hirschfeld theorized that the blurring of gender roles was tied to a plurality of biologically based sexual typologies, including ‘homosexuality’. While social pundits joined medical and scientific experts in debating competing explanations for ‘men-loving men’ and fears of male fragility before 1914, Germany’s defeat in the First World War (1914-1919) and the sweeping social and political transformations of the new democratic Weimar Republic (1919-1933) both deepened and reoriented anxieties about the (dys)functioning of male bodies.
This article explores how medical experts such as Hirschfeld developed the endocrine constitutional model as a vehicle through which to understand and discipline the transgressing of binary gender roles, so-called ‘intermediacy’, that became central to scientific taxonomies of deviancy that emerged out of the First World War. Joining growing interdisciplinary work on the social history of medicine and gender, this article departs from approaches that frame German sexual science through the lens of (primarily Hirschfeld’s) homosexual rights advocacy and the emergence of modern gay identity or, conversely, as a way station on the twisted path to Nazi eugenic pseudoscience. This article instead demonstrates how between 1914 and 1933 practitioners engaged mainstream scientific methodologies of war pathology, endocrinology and constitutional medicine (a field that emphasized interconnected psychic and physiological systems) and deployed these theories in treatments that promised to turn ‘effeminates’ into ideal German men. It illuminates how sexual scientists, in particular, imagined their role in defining and creating the healthy embodiment of patriarchal masculinity, which they saw as constitutive of social stability and political citizenship during a time in which German men were seemingly under threat from the wear of modern combat and the renegotiation of gender roles that took place during the First World War and the immediate postwar era. Many medical experts cast the testicular modification praised by Atherton as a possible antidote to the ‘hysteria’ of returning soldiers and the growing effeminacy of urban men and alleged sexual deviants. While leading sexual scientists such as Moll and Hirschfeld clashed on the ethics of surgeries aimed at restoring normative masculine traits to the ‘weak-willed’ and male homosexuals, they agreed that glandular modification held the key to unlocking the secrets of manhood and the extent—and limits—of human intervention.
This article further traces the evolution of a scientific model of homosexuality defined not only by same-sex oriented sexual desires, but also by the imagined coexistence of both genders as constitutive of subjectivity. Building on a rich historiography on the sexual politics of homosexuality and transvestitism in Weimar Germany, I explore how sexual scientists described the transgression of mutually exclusive and binary constructions of gender as more important than the secondary, so-called deviant sexual behaviours themselves (which alone could reflect a mere ‘pseudo’ deviation or experimentation best addressed by boarding schools, criminologists, public morality activists, sex reformers and/or the police). This scholarship reveals the complexity and ambivalences of sexual-scientific theories such as those elaborated by the reform-minded Hirschfeld, who, while advocating for the fluidity of sexual desires and greater rights for sexual minorities, assumed a biological polarity of gender. Although he argued that the essence of the ‘true’ man and woman was mixed in the so-called ‘intermediacy’ of homosexuals, Hirschfeld’s nuanced sexual typologies nevertheless reflected social and scientific expectations about the correlation between essentialized gender, character traits and appropriate socio-political roles. According to many sexual scientists, male homosexuality, like war hysteria, was explained to a greater degree by the origins of gender than by the variations of sexual practices.
German sexual scientists departed from a psychoanalytic emphasis on mental pathology and instead engaged experimental methodologies to gender what they claimed to be the simultaneously spiritual and bodily origin of selfhood: the endocrine system. While shaped by a historical moment of profound anxiety, theories of deviancy equally emerged out of the unique confluence of researchers’ engagement with various medico-scientific movements: the revival of constitutionalism in wartime pathology, the renaissance of holism and endocrinology and the growing legitimacy of research that attributed deviations from scientific and social norms to dysfunctional biology. Close examination of interwar sexual science also reveals how much the utopian moment of early Weimar experimentation and an expanding authority of self-defined sexual experts owed to the mobilization of health professionals during the First World War. The explosion of scientific interest in constitutional medicine and treatments aimed at healing German soldiers during wartime served to legitimate theories practitioners had advocated since the turn of the century, notably the underlying relationship between pathology and a (potentially endocrine) predisposition and the privileged role for science and medicine in the plasticity of men. The war opened space for these interpretations to flourish and deepened the socio-political imperatives attached to understanding, scientizing and aligning men with expectations of militarized patriarchal masculinity.
Sexual scientists developed glandular treatments in dialogue with anxieties about the functioning of men during the First World War and the spectre of feminized, hysterical pathology. While I argue in my broader work for important continuities in how scientists theorized desire across the traditional rupture point of the First World War, this article begins with a particular focus on the role of the war in expanding concerns about male dysfunction and the authority of medical professionals in modifying men. I then move to an analysis of the field of constitutional medicine, which emerged partially out of war pathology and drew on existing holistic theories in a flexible model that united the body and mind. I examine, in particular, typologies of homosexuality that prioritized the endocrine system in producing gendered and sexed so-called constitutions. I conclude by exploring how sexual scientists drew upon these theories to develop surgical and hormonal procedures aimed at ‘reactivating’ normative masculine traits, and the ethical concerns raised by some practitioners shortly before the collapse of the field once the Nazis came to power in 1933. This article traces how gender anxieties and an optimistic faith in modern medicine created a landscape in which German sexual scientists imagined that they could engineer the body to transform the soul.
The Great War and the Crisis of Masculinity
In a First World War military hospital, Viennese physiologist Eugen Steinach and surgeon Robert Lichtenstern performed one of the first documented testicular transplants aimed at modifying gender characteristics. In this 1915 surgery on Lance Corporal ‘Leopold M.’, who had lost both testicles to battlefield wounds, medical experts invested the function—and, in this case, absence—of the gonads with assumptions about the fundamental nature of the body and self. In the months after Leopold M.’s testicles were removed, medical staff reported a range of disturbing transformations and an alleged feminization of his physiology, morphology and behaviour. He developed neck fat, ‘which gave the patient’s countenance a peculiarly stupid expression’, lost his body and facial hair, particularly the moustache, and developed ‘far-reaching psychic disturbances’. Steinach and Lichtenstern stated that Leopold M. experienced deep ‘psychological consequences’ ranging from ‘severe melancholic depression alternating with states of excitement’ to broad changes in personality. He was reported to show ‘no interest in the events of the war’ and claimed ‘absolutely no libido’ or erections.
Steinach and Lichtenstern linked these changes not to the trauma of battlefield combat in the First World War, but to the powerful effects of the gonads and their secretions on characteristics associated with gendered and sexed behaviours, personality and morphology. Lichtenstern, with Steinach attending, bisected a donor human testicle and affixed it with sutures to a scarified muscle bed in the lower abdominal muscles to promote absorption of the ‘chemical substances’. The donor testicle was attributed to the castration of a man who demonstrated ‘over-normal virile desires’ and ‘hyper-masculinity’. Nine months after the surgery, Steinach reported that Leopold M. had developed a more ‘masculine appearance, intelligence, and sex instinct’ as a result of the renewed secretions of the testicular tissue. His ‘appearance improved and his intelligence was strikingly increased: the facial expression now became lively, the adipose [fat] tissue on the neck gradually disappeared, and the moustache grew again’. Two weeks after the operation, Lichtenstern reported that the ‘company of female individuals now unleashed [Leopold M.’s] libido and erection’. Reflecting on the case in the 1940s, Steinach claimed that Leopold M. was now ‘normal in masculine appearance, intelligence and sex instinct, and enjoys a happy married life’.
In a second case detailed by Lichtenstern one year after Leopold M.’s transplant, a senior lieutenant, Baron S. also experienced what sex researchers described as a process of feminization after the removal of his testicles. Like Leopold M. Baron S. allegedly experienced a resulting loss of body hair, development of fat, disinterest in opposite-gender oriented sexual relations and fluctuating episodes of ‘excitement’ and depression characteristic of hysteria, a nineteenth-century medical diagnosis associated with alleged feminine irrationality and class-specific failures of labour productivity. Before the transplant surgery, Lichtenstern also noted that Baron S.’s psychological state began to deteriorate: ‘his roommates reported that he cried out nearly every night in his sleep’ and attempted to commit suicide.
These early testicular transplants were widely celebrated by German sexual scientists as restoring to men an idealized manhood that they claimed originated in the sex glands. By the early 1920s, a range of medical experts argued that the hormonal substances of the testicles and not the functioning of the reproductive system or penis produced gendered personality traits and behaviours. Drawing on experimental surgery and endocrine research, sexual scientists in particular cast testicular substances as central to taxonomical definitions of gendered and sexual deviancy, typically marked by the blurring of so-called male and female essences. Like his colleagues, Steinach argued that individuals could be transformed through treatments derived from medical models that posited a causal relationship between ostensible sexual and gendered abnormalities and an integrated dysfunction of the self. For many German sex researchers in the early twentieth century, the alleged success of Steinach’s research heralded new possibilities for human intervention.
Lichtenstern’s account of Leopold M.’s return to ‘manhood’, measured by the renewal of the moustache, opposite-gender oriented sexual desire and intelligence, tapped into alarmist claims that linked the sex hormones with anxieties surrounding male dysfunction and the renegotiation of gender identities in the First World War. As early as 1915, most German physicians revised initial predictions that wartime combat would trigger the spiritual rebirth of the nation and forge in men ‘exemplary heroes’ through a ‘steel bath of nerves’. Instead, they feared Germany’s descent into, as Hirschfeld wrote, ‘spiritual and moral emptiness and brutalization’. At the centre of these debates was the soldier, who had served, at least in the form of the officer, since the late eighteenth century as an important vehicle for shifting conceptions of German manhood, citizenship and national identity. Often contrasted with pejorative stereotypes of female emotionality and passivity, discourses surrounding the ideal man commonly emphasized patriotism, self-sacrifice, class-specific economic and social productivity, martial discipline and sexual prowess as well as a standard of athletic, ‘beautiful’ and white bodies. Among propagandists and sociological pundits (although often refused in personal writings by many soldiers themselves), the ideal soldier took on added significance as a pillar of social stability and a symbol of the nation during the war. By 1915, however, failures by German armies to win decisive victories on the battlefield, the enormity of casualties and women’s new visibility as wage earners in war and service industries signalled, to some, the spectre of male impotence. German medical experts, social reformers, religious leaders and bureaucrats argued that the war experience exacerbated ‘sexual disorder’ as well as quickened a moral decline brought on by the country’s rapid industrialization at the turn of the century. They pointed to the dangers of venereal disease, falling birth-rates and a vision of disintegrating family: the unfaithful war-wife in bed with the enemy and a husband returning forgotten and disabled from the front. In alarmist rhetoric, the war was the greatest of all ‘dysgenic disasters’, reaping Germany’s finest men and leaving behind cowards and cripples.
Steinach and Lichtenstern’s experimental surgeries during the First World War reflected not only intensified concern surrounding men’s role in the ‘moral community’, but also medico-scientific experts’ unprecedented access to human candidates from field hospitals and their growing authority in defining standards of dysfunction. Endocrine theories from the prewar era drew new attention from a range of German medical practitioners authorized to meet the challenges of total war. The complexity of the war demanded a centralized public-health policy and vastly expanded bureaucratization of professionals certifying health and sickness. Specialized scientific, engineering and medical ‘experts’ played a crucial role in the war effort; German physicians applied new measures to diet and hygiene and established standards that codified the ideal man’s physiological and mental qualifications for combat.
The military imperatives attached to being able to manage and treat wounded soldiers, in particular, spurred wide debate on the relationship between physiology, behaviour and gender. The unprecedented destructive capacity of modern artillery and machine guns exponentially increased casualties and seemed to confirm, for many, the fragility of the human body in the industrial world; approximately 5.5 million German men were wounded in the conflict. Particularly concerned with the ‘problem of emasculation’, sex researchers pointed to the dangers of specific war wounds, including irreversible damage to the testicles (and, secondarily, the spine and penis). The number of men who suffered injuries to or lost one or more testicles is difficult to ascertain. Unlike in the Franco-Prussian War of 1870/71, in the First World War official data collection forms divided battlefield wounds into those of the head, neck, spinal column back, torso and limbs while the genital region was omitted even in body diagrams. Based on other accounts, damage to the genitals was often paired with injuries to the torso or limbs (such as the thigh, as with Leopold M.), which were recognizable as a debilitating war wound for the purposes of discharge, pension eligibility and social stigma (although pension appeals reveal that veterans with testicular damage did receive subsidies for single or double mutilation). In interwar literature and medical reports, discussion of ‘castrated’ veterans was intertwined with concerns about the psychic effects of testicular loss on these so-called ‘non-men’. In a study of 310 ‘castrates of the war’ compiled in the early 1930s, neurologist Johannes Lange, director of the Psychiatric and Neuropathic Hospital at the University of Breslau, described those who experienced wounds or removal of the testicles in gendered terms; like Leopold M. the ‘castrate’ no longer grew a beard, developed ‘female breasts’ and had soft, ‘girlish’ features. Lange linked the attendant and alleged dulling of ‘courage’ and passion with a failure of manhood and a weakness of the self.
By the end of the First World War, German sex researchers and medical professionals eschewed explanations that emphasized the primacy of psychic trauma resulting from combat (‘traumatic neurosis’) and instead attributed mental disturbances to a flawed physiology and/or ‘will to sickness’. In field and reserve hospitals, reports spread of nervous symptoms and soldiers degenerating into so-called war neurotics and hysterics. Appropriating nineteenth-century diagnoses of hysteria and nerve trauma associated with working-class Germans (neurasthenia), pathologists codified war hysteria with a broad criteria of symptoms including tremors and tics, changes in perception and gait, so-called sexual abnormalities and mental disorders. Sex researchers, in particular, emphasized the inversion of binary gender roles, ‘sexual excesses’ (masturbation, rape), perversion (sadism, masochism, bestiality, same-sex sexual behaviours) and pathophysiology (erectile and ejaculatory dysfunction) as common signs. Unlike physically disabled war veterans, who were often honoured as heroes during the war, war hysterics were uniformly portrayed by German doctors as failing to embody standards of appropriate manhood, particularly expectations of military bravery, rationality and sexual dominance. Physician Siegfried Placzek, for example, described a lieutenant who returned from the war as ‘erratic’, ‘prone to dazed frenzies’ and ‘passive’. Dovetailing with social anxieties about gender reversal, Placzek reported that the lieutenant came under the sway of a domineering, aggressive woman and engaged in ‘perverse’ and masochistic behaviours as her sexual plaything.
Medical definitions of sexual pathology and war hysteria shared a common nexus in an assumed failure of manhood and weakening of the will, or ‘abulia’, the clinical description of the condition. By the end of the war, the psychiatric consensus on war hysteria emphasized not the trauma of emotionally or physically distressing experiences, but a general pathology of the mind. With an eye to shifting responsibility from wartime combat (for which the German state would be liable in the form of postwar invalid pensions) to a pre-existing dysfunction of self, psychiatrists overwhelmingly cast war hysteria as an abnormal reaction to normal human experiences—perhaps triggered but not caused by the war. Those who questioned this diagnosis were ultimately disregarded. As Swiss psychiatrist and neurologist Otto Binswanger reported, in wartime, the ‘sudden and abrupt’ onset of hysterical symptoms was simply ‘much clearer to identify’ than in peacetime. Arthur Kronfeld, who with Hirschfeld co-founded the Institute for Sexual Science in Berlin, a sexual treatment and research centre from 1919 to 1933, similarly argued that the neuroses of returning war soldiers derived from potentially hereditary conditions that disposed some men to develop ‘hysteria’ under specific environmental or physiological circumstances. Clinical psychiatrists, in particular, revived treatment methods such as hypnosis, isolation, electric current and suggestion therapy in addition to newer Freudian psychoanalysis in a broad campaign against hysterical symptoms.
Medical accounts aimed at correcting Leopold M. and Baron S.’s assumed ‘descent’ into femininity echoed fears of such male dysfunction and national decline after 1914. Reflecting on his alleged shock at the ‘epidemic’ of hysterical soldiers, influential neurologist Max Nonne noted, ‘We had said at the time: “Such things happen only with the French, in Germany there is no hysteria for men”‘ By 1918 and Germany’s surrender amidst military losses and a growing influenza pandemic, concerns that soon-to-be demobilized soldiers would be unable to reclaim patriarchal political institutions spurred continued anxiety over male bodies. While in the early 1920s sexual scientists retooled theories developed under the banner of war pathology, the terms of cultural and political debate shifted to reflect the challenges posed by revolution, demobilization and the building of the new Weimar Republic. In 1919, newly empowered liberal politicians crafted an ambitious democratic state that sought to not only emancipate, but also protect and regulate Germans through programmes that extended the wartime government’s reach into their reproductive and sexual lives. While the egalitarian promises made in the Weimar Constitution were often left unrealized, bogged down in bureaucratic channels by legislative and financial difficulty in the 1920s, welfare policies and public-health programmes aimed at reforming and healing Germans provided continued space for debate on the relationship between sex and society. As part of the state’s effort to fund scientific education for the general public, for example, policymakers awarded sex researchers such as Hirschfeld and Moll government stipends. In February 1919 the Prussian government endowed Hirschfeld’s foundation with the symbolic sum of 30,000 Marks for the creation of the Institute for Sexual Science, which aimed to conduct ‘scientific research on the entirety of sexual life’, disseminate such discoveries and ‘enlighten’ German society. Much of the funds for Moll were intended to further the research and treatment of venereal disease, which had been particularly damaging to the health of soldier populations in the First World War.
For politicians and sexual scientists alike, the return of soldiers with physical and cognitive trauma as well as the loss of over 2 million German men (15 percent of men between the ages of twenty and forty) magnified demographic concerns as well as anxieties about gender roles. Policymakers worried over alleged homecoming divorces and the loss of reproductive potential from a generation of traumatized men and so-called surplus women who, as a cohort, outnumbered men and potential husbands their age. In the early 1920s, the spectre of the New Woman further sharpened fears about the consequences of war on the family, reproduction and gendered labour. While visions of the independent woman with her bob haircut and cosmopolitan lifestyle reflected some women’s increasingly visible presence in the economy and leisure spaces, the New Woman became, as one historian aptly put it, ‘a remarkably diverse signifier’ invested with a mixture of cultural fantasies and fears surrounding (both real and perceived) transformations in gender roles in the war and immediate postwar years. In social and political debates, the androgynous or masculinized woman was conflated with stereotypes of sexual deviancy, racial otherness and non-conformity to the maternal, caregiver role.
Hirschfeld claimed in the late 1920s that the ‘progressive masculinization of women’ that was ‘common’ in the interwar period could be traced only in part to changing opportunities for women in the First World War. The real cause was the impotence of traumatized war veterans and the new visibility of effeminate men, homosexuals and the same-sex sexual subcultures that flourished in Weimar cities. Same-sex desire figured for the first time as central and open themes in German film, theatre and cabaret as well as in the expansion of social clubs and bars that catered to a plurality of sexual identities in cities such as Berlin. The brief relaxation of censorship after 1919 similarly spurred greater opportunities for sex-rights organizations, which sought the overturning of Germany’s anti-sodomy statute, Paragraph 175, and greater acceptance for theories that ascribed same-sex desire to a biological intermediacy of gender. For many medical experts, however, the appearance of ‘effeminacy’ in both traumatized soldiers and male homosexuals in the immediate postwar period bespoke a common biological origin. In their research, sexual scientists joined war pathologists in emphasizing a language of inborn and holistic dysfunction—one that not only classified men as deviant, but also provided opportunities for their transformation.
Uniting the Mind and Body: Constitutional Medicine and Homosexuality
German physicians’ ‘war against hysteria’, the attendant legitimacy of attributing behavioural anomalies to pre-existing pathologies and broadening fears of male dysfunction shaped how experts theorized the relationship between gender, personality and physiology into the 1920s. While wartime psychiatrists emphasized hysterical predisposition, sexual scientists increasingly sought to anchor the mental ‘constitution’ in physiology. As scientific and social pundits invested the separation of normative gender roles with new importance during the First World War, the aetiology of alleged perversions became especially pressing for sex researchers. Beginning in the 1910s and flourishing until the Nazi state in 1933, constitutional medicine (Konstitutionswissenschaft) became a primary vehicle for these debates. The medical and biological scientists who championed this approach cast it as the wedding of ‘modern’ biomedicine with clinical holism in a ‘new humoral pathology’. In the constitutional model, the diagnosis and treatment of pathology attributed the general state of an organism to a web of interconnected psychic and physiological systems rather than to the separate processes of organs and nerves. Constitutionalists stressed the intimate relationship between the mind and body and developed taxonomies of human ‘constitutions’ that prescribed specific body types, behavioural patterns, personality and predisposition to disease and/or abnormalities. Thus, while constitutionalists often claimed to examine the overall habitus of the individual, they also codified diversity into statistically normative typologies commonly attributed to identifiable and malleable physiological, typically endocrine, function. As one historian put it, constitutionalists ’embraced holistic goals through reductionistic means’. Constitutional medicine served as a foundation for theories of gender and sexual deviancy, including visions of biological homosexuality and transsexuality, and as the basis for sexual scientists’ efforts to modify men in interwar Germany.
At the 1916 Kriegspathologische Tagung (Congress of War Pathology) in Berlin, leading pathologist Ludwig Aschoff claimed that constitutional medicine was the ‘most important’ methodology in war pathology. The number of articles on constitutional studies in mainstream publications skyrocketed during and after the First World War, and the constitution, although certainly not new to the medical landscape, emerged as a central organizing paradigm in cutting-edge research in neurology, physiology, anatomy and endocrinology throughout Europe and North America. In German eugenicist Hans Günther’s 1922 text Die Grundlagen der biologischen Konstitutionslehre (The bases of the biological constitutional model), he rightly noted that the notion of the constitution was ‘as old as medical science’ and had been recast in specific humoral contexts multiple times throughout European medical history. Constitutionalism was such a dynamic, multidisciplinary and adaptable model that one physician, frustrated with its porous and flexible language, argued that it ‘deals more with emotional interpretations than it does with clear, exact ideas’. Described by historian Carsten Timmermann as ‘a culturally specific hybrid of modernist and antimodernist thought’, constitutional medicine appropriated divergent intellectual traditions: neoromantic critiques of mechanistic science and, conversely, the utilitarian belief in optimizing the human organism for war and work. Pathologists such as Aschoff and Friedrich Martius cast wartime constitutionalism as key to rationalizing humans in the service of Germany’s military, industry and racial development. Other proponents such as popular Danzig surgeon Erwin Liek aligned the field with the condemnations of laboratory science, atomism (the idea that all organisms are the sum of autonomous parts and processes) and an alienation of the body and mind associated with the mechanization of factory labour at the turn of the century. This approach painted the medical expert as a quasi-religious healer empowered by natural empathy in contrast to ‘a depersonalized, biomedically based brand of medicine emphasizing the laboratory over bedside manners’. Sexual scientists drew on the ‘Janus-faced’ methodology to simultaneously ascribe to the body a dominant role in human function and imbue this very biology (particularly elements such as the hormones and blood) with spiritual qualities. In opposition to the consensus of clinical psychoanalysts, constitutions were never merely psychological.
In the constitutional paradigm, the mind and body were not separate ontological categories, but rather united as a collective ‘body-soul’ (Körperseele) that produced both biological function and selfhood. Adherents defined the constitution alternatively as synonymous with a genotype—the ‘inner constitution of the organism [and] its hereditarily given genetic combination’—and/or, more commonly, an endocrine typology that controlled an individual’s predisposition to disease and deviant behaviours. As endocrinologist and sexual scientist Arthur Weil wrote in 1922, ‘The physical and psychological form an inextricably linked entity, from which arises the collective function of personality’. While endogenous (typically genetic and/or endocrine) factors determined disposition to pathology, constitutionalists also highlighted the importance, however secondary, of exogenous or environmental factors in producing disease. Sexual scientists theorized that traumatic life experiences such as childhood abuse or wartime combat triggered hidden pathologies as an adaptive response. Hirschfeld, as well as his colleagues and other social reformers, claimed that the family environment and failures to adhere to racial and class-based assumptions of appropriate parental behaviour influenced the ‘constitutional harmony’ of human development. In the 1920s, many sexual scientists prioritized research on internal causes of deviancy; environmental stimuli, they claimed, were well documented by state-sponsored, racial hygienic and social welfare groups and advocacy surrounding maternal, body, health, housing and educational reform.
Sexual scientists such as Hirschfeld argued that the ‘widespread dualistic view of a deeply divided opposition between … a materially bound body and a higher-aspiring soul’, which he attributed to the benighted theories of the Middle Ages, had finally been overturned by natural science and Enlightenment thought. In his 1926 critique of contemporary medical practices, Erwin Liek described a multitude of case studies in which physicians failed to appreciate the interrelation between mind and body, with disastrous results. The popularity of his book suggests the appeal of such arguments; The Doctor and his Mission: Thoughts of a Heretic sold 30,000 copies in Germany before it was translated into English with multiple editions. The condemnation of aetiologies that separated the ‘bodily from the spiritual’ put sexual scientists and other adherents of constitutionalism in dialogue with a range of antireductionist, holistic medical and social movements in early twentieth-century Europe. These included, among others, psychosomatic medicine, neovitalism, Lamarckism (the genetic transmission of acquired traits, otherwise known as soft inheritance), scientific hypotheses on ‘vegetational anomalies’ (which posited a link between types of individual physiologies and ‘habitus, temperament, psyche and intellect … the entirety of the individual’), Gestalt psychology and monism. An active member of the Deutscher Monistenbund (German Monist League), Hirschfeld inflected his work with conventions derived from monistic theory, a secular-scientific worldview that claimed a fundamental unity of all animate and inanimate phenomena.
In the 1920s, German sexual scientists appropriated constitutionalism to reinvent prewar theories of deviancy that defined homosexuality as both holistic and biological. Although they could not draw on the medical legitimacy of constitutional medicine until the 1920s, forensic criminologists and medical experts began as early as the 1880s to shift analyses of so-called deviancy from taxonomies of behaviour to discussion of holistic, congenital abnormalities. In an 1896 publication, Hirschfeld argued that desire was rooted in the body and that homosexuality or ‘inversion’, much like cleft lip and the physiological hermaphrodite, derived from an embryologic, cellular and/or endocrine hermaphroditism triggered by an ill-defined developmental abnormality. Although critics often reduced his theory to the discovery of a ‘Third Sex’, Hirschfeld cast same-gender oriented sexual desire as one indicator of a complex mixing of what he essentialized as the natural traits of men and women; this inversion could be identified in all aspects of the individual, from sexual organs and physique to ‘mental characteristics’ and behaviours. So-called ‘sexual intermediates’ were the result of anomalies that prevented such individuals from becoming the normative, ideal-type man or woman.
Hirschfeld’s early work popularized the influential trope of the ‘female psyche in a male body’ and linked male-male desire, in particular, with a personality that mimicked nineteenth-century stereotypes of white, middle-class femininity, especially traits such as passivity, fragility and lack of emotional restraint. Although the specific theory of biological homosexuality was one of several sexual typologies (including hermaphroditism, androgyny and transvestitism) included under the larger umbrella of inversion or sexual intermediacy, it became the most popular—and most controversial—in sex research. In the 1920s, the legitimacy of constitutional study, concern surrounding the feminization of Germany’s returning veterans and the emerging political mobilization of gay communities and sexual-rights advocacy (particularly aimed at overturning Germany’s anti-sodomy legal framework) all contributed to making homosexuality the most visible category of inversion in socio-political and medical debates.
Whereas sexual scientists once enumerated behavioural deviations from social norms, in the Weimar Republic they increasingly tied so-called abnormalities to constitutional dysfunction. For Hirschfeld and other medical experts, sex and gender were ‘never only bodily or only spiritual, but rather always both’ and the product of an ‘indissoluble cohesion, an inseparable reciprocity’. Hirschfeld declared in 1926 that the constitution was ‘contingent upon and fundamentally’ sexual. Even constitutionalists not explicitly tied to sexual science echoed Hirschfeld’s statement: Günther argued in 1922 that sexuality was ‘the intrinsic principle that directs the entire individual constitutional complex’. Hirschfeld, in fact, coined a term that reformulated body and soul into a single descriptor of sexuality: die körperseelische Geschlechtlichkeit, which translates imperfectly as ‘bodily spiritual sexuality’.
In the 1920s, sexual scientists hypothesized that organisms developed one of many possible constitutions comprising fixed combinations of male- and female-coded elements that shaped physique, the propensity for specific diseases, personality and the nature and object of sexual desire. Hirschfeld, like Weil, argued that the so-called intersexual constitution of homosexuals was marked by an overlapping of features associated with both the ‘true’ man and ‘true’ woman. He was committed to proving that the body of homosexuals replicated the alleged hybridity of their psyche. In laborious analyses, he documented ‘average’ body dimensions for male homosexuals as compared with so-called normal Germans, identifying changes in morphology that he claimed corresponded to behavioural differences. In studies of the ‘homosexual type’, Hirschfeld emphasized feminine-coded features such as frequent nosebleeds (allegedly similar to women’s menses), small head size, nervous conditions, voice timbre, body hair and skeletal proportions among what seemed to be an ever-growing list of possible criteria. Homosexual men could be identified, Hirschfeld even wrote, by the shape and size of their teeth: the front central incisor to canine tooth was shorter than the normal man by an average of 0.4 millimetres. Constitutionalists such as psychiatrist Ernst Kretschmer joined Hirschfeld in linking behavioural anomalies such as same-gender sexual desire with body types, hormonal dysfunction and ‘temperaments’ (which often replicated nineteenth century psychiatric diagnoses) including ‘Richard Wagner-type’, ‘infantilism’, ‘schizoid-type’ and ‘supervirile’.
Physicians and researchers affiliated with Hirschfeld’s Institute for Sexual Science and those who supported sex-rights activism, in particular, drew on these findings as definitive proof that homosexuality was congenital and therefore not contagious or criminal. In 1922, renowned Berlin psychiatrist Arthur Kronfeld claimed that same-gender oriented sexual desire could not be a criminal ‘perversion of the soul and desire’ because it was ‘to its carriers something intrinsic, adhered to their constitution’ and ‘corresponds to an essential and deep necessity of being’. While early German sexual and gay rights activists drew upon constitutional models to legitimize theories of congenital sexual identity, sexual scientists embarked in the 1920s on research aimed at uncovering the endocrine lever that would alter the entire constitution—not only the object and nature of sexual desires, but also the gendered body and self.
The Endocrine Lever: Hormones and Typology
In his 1922 article, ‘Homosexuelle Charaktere’ (Homosexual character), prolific German sexual scientist Arthur Weil described two types of homosexual men: the ‘virile’ and the more common ‘feminine’. Drawing on constitutional morphology, Weil detailed diagnostic criteria for body structure (Körperbau) in his account of the ‘slender, lanky aesthetic type’ of feminized male homosexual while invoking cultural stereotypes of gender inversion and a transgressing of normative masculinity. In stark contrast to the tall, lean and muscular bodies associated with ideal labour productivity, these homosexuals were, he wrote, ‘for the most part soft and rounded’. Their chests, he claimed, had an ‘average circumference of 80-85 cm and less’ and the shoulder width was ‘approximately 35-37 cm’. His analysis highlighted stereotypes of middle-class, white femininity. ‘The skeletal build is delicate and slender’, he reported, and ‘the hands are small, the fingers long and thin’. Hair and muscles were ‘hardly defined and poorly developed’. Weil went on to describe the ‘swaying gait’, ‘long strides’ and ‘gentle, demure’ high voice in this typology, which he claimed accounted for at least two-thirds of all homosexual men in Germany. He also associated this body type, the ‘hyposthenic’, with a range of physiological pathologies such as ‘neuropathology, nervosa dyspepsia [chronic indigestion], constipation, peptic ulcers, varicosis [and] lung tuberculosis’.
Weil further enumerated details of the feminine male homosexual’s ‘psychic condition’. Recent discoveries in constitutional medicine, he claimed, demonstrated that ‘physique corresponds to a particular character’ and that body and psyche are ‘inextricably linked with each other’ and are of the same elemental source. Beginning with sexual behaviour, he argued that before entering maturity (which was in most cases ‘delayed 2-3 years’ compared to normal development), these children stand out as ‘reclusive [and] sensitive’. They ‘stay away from the wild games of boys’ and instead play with girls, often ‘bashfully and secretly’ with dolls. In adolescence, the feminine-type male homosexual entered a period of confusion and angst, as he struggled to negotiate sexual and romantic feeling with social taboos. Weil described the risk of suicide that resulted from environmental stresses (anguish of ‘hypocrisy’) and weakened will: ‘the revolver and poison already lie ready’ and ‘the will to live often gives way to this tedium’. This ‘Sturm und Drang’ period (referring to the Romantic German literary movement famous for emotional extremes) could last late into life. Weil sketched the feminine homosexual’s ideal sexual type, a ‘romantic’, and his common attraction to ‘new directions in art and literature’, in reference to the experimental and politically engaged forms of expressionism that flourished in Weimar artistic circles. ‘But they are often unstable and unsettled’, he concluded, and regularly ‘change profession and residence, [and] are the asocial type of vagrant and world travellers’. He listed other common psychological character traits such as passivity, sexual pathologies (fetishism, sadism, masochism, etc.) and susceptibility to nervous anxiety.
In this constitutional typology, Weil’s focus was not the contagion of sexual immorality or genetic degenerative traits, common explanations for the so-called feminization of men in prewar sexual science. The ‘elemental source’ Weil emphasized was instead the body’s chemical secretions. Building on the new legitimacy of holistic theories and endocrinology in the first decades of the twentieth century, Weil reasoned that the homosexual constitution originated in the nature and function of the hormonal secretions from ‘certain glands, particularly the thyroid, pituitary gland, thymus gland and the gonads’. The most common morphological criteria for homosexuality, the ratios comparing the upper and lower body and shoulder and hip widths (which differed from the ‘normal man’s’ proportions of approximately 100:95 and 100:97 respectively), were tied to the function of the secreting glands and particularly the male-differentiating chemicals produced by the testicles. In the 1920s, Weil became one of several leading advocates of endocrine constitutionalism and declared, ‘The sum of sexual characteristics is the result of the morpho-genetic function of the secretions of the gonads’. Weil argued that while physicians could use behavioural (playing with dolls, for example), psychological (confessional self-narration of same-gender oriented desire) and bodily markers to identify homosexuality in individuals, the abnormal sexual desires themselves were also a secondary symptom of a more fundamental endocrine deviancy of gender.
Weil’s typology reflected many sexual scientists’ efforts to articulate existing theories of congenital homosexuality through new models of endocrine constitutionalism and cultural discourses of male crisis. Because, as Hirschfeld put it, the ‘human constitutional formula’ was ‘a glandular formula’, sexual scientists commonly attributed non-normative sexualities to endocrine dysfunction. Described by scholar Chandak Sengoopta as the ‘decade of the testicle’, the 1920s were the heyday of the all-powerful gonads in cultural and medical explanations of human function. As leaders of an emerging field that drew on the labour of multiple disciplines, endocrinologists emphasized in the 1920s the ‘chemical-correlative function of the gonads’ and engaged in close dialogue with a range of experimental researchers and clinical medical practitioners. In 1921, Kronfeld wrote that recent discoveries had linked both gender and sexuality to a ‘great number of other bodily and spiritual phenomena, structures and characteristics’ that could all be traced to the ‘nature of the glandular apparatus’. Even scientists such as Berlin physician Albert Moll and Robert Gaup, who argued that the gonads could not be the only cause of homosexuality, supported their key influence in the development of sexual and gendered subjectivity. In his landmark textbook, Artur Biedl, pathologist and professor at the German University in Prague, reasoned that the chemical system operated at the deepest level of the self, circulating in the blood and through ‘every organ, every tissue and in the last sequence of every cell of the organism’. Some speculated that there were a limited number of distinct endocrine personalities such as the adrenal-, thyroid-, thymus-, pituitary- and gonad-centred types. Sexual scientists argued that gonadal secretions, in particular, shaped all aspects of the physical body and personality, including growth, proportions, physique, metabolism, development of tissue, character traits and desire.
Glandular hormones were understood as a mysterious substance that not only governed the chemical interactions of the body but also embodied the most elemental and spiritual form of the self. While secretions such as ‘pancreatic secretin’, adrenalin, insulin and the sex hormones had been isolated in the late nineteenth century, it was only in the 1920s that scientists were able to produce synthetic, pseudo-pure and marketable hormonal extracts. Prewar studies of sexual secretions and ‘influencing substances’ were replaced by discussion of hormones, defined by Hirschfeld as ‘substances that exert a cellular stimulus through the blood pathways’. Experts debated the role of hormones in stimulating and inhibiting different functions, particularly in the process of chemical sex differentiation in the human embryo. Constitutionalists, however, also linked hormones with holistic interpretations of the body and mind and argued that their influence on embryological processes determined the nature of the gendered self. While some interwar experts claimed that humans were an amalgamation of material inherited from their parents (a model that referenced emerging genetic, cellular and chromosomal research), most sexual scientists claimed that this alone could not determine the resulting ‘relationships of the individual parts to each other’ and the interrelationship of psychology and physiology. Inherited material failed then to explain the alleged ‘parallels’ between body structure, ‘personality types’ and behaviour.
Endocrine constitutionalism revived the prewar developmental hypothesis of homosexuality, which claimed that abnormalities in embryological development resulted in ‘intermediate’ individuals such as genital hermaphrodites, homosexuals and bisexuals. Sexual scientists tied intermediacy to influential scientist Ernst Haeckel’s popular biogenetic law: ontogeny recapitulates phylogeny. Adherents of this theory argued that all organisms reflected the morphological evolution of their species. In the absence of definitive research on what would be identified as sex-determining chromosomes in the genetic content of sperm cells, medical experts argued that human embryos, in their earliest developmental form, held the potential for both sexes and, therefore, were essentially bisexual. Even into adulthood, men retained residual nipples; it seemed possible, researchers claimed, that other traits associated with the ‘opposite sex’ could be found in the physiological and psychological development of individuals. Many medical experts argued that humans (up until infancy or puberty, in some cases) even passed through natural bisexual or hermaphroditic phases.
In the 1920s, sexual scientists claimed that the hormonal substances secreted by early stage gonads controlled the processes by which one sex became dormant and the other ascendant and the resulting nature of the endocrine constitution. While eugenicists like Haeckel embedded these theories into evolutionary and racial paradigms, many sexual scientists deployed them to explain homosexuality as an ‘inner-secretory specific form of ambisexuality’. In 1921, for example, Weil argued that homosexuality was an external form of the intrinsic bisexuality of the body’s cells. ‘At the least’, Weil wrote,
there is a special physical predisposition, a certain constitution, which differentiates homosexual people from the normal average, and indeed we can assume in the existence of this predisposition that the gonads, due to some inhibition of their endocrine activity, were not able to shape the body after the purely male type.
In specific individuals, therefore, male and female hormones competed for dominance in both body and mind. This research underscored Hirschfeld’s and other sexual scientists’ claims that sexual secretions shaped different ‘intersexual’ constitutions on a spectrum between two absolute limits of normative masculinity and femininity.
In contrast to the visibly ‘deviant’ sex of physiological hermaphrodites or the transient behaviours of short-term ‘pseudo-homosexuals’, the homosexual constitution embodied the blending of man and woman in all aspects short of the genitalia. The secretions of the ovaries, for example, shaped not only the uterus, secondary sexual characteristics and morphology, but also a femininity based on passivity and sexual submission. The intersexual constitution, Hirschfeld wrote, was defined by a ‘complex bisexual mixture of active and passive components, in the extreme moments of submission and domination, incubistic and succubistic, or masochistic and sadistic feeling’. Sexual scientists joined other constitutionalists who attributed the ostensibly dangerous transgression of gender boundaries, typified in the effeminate male homosexual, to an all-pervading chemical constitution gone awry in embryological development. While some pointed to genetic predisposition, the renaissance of endocrine explanations in the 1920s provided a potential cure: ‘fix’ the hormones.
From Theory to Practice: The Steinach and Testicular Modification
Constitutional medicine offered sexual scientists new tools for envisioning the transformation of men through surgical and hormonal intervention. While medical experts diverged on the implications of homosexuality for the future of the German people and nation, they agreed that hormonal discoveries were the key to solving intractable medical mysteries and social problems. Constitutionalists argued that the endocrine model would inform research on topics such as the alleged periodic fluctuations of sexual virility, the effect of abstinence on productivity, the role of ovarian and placental injections in the ‘temporary sterilization’ of women and the relationship between different constitutional types and alcoholism, sexual exhibitionism, migraines, asthma, tuberculosis and same-sex desire, among others. These investigations hinged on assumptions made by glandular science, which described a self, as historian Sengoopta put it, ‘variable in nature and malleable in practice’. At the same time, interwar constitutionalism offered a way to categorize and demarcate boundaries in the plasticity of sexual and gendered identity. Sexual scientists believed they had uncovered criteria that identified a set of constitutions that stemmed from the balance of the internal secretions and a potential hereditary blueprint hidden deep in the so-called ‘germ-plasm’ of cells. If individuals were defined by a constitution or a fixed set of characteristics, however, and this constitution was shaped by the nature of the gonadal secretions, it seemed logical to practitioners that men could be reshaped given the right modification to the gonads. The testicles became a symbol of these possibilities and of a modern future in which medical technology could engineer the perfect man. Recent work on the chemical bases of gender and the ‘artificial masculinization, feminization and hermaphrodization’ of living creatures, Hirschfeld claimed in 1917, represented the advent of a reconceptualization of gender as subject to surgical modification.
There was no better advocate of endocrine experimentation and surgery than Steinach. From the early twentieth century, Hirschfeld and other German sexual scientists followed his research with great interest and maintained close professional ties with him. One of the most popular and controversial medical scientists of his time (he was nominated for the Nobel Prize six times between 1921 and 1938), Steinach pioneered endocrine research, rejuvenation by vasectomy and testicular surgery such as that performed on Leopold M. In the prewar era, Steinach built on nineteenth-century research by German physiologists Arnold Adolf von Berthold and Friedrich Goltz on the role of gonadal secretions in sex selection and characteristics. Steinach demonstrated (in coordination with colleagues Biedl and Julius Tandler in the so-called Vienna school of reproductive endocrinology) that although an organism’s genitals were determined by either genes or gametes (eggs and sperm), sex development was a more flexible process influenced by the chemical substances secreted by the gonads. Through animal experimentation in castration and gonadal transplantation, Steinach argued that the male sex hormones were produced by a certain type of testicular cell: the interstitial cells, first described by cellular anatomist Franz Leydig in 1850. Scientists subsequently hypothesized that these cells performed a function apart from the other two types in the testes (steroli and generative cells) that were directly implicated in sperm development. After 1914, the mysterious function of the interstitial cells became the basis for theories on the development of the gendered constitution. In successful grafts of testicular tissue (often in the form of bisected testicles, as with Leopold M. in 1915), Steinach reported that interstitial cells replaced dying generative cells and activated secondary sex characteristics associated with archetypical masculinity, including body size and fitness, aggression and dominance over females. He named the interstitial cells the ‘puberty gland’ because of their alleged ability to activate the somatic changes associated with normative ideals of masculinity.
Steinach’s research suggested that testicular grafts and surgical procedures meant to eliminate reproductive function promoted interstitial cell growth and resulted in vigour and masculinization. His ‘puberty-gland theory’ reconfigured nineteenth-century hormonal rejuvenation therapies as antidotes to the feminization of men, with secondary effects in revitalizing energy. Senility in old age was, for Steinach, the reflection of demasculinization and could be ‘influenced’ or ‘reversed’ by the stimulation of interstitial cells. In the 1920s, Steinach achieved world-wide fame for the procedure he marketed as reactivating the gonads. He argued that ‘a minor and absolutely harmless’ vasoligature operation (vasectomy) could ‘stimulate the patient’s gonads to a renewed vigorous endocrine activity’. Because of ‘the interrelationship of the endocrine glands’, Steinach claimed, ‘This reactivation is bound to mobilize the entire endocrine system, and thanks to its renewed cooperation, to produce reactivating effects throughout the whole organism’. In his early research, Steinach also had three individuals vasectomized (without their knowledge) during other procedures and reported that they demonstrated renewed youthful character and body. The operation, coined ‘the Steinach’, was first performed in 1918 and included an esteemed list of patients such as Sigmund Freud and Irish poet William Butler Yeats. It also made its originator, at the height of his international fame, a lightning rod for popular criticism of research termed quackery, unnatural and dangerous.
Sexual rejuvenation procedures were certainly not without critics within the medical community, who questioned the accuracy of results and raised ethical concerns regarding the ‘reversal of sex character’. German proponents framed experimental testicular surgeries as the restoration of a normal masculine constitution to an individual who suffered from endocrine dysfunction and, less commonly in German work (in contrast to American sources, for example), cessation of hormonal function in old age. The Steinach epitomized what historian Sengoopta has called sexual scientists’ ‘utopian project’ of national regeneration: the ‘remasculinizing’ not only of Germany’s elderly population, but also returning veterans and men considered unnaturally womanly, the effeminate homosexual chief among them. Medical experts deployed Steinach’s research in testicular modification as evidence of the congenital and endocrine basis of gendered subjectivity and theorized treatments aimed at eliminating the feminine in intersexed and homosexual men.
German sex researchers reported on Steinach’s work in a public relations campaign aimed at popularizing endocrine constitutionalism and the potential benefits of testicular modification. Steinach’s work became the subject of two films commissioned by the German Medical Film Archive under the direction of several departments in the War Office in the early Weimar Republic. The second of the films, Der Steinach–Film (The Steinach film), was released in popular theatres for a general audience in 1923 and highlighted the ‘inner secretions’ and ‘sex change and hermaphroditism’, among other topics, and footage of testicular transplantations. Der Steinach–Film joined the ranks of other ‘enlightenment films’ during the interwar era, such as the 1919 Anders als die Andern (Different from the others), which featured information on congenital homosexuality and a cameo appearance by Hirschfeld. These films were designed to educate and, as some scholars argue, titillate the general public with sexually explicit material under the guise of social and sexual hygiene. A colleague of Hirschfeld’s, Berlin gynaecologist Ludwig Levy-Lenz, who himself had the Steinach operation, wrote in 1933 that ‘the number of Steinach-jokes, operettas, comedies and novels is legion’.
In the early 1920s, sex researchers such as Hirschfeld, Kronfeld and Leipzig physician Hermann Rohleder promoted testicular grafting as a therapeutic means to ‘remasculinize’ homosexuals and other intermediates. In 1918, Steinach and Lichtenstern published ‘Umstimmung der Homosexualität durch Austausch der Pubertätsdrüsen’ (The conversion of homosexuality through exchange of puberty glands), which detailed the practical application of surgical measures for the ostensible curing of intermediate and homosexual constitutions. In a 1917 article in the Jahrbuch für sexuelle Zwischenstufen (Yearbook for sexual intermediates), ‘Operative Behandlung der Homosexualität’ (The operational treatment of homosexuality), they reported success in a testicular operation on another soldier and ‘psychic hermaphrodite’ with homosexual desire, passive and feminine character and the intersexual body type (in ‘form, hair, breasts’). They wrote that only six months after the operation the patient married a woman and reported perfect health. In addition to his newly acquired opposite-gender oriented sexual desire and other physiological changes, Steinach and Lichtenstein argued that ‘his entire demeanour makes a distinctly masculine impression’. Lichtenstern produced an alleged excerpt from the patient denouncing his earlier behaviours: ‘My health is very good and my wife is very satisfied with me … and today I am so far from the time, which I am disgusted to think on, that I had this other passion’. The popularization of what Munich surgeon Benno Romeis described as the ‘swapping of genders’ extended well beyond Lichtenstein and Hirschfeld. Rohleder similarly recommended the surgery for homosexuals, effeminate men and individuals with lowered potency. Other physicians such as surgeons Richard Mühsam and Heinrich Stabel also reported success in operations on homosexual men referred from the clinical practice at the Institute for Sexual Science.
Practitioners had various motives for advocating testicular transplant surgery, from eliminating the ‘danger’ of homosexuality and normalizing men to providing requested gender reassignment for those with so-called intermediate constitutions. In their 1918 discussion of surgical masculinization, Steinach and Lichtenstern claimed that the ‘operative curability of homosexuality’, a condition they depicted as an unfortunate abnormality, had important benefits for humanity. It ‘appears to indicate a way’, they wrote, ‘for afflicted individuals as well as for human society, to recover from the embarrassing and dangerous condition, and it is therefore not only of practical-medical, but also of forensic and sociological significance’. In almost all cases, surgeons targeted the blurring of gender in the constitution as the cause of abnormal behaviours and desires. For many scientists, the new man created by modern scientific manipulation for ‘a new world’, as historian Heiko Stoff put it, ‘was definitely not effeminate or homosexual’.
Hirschfeld, by contrast, folded testicular operations and endocrine modification into his advocacy for homosexual rights and emancipation in the 1920s. He claimed that Steinach’s research had a ‘three-fold’ importance to sexual intermediates. It was valuable for its scientific contribution to understandings of sexual phenomena and its support of congenital theories of sexual subjectivity, which Hirschfeld used to buttress legal petitions to overturn Paragraph 175, the legal code that criminalized male-male sexual behaviours in Germany. Most important, however, for Hirschfeld and his colleagues was the prospect of ‘the influence and treatment’ of individuals for whom sexual object choice was considered psychologically or ‘socially’ damaging. Testicular therapy was touted for its ability to reactivate the normative masculine constitution and was also used less publicly by some surgeons to explore gender reassignment procedures for transsexuals. Sex researchers noted that new opportunities for cosmetic, endocrine and testicular modification could replace previous methods of therapy, including self-castration, injections of impure gonadal preparations and ‘breast enlarging apparatuses’. Surgeons at the Institute for Sexual Science, in fact, reportedly used hormonal injections, surgical castration and genital grafting to complete requested gender changes after 1920, although records are incomplete. While the specific emphasis on testicular modification waned by the 1930s, the underlying assumptions of endocrine constitutionalism continued to shape studies of hormones and theories of homosexuality for decades to come.
Conclusion
Sexual scientists such as Hirschfeld praised testicular modification for its assumed capacity to transform men. In a 1918 article in the Zeitschrift für Sexualwissenschaft (Journal for sexual science), even sceptic Ernst Ulitzsch argued that although success seemed likely only in children, Steinach’s method offered practitioners the incredible ability ‘to indiscriminately interchange the genders of people’. For more enthusiastic colleagues, such as Berlin physician Iwan Bloch and Hirschfeld, endocrine research had finally reached its therapeutic culmination: homosexuals could be cured or at least further ‘masculinized’ through testicular grafting and hormonal treatments. Bloch advertised such methods as curing the pathology of effeminate homosexuality and revitalizing German manhood. In the 1920s, in fact, Steinach and Hirschfeld both declared that they had pinpointed the source of male homosexuality in a specific type of cell, what they termed ‘F cells’, in the testicles. Although other scientists were unable to find the ‘homosexual cell’ in subsequent work, it seemed at the time that the possibilities of endocrine constitutionalism were boundless. In the exploration of hormones, many sexual scientists celebrated a vision of engineering German men to restore the so-called pillars of social stability and male hegemony.
While some practitioners claimed that endocrine modification would become the corrective to Germany’s failures on the battlefield and broader ‘social problems’, others feared the consequences of an invasive and indiscriminate altering of men. In 1926, Hirschfeld reflected on the supposed capacity of scientists to exchange masculine, feminine and intermediate ‘constitutional variations’. He expressed misgivings that the power afforded by these procedures would lead to a flattening of nature’s variability and an abuse of medical authority. Although Hirschfeld conceded that in this science lay ‘great possibilities for the future’, he was also quick to warn that medical experts still needed to determine ‘whether and to what extent we are justified in changing what we can change in the constitution’. Hirschfeld went on to question whether procedures on homosexuals were an ethical means of dividing genders.
Emerging during the First World War, endocrine constitutionalism provided a flexible language through which sexual scientists theorized the origin of what they perceived to be male dysfunction and sexual deviancies. Although the ‘hormonal solution’ faded from scientific publications, replaced with greater discussion of hereditary pathology and racial science, and few people sought vasectomies for increased masculinization in Nazi Germany, the assumptions of the constitutional model shaped modern paradigms of sexual identity as well as sexual-scientific research. In homosexual-rights campaigns, for example, activists drew upon arguments that linked object-oriented sexual desires with a biological intermediacy of gender, and hormones continued to frame explanations of male virility and selfhood in the decades to come. This article demonstrates how scientific models of the effeminate male homosexual, in particular, emerged out of sex researchers’ interventions in war pathology, constitutional medicine and projects aimed at reforming men during the First World War and the early interwar period. Beginning at least with Leopold M. sexual scientists placed new faith in the testicles and their power to remake alleged deviants into ‘masculine’ men.