Clinical forms of homosexuality. How to recognize a gay? External and psychological characteristics of people with non-traditional orientation

How hard is it to spot a gay person in a crowd? Perhaps someone will think that this is very simple: you just need to look at his appearance and behavior. This is partly true, but what if he hides his orientation? How to recognize a gay then?

After all, if you think about it, then, in addition to an unconventional view of things, they have the same features as ordinary guys. And some can even pass for ardent homophobes. Are there other signs that can reveal the truth?

Why such an interest?

For some, such thoughts are just a waste of time. But everything can change dramatically if it suddenly turns out that a loved one is gay. Think about it, because no one is immune from this, and God bless him if it's just your friend. The situation is much worse in those cases when such truth emerges within the family.

Then everyone starts to wonder: how did I not notice this before? Therefore, do not ignore the information that can explain how to recognize a gay. After all, she obviously cannot harm, but to open her eyes to the truth is quite possible.

How do gay people recognize each other?

You should start with how exactly representatives of non-traditional orientation find each other. And to be honest, the expression “a fisherman sees a fisherman from afar” would be appropriate here. And it's not even about intuition, but about some "tricks" that are common among gays.

First of all, this is a special greeting, which may vary slightly in different regions, but always subtly hints at what the true nature is. this person. They are also able to notice notes of hidden flirting in speech, gestures, facial expressions, and so on. The problem is that if you are not a member of their club, then most likely it will not work to identify a gay person by these signs.

Gays who embraced their hidden desires

In general, all people with non-traditional orientation can be divided into two large groups: who accepted their nature and hidden (latent) gays. That's just the first category is much easier to reveal than the second, because they practically do not hide their "I" under the shell of falsehood. Therefore, their appearance can openly hint at who they are.

However, if we talk about how to recognize a gay, then one more important point should not be overlooked. There is such a category of people as metrosexuals. That is, those who are in love with their appearance. They also devote a lot of time to themselves and their own wardrobe and always dress like a needle. However, this does not speak of their non-traditional orientation, but only emphasizes their love for themselves.

How to recognize the "wrong" guy?

How to recognize a gay if he has already accepted his true nature? Here are a few signs that your friend is not who he claims to be.

First of all, you should pay attention to appearance. Almost all gays take care of themselves: the perfect hairstyle, fresh outfit, well-groomed nails, and so on.
They are always in trend. Such people follow fashion and try to buy only stylish things. In addition, quite often they independently complement their image with various accessories and trinkets.
A special way of speaking. If a gay does not hide his nature, then he can openly flirt with men. You can also keep track of what topics a person likes to talk about. For example, if he talks for a long time about how he chose a perfume for himself or what discounts are in a shopping center, then you should think about who he really is.
You should also look closely at those men who live for a long time without relationships with girls. Naturally, the reason for this may be personal motives, but the chance that he is gay is also very high.

How to recognize a latent gay?

Much worse is the case with those who hide their nature not only from others, but also from themselves. After all, not every person is able to admit that he likes representatives of the same sex. However, disturbing notes can be traced even here, so let's figure out how to recognize a closeted gay.

The first thing that should arouse suspicion is too violent aggression towards gays. This is due to the fact that they want to avert suspicion with all their might. And the best idea for this would be to position yourself as an open homophobe.

Another juicy detail may open your eyes to the truth - all closeted gays are somehow drawn to male attention. For example, they love hugging guys a lot, always try to sit as close as possible and hold their hand for too long when greeting. Also, many gay guys sign up for gyms and wrestling sections, as there is an opportunity to have close contact with the objects of their desire.

Even such individuals quite often criticize girls, because they see them as competitors. This is especially true for those people who meet with guys from the closet gay environment. Therefore, one should be especially careful with those who show too open aggression towards the female.

Is my boyfriend gay?

It also happens that gay people want to hide their addictions so much that they start normal relationships. In this regard, it would be very reasonable to talk about how to recognize if your boyfriend is gay.

Rule one: trust your intuition. Quite often, our sixth sense whispers the correct answer to us, but people do not always listen to it. But in vain! After all, our subconscious notices the danger much earlier than we can imagine it.

Rule two: watch his behavior in bed. It's not that gays are disgusted with sex with a girl, rather, they cannot get full pleasure from it. Therefore, if a guy is acting too stiff and insensitive in bed, then perhaps you should start to panic.

Rule three: his bathroom shelf is much larger than yours. Again, simple skincare and good quality shaving cream is the norm, but if he has a whole range of beauty products, then there is a possibility that he is gay.

However, the most the right way dispel your suspicions - talk to him directly. The paradox is that such people get so tired of pretending that they sometimes give up at the first question.

It is worth mentioning right away that it is possible to identify homosexuals by appearance only in rare cases. Some men who dress blatantly provocatively often really just want to attract the attention of others or copy the style of pop stars, but they are not gay.

You should not pay special attention to the wedding ring on a man's finger - often it is not at all a true indicator of sexual orientation. But the ring on the little finger is one of the characteristic signs used by gays.
Gays often strive to look as normal as possible and even flaunt their conformity by wearing typically masculine and even rugged clothing such as leather jackets with metallic decorations and faux-washed trousers. At the same time, they often look after themselves very carefully: they prefer a model haircut, even if it is short, they wear stylish things, they choose outfits and combinations of wardrobe items with taste, they try to make their body more attractive with the help of physical exercises and special skin care cosmetics. Often men with non-traditional sexual orientation prefer good things from famous brands. They can look rough and even brutally masculine, but at the same time stylish and elegant.

Features of gay behavior with other men

Homosexuals often shake hands a little longer than heterosexuals, and at the same time make eye contact with interest. A menacing look and an overly strong handshake is not their method. In addition, gays usually come close enough to greet rather than extend their hand. However, polite men act in a similar way, who do not want to show their interlocutor that they are trying to distance themselves from him.
If during a handshake a man lowers his eyes or looks away in embarrassment, this can also become one of the signs of non-traditional orientation. However, embarrassment in such cases should not be confused with ostentatious indifference.
One of characteristic features gays - the habit of staring at other men. Of course, this is not flaunted, but if you watch a homosexual, you will notice that he is evaluating the guys. He can pay attention to clothes, figure, hairstyle. In addition, gay men occasionally mention in conversation that they would like to wear the same jeans as the man standing nearby, or that they were delighted with their colleague's new haircut. Most often, they pay attention to guys in places where there are a lot of attractive people - for example, in the gym or in fashionable men's boutiques. However, you can look at others appraisingly both in the subway and on a walk.

Gay men can use the classic female "shooting eyes" and special smiles designed to attract men. It's also easy to spot, especially if the homosexual is talking to a guy he really likes.

How to recognize gay people by intonation and gestures

It is not uncommon for homosexuals to speak with those characteristic notes that are regularly parodied in films and shows. It can be emphasized smooth speech, prolonged “a”, “iridescent”, soft vowels. Of course, in ordinary conversation this is far from being as noticeable as in parodies, but you can still catch special notes in the voice of a gay if you take the trouble to listen to his speech.

A characteristic feature of passive gays can be excessive mannerisms. This is noticeable in their intense, smooth gestures, habit of ostentatious, flamboyant and even theatrical gestures. Some gay men often watch their movements even while smoking or holding a drink. They can fold their fingers in a special way, make unambiguous gestures, reinforcing them with facial expressions and throwing special looks. By observing the behavior of a person in ordinary life, this can be easily noticed.

Homosexuals and women

As mentioned above, outwardly gay people often want to look very similar to heterosexuals, so it can be difficult to recognize them without paying attention to details. This is also expressed in their conversations: often they themselves raise the topic “about women” in a male company, trying to emphasize their masculinity.

At the same time, they can let go of obscene jokes, talk about women in an emphatically rude way, talk about their exploits on love front, list the names of numerous girls they dated. However, this behavior is also characteristic of young people who are not popular with ladies at all and seek to increase their self-esteem and belittle those around them with such conversations.

Also, some gays are characterized by banal comments about women and relationships with them. Such words are clearly overheard, and are repeated in many films and conversations on forums. In addition, homosexuals may talk about relationships with women as if it were something abstract, existing only in theory, but unrealizable in practice.

Clinical forms of homosexuality

Since the end of the 19th century, it has been customary to distinguish between active and passive forms of male homosexuality on the basis that one of the homosexuals during sexual relations plays a male (active) second - a female (passive) role. This division of roles comes out clearly in cases of pederasty.

With mutual masturbation, oral-genital contact, and intercourse between the thighs, it was difficult to establish whether a given homosexual was playing a male or female role. In addition, wanting to please each other, partners sometimes could change roles.

There was no distinction at all between the forms of female homosexuality, since it was apparently assumed that, unlike men, both women play the same role in the homosexual act.

The author, together with his colleague E. M. Derevinsky, examined 96 homosexual women. Most of them were serving sentences for a criminal offense. Of those examined, 9 were younger than 30 years old, 70 were from 30 to 40 years old, and 17 were over 40 years old. The observations made showed that, by analogy with male homosexuality, two forms of female homosexuality can be distinguished - active and passive. As a criterion for the distinction, one should take the sexual self-identification of a homosexual - the presence or absence of sexual disorders, the feeling of belonging to one or another gender - a subjective gender. At the same time, homosexuals who feel like a man should be attributed to the active form, and to the passive form - those who feel their belonging to female gender. The active form of homosexuality was noted in 57, the passive form - in 39 examined.

An active form of female homosexuality. Active homosexual women are characterized by the fact that both in sexual and non-sexual relationships they tend to imitate the behavior of a man, sometimes in an exaggerated form. They note that they feel like men, that they are, as it were, born men and experience sexual attraction only to women. Men do not cause them sexual arousal and are perceived only as comrades. Even the very thought of a man's caresses, not to mention sexual intimacy, is unpleasant for them.

In the external appearance of 60% of active homosexuals, certain masculine features appeared - highly developed muscles, a narrow pelvis, coarse facial features, broad shoulders, a man's gait, angular movements, a low rough voice, vegetation on the pubic male type. At the same time, their mammary glands were normally developed. The majority of active homosexual women from adolescence wore a man's hairstyle - short hair. Almost half were transvestites, that is, they wore men's clothes. Many active homosexual women had a negative attitude towards women's jewelry - rings, earrings, bracelets, brooches. Only one wore a medallion with a portrait of her partner on her chest. About 40% of active homosexual women in their physique and appearance did not differ in any way from heterosexual women.

Masculine features stand out distinctly in the photo of an active homosexual taken by the author (Fig. 2). It must be said that masculine somatic and mental traits are sometimes observed in healthy heterosexual women, so that in themselves they cannot serve as a basis for diagnosing homosexuality, although they are more common in active homosexual women than in heterosexual women.

Rice. 2

The majority of active homosexual women (35 out of 57) noted that already from childhood they discovered the interests inherent in boys - they climbed trees, shot from a slingshot, threw stones, played football, hockey, Cossack robbers, war, knew how to fight, at that At the same time, they never liked to play with dolls, wear pigtails, bows. Showed interest in menswear. In 2/3 of active homosexual women, sexual feeling manifested itself early - before the onset of puberty. It was found in the form of falling in love with a girl or woman. There was a vague attraction to intimacy with her, a desire to hug and kiss her. They declared their love, wrote letters. Childhood or youthful love for boys was extremely rare.

Menstruation began at the age of 12-15 years in 41%, at 16 years old - in 12%, at 17 years old and later - in 47% of the active homosexuals examined by us. Thus, in more than half of them, the time of the appearance of menstruation was normal. Most of them arrived late. In almost half of the surveyed, they were relatively poor. Many of the active homosexual women noted that menstruation was perceived by them as something alien, noted that they were embarrassed by the development of their mammary glands.

More than half of active homosexual women masturbated at puberty or during puberty. Some of them slept in bed with older girls who taught them how to masturbate to each other. Homosexual activity began in most cases after prolonged masturbation or after the girls learned about the intimate side of sexual life. They directed their sexual activity more often to younger girls or women, less often to women of their own age. At the same time, sexual interest was initially hidden. They behaved like devoted, attentive friends: they tried to help in everything, often made gifts. Gradually, having won trust and sympathy, they began to show more and more tenderness. They sought permission to caress, kiss, after which they proceeded to sexual activities. Only a few of them began to show homosexual activity without much preparation. They sought at any cost to cause the experience of orgasm in their partner, while at the same time they showed considerable skill. Many of them first sought to evoke a psychoerotic mood in their partner, then moved on to general caresses of the body, trying to identify erogenous zones. In the future, depending on the peculiarity of the location of these zones, in relation to some women, stimulation of the clitoris by hand or mouth was used, in relation to others, manual stimulation of the vagina. The latter was generally used relatively rarely. Sexual intercourse with a partner often dragged on for up to 20-30 minutes or longer and, depending on her temperament, was repeated many times, until the partner experienced a state of prostration. Simultaneously with irritation of the sexual organs, the partner made frictions of their genitals on her thighs and thus simultaneously reached orgasm with her. Less often, they allowed their partner to cause an orgasm in themselves by manipulating the genitals. The majority of active homosexual women had a single peaked orgasm 1-3 times during the night.

Active homosexuals often showed sadistic inclinations to one degree or another. In general, sexual relations with a partner were characterized by their unevenness. In non-sexual relations with partners, during the formation of a homosexual "family", the majority of active homosexual women also sought to imitate the behavior of the male head of the family. They demanded obedience to their will, disposed of money. The work that is considered traditionally female (cooking, washing, sewing) was not performed, laying it entirely on their "wives". Traditionally, men's work was done with pleasure, sometimes they found high skill in it. Almost all active homosexuals liked it when their partners wore jewelry, wore low-cut dresses, and looked feminine. Many of them were very jealous, and they were jealous of their partner for both women and men.

In addition to the influence of upbringing, innate codes and programs matter for sexual behavior. One of them is the desire for rapprochement, for mastering the opposite sex, the instinct of sexual aggression. This instinct is leading in the formation of sexual behavior in animals, but it can also play a role in the emergence of drives in humans. Unlike heterosexual women, active homosexuals are characterized by high sexual aggressiveness. With great perseverance and perseverance, they pursue the woman they like, sometimes not stopping even before threats and direct aggression.

So, G., 34 years old, a former police lieutenant, fell in love in a therapeutic hospital with her attending physician S. - a woman of 26 years old who had a husband and two children. After her discharge from the hospital, she began to stalk her, waited outside her house every day despite her protests, escorted her to work, sent her flowers and perfume, threatened to commit suicide or stab her husband if she did not agree to “meet” her. Having received a categorical refusal, she came to her house. The husband (a healthy man, 1 m 85 cm tall) refused to call his wife, G., pushing him away, burst into the room and began to insist on a “talk”, begged S. to be with her, threatened her and her husband. It took the intervention of the authorities to protect the family from persecution.

Another homosexual, having entered into the confidence of a girl she liked and stayed with her to spend the night, overcame her resistance and manually deprived her of her virginity; the third achieved sexual rapprochement under the threat of a knife.

However, in most cases, active homosexual women found partners without resorting to violence.

By nature, 60% of the homosexuals we examined were sthenic, resolute, persistent, enterprising, 40% were at the same time fearless, 14% were deceitful, selfish, 20% were kind, sociable.

Although all active homosexual women reported that they had never had a sexual attraction to men, most of them had ever sexual intercourse with a man. At the same time, 3/4 of the respondents noted that in their heterosexual life they did not experience sexual satisfaction and sexual intercourse was unpleasant. None of them started sexual life as a result of rape. We present a typical observation.

Patient V., 47 years old. The father suffered from chronic alcoholism, the mother is a quiet, modest woman. My paternal aunt was masculine, often wore men's clothes, and was not married.

She grew up as a healthy girl. She graduated from the 4th grade, she did not want to study further. She worked as a shoemaker. Served a sentence for theft. As a child, she loved to play only with boys in their games, she knew how to fight well, throw stones; climb trees. At the age of 13, she got herself men's clothes and from that time on she stopped wearing women's dresses, she felt like a man. Menstruation from the age of 14, moderate, painless, for 3-4 days. I learned about sex life from my friends early. She notes that she has never experienced the slightest attraction to male gender, and attracted her only to women. At the age of 14–15, she fell in love with her friends, with one of them mutual manual stimulation was allowed. At the age of 19, she had an accidental sexual relationship with a man, but apart from unpleasant sensations, she experienced nothing.

From the age of 20 homosexual relations with women. Duration of relationship with one partner is up to 4 years. One girl violated her virginity with her hand. Claims that the thought of sexual intimacy with a man is disgusting. She is rude and demanding with her partners. He does not do homework, leaving it entirely to his “wife”. Once she beat her partner for disobedience. By nature, bold, quick-tempered, explosive, vindictive, decisive. Efficiency is high.

The physique is masculine. The posture and gait are male, the movements are angular. The mammary glands, external and internal genital organs are developed normally, from the side of neurology - without features. He refuses to be treated for homosexuality, as he considers his condition natural.

In the above case, manifestations of homosexuality developed in psychopathic personality from the excitable group. In the family, apparently, there was a hereditary burden of homosexuality on the father's side. Attention is drawn to the presence from childhood of some characterological features characteristic of boys, as well as masculine physique and motor skills. The orientation of sexual attraction to persons of the same sex began to manifest itself in early adolescence. Casual sexual intercourse with a man was not accompanied by sexual satisfaction and did not lead to a weakening of the homosexual orientation of sexual desire, but rather contributed to its consolidation. A sectarian attitude towards society and its moral requirements gradually developed. In the genesis of the emergence of an active form of female homosexuality and transvestism in this case, the main role was apparently played by a congenital anomaly in the direction of sexual desire, while situational factors were only of secondary importance, although they contributed to fixing the inversion.

Fig 3. Active homosexual transvestist. The passport is listed as a man. There is a mark of a registered marriage with a woman.

The phenomena of homosexuality can also occur in women who do not detect psychopathic traits character. Thus, a female doctor, active, energetic, kind, balanced by nature, maintained homosexual relations with her partner for two decades. She did not like to use cosmetics, did not wear women's jewelry, but she did not find masculine features in appearance and manners.

Sometimes active homosexual transvestists try to hide their female gender and impersonate a man.

Patient A., aged 35, was referred to a psychiatric clinic of a medical institute for a consultation on mild irritability, excitability, fatigue, and insomnia. Upon admission, she pretended to be a man, demanded that she be placed in the men's department. Dressed in a men's suit (Fig. 3).

She lost her father early. He notes that he was angry, rude, suffered from chronic alcoholism. Mother is a kind, sociable woman. The patient grew and developed normally. I went to school for 8 years, graduated from the 4th grade. During her school years, she loved to play only with boys, fought, and always defended girls. She loved only men's work, she was a loader, and recently she has been working as a security guard.

She has been smoking since the age of 17, and has been abusing alcohol for the last 5 years. By nature, fearless, proactive, decisive.

She claims that she never wore women's dresses, “as a child, she only went in panties, panties, then she began to walk in trousers.” Menstruation from the age of 16, moderate, painless, for 3-4 days, during menstruation the mood is lowered ("I despised myself").

There was an accidental sexual relationship with a man, he is reluctant to talk about it. She never felt attracted to people of the opposite sex, did not experience pleasure from intimacy with a man. In relation to women, she felt like a man, pretended to be a man and illegally received a passport in a man's name. Registered a marriage with a woman. In sexual relations, he plays a male role.

In non-sexual life, he does not perform women's work, he is engaged only in male labor (chopping wood, repairing shoes, performing joinery and carpentry work). Demands attention, but with the "wife" is affectionate, gentle, pitying her. He often gives her gifts. The children of the “wife” from the first marriage are warmly, condescendingly, they call her “dad”, they consider her a man.

At one time she was in love with another woman, began to look after her, and stayed overnight with her. The first "wife" was jealous of her. Both "wives" fought because of her. She stayed with the second "wife" for several months, after which she returned to the first.

In the department, she is calm, sociable, embarrassed to undress in the presence of other patients. Looks at young women, compliments them. Claims that she is now unable to fall in love with others, as she is insanely attached to her "wife". Keeps at ease, in behavior there is a lot of deliberateness, prone to panache.

The patient is of average height, athletic build. Adipose tissue and mammary glands are well developed. On the part of the internal organs without features. From the side of neurology, no symptoms of focal brain damage are detected. Intelligence corresponds to the received education.

Due to the resistance of the patient, a gynecological examination was performed under amytal-sodium anesthesia. According to the conclusion of the gynecologist, the labia minora and labia majora are underdeveloped. The entrance to the vagina is free, the mucous membrane is moistened with whites in a moderate amount. The cervix is formed, cylindrical in shape, the pharynx is punctate, closed. The uterus is small, mobile, with a smooth surface, the appendages are not defined.

Soon her “wife” came to the clinic to see the patient. She refused to give any information. The patient with the "wife" was very tender, hugged, kissed her. She categorically refused treatment for homosexuality. Discharged home.

In this case, A., being a woman, always felt like a man, for many years she was in a registered marriage with a woman, that is, a homosexual family was formed. Both in sexual behavior and in family life, A. played the role of a husband. Men considered her (both colleagues and others) a man. She herself, in her appearance, clothing, a number of characterological features, professional activity(loader, security guard) looked like a man. In contrast to this, her partner (“wife”) in her appearance, manner of dressing, and behavior did not differ from ordinary women; active homosexuals often have separate character traits that are more characteristic of passive ones.

“I read your book “Female Sexopathology” (1st ed. - A.S.), writes M., 26 years old, and classified myself as an active form, although not everything is so straightforward. As a child, I loved boyish games: hockey, football , war, but for some reason I began to play with dolls in the first grade. I think that the concept of male and female activities in our time is very conditional. If I had a same-sex "family", I would not care: wash the dishes or knock with a hammer "If only she liked it. My profession is mostly female, although I don't like it. I almost always use cosmetics, wear elongated hairstyles, wear women's clothes more often, I don't feel much love for trousers. I really like women's jewelry (especially Czech). As a child, she had dreams of clearly erotic content, where she acted as a man.

Menstruation from the age of 10, flow normally. Masturbation since the age of 13. There was no particular remorse in this regard. Somewhere at the age of 15, I began to meet with an interesting young man of 18 years old. Walks, movies, cafes. He spoke passionately to me about love, but I met him only because most of my peers were also friends with someone. Somewhere I even felt sorry for him and that's why I allowed him petting. I experienced an orgasm, but there was no question of delight, the merging of souls. It was like I was doing my duty. We broke up.

For as long as I can remember, I have always fallen in love with women and girls. I fell in love passionately, suffered, suffered. At school, she was always a leader, and she hid her homosexual orientation in every possible way. Once she fell in love with a new teacher, but, having learned that she loves her husband and he loves her, she hid her feelings.

During homosexual contacts, I often acted as a husband. Now about once a year I meet with one woman. She is bisexual and married. I really like her and I can talk to her all night without noticing how time flies. I don't even know how she treats me. It suits her that there is a husband and me. She leaves and again longing and loneliness. And I need to know that after work they are waiting for you at home, that you can take daily care of your loved one. I like to give women compliments, gifts, I appreciate femininity, defenselessness, subtlety of the soul. And if my girlfriend would play an active role, even if there would be something masculine in her, but under all this a sensitive female soul glimmered and there was a desire to create a same-sex “family”, I could well play a passive role. So where can you find it? After all, we do not have such clubs as in Sweden and Denmark, where people find a kindred spirit, and then a sexual partner. Maybe homosexuality is not natural, but since nature has played such bad joke- so be it! I don’t want to change my gender or get treated and I won’t.”

The inversion of sexual desire does not exclude the high development of intelligence, rich emotionality. Among homosexuals there were brilliant artists, musicians, outstanding writers and scientists.

Passive form of female homosexuality characterized by the fact that with her homosexuals, not only in sexual, but also in non-sexual relations, play a female role. They identify with the woman. In appearance, they are no different from the women of their circle. Facial features are soft, feminine. Secondary sexual characteristics are well developed. Many of them had long hair braided in braids, a fashionable hairstyle. All 39 passive homosexual women examined by us dressed only in women's clothes (there were no cases of transvestism) and, unlike the active ones, they liked to wear rings, earrings, bracelets, brooches, painted their lips, let eyebrows, etc. More than half were sociable, soft, calm, easily subject to someone else's influence, easily suggestible. In 8 out of 39, such features as theatricality and demonstrativeness were prominent. Almost all passive homosexuals had women's professions (seamstress, secretary-typist, nurse) or neutral ones.

Passive homosexuals developed as girls. They loved dolls, needlework, tried on dresses and outfits, played with girls, often experienced childhood or youthful love for boys. Their menstruation came on time (24 out of 39 - at the age of 12-15 years and only 5 - at 17 years and later, i.e., with a delay). Of the 39 homosexual women, 36 had ever had a heterosexual sex life in the past, and half of them were married, some had children, but none had a happy marriage. Most of them did not receive sexual satisfaction during their heterosexual life. Few have ever experienced pleasant sexual sensations. Only a few have ever masturbated (unlike active homosexuals).

They all began homosexual relationships at a time when they were not living a heterosexual sexual life, or when they were not satisfied with the existing family relationships. Many of them experienced a feeling of loneliness, a need for tenderness, affection and a close friend. Almost all of them initially saw in their future homosexual partner an attentive, affectionate, devoted and loving friend, sometimes a strong person who can be leaned on. Soon, however, erotic love became more and more prominent in the relationship, and the initial manifestations of tenderness and affection developed into homosexual acts. Most passive homosexual women experienced a strong orgasm for the first time in their life under the influence of homosexual influence, many - an orgasm, much stronger than before during sexual intercourse with men. They had a feeling of falling in love with their partner, which developed into sexual affection. A homosexual couple was formed, in which one of the partners played the role of the husband (leader), the second - the role of the wife. There were very rare cases when, during sexual intercourse, a periodically passive homosexual woman took on an active (“male”) role for some time, but the “leadership” in the family still remained with the active homosexual. Homosexual couples sometimes maintained their relationship over the years, masking it as a friendship. Breaking up with a partner was sometimes extremely painful.

Patient N., 28 years old, complained of a neurasthenic nature, “in addition, she noted a feeling of melancholy and loneliness. These phenomena came, as it turned out, shortly after a break with a close friend, with whom they had lived together for 3 years. No one in the family suffered from neuropsychiatric diseases. The mother is domineering, selfish. The father is sociable and kind. She grew and developed normally. As a child, she loved to play with dolls and other games for girls. She was interested in women's toilets, jewelry, was flirtatious. Fell in love with boys, went on dates. The character is soft, sociable, easily suggestible.

Menstruation from the age of 12, 3-4 days, a cycle of 28 days. Sexual life from the age of 18. Before marriage - three short-term sexual relations with young people. Married since 22, for love. During sexual life with men, she never experienced orgasm, although the sexual intercourse took place for quite a long time. There was only painful sexual arousal, gradually sexual intimacy became disgusting, tried to avoid it in every possible way. The husband turned out to be a rude, inattentive person, he often drank. Relations deteriorated. They separated after 4 years.

The patient switched to new job felt lonely. At this time, she met G., a leading engineer, 10 years older, an intelligent, energetic woman, who began to pay much attention to her, invited her to the cinema and theater. G. lived alone in an apartment and was unmarried. N. began to stay with her for a long time in the evenings, and soon stayed overnight. Under pressure, G. entered into sexual intercourse with her. For the first time in my life I experienced a strong orgasm. In fact, she moved to G. and began to live with her. G. had daily sexual intercourse with her, caused repeated, multiple orgasms, mainly by manual stimulation of the clitoris (intravaginal stimulation did not cause erotic arousal and was rejected). Gradually, a sexual attachment to G developed. Interest in men faded. At home, G. behaved like a man, she did not perform “women's” work, she was assigned to N. G. looked somewhat masculine, did not like women's toilets, jewelry. Recently, she has become rude, inattentive, picky. arose frequent quarrels. It turned out that G. had another partner. This was the reason for their breakup.

N. correct physique, feminine. Long hair is tied in a knot. Lips and eyebrows are tinted. Wears women's clothes, jewelry. During psychotherapy, the patient was pointed out to the peculiarities of her sexual constitution (clitoral type of excitability) and explained why she had not yet experienced sexual satisfaction with men. Instilled installation on heterosexual life. Six months later, she entered into a close relationship with a man who, by additional stimulation of the clitoris during intercourse, caused her an orgasm. A feeling of attachment arose to him, interest in G. disappeared.

Throughout her life, N. always felt like a woman.

In the case cited, the young woman in her childhood and adolescence developed normally sexually and showed a heterosexual orientation of a rather strong sexual desire. I have always felt like a woman. However, during sexual life with men before marriage and with her husband during marriage, she did not receive adequate sexual stimulation (there was a clitoral type of sexual excitability), she remained in a state of frustration, sexual dissatisfaction. As a result, there was a negative attitude towards sexual life. There was no attachment to her husband and as a friend due to his rudeness and drunkenness. The marriage ended in divorce. She experienced a feeling of loneliness. At this time, she became the object of claims from an active homosexual who showed warmth and attention to her. During sexual intimacy with her for the first time began to experience a strong orgasm. Gradually a sexual attraction developed. A homosexual couple was formed, in which N. played the role of a wife, that is, she revealed the phenomena of a passive form of homosexuality. The heterosexual orientation of sexual desire was replaced by a homosexual attitude. The break with the partner caused severe feelings, neurotic depression. Under the influence of psychotherapy and explaining the reasons for the failure of her sexual life with men, she managed to redirect her sexual desire into a heterosexual channel. Sexual life with a man who managed to satisfy her sexually led to the consolidation of this orientation. Thus, the passive form of homosexuality in this case was completely situationally determined and turned out to be reversible.

Sometimes, under the influence of the individual's active desire to overcome homosexuality, a transition to a normal heterosexual life is possible.

Patient V., 38 years old, with masculine somatic and mental features that were found since childhood, at the age of 18–23 years, maintained active homosexual relationships with three partners in turn. Then, under the influence of the conviction of relatives and psychotherapeutic influence, she began a heterosexual sexual life and got married. Sexual intimacy with her husband initially did not cause sexual satisfaction, despite his good sexual abilities. She became a leader in the family. In sexual relations, she seized the initiative, imagined that her husband was her partner, and began to experience an orgasm. Has a 6 year old son. Family relations are good. Within three weeks there was a recurrence of a homosexual relationship during the departure of her husband, after which a normal sexual life resumed.

The phenomena of an active (congenital) form of female homosexuality, which were found even in adolescence, may disappear under the influence of the beneficial effects of the external environment and the active orientation of the individual to overcome them. The following observation is typical.

Patient R., 16 years old, a student of the 9th grade of a boarding school, was admitted to a psychiatric clinic after a suicide attempt. Two months ago, I fell in love with a young teacher, began to write love letters to her, give her flowers, accompany her home, stand by her window for hours. Jealous of her other students. Soon the teacher began to avoid her, recently she allegedly began to treat her badly, forbade her to show any signs of attention. In a state of desperation, R. tried to poison herself with sulfur from match heads.

R. lost her father early and was brought up by her mother and stepfather. The latter treated her well and good, friendly relations developed between them. Mother by nature is a calm, sociable woman. The patient grew and developed normally. I went to school for 8 years, studied well. She lived in a village remote from the school, so from the age of 8 she began to study at a boarding school. Co-education with boys. She was a leader in the class, she had good relations with students.

R. is a beautiful blue-eyed brown-haired woman, of medium height, well built, athletic figure. Secondary sexual characteristics are expressed normally. Menses from the age of 15, regular, profuse, painless. She did not have a sexual life. The boys were successful. They repeatedly offered her friendship, but she reacted negatively to their proposals. The boys were never interested. At the age of 15 I fell in love with a friend. She hugged and passionately kissed her, often saw her in a dream. It was a dream that they were kissing, caressing each other, while sometimes an orgasm arose. I fell in love with the teacher soon after my friend left.

In the psychiatric clinic, at first I really missed the teacher, often saw her in a dream, and waited for her to come. Then she calmed down, began to show more and more interest in the attending physician M. (a young girl), began to show erotic attachment to her. Shortly after discharge, M. began to send love letters to M., and was worried when she did not receive a response.

2 months after discharge, she was again taken to a psychiatric clinic in connection with a suicide attempt (at a school evening she “got upset and drank mercury from two thermometers”). In the emergency room of the clinic, she was interested in the doctor M., who had previously treated her.

The doctor on duty, who knew about her special attitude towards M., consulted with senior comrades and placed her in the regional psychiatric hospital, where M. does not work. The patient asked to be left in the clinic or to call M.. During the conversation, she said that she loved M. and missed her, that she had not received letters from M. for 2 months and then decided to go to the clinic again at all costs to see her. To this end, she staged a suicide attempt.

At the hospital, she was handed over to a young male doctor. She did not pay attention to him, all her feelings switched to another doctor - a young woman.

Psychotherapeutic conversations were held with the patient, during which it was explained to her that falling in love with a friend, teacher, doctor is a natural reaction in adolescence. However, true happiness can only be achieved in a real family. It was suggested that when she gets older, she will be able to choose a worthy life partner, marry him, and experience the joys of love and motherhood.

A follow-up after 6 years showed that a successful marriage led to the normalization of the direction of sexual desire.

In this case, a girl during puberty showed a pronounced orientation of sexual desire to persons of the same sex. It arose without any external cause or adverse effects of the external environment. Instilling in the patient the ideals of family happiness based on heterosexual love and setting a normal sex life led to the suppression of homosexual tendencies and marriage.

Thus, we can conclude that the homosexual attitude of passive homosexual women is less stable than that of active ones. When they get into a favorable situation, they often experience a transition to a heterosexual life, especially if they have a preserved sense of motherhood. If the husband turns out to be able to give her sexual satisfaction (by stimulating the corresponding erogenous zones), then the transition to a normal sexual life may turn out to be stable. frigid natures do not show homosexual activity.Attempts of homosexual seduction are usually unsuccessful if from childhood or from adolescence a person has formed an attitude towards a heterosexual life and has ethical and moral ideas about the inadmissibility of sexual relations between persons of the same sex, and a feeling of motherhood is also expressed. .

R., aged 28, at the age of 18, in a state of alcoholic intoxication, was rudely deflowered by a young man who accompanied her from a party. She was having a hard time with this. Subsequently, there were two more short-term relationships with young people, in which she did not experience sexual satisfaction, remained in a state of frustration. Soon, sexual intercourse became generally unpleasant. I once slept in bed with a young woman whom I sympathized with. This woman at night, by caressing the genital area, caused her for the first time in her life a strong orgasm. Then she began to pursue, seeking intimacy with her. R. categorically rejected the rapprochement on moral grounds, but from that time on she began to masturbate occasionally. After 2 years I met a man whom I fell in love with. She married him. Has two children. She is very attached to her husband and considers her marriage a happy one.

R. is feminine, by nature soft, sociable, emotionally labile.

In the above case, homosexual attraction (passive form) did not arise, despite the fact that sexual life with a man began with a mental trauma and was not accompanied by sexual satisfaction. Orgasm was first caused by a woman, but the high ethical and moral ideas that existed prevented the establishment of homosexual relationships and all development went along the path of a normal sexual life.

In conclusion, it should be emphasized that the study of the etiology, pathogenesis, clinic and therapy of homosexuality in both women and men was previously usually carried out without taking into account clinical forms. For example, it was indicated that homosexual men had impotence, but it was not indicated whether it was characteristic of active or passive ones, although it is obvious that active homosexual pederasts could not perform their acts with a weak potency. When describing heredity, physique, and the development of secondary sexual characteristics, forms of male homosexuality were not taken into account.

When examining male homosexuals, we adopted sexual self-identification as a criterion for classifying them as active or passive. It turned out that active homosexuals do not differ in their physique, characterological features, interests and general behavior from healthy heterosexual men. Effeminate features in body structure and behavior, as well as the desire to wear clothes of the opposite sex, are characteristic only of passive homosexuals (Svyadoshch A.M., Antonov V.V., 1972).

All of the above indicates that the genesis of the active and passive forms of both female and male homosexuality is different. The basis of the active form of female and passive forms of male homosexuality in most cases is an innate inversion of the orientation of sexual desire. This is supported by the frequency of somatic and mental traits of the opposite sex, which are found in these groups of patients already from childhood. Such forms of inversion, in all likelihood, can be caused both genetically and exogenously caused by disturbances in the differentiation of the reproductive centers of the fetus in the critical period and the production of sex hormones in the mother or fetus, the administration of sex hormones to the mother during pregnancy, and also be the result of pathological secretion of gonadotropins. or sex hormones by the placenta, with hereditary or acquired reduced sensitivity of the fetal hypothalamus to hormonal influences (Dorner G., 1972). It is interesting to note that, according to A. A. Ehrhardt and J. Money (1968), in girls whose mothers received male sex hormones during pregnancy to preserve it, “boyish” behavior was surprisingly often observed, i.e., the above characterological features which we have seen in many active homosexual women. Very rare is an inversion acquired as a result of organic brain damage, endocrine and other disorders suffered in adulthood. Situational factors do not play a decisive role in the emergence of an active form of female and a passive form of male homosexuality.

In the genesis of the passive form of female homosexuality, on the contrary, congenital features of sexual desire, as well as cerebral or endocrine disorders, do not play a role. It is based on the formation of a strong conditioned reflex connection between the experience of orgasm and the woman who caused this experience. At the same time, the desire to overcome loneliness, to acquire a friend, etc. contributes to the establishment of regular homosexual relationships. healthy women the attraction to sexual intercourse with a man arises only after they begin to experience an orgasm. In this regard, a woman's sexual life with a man, not accompanied by sexual satisfaction, may favor the fixation of sexual desire on a woman who has managed to arouse her satisfaction. This can also be facilitated by an increased tendency to form very strong conditioned reflex connections.

Thus, we can say that active homosexuals are usually born (more precisely, they are born only with a penchant for an active form of homosexuality), and they become passive. An analogue of the passive form of female homosexuality is the active form of male homosexuality. However, the genesis of this form is more complex. And at its basis, just as at the basis of the passive form of female homosexuality, lies the fixation of the first strong sexual experiences on the person of the same sex that caused these experiences. Two more factors can contribute to this (Svyadoshch A. M., Antonov V. V., 1972).

1. The presence of many boys or youths from 7–8 to 15–16 years of a period of undifferentiated orientation of sexual desire (the period of youthful hypersexuality, according to A. Moll, 1908). At this time, sexual arousal often arises under the influence of a variety of influences, for example, during muscle tension while fighting with a friend, while riding in a car, train, when experiencing feelings of pain, fear, etc. Sexual games are also often observed at this age. both heterosexual and homosexual in nature, consisting in the palpation of other people's genitals, their mutual excitation, etc. Since at this age the orientation of sexual desire is not yet strictly heterosexual in nature, its homosexual orientation can easily arise and be fixed.

2. The absence of an innate response of sexual arousal, characteristic of men, upon contact with naked female genitalia. We have often observed these phenomena in male homosexuals, both active and passive.

So, the congenital form of homosexuality (active in women and passive in men) is characterized by the following triad of symptoms:

1. The feeling of belonging to the sex (violation of sexual self-identification of the gender role) and, in connection with this, the desire to figure as a person of the opposite sex and wear his clothes (transvestism).

2. The presence from childhood of certain somatic and characterological features of the opposite sex.

For a reactive (situationally) conditioned form of homosexuality (active in men and passive in women), the presence of only the third member of the triad without the first two is characteristic.

Transvestism (from the Greek vestis - clothes) - the desire to wear clothes and appear in the role of a person of the opposite sex. Transvestism has long been condemned by society. So, in the Jewish religion (5th book of Moses, 22.5) it was declared a sin for a man to wear a woman's dress and for a woman to wear a man's dress. Among other accusations of Joan of Arc was the accusation that she wore a man's suit.

At the heart of transvestism lies a violation of sexual self-identification - a sense of belonging to opposite sex. Hence - the desire to wear clothes and figure in the role of a person of the opposite sex. It is most often combined with an inversion of the direction of sexual desire and is then considered within the framework of homosexuality. Along with this, transvestism can also act on its own, being observed in persons who are not homosexuals and live a normal sexual life. However, even in these cases, one or another characterological features of the opposite sex are usually noted from childhood, which we cited when describing congenital forms of homosexuality.

Rice. 4 a, b. The man is a passive homosexual transvestist. Works as a cleaner. He calls himself Vasilisa Andreevna (according to his passport - Vasily Andreevich)

A 46-year-old patient was under our supervision. He was married for 24 years. Lived a normal sexual life, had two adult children. The physique featured effeminate features (wide hips), however, the male genital organs were well developed, without any signs of hermaphroditism (Fig. 4 a, b).

Since childhood, he loved women's activities. He liked to try on women's dresses, jewelry. I felt like I belonged to the female sex. In adolescence, this feeling intensified and more and more often there was a desire to wear women's clothes and impersonate a woman. I never experienced sexual attraction to men, but girls caused sexual attraction. Particularly exciting was the sight of a naked female body and touching it. Sexual life began at the age of 17 with a girl 3 years older. After graduation, he was drafted into the army. Successfully advanced in the service. At every opportunity, hiding it from others, he put on a woman's dress. After demobilization from the army, he wore it at home almost constantly. The son's wife began to protest against the fact that he walks in a woman's dress, embroiders, sweeps the floor, cooks dinner. Then he submitted an application to the police with a request to officially recognize him as a woman so that he could freely walk in women's clothes. signs mental illness did not discover.

We believe that such cases of transvestism are a congenital condition. In their basis, as well as in the basis of congenital forms of homosexuality, lie, in all likelihood, violations of the differentiation of the sexual centers in the diencephalic region. These violations may be less pronounced than in congenital forms of homosexuality, and therefore the orientation of sexual attraction to persons of the opposite sex remains.

In women, transvestism is less common than in men, and is usually combined with a homosexual orientation of sexual desire.

There was no distinction at all between the forms of female homosexuality, since it was apparently assumed that, unlike men, both women play the same role in the homosexual act.

The author, together with his colleague E. M. Derevinsky, examined 96 homosexual women. Most of them were serving sentences for a criminal offense. Of those examined, 9 were younger than 30 years old, 70 were from 30 to 40 years old, and 17 were over 40 years old. The observations made showed that, by analogy with male homosexuality, two forms of female homosexuality can be distinguished - active and passive. As a criterion for the distinction, one should take the sexual self-identification of a homosexual - the presence or absence of sexual disorders, the feeling of belonging to one or another gender - a subjective gender. At the same time, homosexuals who feel like a man should be referred to the active form, while those who feel that they belong to the female sex should be classified as passive. The active form of homosexuality was noted in 57, the passive form - in 39 examined.

An active form of female homosexuality. Active homosexual women are characterized by the fact that both in sexual and non-sexual relations they tend to imitate the behavior of a man, sometimes in an exaggerated form. They note that they feel like men, that they are, as it were, born men and experience sexual attraction only to women. Men do not cause them sexual arousal and are perceived only as comrades. Even the very thought of a man's caresses, not to mention sexual intimacy, is unpleasant for them.

Rice. 2. An active homosexual with masculine features. The names of the partners are tattooed on the arms.

newsmen, i.e. wore men's clothes. Many active homosexual women had a negative attitude towards women's jewelry - rings, earrings, bracelets, brooches. Only one wore a medallion with a portrait of her partner on her chest. About 40% of active homosexual women in their physique and appearance did not differ in any way from heterosexual women.

in homosexual women they are more common than in heterosexual women.

Most active homosexual women (35 out of 57) noted that already from childhood they discovered the interests inherent in boys - they climbed trees, shot from a slingshot, threw stones, played football, hockey, Cossack robbers, war, knew how to fight, while At the same time, they never liked to play with dolls, wear pigtails, bows. Showed interest in menswear. In 2/3 of active homosexual women, sexual feeling manifested itself early - before the onset of puberty. It was found in the form of falling in love with a girl or woman. There was a vague attraction to intimacy with her, a desire to hug and kiss her. They declared their love, wrote letters. Childhood or youthful love for boys was extremely rare.

generally used relatively rarely. Sexual intercourse with a partner often lasted up to 20-30 minutes or longer and, depending on her temperament, was repeated many times, until the partner experienced a state of prostration. Simultaneously with irritation of the sexual organs, the partner made frictions of their genitals on her thighs and thus simultaneously reached orgasm with her. Less often, they allowed their partner to cause an orgasm in themselves by manipulating the genitals. Most active homosexual women had a single peaked orgasm 1-3 times during the night.

However, in most cases, active homosexual women found partners without resorting to violence.

By nature, 60% of the homosexuals we examined were sthenic, resolute, persistent, enterprising, 40% were at the same time fearless, 14% were deceitful, selfish, 20% were kind, sociable.

Although all active homosexual women reported that they had never had a sexual attraction to men, most of them had ever had sexual intercourse with a man. At the same time, 3/4 of the respondents noted that in their heterosexual life they did not experience sexual satisfaction and sexual intercourse was unpleasant. None of them began sexual activity as a result of rape. We present a typical observation.

Patient V., 47 years old. The father suffered from chronic alcoholism, the mother is a quiet, modest woman. My paternal aunt was masculine, often wore men's clothes, and was not married.

She grew up as a healthy girl. She graduated from the 4th grade, she did not want to study further. She worked as a shoemaker. Served a sentence for theft. As a child, she loved to play only with boys in their games, she knew how to fight well, throw stones; climb trees. At the age of 13, she got herself men's clothes and from that time on she stopped wearing women's dresses, she felt like a man. Menstruation from the age of 14, moderate, painless, for 3-4 days. I learned about sex life from my friends early. She notes that she never experienced the slightest attraction to the male sex, but only attracted her to women. At the age of 14-15, she fell in love with her friends, with one of them mutual manual stimulation was allowed. At the age of 19, she had an accidental sexual relationship with a man, but apart from unpleasant sensations, she experienced nothing.

In the above case, manifestations of homosexuality developed in a psychopathic personality from the excitable group. In the family, apparently, there was a hereditary burden of homosexuality on the father's side. Attention is drawn to the presence from childhood of some

Fig 3. Active homosexual transvestist.

The passport is listed as a man. There is a mark

about a registered marriage with a woman. Character-

terological features characteristic of mal-

chicam, as well as masculine physique and

motility. The orientation of sexual desire

persons of the same sex began to appear in early

him adolescence. casual sex

with a man was not accompanied by sexual satisfaction

rhenium and did not lead to a weakening of homosexual

no direction of sexual desire, but rather

contributed to its consolidation. Gradually develop-

there was a sectarian attitude to society and its morals

military requirements. In the genesis of the emergence of active

form of female homosexuality and transvestism

tism in this case, the main role, apparently,

played a congenital anomaly of direction

sexual desire, situational factors had

only of secondary importance, although contributing

inversion fixation shafts.

The phenomena of homosexuality can also occur in women who do not show psychopathic character traits. Thus, a female doctor, active, energetic, kind, balanced by nature, maintained homosexual relations with her partner for two decades. She did not like to use cosmetics, did not wear women's jewelry, but she did not find masculine features in appearance and manners.

Sometimes active homosexual transvestists try to hide their female gender and impersonate a man.

play only with the boys, fought, always defended the girls. She loved only men's work, she was a loader, and recently she has been working as a security guard.

She has been smoking since the age of 17, and has been abusing alcohol for the last 5 years. By nature, fearless, proactive, decisive.

In this case, A., being a woman, always felt like a man, for many years she was in a registered marriage with a woman, i.e. a homosexual family was formed. Both in sexual behavior and in family life, A. played the role of a husband. Men considered her (both colleagues and others) a man. She herself, in her outward

to him in appearance, clothing, a number of characterological features, professional activities (loader, security guard) was similar to a man. In contrast to this, her partner (“wife”) in her appearance, manner of dressing, and behavior did not differ from ordinary women; active homosexuals often have separate character traits that are more characteristic of passive ones.

“I read your book “Female Sexopathology” (1st ed. - A.S.), writes M., 26 years old, and classified myself as an active form, although not everything is so straightforward. As a child, I loved boyish games: hockey, football , war, but for some reason I began to play with dolls in the first grade. I think that the concept of male and female activities in our time is very arbitrary. If I had a same-sex "family", I would not care: wash the dishes or knock with a hammer "If only she liked it. My profession is mostly female, although I don't like it. I almost always use cosmetics, wear elongated hairstyles, wear women's clothes more often, I don't feel much love for trousers. I really like women's jewelry (especially Czech). As a child, she had dreams of clearly erotic content, where she acted as a man.

During homosexual contacts, I often acted as a husband. Now about once a year I meet with one woman. She is bisexual and married. I really like her and I can talk to her all night without noticing how time flies. I don't even know how she treats me. It suits her that there is a husband and me. She leaves and again longing and loneliness. And I need to know that after work they are waiting for you at home, that you can take daily care of your loved one. I like to give women compliments, gifts, I appreciate femininity, defenselessness, subtlety of the soul. And if my girlfriend would play an active role, even if there would be something masculine in her, but under all this a sensitive female soul glimmered and there was a desire to create a same-sex "family", I could well play a passive role. So where can you find it? After all, we do not have such clubs as in Sweden and Denmark, where people find a kindred spirit, and then a sexual partner. Maybe homosexuality is not natural, but since nature has played such a cruel joke, then so be it! I don’t want to change my gender or get treated and I won’t.”

The inversion of sexual desire does not exclude the high development of intelligence, rich emotionality. Among homosexuals there were brilliant artists, musicians, outstanding writers and scientists.

Passive form of female homosexuality characterized by the fact that with her homosexuals, not only in sexual, but also in non-sexual relations, play a female role. They identify with the woman. In appearance, they are no different from the women of their circle. Facial features are soft, feminine. Secondary sexual characteristics are well developed. Many of them had long hair braided in braids, a fashionable hairstyle. All 39 passive homosexual women examined by us dressed only in women's clothes (there were no cases of transvestism) and, unlike the active ones, they liked to wear rings, earrings, bracelets, brooches, painted their lips, let eyebrows, etc. More than half were sociable, soft, calm, easily subject to other people's influence, easily suggestible. In 8 out of 39, such features as theatricality and demonstrativeness were prominent. Almost all passive homosexuals had women's professions (seamstress, secretary-typist, nurse) or neutral ones.

Passive homosexuals developed as girls. They loved dolls, needlework, tried on dresses and outfits, played with girls, often experienced childhood or youthful love for boys. Their menses came on time (24 out of 39 - at the age of 12-15 years and only 5 - at 17 years and later, i.e. with a delay). Of the 39 homosexual women, 36 had ever had a heterosexual sex life in the past, and half of them were married, some had children, but none had a happy marriage. Most of them did not receive sexual satisfaction during their heterosexual life. Few have ever experienced pleasant sexual sensations. Only a few have ever masturbated (unlike active homosexuals).

They all began homosexual relationships at a time when they were not living a heterosexual sexual life, or when they were not satisfied with the existing family relationships. Many of them experienced a feeling of loneliness, a need for tenderness, affection and a close friend. Almost all of them initially saw in their future homosexual partner an attentive, affectionate, devoted and loving friend, sometimes a strong person who can be leaned on. Soon, however, erotic love became more and more prominent in the relationship, and the initial manifestations of tenderness and affection developed into homosexual acts. Most passive homosexual women experienced a strong orgasm for the first time in their life under the influence of homosexual influence, many - an orgasm, much stronger than before during sexual intercourse with men. They had a feeling of falling in love with their partner, which developed into sexual affection. A homosexual couple was formed, in which one of the partners played the role of the husband (leader), the second - the role of the wife. Very rarely there were cases when, during sexual intercourse, periodically pass

the active homosexual took on an active (“male”) role for some time, but the “leadership” in the family still remained with the active homosexual. Homosexual couples sometimes maintained their relationship over the years, masking it as a friendship. Breaking up with a partner was sometimes extremely painful.

The patient moved to a new job, felt lonely. At this time, she met G., a leading engineer, 10 years older, an intelligent, energetic woman, who began to pay much attention to her, invited her to the cinema and theater. G. lived alone in an apartment and was unmarried. N. began to stay with her for a long time in the evenings, and soon stayed overnight. Under pressure, G. entered into sexual intercourse with her. For the first time in my life I experienced a strong orgasm. In fact, she moved to G. and began to live with her. G. had daily sexual intercourse with her, caused repeated, multiple orgasms, mainly by manual stimulation of the clitoris (intravaginal stimulation did not cause erotic arousal and was rejected). Gradually, a sexual attachment to G developed. Interest in men faded. At home, G. behaved like a man, she did not perform “women's” work, she was assigned to N. G. looked somewhat masculine, did not like women's toilets, jewelry. Recently, she has become rude, inattentive, picky. There were frequent quarrels. It turned out that G. had another partner. This was the reason for their breakup.

Throughout her life, N. always felt like a woman.

In the above case, a young woman in childhood and adolescence developed sexually normally, found a heterosexual

the direction of a fairly strong sexual desire. I have always felt like a woman. However, during sexual life with men before marriage and with her husband during marriage, she did not receive adequate sexual stimulation (there was a clitoral type of sexual excitability), she remained in a state of frustration, sexual dissatisfaction. As a result, there was a negative attitude towards sexual life. There was no attachment to her husband and as a friend due to his rudeness and drunkenness. The marriage ended in divorce. She experienced a feeling of loneliness. At this time, she became the object of claims from an active homosexual who showed warmth and attention to her. During sexual intimacy with her for the first time began to experience a strong orgasm. Gradually a sexual attraction developed. A homosexual couple was formed, in which N. played the role of a wife, i.e. discovered the phenomena of a passive form of homosexuality. The heterosexual orientation of sexual desire was replaced by a homosexual attitude. The break with the partner caused severe feelings, neurotic depression. Under the influence of psychotherapy and explaining the reasons for the failure of her sexual life with men, she managed to redirect her sexual desire into a heterosexual channel. Sexual life with a man who managed to satisfy her sexually led to the consolidation of this orientation. Thus, the passive form of homosexuality in this case was completely situationally determined and turned out to be reversible.

Sometimes, under the influence of the individual's active desire to overcome homosexuality, a transition to a normal heterosexual life is possible.

Patient V., 38 years old, with masculine somatic and psychic characteristics that were found since childhood, at the age of 18-23 years, maintained active homosexual relationships with three partners in turn. Then, under the influence of the conviction of relatives and psychotherapeutic influence, she began a heterosexual sexual life and got married. Sexual intimacy with her husband initially did not cause sexual satisfaction, despite his good sexual abilities. She became a leader in the family. In sexual relations, she seized the initiative, imagined that her husband was her partner, and began to experience an orgasm. Has a 6 year old son. Family relations are good. Within three weeks there was a recurrence of a homosexual relationship during the departure of her husband, after which a normal sexual life resumed.

Patient R., 16 years old, a student of the 9th grade of a boarding school, was admitted to a psychiatric clinic after a suicide attempt. Two months ago I fell in love with my

lazy teacher, began to write her love letters, give her flowers, see her home, stand by her window for hours. Jealous of her other students. Soon the teacher began to avoid her, recently she allegedly began to treat her badly, forbade her to show any signs of attention. In a state of desperation, R. tried to poison herself with sulfur from match heads.

At the hospital, she was handed over to a young male doctor. She did not pay attention to him, all her feelings switched to another doctor - a young woman.

A follow-up after 6 years showed that a successful marriage led to the normalization of the direction of sexual desire.

In this case, a girl during puberty showed a pronounced orientation of sexual desire to persons of the same name.

gender. It arose without any external cause or adverse effects of the external environment. Instilling in the patient the ideals of family happiness based on heterosexual love and setting a normal sex life led to the suppression of homosexual tendencies and marriage.

R. is feminine, by nature soft, sociable, emotionally labile.

it was pointed out that homosexual men had impotence, but it was not indicated whether it was characteristic of active or passive ones, although it is obvious that active homosexual pederasts could not perform their acts with a weak potency. When describing heredity, physique, and the development of secondary sexual characteristics, forms of male homosexuality were not taken into account.

When examining male homosexuals, we adopted sexual self-identification as a criterion for classifying them as active or passive. It turned out that active homosexuals do not differ in their physique, characterological features, interests and general behavior from healthy heterosexual men. Effeminate features in body structure and demeanor, as well as the desire to wear clothes of the opposite sex, are characteristic only of passive homosexuals (Svyadoshch A. M., Antonov V. V., 1972).

All of the above indicates that the genesis of the active and passive forms of both female and male homosexuality is different. The basis of the active form of female and passive forms of male homosexuality in most cases is an innate inversion of the orientation of sexual desire. This is supported by the frequency of somatic and mental traits of the opposite sex, which are found in these groups of patients already from childhood. Such forms of inversion, in all likelihood, can be caused both genetically and exogenously caused by disturbances in the differentiation of the reproductive centers of the fetus in the critical period and the production of sex hormones in the mother or fetus, the administration of sex hormones to the mother during pregnancy, and also be the result of pathological secretion of gonadotropins. or sex hormones by the placenta, with hereditary or acquired reduced sensitivity of the fetal hypothalamus to hormonal influences (Dorner G., 1972). It is interesting to note that, according to A. A. Ehrhardt and J. Money (1968), girls whose mothers received male sex hormones during pregnancy to maintain it, surprisingly often observed "boyish" behavior, i.e. the above characterological features that we have seen in many active homosexuals. Very rare is an inversion acquired as a result of organic brain damage, endocrine and other disorders suffered in adulthood. Situational factors do not play a decisive role in the emergence of an active form of female and a passive form of male homosexuality.

the formation of a strong conditioned reflex connection between the experience of orgasm and the woman who caused this experience. At the same time, the desire to overcome loneliness, to acquire a friend, etc. contributes to the establishment of regular homosexual relationships. As mentioned, for many healthy women, the attraction to sexual intercourse with a man occurs only after they begin to experience an orgasm. In this regard, a woman's sexual life with a man, not accompanied by sexual satisfaction, may favor the fixation of sexual desire on a woman who has managed to arouse her satisfaction. This can also be facilitated by an increased tendency to form very strong conditioned reflex connections.

1. The presence of many boys or young men from 7-8 to 15-16 years of age of a period of undifferentiated orientation of sexual desire (the period of youthful hypersexuality, according to A. Moll, 1908). At this time, sexual arousal often arises under the influence of a variety of influences, for example, with muscle tension during a fight with a comrade, while riding in a car, train, when experiencing a feeling of pain, fear, etc. At this age, sexual games of both a heterosexual and homosexual nature are also often observed, consisting in feeling other people's genitals, their mutual excitation, etc. Since at this age the orientation of sexual desire is not yet strictly heterosexual in nature, its homosexual orientation can easily arise and be fixed.

So, the congenital form of homosexuality (active in women and passive in men) is characterized by the following triad of symptoms:

2. The presence from childhood of certain somatic and characterological features of the opposite sex.

For a reactive (situationally) conditioned form of homosexuality (active in men and passive in women), the presence of only the third member of the triad without the first two is characteristic.

Transvestism(from the Greek vestis - clothes) - the desire to wear clothes and appear in the role of a person of the opposite sex. Transvestism has long been condemned by society. So, in the Jewish religion (5th book of Moses, 22.5) it was declared a sin for a man to wear a woman's dress and for a woman to wear a man's dress. Among other accusations of Joan of Arc was the accusation that she wore a man's suit.

At the heart of transvestism is a violation of sexual self-identification - a sense of belonging to the opposite sex. Hence - the desire to wear clothes and figure in the role of a person of the opposite sex. It is most often combined with an inversion of the direction of sexual desire and is then considered within the framework of homosexuality. Along with this, transvestism can also act on its own, being observed in persons who are not homosexuals and live a normal sexual life. However, even in these cases, one or another characterological features of the opposite sex are usually noted from childhood, which we cited when describing congenital forms of homosexuality.

Since childhood, he loved women's activities. He liked to try on women's dresses, jewelry. I felt like I belonged to the female sex. In adolescence, this feeling intensified and more and more often there was a desire to wear women's clothes and impersonate a woman. I never experienced sexual attraction to men, but girls caused sexual attraction. Particularly exciting was the sight of a naked female body and touching it. Sexual life began at the age of 17 with a girl 3 years older. After graduation, he was drafted into the army. Successfully advanced in the service. At every opportunity, hiding it from others, he put on a woman's dress. After demobilization. From the army, I wore it at home almost constantly. The son's wife began to protest against the fact that he walks in a woman's dress, embroiders, sweeps the floor, cooks dinner. Then he submitted an application to the police with a request to officially recognize him as a woman so that he could freely walk in women's clothes. He showed no signs of mental illness.

We believe that such cases of transvestism are a congenital condition. At their basis, as well as at the basis of congenital forms

Rice. 4 a, b. The man is a passive homosexual transvestist. Works as a cleaner. He calls himself Vasilisa Andreevna (according to his passport - Vasily Andreevich)

homosexuality, lie, in all likelihood, violations of the differentiation of the sexual centers in the diencephalic region. These violations may be less pronounced than in congenital forms of homosexuality, and therefore the orientation of sexual attraction to persons of the opposite sex remains.

In women, transvestism is less common than in men, and is usually combined with a homosexual orientation of sexual desire.

Fetishism

From transvestism should be distinguished fetishism of clothing (underwear) of the opposite sex. He has no sense of belonging.

to the opposite sex. Underwear is initially used only as a fetish for intercourse or masturbation, and only in the future can sometimes develop a desire to wear it for a longer time.

A fetish (from the French fetiche - an object of worship) is an object that, in the view of superstitious people, is endowed with supernatural, magical powers. In connection with this, fetishism refers to a form of sexual psychopathology, in which sexual arousal occurs only in the presence of an inadequate physical stimulus - a fetish.

A fetish is most often inanimate objects, for example, a cut-off braid, lingerie (bras, stockings), shoes, handkerchiefs, rubberized raincoats, but always used or tried on by a person of the opposite sex. However, such items should not belong to close relatives or a person with whom the fetishist has a sexual life. Hence the often desire to steal these items from strangers or steal them from the store immediately after trying them on (for example, shoes). Thus, a fetish is, as it were, a symbol of the person to whom it belonged. Since close relatives are usually not the causative agents of sexual desire, their things do not acquire the properties of a fetish. A painting or a statue, a certain smell, such as the smell of a rubberized raincoat (macintosh), as well as sounds (timbre of voice, etc.) can also become a fetish.

An acquired fetish is usually applied to the genitals or contemplated. It causes sexual arousal, which is satisfied most often by masturbation, less often by normal sexual intercourse.

A person meets hundreds of people on the street. The vast majority of them are perceived by him as sexually indifferent objects, and only a few attract attention, cause a sexual reaction. This reaction 1 does not arise as a result of the unambiguous and uniform influence of all the elements that make up the perception of a person as a whole, but as a result of a more emphasized influence of any individual properties of the object. For one, this is the slenderness of the figure, for another - certain facial features or the shape of the leg, for the third - the features of the toilet. The fullness of the female figure or light color hair may have an attractive force for some and not affect others. Tastes are formed in the process individual development, while public opinion has a great influence on them. Yes, in Ancient China the attractive power of a woman largely depended on the size of her legs. From the time of Emperor Ta-Ki (1100), special blocks were put on girls' feet to prevent their growth. ideals female beauty even over the last century in European countries have changed significantly.

There are people for whom a certain quality of a person or a feature of any part of his body is of great importance. In this case, other qualities may not be taken into account. Some authors attribute such cases to fetishism (fetishists of the hand, foot, etc.). The boundaries between the norm and pathology in these cases are indistinct.

Fetishism occurs almost exclusively in men and is extremely rare in women.

Under our supervision was a girl with an obsessive fear of redness. At the age of 9, she once experienced a pleasant sexual arousal, tensing and relaxing the thigh muscles, and she periodically repeated these actions. At the age of 15, she was deeply in love with a young man. Together with him was in the Hermitage. They stopped at the sculptural group of Antonio Canova "Cupid's Kiss". The young man squeezed her hands tightly and clung to her. They stood silent. She began to squeeze and relax her hips and then for the first time she had an orgasm. She felt the heat in her face, became embarrassed and thought that others noticed how she blushed. Soon she was forced to part with the young man. Once, when she took out a photograph of this sculpture and began to examine it in the evening, strong sexual arousal reappeared, which she brought to orgasm by squeezing and relaxing the muscles of the thighs. Since that time, obsessive masturbation has been established, before which she contemplates this photograph, which has become a sexual fetish for her. Since then, there has been a fear of redness.

By nature, anxious and suspicious, easily embarrassed, with a highly developed sense of duty.

Obviously, in this case, fetishism is based on the emergence in the girl of a conditioned reflex connection between strong sexual arousal and contemplation of the statue "Cupid's Kiss". The fear of blushing symbolized the fear that others would recognize from her face about her sexual desire and how she satisfies it. The connection between fetishism and neurosis obsessive states stands out clearly here.

According to psychoanalysts, a fetish always reflects one or another unconscious sexual object. Most often, for men, they are supposedly parts of the mother's body (fur as a symbol of pubic hair, etc.), and for women, objects symbolizing the male genital organs. S. Freud believed that the basis of foot and hair fetishism is a repressed attraction to objects of repressed coprophilic experiences (feet and hair usually have a specific smell). In contrast to this, we believe that the basis of fetishism, as well as some other anomalies of sexual desire, is the formation of pathologically strong conditional bonds during sexual experiences in childhood or adolescence.

CONTENT

Introduction 3
Anatomy and physiology of homosexuality 4
Homosexuality: what sexologists and sexologists talk about 14
Homosexuality from the point of view of urologists 24
Homosexuality (hermaphroditism) from the point of view of pediatricians and endocrinologists 43
Conclusion 46
Memento! 49
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INTRODUCTION
Until recently, in our country, the publication of information about the biology of human sexual life was under an unspoken ban. A wide range of readers did not have the opportunity to obtain elementary knowledge in this area.
The word sex in Russian is translated as "sex". There is male sexual behavior and female sexual behavior. Appearance, clothing and jewelry are different for both men and women. This, by the way, is also an element of sexual behavior. Male and female sexual behavior are, as it were, opposite, alternative. But there is also bisexual (bisexual) behavior, in which a person behaves either like a man or like a woman. This state is also referred to as intermittent sex. Normal for a person is heterosexual behavior, that is, attraction to the opposite (contralateral) sex. Homosexuality is the sexual attraction to the same sex.
At present, in our society, homosexuality is considered promiscuity, depravity, sexual perversion and is punished as a criminal offense by imprisonment (imprisonment). In many countries of Europe and America, homosexuality is not considered a criminal offense, but in some countries of the Arab East, homosexuals are punished by death.
Meanwhile, homosexuality is a clinical manifestation of anomalies (malformations, deformities) of the genital organs and sex. Therefore, this is a disease, and depriving of freedom and killing sick (suffering from a developmental defect) people is evidence of the medical illiteracy of society.
In connection with the removal of restrictions on the publication of some previously closed topics, articles about homosexuality appeared in the Medical Newspaper of September 2, 1988 (F. Podkolodny "Sodom sin"), in Literary Newspaper of March 29, 1989 (O. Moroz "Is punishment fair?") and dated 20.09.1989 (T. Fast "13 steps. The story of a series of unique operations, as a result of which a woman became a man"), etc. These publications leave many perplexed questions to which there are no answers. In the brochure offered to the reader, I will try to answer many of them.
Homosexuality has to be dealt with by doctors of many specialties: psychiatrists, sexologists, forensic doctors, venereologists, and even pediatric surgeons and pediatricians. Currently, doctors (specified specialists) interpret and interpret the nature of the same diseases in different ways. This also applies to homosexuality. That is why doctors of different specialties treat patients suffering from homosexuality in different ways, in which they have completely different results his therapy.

ANATOMY AND PHYSIOLOGY OF HOMOSEXUALISM
We do not consider it shameful and indecent to know that a person has a heart, stomach, lungs, spleen and other organs, but to be interested in the features of the organs that serve for reproduction, that is, the genital organs, is somehow considered indecent. This speaks of ignorance and hypocrisy, alas, of a considerable part of our fellow citizens.
So, in order.
Female genital organs: clitoris, small and large labia (two each), vaginal vestibule, vagina, cervix, uterus, uterine (or fallopian) tubes (two), two ovaries (Fig. 1). They are usually divided into external and internal. The external genital organs of a woman: the clitoris, small and large labia, the vestibule of the vagina. Internal: vagina, cervix, fallopian tubes, ovaries.
Genital organs of a man: penis, scrotum, gonads (testicles - there are two of them), epididymis, vas deferens, seminal vesicles, prostate gland (Fig. 2).

Rice. 1. Schematic representation of the female genital organs (the uterus and part of the vagina are shown in section; the bladder also shows a window that allows you to see the mouths of the ureters that flow into the bladder): 1 - clitoris, 2 - labia, 3 - vaginal vestibule, 4 - vagina, 5 - cervix, 6 - uterus, 7 - fallopian tubes, 8 - ovaries, 9 - kidneys, 10 - ureters, 11 - bladder, 12 - urethra

Rice. 2. Schematic representation of the male genital organs (the scrotum is not shown in the figure): 1 - penis, 2 - testicles, 3 - epididymis, 4 - semen ducts, 5 - seminal vesicles, 6 - prostate gland, 7 - kidneys, 8 - ureters, 9 - bladder, 10 - urethra

In men and women, the anatomy of the kidneys, ureters and bladder does not differ in any way, but the anatomy of the urethra, through which urine “from the bladder is excreted, differs sharply.
In women, the urethra is short, wide and straight. Its outer opening opens
between the labia minora, below the clitoris and above the entrance to the vagina. In men, the urethra is long, narrow, and curved. The initial section of it covers, like a clutch, the prostate gland. The urethra in men runs through the entire penis and opens at the pole of the glans penis.
The urinary and genital organs develop from the same embryonic (embryonic) anlage, and often deformities of the urinary and genital organs are combined. It is known that approximately 10% of people suffer from anomalies genitourinary system organs. This prodent far exceeds the prodent of anomalies of all other organs and systems of the human body.
Human sexual behavior depends on the effect on the brain of sex hormones that are produced in the gonads (sex glands). Women have ovaries, they produce both eggs (germ cells) and female sex hormones called estrogens. These hormones are released from the ovaries into the blood. With the blood, estrogens enter the brain and provide both female sexual behavior and the appearance of a woman (the so-called secondary sexual characteristics). Men have testicles that produce both sperm and male sex hormones (androgens). These hormones move from the testicles into the bloodstream and are transported by the bloodstream to the brain, which determines male sexual behavior and the appearance of a man.
Among people who do not have a medical education, there is a widespread belief that people are only of two sexes: male and female. In fact, there are four sexual varieties: 1) male;
2) female; 3) bisexuality, or hermaphroditism; 4) demon-cavity, or eunuchoidism.
Bisexuality, or true hermaphroditism, is expressed in the fact that a person has one ovary and one testicle. In hermaphroditism, one or both sex glands can be built so that half of the gland consists of testicular tissue, and the other half of the same gland is made of ovarian tissue. And finally, mosaicism of one or both gonads is also observed, when ovarian tissue is mosaically included in the tissue, for example, of the testis, and vice versa. If there are tissues of both female and male gonads in one gland, the gland is called ovotestis, or ovotesticle (ovarnum - ovary, testis, testicle, - testis). As already mentioned, one or both gonads can have such a structure. Such people can produce both eggs and sperm, they produce both male (androgens) and female (estrogens) sex hormones. Such people may look like men or like women. Their appearance may be different: they may have both male and female secondary sexual characteristics. Since both male and female sex hormones circulate in the blood, these people behave both like men and like women, which is denoted by the terms "intermittent sex", "bisexualism", "transsexualism", etc.
Some people have sharply underdeveloped or even absent gonads. They cannot have offspring, sexual (sexual) behavior is not observed. These people have neither female nor male secondary sexual characteristics. This deformity is called eunuchoidism. The same condition occurs in a person after castration (removal of the gonads).
Homosexuality is a medical problem. Every science has an object and methods for studying, some methods are universal and are used in other sciences, such as statistics, mathematics, etc. But each science also has its own specific methods.
Based on the symptoms of the disease, blood and urine tests, the doctor can only localize the disease, that is, roughly determine which organ or organ system is affected. And to establish a diagnosis, you need to see this organ (directly and indirectly), for which X-ray, radioisotope, ultrasound, thermographic, endoscopic and many other instrumental objective methods of examining a patient are used.
Different branches of medicine study diseases of only one organ system. Cardiology - heart disease, gastroenterology - gastrointestinal tract, pulmonology - lungs, proctology - rectum, etc. Moreover, a proctologist does not treat, for example, diseases of the female genital organs. But psychologists, psychiatrists, neuropathologists, sexologists, endocrinologists, gynecologists, urologists deal with homosexuality.
Psychiatrists and sexologists (and these are also psychiatrists, but with more narrow specialization) believe that homosexuality is a complex of symptoms of a brain disease. Urologists, gynecologists and endocrinologists consider homosexuality to be a clinical manifestation of various anomalies (deformities, malformations) of the internal or external genital organs.
It so happened that representatives of three therapeutic profiles (psychiatrists, sexologists, endocrinologists) and two surgical specialties (urologists and gynecologists) are now dealing with issues of homosexuality.
(Psychiatrists and sexologists are sure that a person’s homosexual behavior is the result of a perverse brain function, and therefore, in order to treat homosexuality, it is necessary to influence it. Therefore, psychiatrists and sexologists treat homosexuality with so-called psychotherapy (conversations, suggestions, persuasion, hypnosis, etc. .). Seeing the frequent inefficiency of such treatment, they even suggest the possibility of surgical intervention on the sexual centers of the brain. At the same time, experts for some reason forget that the brain itself never produces any behavior (including sexual behavior). the brain receives various signals (stimuli), and in response to them, a person’s behavior is formed, which is a response (reaction) to these stimuli.For example, the sensation of pain.This is not a product of the brain itself, but a response to injury, inflammation, tumor, or some or another ailment that leads to bleeding and destruction of tissues and organs. ty nervous system, through which they send signals to the brain, there will be no reaction to the stimulus. For example, any surgical operation is accompanied by tissue destruction, but anesthesia, which is the blockade of the nervous system, allows you to perform a surgical operation without feeling pain.
Psychiatrists and sexologists often overlook the brain stimuli that cause homosexual behavior. Meanwhile, these causes of homosexuality have long been well known to endocrinologists, urologists and gynecologists. We are talking about sex hormones.
If only female sex hormones are produced in the body, this person will sexually behave like a woman. But there are such anomalies of the external female genital organs, when they look like men's. Do I write down such people at birth? as men, thus creating a discrepancy between the biological (gonadal, hormonal) and metric (passport, social, legal) sexes. Such a person has a male passport, but behaves in. sexual relationship as a woman, and for society he is a homosexual.
If only male sex hormones are produced in the human body, his sexual behavior is masculine. But sometimes anomalies of the external male genital organs are observed, when they look like women in appearance. Sexually, such a holder of a female passport behaves like a man and courts women. Such a person behaves biologically correctly, but for society it is a homosexual.
The disease, when a person has gonads of the same sex, and the external genital organs, as a result of a malformation, resemble organs of the opposite sex, is called false hermaphroditism, or pseudohermaphroditism. It is necessary to distinguish between male and female pseudohermaphroditism. False male hermaphrodite - male, but with female external genitalia. False female hermaphrodite - a woman, but with male external genitalia. The principle of treatment of false hermaphroditism is to change the legal, legal gender and surgical correction external genital organs in accordance with the gonadal, hormonal sex. Unfortunately, the social, legal or civil gender prevails in the minds of people so much that it is often necessary to sacrifice biological sex and transform the hormonal sex in the direction of the legal gender. Such patients are castrated, and then loaded with sex hormones corresponding to the passport sex. These hormones are injected into the body for the rest of your life.
With true hermaphroditism, the body has both male and female gonads (tissues of both the ovary and testicles). In such cases, both male and female sex hormones are produced. The sexual behavior of a person will be both male and female - bisexual, intersexual, transsexual, etc. Clinically, true hermaphroditism is manifested by homosexuality or bisexuality. Treatment of true hermaphroditism is only surgical. It is necessary to remove all the organs of one sex and leave, and also correct the organs of the other sex. The principle of treatment of any form of hermaphroditism is to choose the biological sex, and then eliminate the "clogging" of the body by the organs of the opposite, contralateral sex.
True hermaphroditism seems to be an amazing biological phenomenon. But after all, all life on earth came from hermaphroditism. Viruses, bacteria and protozoa have no sexes. For reproduction, one individual is enough. It is not only in primitive organisms that hermaphroditism is observed. For example, worms have a complete set of both female and male genital organs, and one individual is enough for reproduction. Hermaphroditism is widespread among insects and flora. Hermaphroditism as a norm is observed in fish and even in lishers. All this information is available in textbooks on biology, but often in newspapers cases of hermaphroditism are presented as sensational. For example, in the newspaper "Izvestia" dated February 19, 1987, I. Kovalev publishes an article entitled "A strange phenomenon." Here verbatim text: “According to the Jakarta Post newspaper, citing the New Zealand Minister of Lands, Forestry and Land Property Valuation Koro Uetiri, the New Zealand government intends to create a nature reserve on the Kermandak Islands in order to preserve the rare fish that live in the waters of these islands. This fish - spotted black grouper in the process of life changes its sex. The females are transformed into males. The note is inaccurate. The fish in question are born as males and then (after a few years) turn into females.
J.-I. Cousteau and I. Pakkale in their book “Surprises of the Sea” write that some fish species have the ability to change sex during life. This feature is characteristic of two families of fish: spar or crucian carp, and stone perches, which include a fish called merow. Some of these fish have bisexual sex glands, consisting of two parts and producing both male sex cells (sperm) and female (caviar). Hermaphrodite fish, which have the sexual organs of both males and females, can fertilize themselves. But usually one of the parts of the gonads matures earlier than the other, and in order to continue the existence of the species during spawning, each individual must find one whose temporal development is hormonally shifted in comparison with it. Merou fish have a different sexual organization than most fish. The sex glands function in such a way that the sex of an individual changes in the course of life. Fish are born as males. This state has been maintained for several years. Then they turn into females. During the transitional period, which lasts about a year, the fish have mixed gonads called ovotesticles. Merow fish (a subfamily of groupers) reach impressive sizes. The giant of this group of fish is the Australian fish, called the Cays rock perch. It reaches a length of 4 m and weighs up to 500 kg.
Since a person in the process of embryonic, intrauterine development repeats the entire process of the evolutionary development of the animal world on our planet in about one or two months, people have always had, have and will have hermaphroditism as an anomaly (deformity) in one form or another. This deformity needs to be known, identified, diagnosed and treated. Moreover, the treatment of hermaphroditism is very effective and consists in removing the gonads of one sex and leaving the gonads of the other sex. The direction of sex correction to the male or female side depends on the development and anomalies of other genital organs (except for the gonads). Sexually mature patients usually choose the direction of sex correction themselves. They themselves feel either men or women. Moreover, this sexual self-awareness depends only on whether male or female sex hormones prevail in the body. People who have a complete set of both male and female genital organs are very rare. Other numerous variants of false and true hermaphroditism are quite typical (according to the literature data, 2 - 6%). Most often, hermaphrodites have a complete set of organs of one sex and some genital organs of the other sex.
Sexual intercourse is the only physiological act in humans that requires a partner. For some reason, people do not hide breathing and eating and do not see anything shameful in this physiology. Moreover, people usually eat in the company of others, and in a restaurant they also have music and flowers. By the way, the symbolism of flowers is widely used in human sexual behavior. If a man gives flowers to a woman or a woman gives flowers to a man, this is normal sexual behavior.
Defecation and urination are often considered indecent physical acts and are therefore performed without witnesses. Sexual intercourse (copulation, intercourse) is also usually performed without witnesses and is a deep secret.
In medicine, there is a term - libido. It denotes sexual desire. Libido is always there if a person has sex hormones circulating in the cut. There is no libido if there are no sex hormones in the blood.
There are a huge number of definitions of the concept of "love", and most of them belong to poets and writers. They carry a very small share of information, but always emphasize the sublimity, grandeur and incomprehensibility of this feeling. For poets and writers, the anatomical localization of love is in the heart. Recently, definitions of the concept of love have appeared, formulated not by poets, but by sexologists who believe that love arises in the brain. Their formulations of love contain the following ethical concepts: mutual affection, harmony, respect, nobility, duty, etc. From a biological, medical point of view, love is simply sexual behavior, which is determined by sex hormones. We have schematically depicted the genea of love in the views of poets and writers, psychiatrists and sexologists, urologists, gynecologists and endocrinologists (see diagram).
One of the symptoms of homosexuality is transvestism. This is what is called the desire to wear clothes of the opposite sex in order to appear as a person of that sex. It is very important that at the same time, sexual behavior also changes according to clothing. Transvestism is observed in active homosexual stock women and passive homosexual men. In a pair of women, an active homosexual is called a partner who plays the role of a man. The passive homosexual in a pair of men is the one who plays the role of the woman.
Active homosexual women dress in men's clothes, they gravitate towards men's jewelry and men's work. They wear belts, belts, daggers, knives, etc. Passive male homosexuals paint their faces, lips, eyebrows, eyelashes, wear women's clothing, jewelry.
Transvestism is often presented as a mysterious phenomenon. In fact, everything is explained very simply. For such people, the legal (metric, passport, social, legal) gender does not correspond to the biological (gonadal, hormonal), and they tend to dress and adorn themselves in accordance with their biological, and not passport, sex.
In the old days, not only homosexuality, but also transvestism, that is, the desire of men to dress in women's clothes, and women in men's, was very strictly persecuted. Among other accusations, Joan of Arc included the accusation that she wore a man's suit. It is known that in 1431 Joan of Arc (Maid of Orleans) was sentenced to be burned at the stake and burned. At present, fortunately, they are not burned at the stake for wearing attributes of the opposite sex at the stake. But to put it mildly, they are often not very encouraged. For example, the newspaper Izvestia (09/07/1989) reports that, by order of the regional executive committee of one national autonomous region, the police do not let women in trousers into the building of the regional executive committee, even if these trousers are not men's, but women's. (But this, of course, is a curiosity.)

HOMOSEXUALISM: WHAT SEXOLOGISTS AND SEXOPATHOLOGISTS TALK ABOUT
The well-known sexologist and sex therapist K. Imelinsky argues that sexuality is an innate need and function of the human body. Of course, the highest stage in the development of human sexuality is erotic love. Erotic love is a typically human product associated with human development as a whole. Further, Imelinsky writes: “Etiology
homosexuality is still little studied. But even if the etiology and pathogenesis were clarified, their essence remains mysterious and incomprehensible.
The author refers homosexuality to "atypical sexual deviations" and immediately points out that it takes place in all cultures and eras. “The distinction between the two directions of human sexual desire according to dominant needs shows that heterosexuality and homosexuality can be represented as two poles of a biological series of varieties, with the majority of people grouped at the heterosexual pole, a minority at the homosexual pole, and a certain number of persons distributed between these two poles. The last group of people are characterized as bisexual.” Thus, K. Imelinsky emphasizes that homosexuality is not a disease to be treated. This is a normal occurrence in the biological range of varieties. Numerous observations and studies show that the tolerant or intolerant attitude in a society does not affect the number of homosexuals in this society.
The first mention of homosexuality is found in Egyptian papyri, according to which the gods Fet and Horus were in a homosexual relationship. Homosexuality existed in ancient India, Babylon, Egypt, Greece and the Roman Empire. In ancient Greece, male homosexuality was called Uranism after the goddess Urania, who was born not from a woman, but from the god Uranus. Female homosexuality is called lesbian love, or sapphism, after the ancient Greek poetess Sappho, who lived on the island of Lesbos (VII - VI centuries BC) and was an active homosexual. Female homosexuality is also called tribadia (from the Greek word "tribein", which means "to rub"). This term indicates a way to satisfy sexual desire.
Pederasty (sodomy) is a form of male homosexuality in which sexual intercourse is performed through the anus. Homosexuality (both male and female) occurs in about 1 - 2% of cases from total number population and is the most common form of sexual psychopathology. Homosexuality has always existed and exists in all countries.
In normal heterosexual intercourse, the man's penis is inserted into the woman's vagina, the man plays the active role, and the woman is the passive sexual partner. For homosexuals, both in a male and female pair of sexual partners, one partner always plays an active male role, and the other a passive female one. But a pair of homosexual men and a pair of homosexual women have the same sexual organs, and therefore they cannot have normal sexual intercourse. Homosexuals resort to various techniques and tricks to achieve orgasm. If heterosexual people are cold (frigid), then homosexuals always have an orgasm and never frigidity.
Anomalies of the genital organs can also be found in frigid people. In a pair of homosexual men, sexual intercourse can be performed by inserting the penis into the anus (rectum). The penis can be inserted between the thighs. Oral-genital contact (crossed or French love) is very common among homosexuals, both men and women. Each partner or partner irritates the genitals of another partner or partner with lips, tongue.
Sexual contact of female homosexuals is carried out by rubbing the genitals or mutual masturbation. Homosexual women use various imitations of the Artificial Penis, which the active partner, acting as a husband or lover, attaches to her genitals. The other partner plays the role of wife or mistress.
Often homosexuals are family women. They simultaneously live sexually with both their husband and their homosexual partner. It is important to note that such active homosexual women are always cold towards their husbands and men in general, which indicates the presence of androgens - male sex hormones - in their bodies. Passive homosexual women can receive sexual satisfaction both from male partners and from active homosexual partners. Such states are designated by the term bi-sexualism. Some active homosexual women have a clitoris so large that they can insert it into the vestibule of their partner's vagina.
Some sexologists regard active female homosexuality as an incurable brain disease. It's perfect misconception. It's just that active lesbians have androgens, which, by acting on the brain, change behavior to a man's. They are either males with a female passport (false hermaphrodites) or true hermaphrodites. All sexologists consider female active homosexuality curable.
An active lesbian is characterized by a masculine appearance and masculine behavior not only in sexual life. A passive homosexual always has a normal female appearance and female sexual behavior. There are no anomalies of the genital organs in passive lesbians. In homosexual men, everything looks the other way around. The active partner has a normal masculine appearance, normal masculine behavior, and no genital anomalies. Active. a homosexual male receives sexual satisfaction both with women and with men - passive homosexuals (bisexualism). A passive male partner is often feminine, which means that there are estrogens (female sex hormones) in his body. A passive homosexual is either a woman with a male passport (false female hermaphrodite) or a true hermaphrodite Sexologists consider passive male homosexuality to be incurable
Sexologists believe that the prevalence and persistence of homosexuality can only be explained by biological factors. But what these factors are is not fully understood:
A M Ovyadosh and E M Derevinskaya examined homosexual women. Most of them were serving sentences for a criminal offense. All patients were divided into two categories: active homosexuals and passive ones. As a criterion for this division, the authors used the sexual self-identification of a homosexual (a sense of belonging to one or another gender). The authors referred homosexuals who felt like men to the active form, and those who felt like women to the passive form. The active form was noted in 57 examined, the passive - in 39. Active homosexual women experienced sexual attraction only to women. In the appearance of 60% of active homosexual women there was masculinization, that is, masculine features, strongly developed muscles, a narrow pelvis, broad shoulders, a masculine gait, a low rough voice, male-type hair. Almost half of the active homosexuals were transvestites, that is, they wore men's hair and clothes. All active homosexual women had a negative attitude towards women's jewelry.
Most active homosexual women felt like boys in their childhood. Many menstruation came late and were scanty, some menstruation was not at all. More than half of active homosexual women masturbated. During sexual intercourse with passive homosexual women, active homosexual women try to identify erogenous zones - places that, when touched, cause sexual arousal in a partner. Depending on the location of these zones, clitoral irritation with the hand or mouth, or vaginal irritation with the fingers, is applied. Active homosexual women try to delay sexual intercourse with a partner for up to 20-30 minutes or longer, then repeat it many times until the partner has a state of prostration. Simultaneously with irritation of the partner's genitals, they rub their genitals.
her hips and thus reach orgasm at the same time as her. Sometimes they allow their partner to induce an orgasm in themselves by manipulating the genitals. When forming a homosexual "family", most active homosexual women tried to imitate the behavior of the man, the head of the family. They are jealous of their partners both to women and men, out of jealousy they attack their rivals. Sometimes an active homosexual woman resorts to violence against a woman she likes. Despite the fact that active homosexual women are not attracted to men, most of them have ever had sexual intercourse with them. Moreover, sexual intercourse was unpleasant for them.
Passive homosexuals have feminine behavior and feminine appearance. Consider themselves women. All 39 passive homosexuals examined by A. M. Svyadoshch and E. M. Derevnskaya did not differ in any way from normal women. In the past they lived normal heterosexual lives. Half of them were married, some had children. The majority during heterosexual life did not experience sexual satisfaction. Very few have masturbated before. They all began homosexual relationships at a time when they were not living a heterosexual life or when they were not satisfied with the established family relationships. Many experienced a feeling of loneliness and a need for tenderness, affection and a close friend. All of them initially saw in their future homosexual partner an attentive, affectionate, devoted and loving friend, sometimes a strong person who can be relied upon. Most passive homosexual women experience orgasm for the first time in their lives during homosexual intercourse.
AM Svyadoshch describes a case in which a passive homosexual woman, after psychotherapy, returned to a heterosexual life and got married. And she was very satisfied with her husband. The main point in the treatment was the explanation of the reasons for the failure of her sexual life with men.
A. M. Svyadoshch also examined homosexual men. As a criterion for classifying them as active and passive forms, sexual self-identification was adopted ( own feeling male or female). Active homosexual men are no different from healthy heterosexual men. Passive male homosexuals are characterized by feminization.
Characteristically, it is men who are passive homosexuals who are actively looking for sexual partners.
Thus, active homosexuals seduce normal women into homosexual life, who become passive homosexuals. Passive homosexual men seduce normal men (hereinafter active homosexuals). As you can see, the causes of active and passive forms of both female and male homosexuality are different.
It has long been known that normal sex hormones are the cause of both benign and malignant tumors. Female sex hormones (estrogens) cause fibroadenomas ( benign tumor) and breast cancer. Previously, when breast cancer was treated by removing it and radiation exposure, almost all women died 3 to 7 years after the operation. Today, after the removal of the mammary gland, the ovaries are also removed (to stop the production of female sex hormones in the body). A woman is prescribed male sex hormones, which are administered to her for a long time. With this treatment, almost all women recover from breast cancer, but they become masculinized (masculine appearance and behavior). This is the result of the action of male sex hormones on the brain and on the entire body of a woman.
If older men maintain high levels of male sex hormones in the blood, they often develop an adenoma (benign tumor) and cancer prostate. Prostate cancer is usually diagnosed late, when surgery is no longer feasible and there are tumor metastases to the lungs and bones. In such patients, the prostate gland is not removed, they are prescribed female sex hormones (sinestrol and other estrogen preparations). Cancer tumor in the prostate gland is replaced by scar tissue, metastases in the lungs and bones often resolve. If the patient is no longer injected with female sex hormones, cancer reappears in the prostate gland. Receiving sex hormones, patients live a long time, but they experience feminization: female mammary glands appear, etc.
If a person suffers from eunuchoidism, that is, from birth does not have gonads (sex glands), or if a person is castrated (his gonads are removed), by introducing sex hormones into the body, you can turn him into a man (if androgens are administered) or into a woman (if estrogen is administered). ). Such a person will look like a man or a woman, although he cannot give offspring. At present, there is the possibility of a more radical formation of sex. To do this, the patient or patient needs to transplant into the body a testicle or ovary from a living donor or from a deceased person.
Homosexual behavior can appear in a healthy heterosexual person under the influence of coercion, self-interest, imitation, seduction and other social circumstances. Sexologists call this phenomenon pseudo-homosexuality (false homosexuality). But they don't add that this applies only to passive homosexual-cokens and active male homosexuals.
Thus, active homosexuals and passive homosexuals are born, and passive homosexuals and active homosexuals are made.
Sexologists also divide homosexuals into primary and secondary. Primarily homosexual individuals do not show any attempts at heterosexual contacts. The group of secondary homosexuals is heterogeneous. It includes all manifestations and forms of homosexuality that have arisen in a variety of ways, with the exception of primary, true, innate homosexuality.
K. Imelinsky divides homosexuals into 4 groups:
1) pseudo-homosexuals (they carry out homosexual acts not for homosexual motives, but on the basis of other considerations, such as material benefits);
2) homosexuality of the period of development (the author writes about some childhood phase of the development of sexual desire). Here comes the question. In childhood, there is no sexual attraction. sex drive occurs under the influence of sex hormones only in mature people;
3) homosexuality due to various mental retardations. And again a contradiction. Mental retardation cannot be the cause of homosexuality. Even in oligophrenics (congenital dementia) there is no homosexuality if there are no anomalies of the genital organs;
4) homosexuality due to homosexual inclinations is true homosexuality. Many sexologists describe the so-called transsexualism. This term refers to the discrepancy between the mental sense of one's own sex and the morphobiological structure of the body. A person feels like a man enclosed in a woman's body (active homosexuals), or, conversely, he feels like a woman enclosed in a man's body (passive homosexuals). The term "morphobiological structure of the body" emphasizes the misunderstanding and ignorance of the anomalies of the internal and external genital organs. The mental sense of sex depends on the influence of sex hormones on the brain, and therefore, in these cases, the mental and biological (hormonal) sex coincide, but this gender does not correspond to the appearance of a person and social (passport) gender. The sexual attraction of transsexuals does not correspond to the passport gender, therefore they are homosexuals. Transgender persons dress in accordance with the mental sense of their gender, which does not coincide with the passport gender. They show a desire to change the structure of their body, not stopping even before complex surgical interventions.
These are quite complex surgical interventions. And yet, many go to him and, being refused to perform these operations, often end their lives on their own? murder.
A. M. Svyadoshch describes several theories of the origin of homosexuality (the term “theory” means, perhaps, existing, but not proven).
Genetic theory of homosexuality. The orientation of sexual desire in both animals and humans is genetically determined (innate), that is, it is written in the gene code and is inherited (in our opinion, this theory does not stand up to criticism and
what does he explain; she cannot explain bisexuality; embryologists, urologists, gynecologists and endocrinologists have long known that the chromosomal (genetic) sex may not coincide with the biological (gonadal) lol; what is chromosomal (genetic) sex will be explained in the following chapters).
neurogenic theory. It is believed that there are sexual brain centers in the brain (in the temporal and hypothalamic regions). Violation of the process of differentiation of female and male brain centers of sexual behavior is the cause of homosexuality. So, I repeat: according to this theory of brain damage, there is the cause of homosexuality (this theory, in my opinion, also does not stand up to criticism: there are no centers of male and female sexual behavior in the brain; the brain can provide both female and male (behavior of one and the same person, depending on the impact on him of female or male sex hormones).
endocrine theory. According to her, homosexuality is based on dysfunction of the endocrine glands, which produce various hormones and secrete them into the blood. The gonads are the endocrine glands. As a justification for this theory, it is indicated that homosexuality is observed in women treated large doses male sex hormones, for example, for breast cancer. (I think that the theory of the etiology of homosexuality is true, but many psychiatrists and sexologists believe that endocrine factors do not play any significant role in the genea of homosexuality.)
Conditioned reflex theory. All forms of homosexuality are acquired, and they arise under the influence of unfavorable conditions. external influences. Lack of access to members of the opposite sex contributes to the development of homosexuality. However, some sexologists believe that lack of access to members of the opposite sex leads to masturbation rather than homosexuality.
Homosexuals themselves assess their condition differently. Approximately 60% of homosexuals do not consider their condition unnatural and do not want to be treated. They are even ready for their propensity to go to jail. If it is quite difficult for an active homosexual to find a partner in ordinary life, then in the women's section of the prison (prisoner camp) she has many sexual partners. A man - a passive homosexual finds a partner with great difficulty, but in the male prison camp he has such a choice is more than sufficient.
Approximately 25% of homosexuals are having a hard time with their status, which is expressed in the discrepancy between the biological and passport sexes. Approximately 3% of homosexuals commit suicide. These are mostly young people.
Castration was previously suggested as a treatment for homosexuality. But it does not lead to a cure for homosexuality, but to the destruction of sexuality in general.
As already mentioned, sexologists-bichiatrists believe that there are centers in the brain that determine a person’s sexual behavior. Attempts have been made surgical interventions on the brain. Such operations (the areas of the brain were destroyed or dissected in the place of the alleged sexual centers) did not give a result. Homosexuality has not been cured.
Sexologists-psychiatrists are good at treating situationally determined forms of homosexuality, which are based on a conditioned reflex mechanism. Psychotherapy is effective in the passive form of female and active form of male homosexuality. Many sexologists believe that the active form of female and the passive form of male homosexuality are generally incurable.
Therapy for congenital forms of homosexuality has not yet been developed. For its success, one can be able to determine hormonal imbalances in the fetus in the prenatal period of life and eliminate them. V.I. Zdravomyslov, Z.E. Anisimova and S.S. Liebikh (1985) believe that in the future science will make it possible to diagnose and eliminate hormonal disorders in the fetus, and then new opportunities will open up for the prevention of congenital forms of homosexuality.
Nevertheless, congenital homosexuality can still be treated very effectively today. To do this, you need to be able to diagnose gonadal (hormonal, biological) under, false4 and true hermaphroditism, be able to make surgical correction or transformation
Macia of the floor. As soon as mental, biological and passport sex are combined, homosexuality will disappear. Now there is every opportunity to change the biological, and mental, and legal gender. Obstetricians and pediatricians should be able to diagnose genital anomalies in early childhood.
Children do not have manifestations of homosexuality before puberty. And yet, the prevention of homosexuality in childhood is possible, but only when there are any deformities of the external genital organs. Unfortunately, the parents of such children turn to pediatricians, and children's doctors often do not have elementary ideas about the anomalies of the genital organs, which is explained by the imperfection of our medical education. In medical schools and medical faculties of universities in the curricula and programs, as well as in textbooks, there are no sections on anomalies of the gonads, true and false hermaphroditism, surgical correction and sex transformation.
Thus, psychiatrists, sexologists, psychoneurologists and psychologists study human sexual behavior in isolation from the physiology and congenital pathology of the genital organs. Therefore, they do not see the reasons for homosexuality and write about some "mysterious" biological factors.

HOMOSEXUALISM FROM THE POINT OF VIEW OF UROLOGISTS
Crushing medical sciences and medical specialties into narrow sections according to the principle of diseases of the organ system - a very progressive phenomenon. But any progressive and expedient undertaking can be carried to the point of absurdity, to the extreme. The foregoing applies to urology as a science and medical specialty.
Urologists study surgical diseases of the kidneys, urinary tract, and male reproductive organs. This is a large, but rather isolated circle of diseases. Now there is a tendency to break urology into narrow sections. Pediatric urology, oncourology (tumors urinary organs), phthisiourology (tuberculosis urinary organs), urological necology (adjacent diseases of the urinary tract in the female genital organs), aidrology (diseases of the male genital organs), operative nephrology (surgical treatment of the kidneys). There is also nephrology, which deals with the so-called therapeutic diseases kidneys.
In order for a specialist urologist to understand the state of a particular homosexual, you need to know pediatric urology, andrology, gynecology, and also embryology (the science of the development of an embryo-embryo).
In every cell of any human tissue (and other animals and plants) there is a record of the organism's development program. This developmental code is located on the chromosomes. Normally, a person contains 22 pairs of chromosomes, which are present in all cells of an individual of any sex. There are two sex chromosomes. The sex chromosomes of females are denoted by XX. The two sex chromosomes in males are marked XY. Germ cells-gametes have a half set of chromosomes, which includes only one sex chromosome. The eggs that are produced in the female sex gland (ovary) contain 22 chromosomes and always only one sex X chromosome. Spermatozoa, which are produced in the male sex gland (testis), contain 22 chromosomes and only one sex chromosome - either the X chromosome or the Y chromosome. If, as a result of fertilization of an egg by a sperm cell, a set of XX sex chromosomes is obtained, the embryo develops female genital organs. If you get a set of XY sex chromosomes, the male reproductive organs are formed in the embryo.
In the process of embryonic development, the human fetus goes through the hermaphroditic phase of development. At the 5th week of intrauterine development of the fetus, the genital tubercle is formed, and at this stage of development in the female and male fetus it does not differ in any way. This hermaphroditic stage of development persists until the 6th - 8th week of fetal life. The outlines of the rudiments of the external genitalia are such that they allow them to develop both in the female and in the male direction.
Approximately by the 12th week of intrauterine development, the type of external genital organs (male or female) begins to form in the fetus. But before that, gonads are formed. The formation of the external genital organs depends entirely on their normal influences. If the testicles have formed in the embryo, then they produce androgens that ensure the development of the male external genital organs. If the embryo has formed ovaries, they produce estrogens and ensure the development of the female genital organs. At the hermaphroditic stage of embryo development, scrotolabile (scrotal-labial) folds are formed. Of these, the scrotum is formed in the male embryo, and the labia in the female embryos. The formation of the genital organs ends by the end of the 4th month of pregnancy.
If both testicular tissue and ovarian tissue are formed in the embryo in the gonads (or one ovary and one testicle is formed), various anomalies in the structure of the external genital organs occur. Such hermaphrodites may develop normal female or male external genitalia. However, more often there are deformities of both male and female external genital organs. Sometimes it is very difficult or even impossible to determine the sex of a newborn by the structure of the external genitalia.
Thus, in such a fetus, disturbances in the development of the gonads first occur, and only secondarily there are deformities in the structure of the external genital organs. There are many clinical and experimental observations indicating the dependence of the structure of the external genitalia on fluctuations in the balance of sex hormones of the fetus or mother. Sometimes, after intensive use of sex hormones by women (for the purpose of terminating a pregnancy), boys and girls were born with various anomalies of the genital organs.
There are four forms of sex in each person:
1) chromosomal, or genetic, sex;
2i gonadal or hormonal sex;
3) psychological gender, that is, sexual (sexual) psychoorientation;
4) metric, passport, legal, social, legal, or civil, sex.
Moreover, it is necessary to distinguish between two categories of sexual psycho-orientation. The sexual psychoorientation of children is entirely determined by the information received from parents or others about whether he is a boy or
girl. In children, sex hormones are not produced by the gonads (unlike embryos). If a child is dressed in women's clothes and given girls' toys (dolls, etc.), then the child is brought up as a girl, then this child will consider himself a girl until a certain age. And vice versa: if a child is dressed in boy clothes and given certain toys (pistols, guns, etc.), he will consider himself a boy.
If at birth the sex of the child was determined incorrectly, then upon reaching puberty, the sexual psycho-orientation changes. The girl begins to feel like a boy and behaves like a man, because androgens are produced in the body. This is how homosexuality often manifests itself. The passport gender is female, so for society it is an active homosexual. Or vice versa: the boy begins to feel like a girl because estrogens are produced in the body. He behaves like a woman. For society, he will become a passive homosexual.
Thus, it is necessary to distinguish between two categories of sexual psycho-orientation: sexual psycho-orientation, inspired from childhood, when a person did not have genital organs (this is sexual psycho-orientation accepted by the child from others), and sexual psycho-orientation, which appears at puberty due to the impact on the brain of the sex organs, hormones.
If at the birth of a child the sex was determined incorrectly, then these two sexual psychoorientations turn out to be opposite. This is a heavy drama For a man.
Some gynecologists distinguish not four, but five forms of sex in each person:
1) gender of the genotype (chromosomal);
2) gender of the gonad (hormonal);
3J gender of the phenotype, or somatic sex (depending on appearance: male or female);
4) psychological gender (sexual psychoorientation);
5 legal, metric, passport, civil, social, legal gender.
In a healthy, normal person, all these forms of sexes should coincide. In patients (false and true hermaphrodites), they do not match.
Diagnosis of somatic sex (phenotype) is not difficult. This is the external appearance of the body structure according to the male or female type. Diagnosis of psychological sex (sexual psychoorientation) is also not difficult. The patient himself says who he considers himself - a man or a woman. Legal gender is determined by the entry in the passport. Complex studies are needed to diagnose genetic (chromosomal) and gonadal (hormonal) sexes.
Chromosomal sex can be determined by examining the chromosomes of the cells. You can also use the method of determining the sex chromatin of cell nuclei. A cut of the skin or a scraping from the mucous membrane of the mouth is taken (you can - a blood smear). The drug is subjected to a special staining. The location of the staining parts in the nuclei of cells is different in men and women.
The method of determination is imperfect only because the location of the sex chromatin typical for the female sex is found in women only in 70 - 90% of all cells. This arrangement of chromatin is found in 5 - 6% of cells male body. In patients with true hermaphroditism, the sex chromatin in the cells on one side of the body is located according to the female type, on the other side - according to the male type.
Recently, data have appeared that dermatoglyphics, the skin pattern of the fingers, palms and feet, can be used to determine the chromosome sex. Such a pattern can be male or female. Chromosomal sex alone is not a determinant of gender.
Gonadal (hormonal) sex is an accurate determinant of biological sex. It is expressed in sexual behavior. Biological sex always coincides with sexual psychoorientation (but may not coincide with chromosomal and legal sex).
There are four gonadal sexes, as mentioned above: female (there are ovaries in the body), male (there are testicles), bisexuality (true hermaphroditism: there is both ovarian tissue and testicular tissue), asexuality, or eunuchoidism (there are no gonads).
It would seem that determining the true biological sex4 is possible by studying the presence of certain sex hormones in the blood. But accurate and publicly available methods for determining the biological sex by studying sex hormones in the blood do not yet exist. That is why the biological sex is determined by histological examination. Histology is the science of the structure of living tissues of humans and animals. A piece of tissue is taken from the pancreas. Thin sections are made from a piece of gland. These sections are stained and then examined under a microscope. When studying these sections, it is precisely determined what tissue (testis or ovary) the examined tissue consists of. gonad. Moreover, it is necessary to examine both sex glands, since one of them may turn out to be an ovary, and the other - a testicle.
A mosaic structure of the gland can also be observed. In the tissue, for example, of the ovary, there are sections of the testicle. Or vice versa.
In order to take a piece of the gland for examination, you need to expose it. The gonads in a person should normally be: in men - in the scrotum, in women - in the abdominal cavity, between the bladder and the rectum. With hermaphroditism, the testicle may be in the abdominal cavity, and the ovary in the scrotum (by the way, the uterus may also be in the scrotum). The gonads sometimes reside in the labia majora, in the inguinal canals, and in the inguinal hernia.
In order to determine the presence of glands in the abdominal cavity, laparoscopy is done. Through a small incision in the abdominal wall, an optical instrument is inserted into the abdominal cavity, with the help of which the space between the bladder and the rectum is examined.
Somatic (soma - body) sex, or gender of the phenotype, is the type of external genitalia, secondary sexual characteristics, the general appearance of the patient. These signs depend on the influence of sex hormones and may vary depending on age and the occurrence of tumors from the tissue of the gonads. Changes in the phenotypic picture are always due to the influence of the hormonal activity of the sex glands.
Our laws regulating the position of a person in society do not provide for the possibility of the existence of a person who does not have a gender - a bisexual.
In the first days after the birth of a child, the sex is officially registered. However, it may be incorrectly defined.
False male hermaphroditism is a condition when a man has deformities of the external genital organs. They are similar to the external genitalia of a woman. These anomalies occur in one in 300 to 400 newborn boys. Usually there is a combination of two anomalies. One of them is the abnormal development of the male urethra, and the other is the incorrect location of the testicles.
The testicles "in the embryo are laid in lumbar region, and then (in the embryonic period of life) go down, pass through the inguinal canals and descend into the scrotum. As a result of abnormal development, the testicles may remain in the abdomen or inguinal canals and do not descend into the scrotum. This anomaly is called cryptorchidism.
There are two forms of cryptorchidism: abdominal and inguinal. With this anomaly, the scrotum is empty or non-existent.
Another anomaly is called hypospadias and is an underdevelopment of the male urethra with the replacement of the missing section of this canal with a dense cicatricial cord. Underdeveloped peripheral parts of the urethra. The forms of this anomaly are classified according to the location of the external opening of the urethra.
Hypospadias of the glans penis. The external opening of the urethra opens at the base of the glans penis. The patients themselves do not notice this form of deformity and believe that in all people the external opening of the urethra is located not at the pole of the glans penis, but at its base. This form of anomaly does not violate either the act of urination or sexual intercourse and does not require treatment.
The stem form of hypospadias is that the external opening of the urethra opens on the back surface of the shaft of the penis. From this opening to the head of the penis there is a short cicatricial cord, which pulls the head to the external opening of the urethra.
canal thus curves the penis in the form of a hook. This form of deformity causes trouble to the sick. When a child urinates, a stream of urine is sprayed. In adults, sexual intercourse is impossible; a penis that is curved and fixed downwards cannot be inserted into the vagina.
The scrotal form of hypospadias. The external opening of the urethra opens at the root of the penis, where the scrotum begins. The penis is usually poorly developed and hooked. The act of urination is carried out according to the female type, squatting. Sexual intercourse is not possible.
Scrotal hypospadias. The scrotum is split into two halves, which look like the labia majora in women. The external opening of the urethra opens between the halves of the split scrotum. The penis is underdeveloped and looks like a female clitoris. The act of urination according to the female type.
Perineal hypospadias. The urethra is short, like in women, and opens at the perineum. The scrotum is split, or it is completely absent. The penis is pulled up to the external opening of the urethra and looks like a clitoris. As a rule, with scrotal and perineal hypospadias, cryptorchidism is also observed, that is, the testicles are located either in the abdominal cavity or in the inguinal canals.
Newborn boys suffering from scrotal and perineal hypospadias are often registered in maternity hospitals as girls. The external genitalia look like a female. There are labia (split scrotum), as well as a clitoris (poorly developed and curved penis). Quite often at such patients the so-called genitourinary sinus remains. This is the cavity into which the urethra flows into the embryo and the vagina opens. The opening of this urogenital sinus looks like the entrance to the vagina. Sometimes in such patients, the urogenital sinus passes into the rudiment of the vagina. Such a "girl" urinates in a female pattern (squatting) and is brought up as a girl. When it comes puberty, there is a conflict between biological and social nature. The life of the sick turns into torment. They rarely go to doctors, and if they do, they go to sexologists. And they don't get any help. Surprisingly, obstetricians who make a mistake in determining the sex, as a rule, persist in their diagnosis.
I had to see a newborn who was registered as a girl On the third day after birth, a urologist was called to the maternity hospital to confirm the baby was female looked like a big clitoris. There were no testicles in the split scrotum. They were palpated in the inguinal canals. The urologist recorded that it was a boy suffering from scrotal hypospadias and cryptorchidism. However, obstetricians did not change the metric gender. They examined the child with a finger through the rectum and allegedly found a uterus in the child. The desire of obstetricians not to correct their oversight was clearly visible. On the seventh day after the birth of the child, a council of obstetricians, urologists, pediatricians and endocrinologists was convened. The council established the male sex of the child and the diagnosis of hypospadias with cryptorchidism. Only after that the legal gender of the child was changed
Patients suffering from male pseudo to hermaphroditism need to undergo surgical correction of the genital organs and change the legal sex if it was incorrectly determined at birth.
In many countries (England, France, Germany, etc.), the legislation provides for the possibility of correcting the legal gender in case of a mistake. In the legislation of our country there are no special provisions on changing the passport gender. But legal barriers to gender reassignment (according to medical indications) is not usually found.
N. E. Savchenko in 1962 wrote that out of 88 patients suffering from hypospadias, in four cases there was an incorrect sex determination at birth. Sick boys were recorded as girls. In 1974, N. E. Savchenko reported that he had found in medical literature description of 96 patients with hypospadias, whose sex was determined incorrectly at birth. Especially often such errors are observed in scrotal and perineal hypospadias with bilateral cryltorchism. In these patients, the split scrotum looks like the labia. They often have preserved urogenital sinus, which gives the impression of having a vagina. According to the literature collected by NE Savchenko, in 30 of 76 such patients, the sex at birth was determined incorrectly. N.E. Savchenko found in the literature a description of 30 such patients who were listed as women and married, but turned out to be men
NE Savchenko writes that he is surprised by the persistence of doctors with which they defend their mistake in determining sex, leaving patients with the wrong social sex for a long time. Only in 3 patients (out of 18) it was corrected before the age of 5 years. In other cases, doctors oriented relatives of patients to a natural solution to the problem. "They will grow up and decide for themselves whether they are men or women." Such tactics are very dangerous and can lead to tragedy.
In sick men who suffered from hypospadias, with a female legal sex, homosexuality is observed. They are active lesbians. With such congenital anomalies sex reassignment in childhood is a natural prevention of homosexuality.
The principle of operations for hypospadias is to straighten the penis and create a male urethra, the external opening of which would open at the glans penis. If the patient also has cryptorchidism, the testicles descend from the inguinal canals into the scrotum (if any).
Surgical operations should be started in the first 2-3 years of life and completed by 4-5 years. Of course, these operations are possible later and even in adults, but their results in such cases will be worse.
It is impossible to eliminate hypospadias at once (with the help of one operation). The first operation aims to straighten the penis. Straightening it is achieved by excision of a dense cicatricial cord, which is located under the skin of the penis and is an underdeveloped shortened rudiment of the peripheral part of the male urethra. After excision of this strand, the penis becomes straight. But at the same time, the external opening of the urethra moves even closer to
perineum. After straightening the penis (if the operation is performed on an adult), sexual intercourse becomes possible, since the straight penis freely enters the woman's vagina. But the act of urination remains in the female pattern (squatting). For some adults, this first step of the operation is quite satisfying, because it makes sexual intercourse possible. Children cannot be satisfied with the first stage of the operation alone, because if a boy urinates in the school toilet not standing up, but squatting (like a girl), then often this is enough for his school friends to drive him to suicide.
A few months after the straightening of the penis, a second operation is performed, the purpose of which is the formation of the urethra (with an external opening on the glans penis).
False female hermaphroditism. These are people with a female genetic (chromosomal) sex. Newborn girls may have abnormalities of the external genitalia that make them look like male genitalia. In such girls, the sex is incorrectly determined at birth.
We observed a child suffering from false female hermaphroditism. At birth, he was assigned a male gender. The child was brought up as a boy. From the age of 12, the patient acquires a feminine appearance and begins to behave like a girl. Pediatricians suspected a tumor of the adrenal gland, which produces and secretes female sex hormones into the blood. The child was taken to our urological clinic for a complex instrumental and X-ray examination. Examination of the child showed that he has a well-formed male penis with a male urethra, and there was an underdeveloped empty scrotum. She had no testicles. An entrance to the vagina was found between the root of the penis and the scrotum. It was injected with a radiopaque substance and photographs were taken, which showed the uterus, fallopian tubes and ovaries. Thus, it turned out to be a girl whose gender was erroneously determined at birth. This situation persisted until the period of maturation, when the real biological sex appeared. If the true sex had not been diagnosed in a timely manner, then after puberty this "man" would have been a passive homosexual.
True hermaphroditism. True hermaphroditism. normal phenomenon is widely, I repeat, distributed in the animal and flora. True hermaphroditism in humans is observed as an anomaly (deformity) and lies in the fact that in one individual both male and female gonads function. True hermaphroditism can be observed with properly developed both male and female external genitalia. But more often with true hermaphroditism, malformations of the external genital organs are observed.
N. E. Savchenko collected 112 observations of true hermaphroditism, diagnosed by histological examination. Of these 112 cases, 109 patients had hypospadias. Patients may experience periods (menses), indicating that they have functioning ovaries, uterus, and vagina. In such patients, the ovary and uterus, together with the fallopian tube, can be located in the abdominal cavity, in the inguinal canal, in the hernial sac (if there is an inguinal hernia.) And in one of the halves of the split scrotum. Cases are described when ovotesticles (sex glands, consisting of testicular and ovarian tissues) were located in both halves of a split scrotum or even in the labia majora, when the external genitalia were female.
All true hermaphrodites are bisexual and require sex reassignment surgery, which involves removing the organs of one sex and leaving those of the other. From a true hermaphrodite, you can make both a man and a woman. The choice of biological sex is dictated by the best or worst development male or female genital organs. If a person has a more developed set of male genital organs, it is more expedient to make a man out of him. If the set of female genital organs is better developed, it is better to remove the male genital organs. In patients suffering from hypospadias, it is more expedient to perform gender correction in the male direction. But the choice of sex in hermaphrodites also depends on the desire of the patient himself.
Radical treatment of true hermaphrodites in cases of a mosaic structure of the gonads is their castration - removal of the gonads followed by transplantation of the gonads of the desired sex. But transplantation of the gonads from donors to recipients is currently inaccessible practical medicine. It is very difficult to find a donor gonad that matches the tissue spectrum with the tissues of the recipient (if the tissue spectra do not match, the transplanted gonad is rejected). In order to reduce the immune response of rejection, D. L. Gorbatyuk suggests using the gonads of immature donors. Currently, very promising work is underway to create in the body a focus for the production of sex hormones without a gonad transplant. M. E. Basmadzhan, I. D. Kirpatovsky, V. I. Gevorkyan, M. L. Ov-senyan developed a method of transplantation (transplantation) of human ovarian cells cultured outside the body, which produce male sex hormones - androgens. These cells are called interstitial endocrinocytes. They are extracted from the testicles of human fetuses at the age of 14 - 24 weeks of intrauterine development (no later than 5 hours after the death of the fetus). Cultivation of cells is carried out on nutrient media in vials. These cultures of embryonic interstitial endocrinocytes easily take root in the patient's body and produce sex hormones. The transplanted cell culture is not rejected by the recipient's body. This is due to the fact that the embryo is in conditions of tissue incompatibility between it and the mother in whose womb it is located. Therefore, some biological mechanism has already been formed to overcome the barrier of tissue incompatibility between the cells of the embryo and the organism into which they are transplanted. N. A. Lopatkin and A. A. Gaibullaev are developing a technique for transplanting the female gonad (ovary) into the body of a man for hormonal treatment prostate cancer. This technique can also be used to transplant an ovary to a castrated hermaphrodite in cases of gender reassignment to the female side.
Sex correction to the male side is performed by urologists. Sex correction to the female side is performed by gynecologists. Moreover, gynecologists often perform a sex transformation, and a man is turned into a woman. How and why this is done will be described in the next chapter.
Many pediatricians work in our country, but they are not able to carry out the prevention of homosexuality due to insufficient knowledge of the issues of sex and genital anomalies. There are very few pediatric urologists and pediatric urological departments. Therefore, children's surgeons and urologists treating adults are forced to deal with issues of prevention and treatment of homosexuality.
N. L. Kushch, V. P. Sleptsov write that the knowledge of pediatricians and obstetricians-gynecologists on establishing sex is very superficial and clearly insufficient. Among the 62 patients observed by these authors with malformations of the external genitalia, sex was incorrectly established in 29.8%.
Sex determination in childhood in true hermaphrodites can be very complex and difficult. L. Kushch and V. P. Sleptsov (1973) describe such a case.
A child, 14 years old, with a male sexual psychoorientation, was brought up as a boy. Hair on the female type, high timbre of voice. Mammary glands up to 7 cm in diameter, rise above the surface chest by 3 - 4 cm. The penis is up to b cm long, sharply curved with a hook. There is perineal hypospadias. The external opening of the urethra is located in the perineum. Urination, female pattern. The scrotum is underdeveloped, split and resembles a large labia. The right testicle is missing. The left testicle is of normal size and consistency, located in the inguinal canal. A diagnosis of perineal hypospadias and gynecomastia (presence of mammary glands in a man) was established. The patient made the straightening of the penis. Six months later, a male urethra was formed in the penis. The patient's mammary glands were then removed. At the age of 16, this patient developed cyclic bleeding of the menstrual type from the urethra lasting 4-5 days. True hermaphroditism was suspected in connection with the appearance of menstruation. The abdominal cavity was opened. In it, between the bladder and the rectum, a uterus with the right tube and the right ovary was found. The left ovary was absent. Thus, the patient suffered from true hermaphroditism. His left gonad was a testicle and was located in the inguinal canal. The right gonad, located in the abdominal cavity, was an ovary. Taking into account the male psychoorientation of the patient and the previous correction of the external genital organs, the patient's uterus with the right ovary was removed, and left testicle from the inguinal canal down to the scrotum. The patient was examined after 7 years. Lives sexually as a man. The psyche is normal. Feeling good.
N. L. Kushch, V. P. Sleptsov, T. I. Kushch, A. D. Timchenko, A. G. Momotov observed 79 patients with anomalies of the genital organs for 2 years, 6 of them suffered from true hermaphroditism. The diagnosis was established by examination of the abdominal cavity and histological examination of the gonads. In 9 patients (out of 79), the true sex was established, previously registered incorrectly. There were 13 children with false male hermaphroditism, in 3 of them the sex was determined incorrectly. One child at the age of 15 (a boy), who was brought up in a female psychoorientation, at the categorical insistence of the "sick" and her parents, had to be castrated (to remove the testicles) and prepared for the formation of the vagina.
The above authors observed true hermaphroditism in 5 children and 1 adult. Four patients had a male psychoorientation, two had a female one. In five hermaphrodites, gonads of both sexes were found, that is, a testicle on one side, and an ovary on the other. In one hermaphrodite, mixed glands of the ovotestis type were found. Four children underwent surgical male gender reassignment. One adult patient underwent sex correction also in the male direction. One adult patient underwent gender reassignment to the female side. The authors of the cited work believe that with true hermaphroditism, if the gonads are equally complete in the morphological structure, the choice of sex depends only on which external genital organs are more developed (male or female). In those cases when one of the gonads in the morphological structure is defective, the sex is corrected for a full-fledged gonad.
With true hermaphroditism in the gonads (both male and female), benign and malignant tumors often occur. Moreover, a characteristic feature of these tumors is their hormonal activity. They produce sex hormones. Tumors from testicular tissue produce male sex hormones, and from ovarian tissue - female ones.
Hormonally active tumors of the gonads cause tumors in other genital organs - in the mammary and prostate glands, and many true hermaphrodites die from cancer.
True hermaphrodites, both in the guise of men and in the guise of women, can have children.
A. A. Zaraiskaya (1975) described a case with a 49-year-old patient. He was born with only one right testicle. Since childhood, he suffered from a right-sided inguinal hernia. From the age of 18, he noted periodic pains in the sacrum at intervals of 3-4 weeks, which lasted 5-6 days. During these periods, pain appeared during urination, tingling in the urethra, the patient noticed on feces fresh dark blood in a small amount. The mammary glands swelled, the nipples became painful. The patient married at the age of 19, his wife had no pregnancies. The penis and prostate gland are developed normally. During an operation for a hernia, a uterus was found in the hernial sac with fallopian tubes. An ovary was found to the left of the uterus. The uterus was well developed and passed into the vagina, which communicated with the rectum with a small opening. The patient has been menstruating since the age of 18 and could become pregnant if the sperm got into the rectum during sexual intercourse through the rectum, as men do” - passive homosexuals.
Often there are true hermaphrodites in female form, and they give birth to children.
R. Klueak, a doctor from Czechoslovakia, in 1968 observed a 25-year-old woman of normal physical development. She was brought up as a girl. During puberty, she began to feel like a man. Enrolled in military courses. She had sexual relations with girls (active homosexual). At the urging of her family, and in an effort to get rid of her abnormal sexual behavior, she got married. Marital intercourse was performed only in a state of intoxication and ee-aa irresistible disgust for her husband. But she gave birth to a child. The marriage was soon annulled. The child born in this marriage was brought up by the sick parents. After the dissolution of the marriage, she began to turn to doctors with a request to remake her from a woman into a man. Having been refused by doctors in the surgical transformation of the sex, she made several attempts to commit suicide. In the end, the author of the described observation proceeded to the surgical transformation of the sex. The first stage is the removal of the mammary glands; The operation brought the patient "tremendous satisfaction." The next stage: a penis was formed from a skin stalked flap taken with subcutaneous tissue in the ilio-inguinal region. This dermal soft penis had a base directly above the clitoris. After 2 months, a rib (section 17 cm long) was taken from the patient, the bone was inserted into the skin penis to give it a dense consistency, necessary for the possibility of inserting the penis into the vagina. Such prosthetics is not an invention of Czechoslovak surgeons. The fact is that the dense consistency of the penis during an erection is achieved by filling with blood three so-called cavernous bodies, of which the penis consists. Some animals (for example, dogs) do not have them in the penis, and its density is achieved by the fact that a bone is located in the penis. In people, too, in the penis, in addition to the cavernous bodies, sometimes a bone is also found. Urologists often have to resort to prosthetic penis in men. These are patients who do not have an erection while maintaining sexual desire and normal sperm production. For internal prosthetics of the penis in such patients, plastic rods are currently used instead of the rib bone (because it is resorbable).
For cosmetic imitation of the scrotum in the described patient, silastic prostheses were sewn into both labia majora, the size and shape of which imitate the testicles. The male urethra was not formed in the artificial penis. There was a short female urethra. The act of urination remained on the female type. The vagina, uterus and appendages were not removed. Along with the described surgical operations hormone therapy with androgens was carried out, which led to the formation of
masculine appearance. Hair appeared on the face, the voice became lower and rougher. The general outlines of the body took on a masculine appearance.
After that, the legal gender was changed. Identity card legalized change female name on the male, after which the last operation was performed. The abdominal cavity was opened, the uterus was removed, but the gonads were left.
In our opinion, a mistake was made in gender correction. It is quite obvious that in this case there was a true hermaphroditism with a full set of female genital organs (which is proved by the fact that the patient gave birth to a child). But the patient had a source of androgens (ovarian tissue) and therefore felt like a man. It is possible that the patient had one ovary, and in place of the other, a developed male gonad. Perhaps one of the glands was an ovo-testis (that is, there was both ovarian tissue and testicular tissue in one gland), but most likely, in the patient, both gonads were ovotesticles. Therefore, during the removal of the uterus, it was necessary to make a histological examination of pieces of gonads taken from the upper and lower poles of the glands, and remove the ovarian tissue, leaving the testicular tissue. This was not done.
So, the patient underwent a sex transformation and eventually she (now he) got married. Before marriage, the patient brought his fiancée to a surgeon who performed sex transformation. The doctor explained to the bride (a normal young girl) in great detail what her fiancé was like. But this did not upset the marriage, it was concluded. The surgeon observed this marriage for two years. Both spouses were happy...
R. Kluzak called this case transsexualism. This sexological term means that an anatomically normally developed woman, for some unknown reason, considers herself a man and is an active homosexual. The reasons for this phenomenon have not been fully elucidated. It is quite obvious that in such cases true hermaphroditism takes place. There is also male transsexualism, when a seemingly normally developed man feels like a woman and is a passive homosexual.
The medical literature describes many observations
ny transsexualism. Now such descriptions appear in the newspapers. For example, in Literaturnaya Gazeta (09/20/1989) Tatyana Fast in the article "13 steps" spoke about a series of unique operations, as a result of which a woman became a man. She wrote that in 1969 the Latvian surgeon Victor Calibere performed an operation to transform a woman into a man. Moreover, this was followed by an order from the Minister of Health of the USSR to severely punish this surgeon for performing an operation that was not accepted in the USSR and performed without the permission of the ministry. The article says that it is high time to switch to a new way of thinking in medicine, to remove many bureaucratic locks from it.
For what 13 operations performed in Riga in 1969, V.K. Kaliberz (now an academician traumatologist-orthopedist) was severely punished?
A patient who suffered from transsexualism, that is, true hermaphroditism, who felt like a man and was ready for suicide if her sex was not changed, had a sex correction in the male direction. The author of an article in the newspaper contrasts the concepts of "hermaphroditism" and "transsexualism", although in principle they are one and the same (only a transsexual has a normally developed female reproductive organs). The patient suffered from true female homosexuality (active lesbian). “In order not to burn bridges”, it was decided: if the patient suddenly refuses to transform the sex and decides to remain a woman, the “excess” will be removed and her former sex will be restored. By "superfluous" the author of the publication means an artificially formed penis. And by "not burning bridges" is meant the abandonment of all female genital organs. Obviously, 12 operations were stages of the formation of the penis from a stalked skin flap with internal prosthesis of this penis with a bone or a plastic rod. The ovaries, or rather, the bisexual gonads, were not removed from the patient. Histological examination of the gonads, obviously, was not carried out, but the patient was "planted" with canned male sex glands (testicles), taken, obviously, from a corpse. It must have been the 13th operation.
The author of the article reports that there was no violation on the legal side. There is a special bureau of forensic medical examination of the Ministry of Health, which deals with the legal registration of sex change in case of hermaphroditism.
Thus, all of the above allows us to conclude that active homosexuals and passive homosexuals are most often false or true hermaphrodites. For medical help, they should not turn to sexologists, but to urologists (if they want to become men) or gynecologists (if women). It is not necessary for all urologists and gynecologists to have subtle methods diagnosis of the true biological sex and methods of correction and transformation of sex. However, every urologist and gynecologist should send such patients on time to special urological or gynecological departments, where they can diagnose and treat false and true hermaphroditism.
Passive homosexual women and active homosexual men do not need surgical treatment and can be successfully treated by psychiatrists and sexologists.

HOMOSEXUALISM (HERMAPHRODITHISM) FROM THE POINT OF VIEW OF PEDIATRICS AND ENDOCRINOLOGISTS
Pediatricians distinguish a large number of syndromes of violation of sexual differentiation. The term "syndrome" refers to a combination of several symptoms observed in different diseases. For example, pediatricians have a micropenis (small penis) syndrome. But a small and poorly developed penis can be with a false male, and with a false female, and with true hermaphroditism, and with the absence or underdevelopment of the testicles.
M. A. Zhukovsky, N. B. Lebedev, T. V. Semicheva, L. V. Chkheidze, A. E. Khaisman (1989) describe the viril syndrome in girls, which consists in the fact that girls have male secondary sex characteristics. Moreover, the authors believe that this syndrome is explained by the presence of male sex hormones in the blood of patients. Therefore, it must be assumed that these are children suffering from either false male or true hermaphroditism. As the authors write, in the children's clinic of one of the institutes of the Academy of Medical Sciences of the USSR, 350 children with various disorders of sexual differentiation were observed over 25 years. Pediatricians believe that it is very difficult to assess the development of the external and internal genital organs in young children. And therefore, we must wait in which direction the formation of the genital organs will go. This is not true because after the birth of a child, no changes in the formation of the genital organs occur, and knowing clearly the forms of anomalies observed in false and true hermaphroditism, these anomalies are easy to diagnose. Moreover, in children, both chromosomal and gonadal sex can be determined, but this requires special research methods.
Pediatricians and endocrinologists consider agenesis (absence) of gonads to be the most common form of pathology of sexual formation. They call this anomaly the Shereshevsky-Turner syndrome. By the way, naming illnesses by surnames is a rather harmful tendency. It turns out a complete encryption of the essence of the disease. Moreover, many and very diverse diseases often appear under one surname. Things come to the point that we have to publish deciphering tables, reference books, where it is noted which diseases are listed under which names.
For about 20 years, I. R. Lazovsky collected and systematized the syndromes, symptoms and diseases named after the names of the authors. In 1981, the second edition of his handbook was published, which reports which diseases are named after the names of doctors. To designate a disease, a term is needed that carries information about the essence of this pathology (for example, underdevelopment or complete absence gonads, and not Shereshevsky-Turner syndrome).
Pediatricians and endocrinologists also describe the syndrome of gonadal bisexuality, or true hermaphroditism, when both elements of the testicle and elements of the ovary are formed in the embryo. Pediatricians also use the term vulvar bisexuality.” They believe that in the female fetus, the differentiation of the external genital organs occurs independently of the state of the gonads, due to an autonomous tendency to develop the genital organs according to the female type. The external genital organs of the male fetus are formed under
influence of male sex hormones. The inferiority of the embryonic testicle in this period contributes to the violation of sexual differentiation and leads to the syndrome of incomplete masculinization, which consists in splitting the scrotum, hypospadias, and underdevelopment of the penis. Under the underdevelopment of the penis, pediatricians understand its curvature. It is observed with underdevelopment of the male urethra (hypospadias).
Pediatric endocrinologists clearly differentiate false male hermaphroditism and testicular feminization syndrome (translated as testicular femininity), although in principle they are one and the same.
M. A. Zhukovsky, N. B. Lebedev, T. V. Semicheva, L. V. Chkheidze, A. E. Khaisman (1989), speaking of true hermaphroditism, indicate that it was first described in 1876. Further they erroneously state that domestic literature about 40 observations are described, and in the world literature a little more than 200 cases of true hermaphroditism. The smallness of these numbers is astonishing. Obviously, they characterize the low competence of pediatricians in matters of pediatric urology, as well as in matters of homosexuality and bisexuality. Many hundreds of thousands of people live on the globe - true hermaphrodites. So, in the presence of scrotal and perineal hypospadias, in 30 - 40% of cases, it is true hermaphroditism that is observed. Moreover, one patient with hypospadias accounts for 200-400 of all births. If all patients suffering from hypospadias, using echography and laparoscopy, look for a gonad in the abdominal cavity and perform a histological examination of this gonad, then many true hermaphrodites can be found in every pediatric urological department. It is known that in all countries there are a large number of passive homosexual men. They are all true hermaphrodites. In all countries there are a large number of 0isexuals, that is, people with alternating sex. If they had a biopsy of the gonads, true hermaphroditism was always found.
Pediatricians believe diagnostic sign true hermaphroditism - the presence of a large labia on one side and the presence of a scrotum with a testicle on the other side. But in such cases, without a histological examination of the gonads, the diagnosis of true hermaphroditism cannot be established.
Endocrinologists quite rightly believe that these studies of sex hormones in the blood do not allow diagnosing true hermaphroditism.
Both pediatricians and endocrinologists quite correctly believe that the treatment of true hermaphroditism can only be surgical and should consist in the removal of the genital organs of one sex and the correction of the remaining genital organs of the other. After surgical correction, further treatment with sex hormones is considered appropriate.

CONCLUSION

There are two categories of homosexuals. The so-called pseudo-homosexuals and true homosexuals. False homosexuals - passive partner in women's homosexual couple and active partner in a male homosexual couple. They do not have any anomalies of sex and genital organs. This is the so-called situational homosexuality, and it can be effectively cured with the help of psychotherapy.
True homosexuals are the active partner in a female homosexual couple and the passive partner in a male homosexual couple. They suffer from anomalies of the sex and genital organs, are false or true hermaphrodites and require surgical treatment.
At present, when the possibilities of transplantation of the sex glands or the culture of their cells are opening up, it is possible to manipulate the hormonal sex in any direction.
In order for homosexuals to seek medical help, a new approach to this problem is needed both among the patients themselves, and among doctors, lawyers, and the whole society. It is necessary to remove the secrecy of the disease, to abandon excessive modesty and hypocrisy, hypocrisy in views on normal and abnormal sexual life. And of course, it is absolutely necessary to abolish articles in the criminal code that provide for imprisonment for homosexuality.
In nature, only a certain period of time is programmed for sexual life and reproduction. In humans, the possibility of reproduction takes a very long time - 30 - 35 years or more. It is in this period that the issues of homosexuality and hermaphroditism are topical.
The period of extinction of sexual life is called climacteric. After the onset of menopause, the issues of sexual life for each person lose their relevance. And if during this period of the extinction of the sexual life, the gonads continue to secrete a large amount of sex hormones into the blood, tumor diseases occur, and in strictly defined organs.
It turns out that completely normal sex hormones produced in the body are the cause cancer. Castrated women (if their ovaries are removed) never get breast cancer. If it has already occurred, surgical castration and chemical castration(which consists in the introduction of male sex hormones into the body of women) are very effective in the treatment complex.
Castrated men never have an adenoma (benign tumor) and prostate cancer. These tumors are caused by male sex hormones. Thus, nature has programmed death from sex hormones, but after the extinction of sexual life, that is, after the end of the reproduction period.
In all women, sexual function disappears after the cessation of menstruation. This usually happens at the age of 45 - 55 years.
In men, sexual function lasts longer - up to 60 years. But this fading is observed only in 30% of men. In 70% of cases in men, the testicles continue to function actively at the age of 70 years or more. It is these men who are more likely to develop adenoma and prostate cancer. I repeat: only 30% of men have menopause. And in 70% of men there is a condition opposite to menopause, which leads to the appearance of tumors in the prostate gland, which are very effectively treated by female sex hormones.
And the last necessary remark. I suppose that after the publication of this pamphlet, both I, as the author, and the editors, will receive many letters in which indignant readers will say something like the following: why are you stuffing us with details about this homosexuality, why do we need to know all sorts of "dirt"?
I will say right away: what was discussed in the brochure is a very serious problem. It affects the lives of tens of thousands of people. From the fact that many doctors (and not only) turn a blind eye to her, the problem will not disappear. All of us, the whole society should take a step towards unfortunate people, understand them and accept them as full-fledged members in the multi-million family of our fellow citizens.

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