I frequently, perhaps several times a month, would have vague sexual dreams.  These always, I think, occurred when I happened to be sleeping with someone whom, in my dream, I would mistake for my intimate friend, and would awaken myself by embracing my bedfellow with sometimes a slight, sometimes considerable degree of passion.  I have finally arrived at some understanding of my own temperament, and am no longer miserable and melancholy.  I regret that I am not a man, because I could then have a home and children.”

HISTORY XXXIX.—­Miss D., actively engaged in the practice of her profession, aged 40.  Heredity good, nervous system sound, general health on the whole satisfactory.  Development feminine but manner and movements somewhat boyish.  Menstruation scanty and painless.  Hips normal, nates small, sexual organs showing some approximation toward infantile type with large labia minora and probably small vagina.  Tendency to development of hair on body and especially lower limbs.  The narrative is given in her own words:—­

“Ever since I can remember anything at all I could never think of myself as a girl and I was in perpetual trouble, with this as the real reason.  When I was 5 or 6 years old I began to say to myself that, whatever anyone said, if I was not a boy at any rate I was not a girl.  This has been my unchanged conviction all through my life.

“When I was little, nothing ever made me doubt it, in spite of external appearance.  I regarded the conformation of my body as a mysterious accident.  I could not see why it should have anything to do with the matter.  The things that really affected the question were my own likes and dislikes, and the fact that I was not allowed to follow them.  I was to like the things which belonged to me as a girl,—­frocks and toys and games which I did not like at all.  I fancy I was more strongly ‘boyish’ than the ordinary little boy.  When I could only crawl my absorbing interest was hammers and carpet-nails.  Before I could walk I begged to be put on horses’ backs, so that I seem to have been born with the love of tools and animals which has never left me.

“I did not play with dolls, though my little sister did.  I was often reproached for not playing her games.  I always chose boys’ toys,—­tops and guns and horses; I hated being kept indoors and was always longing to go out.  By the time I was 7 it seemed to me that everything I liked was called wrong for a girl.  I left off telling my elders what I did like.  They confused and wearied me by their talk of boys and girls.  I did not believe them and could hardly imagine that they believed themselves.  By the time I was 8 or 9 I used to wonder whether they were dupes, or liars, or hypocrites, or all three.  I never believed or trusted a grown person in consequence.  I led my younger brothers in everything.  I was not at all a happy little child and often cried and was made irritable; I was so confused