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Eighty-four cases of hermaphroditism from the medical literature are examined, and it is shown that, in the great majority of these, the hermaphrodite assumes a heterosexual libido and sex role that accords primarily not with his or her internal and external somatic characteristics, but rather with his or her masculine or feminine upbringing. This is shown to be true in the case of pseudohermaphrodites, ?true hermaphrodites, and true hermaphrodites. On the basis of these facts, the conclusion is drawn that heterosexuality and homosexuality in hermaphrodites are primarily caused not by direct hormonal or other physiological factors but by environmental ones. Since, however, the hermaphrodite's environment conspicuously includes his somatic anomalies, it is also concluded that the problem of “normal” and “abnormal” sexual behavior among hermaphrodites is importantly a psychosomatic one; as is, too, the broad problem of psychosexuality in normal human beings. The necessity is also pointed out for a careful consideration of hermaphrodite patients in their psychiatric as well as medical aspects.
Albert Ellis (Thu,) studied this question.