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Journal of the History of Sexuality 10.3&4 (2001) 566-568

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Book Review

Stepchildren of Nature:
Krafft-Ebing, Psychiatry, and the Making of Sexual Identity

Stepchildren of Nature: Krafft-Ebing, Psychiatry, and the Making of Sexual Identity. By Harry Oosterhuis. Chicago Series on Sexuality, History, and Society, edited by John C. Fout. Chicago: University of Chicago Press, 2000. Pp. x + 321. $35.00 (cloth).

Foucault argued that modern sexuality was a social construction of scientific discourses and disciplining practices. In his new book, Harry Oosterhuis convincingly disputes that one-dimensional account. Stepchildren of Nature concerns the psychiatric practice of a figure whom Oosterhuis views [End Page 566] as central to the development of modern sexuality: the German sexologist Richard von Krafft-Ebing (1840-1902). It argues that Krafft-Ebing's theories were not unilaterally imposed on his patients; rather, his ideas evolved in dialogue with patients and incorporated their subjective experiences. Patient narratives thus "influence[d] the production of medical knowledge" and, by extension, the development of a modern individualized and psychological understanding of sexuality. Focused primarily on male homosexuality, Stepchildren offers a nuanced, multidimensional account that, avoiding the reductionism of both essentialism and social constructionism, links sexual identity, psychiatric discourse, and the society of fin-de-si├Ęcle Central Europe.

The work is broader than its title suggests because it contextualizes Krafft-Ebing's work and his patients' views, diachronically and synchronically, by examining long-term developments since the eighteenth century. The first half of the book provides background on the development of sexual science, on nineteenth-century psychiatry, and on Krafft-Ebing's career. Synthesizing a large body of secondary literature, these chapters offer, on the whole, useful introductions to their respective fields.

The second half of the book, its heart, develops Oosterhuis's thesis about the reciprocal relationship between Krafft-Ebing's thought and the views of his patients. Oosterhuis carefully sifted through 440 of the physician's published and unpublished case histories. Many of these included letters and autobiographical accounts from patients he treated or from those who corresponded with him. It was largely as a result of listening to his patients that Krafft-Ebing shifted his emphasis from a biomedical to a psychological interpretation of sexuality and came to believe that same-sex desire was both inborn and similar to heterosexual love. This is a strikingly revisionist account of Krafft-Ebing as a progressive crusader for tolerance and an enabler, through his writings and medical practice, of homosexual identity. Krafft-Ebing argued that homosexuality was "not by definition 'immoral,'" and thus, while he continued to view it and other "perversions" (masochism, fetishism, etc.) as psychopathology, he advocated compassion and tolerance, calling for the decriminalization of homosexuality (with the exception of pederasty).

Medicine and, in particular, Krafft-Ebing's bestseller Psychopathia Sexualis shaped, in turn, patients' views of their sexual proclivities. They categorized themselves within medical classifications and performed self-analyses that followed the narrative structures and rhetoric of medical case histories. Many homosexuals and other "perverts," it seems, adopted the medical view that their sexuality was pathological. Yet patients were neither passive objects nor victims in this process. Indeed, many found comfort and empowerment in a medical model that divorced perversion from immorality. Others asserted the healthiness of their feelings and critiqued the repressive norms of their society. Still others challenged and engaged [End Page 567] Krafft-Ebing in debate. Krafft-Ebing's work not only provided "perverts" a voice; it contributed to the formation of a social identity and a sense of community among the sexually marginalized and stigmatized.

It is no accident that the majority of patients whom Krafft-Ebing treated in private practice and with whom he corresponded were from the middle and upper classes. These patients shared with their physician a set of cultural beliefs and values from which, according to Oosterhuis, both psychiatric ideas and patient sexual identity emerged. Patient autobiographical narratives displayed a distinctly modern view of sexuality. They saw it in psychological terms, as an essence detached from reproduction...


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