Page:Edward Prime-Stevenson - The Intersexes.djvu/641

The foregoing study easily may have an immediately personal interest for some of its readers. A practically useful mission has been the chief reason for its completion.

As a help to such personal diagnosis, or to a diagnosis of some one else, whether heterosexual, Uranian, Uraniad, Dionian-Uranian or what else in individuality, is appended the ensuing series of categoric questions. They are only partially of the authour's framing; a large majority are freely translated from a group prepared by that eminent specialist on Intersexualism, Dr. Magnus Hirschfeld, of Charlottenburg (Berlin), and published by him in the "Jahrbuch für Sexuelle Zwischenstufen," for 1899, (Leipzig, Max Spohr). But a considerable readjustment and enlargement of Dr. Hirschfeld's series is here presented, covering details less explicitly included in the German.

The series is arranged in such a way that it can be filled out for the opinion of a confidential psychiater—if the reader has occasion to consult such a specialist.

Name:
Sex:
Age:
Nationality:
Residence:
Married or single?	${\displaystyle \scriptstyle {\left.{\begin{matrix}\ \\\ \end{matrix}}\right\}\,}}$
Widowed or divorced?
If latter, on what grounds?
Profession or occupation: