However, no surgeon could be found to carry out the recommended operations. He was then sent to another hospital where, although his psychological femininity was conceded, surgery was refused. Although he had never heard or read about such activity, H began spontaneously to masturbate toward the end of his thirteenth year. He masturbated about four times a week. His masturbatory fantasies were of males, often of soldiers carrying guns.
H is the fourth of five siblings.
With his oldest sister, seventeen years older than H, there was mutual dislike and constant conflict. She refused emphatically to accept him as a girl and objected to his wearing girls' clothing regarding this as a threat to her own social status. Since the parents sided with H, this sister left the home. She has since refused to have anything to do with him. With a sister eleven years his senior, H had an affectionate relationship.