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Close examination of Freud's Three Essays on the Theory of Sexuality (1905a) reveals an ambiguity in Freud's language as he simultaneously tries to escape 19th-century psychiatric paradigms concerning sexuality and perversion while also retaining a normative approach to adult sexuality that created new categories of pathology. The result is an ambivalent legacy that has both hampered and helped contemporary clinicians as they deal with a diverse array of presentations of gender and sexual orientation in today's world.