The pamphlet accompanying the current exhibition of Walter Sickert’s Camden Town series of nudes, in Somerset House, London, has breathed life into the dying controversy about the true identity of Jack the Ripper.

Few would question the quality of the paintings, but it is hard to deny that they display a side of Sickert’s psyche far removed from whatever inspired his paintings of Normandy beaches, or even those of life in London music halls and theatres.

Early photographs of Sickert show an expression as refined as it is detached and cruel. He had a complex personality that resulted in his sudden removal from one school and expulsion from another. He finally completed two full years, and his university entry exams, at King’s College School, with distinction, but he never went to university.

Patricia Cornwell, in her analysis of Jack the Ripper’s case, describes Sickert’s extraordinary arrogance, his periodic lack of sensitivity to other people’s feelings and his magnetic, manipulative powers as being typical of psychopathy. Apparently Sickert’s childhood was studded by rages and sadistic games.

Sickert had a disturbed background, but the emotional problems that this could have induced were as nothing to the psychological trauma that a hopelessly deformed penis must have inflicted on him. The repetitive surgery at St Mark’s Hospital – then, as now, a centre of excellence for below-the-belt operations – failed to correct his problems. The poor boy was only 3 when he first had surgery, and he endured three major operations before he was 5.

Sickert’s deformity is described as a fistula, a term meaning an abnormal passage either between two organs or from one organ to outside the body. Sickert suffered from hypospadias, a condition in which the meatus (opening) of the penis is not at its end but on its underside, somewhere between the tip and the perineum (the area between the base of the penis and the anus).

One boy in 350 is born with some degree of hypospadias. The most common form is with an elongated meatus on the underside of the head of the penis, the normal meatus being replaced by a small, blind pit. The disadvantages suffered from this common type of hypospadias are trivial and rarely warrant surgery. These small deformities are often noticed by a patient only when a doctor draws attention to them.

Openings of the urethra along the underside of the penis are less frequently seen but still relatively common. The farther back the meatus, the greater the potential troubles. Unfortunately the length of penis in front of the abnormal opening is reduced on average by about a third, and the penis when erect is often angled downwards.

The worst problems suffered by those with hypospadias are experienced by those who, like Sickert, have an elongated urethra opening in the perineum. They may well also have a very small penis. As the urethra is often slit-like, there may be confusion about the baby’s sex at birth.

When Cornwell wrote her book, the standard textbook of erectile dysfunction was not yet established. It deals thoroughly with the effects of hypospadias on the sex life and psyche of those with the condition.

Even without an emotionally charged home background such as Sickert had, two thirds of patients with severe perineal hypospadias have psychological problems. In half of these cases the problems are serious enough to disrupt quality of life, and in more than a fifth the problems are psychosexual. Patients with a perineal hypospadias are also more likely to have difficulty with ejaculation and to be impotent.

An earlier study showed that patients with a severe – even if not perineal – hypospadias were underachievers and had a reduced ability to make social and emotional relationships. Research shows that successful surgery depends on the severity of the hypospadias, its site, the surgeon’s skill and the age of the patient when surgery is completed.

Sickert’s parents did their best for him. He was sent to Sir Alfred Cooper, a distinguished surgeon at St Mark’s, who had a reputation as both a urologist and a colorectal surgeon. Even so, surgery in the mid-19th century was an ordeal, and for a child under 5 it must have been hell. Little wonder that although Sickert was brilliant and had outstanding looks, he was also “a handful”, “volatile” and “perverse and wayward”. According to other descriptions of Sickert’s temperament, he was solicitous, kind and generous at times, but could also be rebellious, reclusive and unconcerned by what society thought.

Cornwell’s conclusions about the identity of the Ripper are controversial, but she draws attention to circumstances that are at best strange coincidences. Certainly his early background and his genital abnormalities could well have been the basis of Sickert’s difficult, gothic personality – and in others, if not in him, could have triggered aggressive psychopathy.

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