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The first edition of Freud’s Three Essays on the Theory of Sexuality contains a theory of perversion and of sexuality that contradicts the idea of a “perverse structure.” Indeed, the idea of a “perverse structure” tends to reintroduce a reference to a nosological entity (“identity”) that is essentially different from other identities. We show that this idea contradicts the patho-analytic perspective that Freud develops in the first edition of the Three Essays. In this way it becomes clear that the Lacanian theory of perversion can only be understood from the perspective of French psychiatric history and, more particularly, the work of Ernest Dupré.