In general, homosexuality and homosexuals were viewed with great disdain and contempt in the late nineteenth and early twentieth centuries. In many countries, homosexual behavior was severely punished, and any hint of homosexuality was often considered shameful and ruinous to one's reputation. Oscar Wilde's career ideed was ruined when he was accused of being a homosexual, and various other writers -- even including Walt Whitman -- were wary of being accused of homosexual conduct. Homosexual behaviors (even meetings with other homosexuals) were often secretive and accompanied by great anxiety. Public admissions of homosexuality were extremely rare, and much writing implying homosexuality was "coded" or implied. Homosexuality was often considered sinful, sick, unnatural, or all three combined. These attitudes continued to prevail throughout much of the rest of the twentieth century; it was not until the 1970s that a more tolerant attitude began to arise, and of course full toleration does not exist even today.
Literary works that hinted at homosexuality -- such as Willa Cather's "Paul's Case" -- could do little more than hint. Works that dealt sympathetically with homosexuals would have been very poorly received by the broad reading public. Works that dealt at all explicitly with homosexual behavior ran the risk of being banned or otherwise legally suppressed. If Paul in "Paul's Case" has any homosexual feelings or desires, he would have had little choice but to try to suppress or hide them. His suicide at the end of the story may reflect, to some degree, his sense that there would never be any place for him in the society of his era.