Kohout was born and grew up in Vienna. His mother, Amalia, and father, Josef senior, were wealthy Catholics, and his father had a high-ranking job in the civil service. Kohout was arrested in March 1939, at age 22, when a Christmas card he had sent to his male lover, Fred, was intercepted. His lover Fred, whose father was a high-ranking Nazi official, was deemed "mentally disturbed" and escaped punishment.

Incarceration

Kohout was interned in the Sachsenhausen concentration camp. He reported that homosexual prisoners were the most reviled of all the camp's detainees, and prevented from mutual association. Though the SS guards controlling the camp prevented the homosexual prisoners from associating with one another, sex between straight guards and gay prisoners nonetheless took place, with the guards construing such encounters as a "natural" expression of their "normal" sexuality in unusual circumstances. Kohout was selected for sexual services by a Kapo, and then the senior of his block. Florence Tamagne describes these involvements as fortunate for Kohout; the preferment of these relatively privileged men may have helped Kohout to survive.

Like other prisoners, Kohout was assigned futile tasks during his time in the camp, including using barrows to move the snow (and bare hands to move rocks) from one side of the compound and then back to the other. The repetition and pointlessness of the tasks were such that many prisoners committed suicide. Kohout observed the beating and the torture of prisoners, and theorized in his writings that the sadism of some of the SS officers reflected repressed homosexual desires of their own.

Later, Kohout was transferred from Sachsenhausen to Flossenbürg, in Bavaria.

Liberation

Flossenbürg was liberated by the U.S. Army's 90th Infantry Division on April 23, 1945. Kohout's journal entry for his final day in the camp reads only "Amerikaner gekommen" ("Americans came").

He was eventually reunited with his mother. His father had committed suicide in 1942, leaving a note for his ife, Amalia, asking "May God protect our son".

As well as describing the barbarism of life within the camp, Heger's book offered criticism of the treatment of gay concentration camp survivors after liberation. After the camp's liberation, Kohout - like other homosexual prisoners - was still regarded as a criminal, since homosexuality remained illegal after the demise of the Nazi regime. He was not eligible for compensation and, despite attempts on his part, he received none from the West German government. Many other gay men who had survived concentration camps were returned to prison, and the time they had spent interred in the camps was not deducted from their sentences.

The book remains one of very few in existence that document the experiences of homosexuals imprisoned by the Nazis. It is taught and read in college courses internationally, including at universities and Jewish seminaries.

Erik Jensen, writing in the Journal of the History of Sexuality, identifies the publication of Kohout's memoir as a turning point in the history of the gay community, when the activists of the 1960s and 70s began to take account of the perspectives of the preceding generation and to embrace the pink triangle as a symbol of gay identity.

Kohout died in Vienna at age 79, and certain items of his possession were donated by his companion to the United States Holocaust Memorial Museum. They included Kohout's journals from the camp, a number of letters sent by his parents that had never reached him while he was imprisoned, and the cloth strip with the pink triangle and his prisoner number that he had been forced to wear. It was the first pink triangle belonging to an identifiable individual that had been recorded.