Billy is not a real trans-sexual, but he thinks he is. He tries to be. He's tried to be a lot of things, I expect.

And you said that I was very close to the way we would catch him. What did you mean, doctor?

There are three major centers for trans-sexual surgery: Johns Hopkins, the University of Minnesota, and Columbus Medical Center. I wouldn't be surprised if Billy had applied for sex reassignment at one or all of them, and been rejected.

On what basis would they reject him?

Look for severe childhood disturbances associated with violence. Our Billy wasn't born a criminal, Clarice. He was made one through years of systematic abuse. Billy hates his own identity, you see, and he thinks that makes him a trans-sexual. But his pathology is a thousand times more savage and more terrifying.