[1—Doctor's Note]

From the notebooks of Dr. Nadine Hopewell:

DANIELLE LYNN HEYWOOD

October 06, 1976

Sixteen year old female, of slight build and fair complexion and sandy blonde hair, 5'2" and 105 lbs.  No known health issues.

Danielle was referred to me by Judge Elton Marcus, who ordered a psychological evaluation.  She appeared in court with both her father and a lawyer and wished to have her gender changed legally.  The putative lawsuit began after Danielle was denied a chance to take the test for her driver's license.  She refused to disclose her gender and defaced the application.  He believes she may have some form of gender disphoria.

FAMILY HISTORY:  She is from a middle-class family in St. Louis, Mo, first of three children.  She has a younger sister (Regina, 13), and a brother (Robert, 10).   Her father works in the electronics industry and her mother is a part-time paralegal.  No history of mental illness or abuse in either parent.  No alcohol or other drug abuse reported.

ASSESMENT:  Subject prefers to be called 'Dani'.  When asked why, she replied "Because it's not a girl's name." but denies identifying as a male. 

Dani was wearing clothing appropriate to her age and perceived gender, but displayed signs of discomfort and self consciousness about her appearance. 

Expressed anguish at the idea of being thought 'crazy.'

Dani seems intelligent and alert—anxious rather than depressed.  Instead, she seems bored with her home and school life and is anticipating the future with perhaps too much attention. 

She in an accelerated learning program and has voluntarily taken summer school since she was thirteen; she will graduate from high-school at the end of this term.  She shows no sign of school-related stress, but instead seems determined to work hard and is goal oriented.

She showed curiosity about my professional credentials and seems to accept that I am here to help her.  She denies being confused about her gender, and stated that she felt misunderstood. 

Further discourse revealed that she thinks she is neither female nor male, in either sex or gender. 

MEDICAL HISTORY:  Subject is sixteen with the physical appearance of late adolescence.  Does not use any known form of birth control, but claims to be abstinent.

She denies having reached menarche.  When asked about feminine hygiene, she revealed she has no plans of ever menstruating, and has taken no precautionary steps for eventual onset of menses.

I tried to counsel her on the necessity of proper care of one's bodily functions, but she seemed completely uninterested and insisted it did not apply to her.  When I gave her a box of tampons, in case of emergency, she told me she didn't have any place to put them.  I told her she could carry them in her purse—or a smaller case if she was embarrassed—and she told me "I don't carry tampons because I don't have any place to bleed from.  I don't have a vagina."

PROGNOSIS:  I do not think the girl is a danger to herself or others, although she may have delusions.  But there are few other indications of mental illness or poor mental health. 

I find it interesting that this ordeal was brought on by a conflict with authority during what is an important rite of passage to adulthood in American culture.

I will confer with my colleagues and Judge Marcus to determine the extent of her illness and recommend a treatment. 

I Recommend seeing Dani bi-weekly, if she is agreeable.