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this, he decided, he would be fit to join the ranks of his fellow human beings despite all his other “failures. ” He has been at it since he was sixteen.
    The other is an African-American homosexual—I’ll call him Lou—who firmly believes he is pregnant. What makes him think so? If he places his hand on his abdomen he can feel the baby’s pulse. Arthur Beamish (who is gay himself), his staff physician and our newest psychiatrist, has not been able to convince him that everyone’s abdomen pulses with the beat of the abdominal aorta and other arteries, or to persuade him that fertilization in a man is impossible due to the absence of a major component of the reproductive system, namely an egg cell.
    What has led to this bizarre conception? Lou has the mind of a woman trapped in a man’s body, a not uncommon gender-identity problem known as transsexualism. When he was a child he enjoyed dressing in his big sister’s clothing. His unmarried mother, who had problems of her own, encouraged this practice and insisted he urinate sitting down, and it wasn’t until he was twelve years old that the truth was discovered during a routine school physical. By that time Lou’s sexuality was firmly established in his mind. Indeed, he refers to himself as “she, ” something the staff does not encourage as it would only make things worse. Oddly, a benign cyst in his bladder caused some occasional minor bleeding, a fact he used to “prove, ” at least to himself, that he was menstruating.
    Although a subject of intense verbal abuse throughout high school, he stubbornly maintained his female characteristics, wearing skirts and bras, using makeup, etc. He padded his breasts, of course, but so did some of the girls. After graduation, he and his mother moved to a different state where no one knew them, and Lou’s identity was secure. He got a job as a secretary for a large corporation, and it wasn’t long afterward that he fell in love with a man who happened to notice his five o’clock shadow in the elevator late one afternoon. A passionate relationship followed, and it was only a few months later that the urinary bleeding mysteriously stopped and Lou took this to mean he was pregnant. He was ecstatic. He badly wanted to have a child in order to validate his existence. Almost immediately thereafter he was afflicted with morning sickness, abdominal pains, fatigue, and all the rest. He has been wearing maternity clothes ever since.
    The “father” of his child, frightened by something he did not understand, convinced Lou to seek psychiatric help, and he ended up with us at MPI. That was six months ago, and the baby is “due” in a few weeks. What will happen when it comes to term is a matter of conjecture and concern among staff members and patients alike. Lou, however, awaits that fateful day with sublime anticipation, as do some of the other inmates, who are already suggesting possible names for the new arrival.

SESSION NINETEEN
    I think I found the focus for my book, ” Giselle announced as I was coming out of my office.
    “I’m on my way to a meeting. Want to walk?”
    “Sure. ” She fell in beside me with quick little steps.
    “Isn’t it space travel? UFO’s? Little green men?”
    “Not really. The first chapter will be about the likelihood of extraterrestrial life. The second will be a rehash of my article about UFO’s. It’s the other chapters I’m talking about. “
    “Have you asked him about UFO’s?”
    “Uh-huh. “
    “Well, what does he think?”
    “He says ‘There ain’t any. ‘ “
    “How does he know that?”
    “He says it would be like riding a pogo stick a trillion times around the Earth.”
    “So how does he account for all the sightings that people claim?”
    “Wishful thinking. “
    “Huh?”
    “He says that even though there are no alien ships, there are a lot of humans who would like to believe otherwise. ‘
    Klaus Villers joined us. “Hi, Klaus. What’s the focus of the other