SUMMERSVILLE COUNTY PSYCHIATRIC UNIT
CASE NOTES
CASE #: 022523-A
PATIENT: Leonard Arnold
DOB: 4/29/XXXX
STAFF: Edna Keener, D/Psy. D
REFERRED BY: Municipal Court/Hargrove
February 15
PRE-SESSION CLINICAL NOTES:
Patient suffers from multiple issues including personality disorder, neurosis, depression and idealization of his wife. It is my belief that patient is being taken advantage of and physically harmed by his wife and her boyfriend although patient insists he consents to the exploitation and punishment.
PRE-SESSION ACTION PLAN:
Watch for further signs of abuse that could trigger an automatic law enforcement response independent of patient's permission. Patient was prescribed Alprazolam 0.5 mg at initial session. Monitor drug's effects, adjust dosage accordingly.
Interview transcript follows:
DR. EDNA: Oh. My. Hello, Leonard.
LEONARD: Um ... hi. You're probably wondering--
DR. EDNA: Well, yes. I see you're dressed ... a bit differently this time.
LEONARD: Uh, I ... I'm coming out. This is who I am inside.
DR. EDNA: Coming out?
LEONARD: As a ... a trans. Transgender. I'm coming out. It's who I am inside.
DR. EDNA: Oh? Well ... congratulations, Leonard. Um, when did you make this decision? To come out?
LEONARD: Uh, about a week ago?
DR. EDNA: After our session?
LEONARD: Um, yeah.
DR. EDNA: Leonard, have you always felt like this? That you're transgendered, I mean. You didn't mention it last time.
LEONARD: Oh, well ... I was ... I didn't want to tell you. But now I want to come out as a trans person because, uh, this is who I am inside.
DR. EDNA: When did you first start having these feelings?
LEONARD: I-I think I was, like ... two?
DR. EDNA: Two? That seems young.
LEONARD: Um, I mean, maybe five? Six? It ... I don't remember exactly. It's just who I am inside. Since as long as I can remember, you know. I just felt like I was a trans person ... inside. From when I was a kid. Real little. I want to come out as a trans person now, finally, because ... um, this is who I am ... uh, inside.
DR. EDNA: Leonard, I've got to be honest with you, it sounds like you're reciting a script. Is this really something that you're feeling ... or are James and Dawn making you do this?
LEONARD: I ... uh ...
DR. EDNA: Please be honest with me, Leonard.
LEONARD: Um ... well, they did ... uh, no. No, Dr. Edna. This really is who I am inside. I want to come out as a trans person. And that means you can't discriminate against me or call the police. Because I'm trans.
DR. EDNA: Oh. Now I see.
LEONARD: Are you gonna call the cops?
DR. EDNA: Why are you so worried about that? You said last time that Dawn would be mad if the police were to do a wellness check at your home. Why?
LEONARD: She hates cops. So does James. OMG, does he hate cops.
DR. EDNA: Is that it?
LEONARD: Is what it?
DR. EDNA: Is that the only reason you don't want me calling the police?
LEONARD: Look, Dr. Edna ... I don't expect you to understand. I told you before, we don't have a normal marriage. Yeah, I have to put up with some things ... getting the whippings ... and now having to be a sissy--
DR. EDNA: A sissy? That's no way to talk about yourself, Leonard.
LEONARD: That's what I am, isn't it? A sissy? Look at me.
DR. EDNA: Well ... I'm not--
LEONARD: Listen, Dr. Edna, I don't know why we even have to keep doing this. Dawn and James are really mad that I'm not home to serve them, and they don't like me coming here telling you what goes on in our house.
DR. EDNA: If this is a consensual lifestyle for you all, and nobody's being forced to do anything, there should be nothing to hide. Lots of people live in alternative relationships.
LEONARD: They say it's none of your ... effing business. Excuse my language.
DR. EDNA: Well, Leonard, Dawn and James need to understand that unless you work with me in these sessions you won't complete the program, and you'll likely be facing the original criminal sexual misconduct charge, along with contempt of court for lack of cooperation during the psychological evaluation.
LEONARD: I did try to tell them. They won't listen.
DR. EDNA: Well, Leonard, I'm trying to--
LEONARD: I mean, what difference does it make for me to sit in here and complain for an hour, anyway? I've got a shitty life, okay? Is that what you want to hear? I'm a sap because I let my wife walk all over me. Okay? And now I have to go through this ... this ... complete embarrassment. It's a nightmare.
DR. EDNA: What are you talking about? What embarrassment?
LEONARD: This. These clothes. Coming out. At work. (crying)
DR. EDNA: It's okay, Leonard. Here, take a drink of water.
LEONARD: T-thank you.
DR. EDNA. You're welcome. Now, tell me about it. Coming out at work.
LEONARD: I-I came in the first day wearing a dress and ... everyone died laughing. They thought it was some kind of joke -- until I told them I was coming out as a trans person and they all stopped laughing right quick. James was right.
DR. EDNA: Right about what?
LEONARD: Um ... well trans people are kinda protected. Everyone tries not to offend them. If not, they file a lawsuit.
DR. EDNA: And this is what James says?
LEONARD: Yeah.
DR. EDNA: So, he made you come out as a transgender so I'd be reluctant to call the police because I'd be afraid you'd sue me?