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Hannibal Lecter: 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.Clarice Starling: And you said that I was very close to the way we would catch him. What did you mean, doctor?Hannibal Lecter: 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.Clarice Starling: On what basis would they reject him?Hannibal Lecter: 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.

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