In Harris’s novel, Jame is on black-market estrogen for minor feminization and has a mournful attachment to their late beauty-queen mother, whose pageants they intently watch on VHS. These elements are not present in the film, though Jame sewing together a “woman suit” from the skin of their victims remains unaltered, a salacious hook for viewers. Jame’s kills are revealed as a trail of necrotic clues: a decomposing head in a storage facility, an autopsy of a young girl with diamond-shaped sewing-pattern pieces carved into her back. The audience can form a disturbing image of Jame in their heads before the character appears. Perhaps it was the very suggestion by Lecter that the character thought they were trans that permitted viewers to consider Jame in a lineage with other on-screen transfeminine serial killers: Norman Bates in Psycho (1960), Bobbi in Dressed to Kill (1980), and Angela in Sleepaway Camp (1983).
In the movie version, when we first encounter Jame, they are using Ted Bundy’s modus operandi of apprehending a female victim by posing as an injured man in need of help. Catherine Martin (Brooke Smith) explodes onto the screen, singing her heart out in her car to “American Girl” by Tom Petty and the Heartbreakers, in one of the adept uses of character behavior and popular music to create identification that Demme is known for. Catherine stops to help when she sees that Jame is struggling to lift a couch into the back of their van. Because of the empathy with which she was introduced, it is particularly jolting when Jame abducts her. But the director also extends a strange and complex empathy to Jame. Demme and cinematographer Tak Fujimoto opt for a point-of-view shot when Jame cuts Catherine’s blouse open from the back, symbolically suggesting the “carving” that will eventually be done. Jame stares in admiration, gently grazing their palm over her skin, and rattles out, “Good . . . good.” The implication of potential trans femininity renders the scene even more chilling, because viewers can grasp both the wrongness of the actions and the skewed logic of the motivations that underlie them. The irony of both the novel’s and the film’s waffling over the transness of the character is that these layers of Jame are most readily available if the character is in fact trans, and has suffered under the scrutiny and gatekeeping of the medical establishment. Otherwise, Jame is just a monster.
In book and movie, we learn that Jame once sought treatment at the Johns Hopkins University Gender Identity Clinic, and an understanding of that institution’s significance to trans medicine in the United States adds complexity to the question of the character. Opening in 1965, the JHU Gender Identity Clinic was one of the earliest of its kind in the United States. Americans could, if approved, have trans procedures at a globally recognized institution in their own country, instead of going abroad, as the actress and singer Christine Jorgensen had famously done a generation earlier. Tally’s script portrays the Gender Identity Clinic as a bastion of compassionate do-gooders, with its avatar, Dr. Danielson, referring to his patients as “nonviolent people with a real problem.” He is put off by Agent Jack Crawford (Scott Glenn) and his dogged pursuit of Jame’s file. However, Danielson, who in the book is a calculating bureaucrat, ultimately acquiesces after the FBI threatens to shut down the clinic because of the Jame connection.