Abstract Purpose This article provides a psychiatry resident's reflections on repeated interactions with a patient in the emergency department. Beginning with an overview of the clinical scenario of a 36-year-old transgender female brought in by police due to homicidal ideation, the author reflects on her own identity as a queer woman and the role of countertransference in clinical interactions. Materials and methods The patient history and the author's clinical assessment were extracted from electronic medical record notes. A pseudonym has been used for both Jasmine and Stella, and some identifying details have been changed to protect confidentiality. Results The narrative explores themes of paternalism, overidentification with the patient, and identification with the perpetrator. Conclusion The author concludes by emphasizing strategies to reframe feelings of isolation into structural intervention in order to foster hope and belonging for clinician and community alike.

中文翻译：

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一位住院医师对急诊精神病学酷儿性和反移情的反思

摘要 目的本文提供精神科住院医师对急诊科患者反复互动的感想。作者首先概述了一名 36 岁跨性别女性因杀人意念而被警方带走的临床情景，反思了她自己作为酷儿女性的身份以及反移情在临床互动中的作用。材料和方法 从电子病历记录中提取患者病史和作者的临床评估。Jasmine 和 Stella 都使用了化名，并且更改了一些识别细节以保护机密性。结果 叙述探讨了家长作风、对患者的过度认同以及对肇事者的认同等主题。