This article borrows from the lessons of dystopic science fiction to analyze fantasies that surround gender variance and perversion in the psychoanalytic clinic. Philip K. Dick's novel Do Androids Dream of Electric Sheep? is used to substrate Lacan's formations of perversion and their relationship to the paradoxical nature of desire. Lacan's idiosyncratic handling of perversion formulates an essential truth about the problematic nature of human desiring, a problem that must be creatively mitigated. This article postulates that quotidian difficulties of desire manifest symptomatically in psychoanalytic and psychiatric work with transgender patients through clinical expressions of transphobia. These claims are illustrated with a close reading of a 1948 clinical case study with a transgender analysand. The case pays special attention to the patient's pencil drawing, produced while in treatment, which visually represents their gender.