Life at home, meanwhile, was bad enough. Ms. Albert ran away. She landed in the punk scene, in the East Village, with the hustlers and the addicts. This was around the time of her initial trip to a psychiatric ward. She was still in her early teens.

Eventually, she said, her parents sent her to a group home, where she lived as a ward of the state. (She considered Mayor Koch to be her father.) The stories of the girls she met were incorporated later into fiction, not unlike the stories of the punks from Tompkins Square.

Then, in 1989, she moved to San Francisco, where she worked as a maid and a baby sitter and sold her blood in order to survive. She also worked as a phone sex operator and perfected a sultry Southern accent she would later put to use in interviews as JT Leroy, including one, played in court, with Terry Gross, the NPR host.

It was in San Francisco, she said, that she started calling suicide hot lines from a pay phone on the street. Incapable of speaking as herself, she adopted the personas of various teenage boys.

One of those was a tattered runaway from West Virginia, a misfit from an educated family, who was living on the street. His name was Jeremy or Jeremiah: an embryonic version of JT Leroy.

At this point, fractured as it was, Ms. Albert’s psyche seemed to fracture yet again. She had, for months, as Jeremiah, been talking on the hot line to Dr. Terrence Owens, a psychiatrist. When Dr. Owens said he wished to meet, Ms. Albert paid a street waif to appear as Jeremiah, and then went along as his friend and roommate Speedy — which is to say, a patient standing with her alter ego in the third-degree remove of the alter ego’s friend.

Speedy was a character that remained with Ms. Albert even after “Sarah” was released in 2000 to almost instant critical acclaim. When Steven Shainberg, the proposed director of the film, flew to San Francisco to meet JT Leroy, Ms. Albert, in the guise of Speedy, picked him up and whisked him off to an expensive sushi restaurant, where “JT,” played by the sister of Ms. Albert’s former boyfriend, sat there mute throughout the meal, and then stuck Mr. Shainberg with the check.