Gregory Koval was born and raised in Chicago. An only child, his parents separated when he was young, and he was subsequently raised by his mother, a former concert pianist. His early years were rather unremarkable. He displayed musical talent early on and was tutored in piano at home by his mother. While by no means a wealthy upbringing, his early childhood was, by all accounts, a fairly stable one.
The first signs of trouble began at puberty, when a previously undiagnosed genetic condition left the young man with a distinctly female-looking body. The stress and embarrassment caused the previously outgoing young man to withdraw and focus more heavily on his music as a way of coping. While continuing to study piano, the young man also began playing alto saxophone, developing a taste for both classic and modern jazz music. In some ways, this shift in focus proved beneficial, earning him a scholarship to Chicago's Colombia College, where he majored in instrumental jazz. He dropped out his sophomore year, however, following his mother's death from cancer. This was followed by an attempt to join the army, which was denied on medical grounds.
The loss of his mother, who had been his sole means of emotional support, had a profound effect. Instead of attempting to continue his education, he began supporting himself by playing saxophone in various venues in the greater Chicago-land area. Worsening feelings of depression lead to a drug habit, which eventually required a stint in rehab. While Gregory managed to maintain sobriety following his release, the drug use may have exacerbated an underlying mental illness. He began suffering paranoid delusions, first convinced that a close friend had turned on him, and then believing that he had been a participant in a foreign war, and that the army had subsequently performed experiments on him, leading to his physical condition. These persistent paranoid delusions finally resulted in a violent confrontation with a close acquaintance which lead to Gregory's admission to Landel's institute.