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The induction of Jeffrey Eugenides' Middlesex into Oprah's Book Club renewed public interest in the Pulitzer-winning novel that narrates the life of Cal, an intersex individual. This document is designed to answer questions readers might have about the relationship between the book and intersex activism.
Intersex refers to one of many physical conditions in which development of chromosomal, gonadal, or anatomical sex is atypical. It is also known as "disorders of sex development" or DSD in medical literature. The protagonist of Middlesex has a very rare intersex condition, 5-alpha reductase deficiency syndrome. To find out more about intersex, please read intersex FAQ.
"Hermaphrodite" is an archaic term used for intersex individuals, and is now considered derogative as well as misleading. Eugenides may have chosen to use this term for a literary reason--in order to link the Greek immigrant family's experiences to the ancient Greek mythology of Hermaphroditis--but the word should be avoided when discussing intersex people outside of this specific context.
The specific condition Cal has, 5-alpha reductase deficiency syndrome, is unique in that children affected by this condition typically appear more like a female than a male at birth, but go through masculinizing puberty (unless testes are removed, that is).
The reason this happens is that people with this condition do not produce certain enzyme that is necessary for developing male primary sex characteristics, but not necessary for secondary sex characteristics. This does not happen in other intersex conditions: all other children develop physically along the line of how they have been born, unless of course hormonal intervention is taken.
As for gender identity, some children with 5-alpha reductase deficiency syndrome come to identify as male as Cal does, although not all. When a child with this condition identifies as female, she could receive gonadectomy (removal of testes) and hormone replacement therapy to remain female.
The uniqueness of 5-alpha reductase deficiency syndrome makes for an interesting plot for a novel in terms of the protagonist's struggle to define what gender he or she belongs to, but that is not a typical intersex experience. In fact, feelings of confusion and doubt Cal went through are probably more common among transgender people (i.e. those who are born with sex-typical bodies, but have gender identities that are atypical) rather than among intersex people.
On the other hand, some of what Cal experiences is similar to what actual intersex people do feel, such as the sense of isolation, shame, and sometimes anger. If you are interested in finding out more, read Intersex in the Age of Ethics ed. by Alice Dreger for first-person narratives written by people with various intersex conditions.
In short, please remember that Cal's experiences is that of just one (fictional) intersex person; other intersex people can have very different experiences.
He is obviously very talented author, and the book Middlesex is beautifully written. But he is definitely not an expert about intersex issues, and he did not meet with any intersex person before writing the novel. While this is not his fault, it appears that Mr. Eugenides is frequently asked to answer questions about intersex in media interviews as well as at public readings. These questions need to be directed toward intersex advocates who are actually familiar with the topic, and not some novelist with limited knowledge about the issue. Oprah, are you listening?
Yes. However, it appears that Intersex Society of North America was not yet around the time Cal joined it in Middlesex, so perhaps a standard warning should apply here: groups depicted in this novel are fictional, and their similarities to the actual groups are coincidental. In reality, ISNA was founed in 1993 in California to end shame, secrecy, and unwanted surgeries on children born with intersex conditions (or DSD).
This material is provided to you by:
Intersex Initiative
PO Box 40570, Portland OR 97240
Email: info@intersexinitiative.org
If you have any other questions not answered in this document, please feel free to email us.