Introduction About Eugenides's Middlesex

By Author: Amandda
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Jeffrey Eugenides's Pulitzer Prize—winning novel, Middlesex, is an excellent and accessible way to introduce students to intersex issues. The novel tells the haunting, evocative, and finally affirmative story of Cal Stephanides (nee Cali-ope), who "was born twice: first as a baby girl, on a remarkably smogless Detroit day in January of I960; and then again, as a teenage boy, in an emergency room near Petoskey, Michigan, in August of 1974". Cal, who has ambiguous genitalia (technically he is born with 5-alpha reductase deficiency, a form of androgen insensitivity), is raised as a girl, falls in love with a female classmate whom he humorously Breitling Replica nicknamed "the Obscure Object (of desire)," and is medically treated by the infamous Dr. Luce, who insists that, no matter what Cal feels, that because he was raised a girl, he will want to be a girl. The book ends, after we follow him through a number of self-revelations, with Cal asserting his identity as a man and starting a new relationship with a woman. The novel is beautifully written, often quite ...
... funny, and remarkably pleasurable, especially given the weightiness of its subject. It also details much of the pain and confusion experienced by intersex people at the hands of the medical profession, as the following passage shows:

There was a hint of annoyance, of command in [Dr. Luce's] voice. I took a deep breath and did the best I could. Luce poked inside. For a moment it felt merely strange, as he suggested. But then a sharp pain shot through me. I jerked back crying out. "Sorry."

Nevertheless, he kept on. He placed one hand on my pelvis to steady me. He probed farther, though he avoided the painful area. My eyes were welling with tears.
"Almost finished," he said. But he was only getting started.

This experience will resonate with intersex students who have had repeated experiences with the medical profession. It also will communicate to non-intersex students, as does the book as a whole, the specific experiences undergone by intersex people. When teaching Eugenides's novel, I often assign papers that ask the students to reflect on how the novel changes their understanding of sex and gender. I also ask students to reflect on how we can change medical and social practices to better empower intersex people. This is important not only for those students for whom intersex issues have already touched their lives but also for all of them who may in the future fall in love with, or give birth to, an intersex person.

The unnecessary medical interventions depicted in Eugenides's novel are a core part of the experience of many intersex people. Many of them undergo multiple, initially unnecessary surgeries, surgeries that often produce greater complications than the ones I experienced. Moreover, most of the initial surgeries are undertaken during infancy or early childhood, when there is no realistic ability for the intersex person to consent to the procedure. This is ostensibly done to prevent the intersex subject from experiencing the social stigma of having a visibly different body, but instead it often produces the lasting trauma that can be caused by undergoing painful and invasive nonconsensual surgery. Many of these surgeries are less than completely successful, producing the need for further surgeries. Many have unintended side effects, such as pain during sex, less-than-fully-functional sex organs, and recurrent infections.

As part of teaching Middlesex, teachers can make students aware of some important related activism. In 2006, the ISNA achieved an important victory in influencing the National Institute of Health's Strategic Plan for Urology. The plan "sounded an alarm by describing the clinical management Breitling Replica Watches and treatment of DSDs [Disorders of Sex Development] as being 'in crisis' due to multiple challenges to the traditional standard of care, and noting 'there are insufficient data to guide the clinician and family' in making decisions about medical management" ("Dear ISNA," par. 3). Even more significantly, also in 2006, the organization worked with medical professionals to publish the "Consensus Statement on the Management of Intersex Disorders" in the journal Pediatrics (Lee et al.). While "far from perfect," it incorporates a number of "ground-breaking changes" and advocates concepts and practices long endorsed by the ISNA ("Dear ISNA," par. 5). The consensus statement emphasizes a number of concepts that I encourage teachers to explore with their students in relationship to Middlesex: progress in patient-centered care, a more cautious approach to surgery, and eliminating the misleading language based on a binary sex model.