Middlesex by Jeffrey Eugenides. Bloomsbury, £16.99, pp 529. ISBN 0 7475 6023 4. Rating: ★★★★
Cal Stephanides is a 41 year old Greek-American cultural attaché working in Berlin. In this brilliant novel he looks back on his life as man and . . . girl. Born Calliope, he has 5α-reductase deficiency. This autosomal recessive disorder is characterised by impaired conversion of testosterone to dihydrotestosterone in androgen-dependent target cells. Thus the inspired Jeffrey Eugenides acknowledges his debt to Imperato-McGinley et al's paper in the Journal of Clinical Endocrinology and Metabolism (1992;75:1022-6).
Most patients are raised as females from birth but gender conversion to male occurs at puberty with striking virilisation and male psychosocial orientation. Cal's epic traces his family tree, “this rollercoaster ride of a single gene through time. Sing now, O Muse, of the recessive mutation on my fifth chromosome!”
Eugenides breathes life into his creation: “Put yourself in my shoes, reader, and ask yourself what conclusion you would have come to about your sex, if you had what I had, if you look the way I looked.” The text does precisely that. We are exposed to the massed indignities Calliope endures. These run from the bathetic—“in the Christmas pageant she is cast not as Mary as in past years but as an elf”—to the later major traumas at the hands of her carers where the doctors “pretend to be interested in me as a person.” She notes the irony in gaining a badge for orienteering at summer camp.
Calliope's parents are sensitively depicted with great skill—“It was terrifying to see your child in the grip of unknown forces.” Eugenides is excellent on the drawn out multiple humiliations of adolescence, the brattish peers, the long hair to cover the face. For those with delayed puberty these torments are more acute—Calliope fakes periods: “I did cramps the way Meryl Streep does accents.”
Her insensitive doctor concludes “that sex of rearing, rather than genetic determinants, plays a greater role in the establishment of gender identity.” He proposes hormonal treatments and surgery. Calliope is immune to this consultation and is quite aware now of what she is going through. She runs away and becomes Cal, saying, “I live my own life and nurse my own wounds. It's not the best way to live. But it's the way I am.”
Parts of this novel are an extended philippic against the very language used to describe such conditions. When Cal explores Webster's dictionary and notes under hermaphrodite “see synonyms at MONSTER,” we read this with shock and guilt.
This writer has the storytelling brio of a Rushdie. The art/science interface is rarely dealt with in literature with such deftness. Axillae may burn at some passages but this is a good clinical sign of great fiction.