The Intersex Condition

April 13, 2007 at 10:03 am | Posted in Gender, Literature, sex | Leave a comment
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I finally continued reading Jeffrey Eugenides’ novel Middlesex. I had been a bit disappointed by it, because I had expected something more outspokenly political, something to advocate the case of intersexuality. It takes the novel forever to get to that topic though, with the story beginning with the protagonist’s grandparents, Greek brother and sister declaring themselves husband and wife on their journey to America in the 1920s, then covering the story of father and mother, both cousins, and finally arriving at what I had hoped to be the key topic way after half of the novel. I had finally decided to skip everything I wasn’t interested in – the passages told from the perspective of the grown-up character who had decided to live as a male were the ones that interested me most.

Of course one could also argue that it was laudable of Eugenides to _not_ dwell on the intersex issue too much, in order not to sensationalize the topic. And he won the Pulitzer Prize for Fiction anyway, so who am I too complain.

Lying down with the flu I took to the novel again, this time reading everything I had skipped previously (I have tons of student assignments to correct, but when I am ill reading these just seems to be so much more strenuous), finally arriving at the chapters that cover Calliope’s teenage years when here condition, 5-alpha-reductase-deficiency, was finally discovered. To put the effects of this condition in a nutshell: The protagonist is genetically male (XY), but with no developed male genitalia in utero, due to this very deficiency. The individual begins to virilize only during puberty, the testicles, hitherto hidden within the body, begin to descend and a penis (up to this point only a slightly larger clitoris) begins to grow. What doesn’t grow are breasts, and no menstruation sets in, as there are no ovaries or uterus. The fact of the individual being taken for female at birth mostly have to do with the absence of a proper penis or testicles.

What happens most of the time, if patriarchy (which only accepts full penises) and cosmetic surgery (the proof that man can change whatever he wishes) have their way, is that these individuals are then medically feminised: through surgery and hormones. The mere thought of it makes me angry and what the novel was good at was showing how and why a teenager can easily be coerced into NOT disagreeing with patriarchy’s and surgery’s wish – how is a thirteen or fourteen year old who hitherto thought of herself as a female, supposed to decide anyway? How many people do only find out after puberty that they are interested in the same sex? Once the penis has been removed, of course, it’s gone, and the personality and psyche irrevocably damaged – the main point of the operation seems to be to set parents and society at ease to whom the thought of ambiguous genitalia is plainly unbearable.

The same destiny seemed to be awaiting Calliope – but Eugenides regained my favour just in time by allowing Calliope to escape surgery. YES! Maybe for his research, I wondered, he had also stumbled upon this case reported by a Dr. Reddy in Hyderabad, India, which describes a case of surgical and hormonal “correction” in a case of 5-alpha-reductase-deficiency, using exactly the same irritating lines of argument that Eugenides’ Dr. Luce used to describe Calliope:

A diagnosis of 5 alpha reductase deficiency syndrome was made after detail workup. Patient was counselled and in view that the patient was brought up as a female, decision of orchidectomy was done on 18.6.02. Postoperatively patient was fine and discharged on day 5 on ethinyloestradiol and asked to follow up on OPD basis. Cliteroplasty and urethral reconstruction was advised after a period of 1 year. The geneticist is responsible for verifying the karyotype and discussing with the family the autosomal dominant sex-linked nature of 5-ARD, which includes the recurrence risk of 1:8 for each subsequent pregnancy (50% of XY foetuses) and the potential for prenatal diagnosis.

Orchidectomy = removal of the testicles (Orchid = testicle). Oh, this makes me sooooo angry! For as long as mankind exists, such phenomena have occurred and even made their way into mythology as Hermaphroditus. But give mankind cosmetic surgery, and they’ll erase whatever might put them off ease!

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