Middlesex

The chief imperative in cases like mine was to show no doubt as to the gender of the child in question. You did not tell the parents of a newborn, “Your baby is a hermaphrodite.” Instead, you said, “Your daughter was born with a clitoris that is a little larger than a normal girl’s. We’ll need to do surgery to make it the right size.” Luce felt that parents weren’t able to cope with an ambiguous gender assignment. You had to tell them if they had a boy or a girl. Which meant that, before you said anything, you had to be sure what the prevailing gender was.

Luce could not do this with me yet. He had received the results of the endocrinological tests performed at Henry Ford Hospital, and so knew of my XY karyotype, my high plasma testosterone levels, and the absence in my blood of dihydrotestosterone. In other words, before even seeing me, Luce was able to make an educated guess that I was a male pseudohermaphrodite—genetically male but appearing otherwise, with 5-alpha-reductase deficiency syndrome. But that, according to Luce’s thinking, did not mean that I had a male gender identity.

My being a teenager complicated things. In addition to chromosomal and hormonal factors, Luce had to consider my sex of rearing, which had been female. He suspected that the tissue mass he had palpated inside me was testicular. Still, he couldn’t be sure until he had looked at a sample under a microscope.

All this must have been going through Luce’s mind as he brought me back to the waiting room. He told me he wanted to speak to my parents and that he would send them out when he was finished. His intensity had lessened and he was friendly again, smiling and patting me on the back.

In his office Luce sat down in his Eames chair, looked up at Milton and Tessie, and adjusted his glasses.

“Mr. Stephanides, Mrs. Stephanides, I’ll be frank. This is a complicated case. By complicated I don’t mean irremediable. We have a range of effective treatments for cases of this kind. But before I’m ready to begin treatment there are a number of questions I have to answer.”

My mother and father were sitting only a foot apart during this speech, but each heard something different. Milton heard the words that were there. He heard “treatment” and “effective.” Tessie, on the other hand, heard the words that weren’t there. The doctor hadn’t said my name, for instance. He hadn’t said “Calliope” or “Callie.” He hadn’t said “daughter,” either. He didn’t use any pronouns at all.

“I’ll need to run further tests,” Luce was continuing. “I’ll need to perform a complete psychological assessment. Once I have the necessary information, then we can discuss in detail the proper course of treatment.”

Milton was already nodding. “What kind of time line are we talking about, Doctor?”

Luce jutted out a thoughtful lower lip. “I want to redo the lab tests, just to be sure. Those results will be back tomorrow. The psychological evaluation will take longer. I’ll need to see your child every day for at least a week, maybe two. Also it would be helpful if you could give me any childhood photographs or family movies you might have.”

Milton turned to Tessie. “When does Callie start school?”

Tessie didn’t hear him. She was distracted by Luce’s phrase: “your child.”

“What kind of information are you trying to get, Doctor?” Tessie asked.

“The blood tests will tell us hormone levels. The psychological assessment is routine in cases like this.”

“You think it’s some kind of hormone thing?” Milton asked. “A hormone imbalance?”

“We’ll know after I’ve had time to do what I need to do,” said Luce.

Milton stood up and shook hands with the doctor. The consultation was over.

Keep in mind: neither Milton nor Tessie had seen me undressed for years. How were they to know? And not knowing, how could they imagine? The information available to them was all secondary stuff—my husky voice, my flat chest—but these things were far from persuasive. A hormonal thing. It could have been no more serious than that. So my father believed, or wanted to believe, and so he tried to convince Tessie.

I had my own resistance. “Why does he have to do a psychological evaluation?” I asked. “It’s not like I’m crazy.”

“The doctor said it was routine.”

“But why?”

With this question I had hit upon the crux of the matter. My mother has since told me that she intuited the real reason for the psychological assessment, but chose not to dwell on it. Or, rather, didn’t choose. Let Milton choose for her. Milton preferred to treat the problem pragmatically. There was no sense in worrying about a psychological assessment that could only confirm what was obvious: that I was a normal, well-adjusted girl. “He probably bills the insurance extra for the psychological stuff,” Milton said. “Sorry, Cal, but you’ll have to put up with it. Maybe he can cure your neuroses. Got any neuroses? Now’s your time to let ’em out.” He put his arms around me, squeezed hard, and roughly kissed the side of my head.