Middlesex

  Soft chuckling came from the other side of the screen.

  I came out, feeling awkward. I was taller than everyone else in the room, though I weighed much less. The floor felt cold against my bare feet as I crossed to the exam table and jumped up.

  I lay back. Without having to be told, I lifted my legs and fit my heels in the gynecological stirrups. The room had gone ominously silent. The three doctors came forward, staring down. Their heads formed a trinity above me. Luce pulled the curtain across the table.

  They bent over me, studying my parts, while Luce led a guided tour. I didn’t know what most of the words meant but after the third or fourth time I could recite the list by heart. “Muscular habitus . . . no gynecomastia . . . hypospadias . . . urogenital sinus . . . blind vaginal pouch . . .” These were my claim to fame. I didn’t feel famous, however. In fact, behind the curtain, I no longer felt as if I were in the room.

  “How old is she?” Dr. Winters asked.

  “Fourteen,” Luce answered. “She’ll be fifteen in January.”

  “So your position is that chromosomal status has been completely overridden by rearing?”

  “I think that’s pretty clear.”

  As I lay there, letting Luce, in rubber gloves, do what he had to do, I got a sense of things. Luce wanted to impress the men with the importance of his work. He needed funding to keep the clinic running. The surgery he performed on transsexuals wasn’t a selling point over at the March of Dimes. To get them interested you had to pull at the heartstrings. You had to put a face on suffering. Luce was trying to do that with me. I was perfect, so polite, so midwestern. No unseemliness attached itself to me, no hint of cross-dresser bars or ads in the back of louche magazines.

  Dr. Craig wasn’t convinced. “Fascinating case, Peter. No question. But my people will want to know the applications.”

  “It’s a very rare condition,” Luce admitted. “Exceedingly rare. But in terms of research, its importance can’t be overstated. For the reasons I outlined in my office.” Luce remained vague for my benefit, but still persuasive enough for theirs. He hadn’t gotten where he was without certain lobbyist gifts. Meanwhile I was there and not there, cringing at Luce’s touch, sprouting goose bumps, and worrying that I hadn’t washed properly.

  I remember this, too. A long narrow room on a different floor of the hospital. A riser set up at one end before a butterfly light. The photographer putting film in his camera.

  “Okay, I’m ready,” he said.

  I dropped my robe. Almost used to it now, I climbed up on the riser before the measuring chart.

  “Hold your arms out a little.”

  “Like this?”

  “That’s good. I don’t want a shadow.”

  He didn’t tell me to smile. The textbook publishers would make sure to cover my face. The black box: a fig leaf in reverse, concealing identity while leaving shame exposed.

  Every night Milton called us in our room. Tessie put on a bright voice for him. Milton tried to sound happy when I got on the line. But I took the opportunity to whine and complain.

  “I’m sick of this hotel. When can we go home?”

  “Soon as you’re better,” Milton said.

  When it was time for sleep, we drew the window curtains and turned off the lights.

  “Good night, honey. See you in the morning.”

  “Night.”

  But I couldn’t sleep. I kept thinking about that word: “better.” What did my father mean? What were they going to do to me? Street sounds made it up to the room, curiously distinct, echoing off the stone building opposite. I listened to the police sirens, the angry horns. My pillow was thin. It smelled like a smoker. Across the strip of carpet my mother was already asleep. Before my conception, she had agreed to my father’s outlandish plan to determine my sex. She had done this so that she wouldn’t be alone, so that she would have a girlfriend in the house. And I had been that friend. I had always been close to my mother. Our temperaments were alike. We liked nothing better than to sit on park benches and watch the faces go by. Now the face I was watching was Tessie’s in the other bed. It looked white, blank, as if her cold cream had removed not only her makeup but her personality. Tessie’s eyes were moving, though; under the lids they skated back and forth. Callie couldn’t imagine the things Tessie was seeing in her dreams back then. But I can. Tessie was dreaming a family dream. A version of the nightmares Desdemona had after listening to Fard’s sermons. Dreams of the germs of infants bubbling, dividing. Of hideous creatures growing up from pale foam. Tessie didn’t allow herself to think about such things during the day, so they came to her at night. Was it her fault? Should she have resisted Milton when he tried to bend nature to his will? Was there really a God after all, and did He punish people on Earth? These Old World superstitions had been banished from my mother’s conscious mind, but they still operated in her dreams. From the other bed I watched the play of these dark forces on my mother’s sleeping face.

  LOOKING MYSELF UP IN WEBSTER’S

  Itossed and turned every night, unable to sleep straight through. I was like the princess and the pea. A pellet of disquiet kept unsettling me. Sometimes I awoke with the feeling that a spotlight had been trained on me while I slept. It was as if my ether body had been conversing with angels, somewhere up near the ceiling. When I opened my eyes they fled. But I could hear the traces of the communication, the fading echoes of the crystal bell. Some essential information was rising from the depths of my being. This information was on the tip of my tongue and yet never surfaced. One thing was certain: it was all connected with the Object somehow. I lay awake thinking about her, wondering how she was, and pining, grieving.

  I thought of Detroit, too, of its vacant lots of pale Osiris grass springing up between the condemned houses and those not yet condemned, and of the river with its iron runoff, the dead carp floating on the surface, white bellies flaking. I thought of fishermen standing on the concrete freighter docks with their bait buckets and tallboys, the baseball game on the radio. It’s often said that a traumatic experience early in life marks a person forever, pulls her out of line, saying, “Stay there. Don’t move.” My time at the Clinic did that to me. I feel a direct line extending from that girl with her knees steepled beneath the hotel blankets to this person writing now in an Aeron chair. Hers was the duty to live out a mythical life in the actual world, mine to tell about it now. I didn’t have the resources at fourteen, didn’t know enough, hadn’t been to the Anatolian mountain the Greeks call Olympus and the Turks Uludag, just like the soft drink. I hadn’t gotten old enough yet to realize that living sends a person not into the future but back into the past, to childhood and before birth, finally, to commune with the dead. You get older, you puff on the stairs, you enter the body of your father. From there it’s only a quick jump to your grandparents, and then before you know it you’re time-traveling. In this life we grow backwards. It’s always the gray-haired tourists on Italian buses who can tell you something about the Etruscans.

  In the end, it took Luce two weeks to make his determination about me. He scheduled an appointment with my parents for the following Monday.

  Milton had been jetting around during the two weeks, checking on his Hercules franchises, but on the Friday preceding the appointment he flew back to New York. We spent the weekend spiritlessly sightseeing, assailed by unspoken anxieties. On Monday morning my parents dropped me off at the New York Public Library while they went to see Dr. Luce.

  My father had dressed that morning with special care. Despite an outward show of tranquillity, Milton was beset by an unaccustomed feeling of dread, and so armored himself in his most commanding clothes: over his plump body, a charcoal pinstripe suit; around his bullfrog neck, a Countess Mara necktie; and in the buttonholes of his shirtsleeves, his “lucky” Greek Drama cuff links. Like our Acropolis night-light, the cuff links had come from Jackie Halas’s souvenir shop in Greektown. Milton wore them whenever he met with bank loan officers or auditors from the
IRS. That Monday morning, however, he had trouble putting the cuff links in; his hands were not steady enough. In exasperation he asked Tessie to do it. “What’s the matter?” she asked tenderly. But Milton snapped, “Just put the cuff links in, will you?” He held out his arms, looking away, embarrassed by his body’s weakness.

  Silently Tessie inserted the links, tragedy in one sleeve, comedy in the other. As we came out of the hotel that morning they glittered in the early morning sun, and under the influence of those two-sided accessories, what happened next took on contrasting tones. There was tragedy, certainly, in Milton’s expression as they left me off at the library. During Milton’s time away, his image of me had reverted to the girl I’d been a year earlier. Now he faced the real me again. He saw my ungainly movements as I climbed the library steps, the broadness of my shoulders inside my Papagallo coat. Watching from the cab, Milton came face-to-face with the essence of tragedy, which is something determined before you’re born, something you can’t escape or do anything about, no matter how hard you try. And Tessie, so used to feeling the world through her husband, saw that my problem was getting worse, was accelerating. Their hearts were wrung with anguish, the anguish of having children, a vulnerability as astonishing as the capacity for love that parenthood brings, in a cuff link set all its own . . .

  . . . But now the cab was driving away, Milton was wiping his brow with his handkerchief; and the grinning face in his right sleeve came into view, for there was a comic aspect to events that day, too. There was comedy in the way Milton, while still worrying about me, kept one eye on the rocketing taxi meter. At the Clinic, there was comedy in the way Tessie, idly picking up a waiting-room magazine, found herself reading about the juvenile sexual rehearsal play of rhesus monkeys. There was even a brand of harsh satire in my parents’ quest itself, because it typified the American belief that everything can be solved by doctors. All this comedy, however, is retrospective. As Milton and Tessie prepared to see Dr. Luce, a hot foam was rising in their stomachs. Milton was thinking back to his early navy days, to his time in the landing craft. This was just like that. Any minute the door was going to drop away and they would have to plunge into the churning night surf . . .

  In his office Luce got straight to the point. “Let me review the facts of your daughter’s case,” he said. Tessie noted the change at once. Daughter. He had said “daughter.”

  The sexologist was looking reassuringly medical that morning. Over his cashmere turtleneck he wore an actual white coat. In his hand he held a sketchpad. His ballpoint pen bore the name of a pharmaceutical company. The blinds were drawn, the light low. The couples in the Mughal miniatures had modestly covered themselves in shadow. Sitting in his designer chair, with tomes and journals rising behind him, Dr. Luce appeared serious, full of expertise, as was his speech. “What I’m drawing here,” he began, “are the fetal genital structures. In other words, this is what a baby’s genitals look like in the womb, in the first few weeks after conception. Male or female, it’s all the same. These two circles here are what we call the all-purpose gonads. This little squiggle here is a Wolffian duct. And this other squiggle is a Müllerian duct. Okay? The thing to keep in mind is that everybody starts out like this. We’re all born with potential boy parts and girl parts. You, Mr. Stephanides, Mrs. Stephanides, me—everybody. Now”—he started drawing again—“as the fetus develops in the womb, what happens is that hormones and enzymes are released—let’s make them arrows. What do these hormones and enzymes do? Well, they turn these circles and squiggles into either boy parts or girl parts. See this circle, the all-purpose gonad? It can become either an ovary or a testis. And this squiggly Müllerian duct can either wither up”—he scratched it out—“or grow into a uterus, fallopian tubes, and the inside of the vagina. This Wolffian duct can either wither away or grow into a seminal vesicle, epididymis, and vas deferens. Depending on the hormonal and enzymatic influences.” Luce looked up and smiled. “You don’t have to worry about the terminology. The main thing to remember is this: every baby has Müllerian structures, which are potential girl parts, and Wolffian structures, which are potential boy parts. Those are the internal genitalia. But the same thing goes for the external genitalia. A penis is just a very large clitoris. They grow from the same root.”

  Dr. Luce stopped once more. He folded his hands. My parents, leaning forward in the chairs, waited.

  “As I explained, any determination of gender identity must take into account a host of factors. The most important, in your daughter’s case”—there it was again, confidently proclaimed—“is that she has been raised for fourteen years as a girl and indeed thinks of herself as female. Her interests, gestures, psychosexual makeup—all these are female. Are you with me so far?”

  Milton and Tessie nodded.

  “Due to her 5-alpha-reductase deficiency, Callie’s body does not produce dihydrotestosterone. What this means is that, in utero, she followed a primarily female line of development. Especially in terms of the external genitalia. That, coupled with her being brought up as a girl, resulted in her thinking, acting, and looking like a girl. The problem came when she started to go through puberty. At puberty, the other androgen—testosterone—started to exert a strong effect. The simplest way to put it is like this: Callie is a girl who has a little too much male hormone. We want to correct that.”

  Neither Milton nor Tessie said a word. They weren’t following everything the doctor was saying but, as people do with doctors, they were attentive to his manner, trying to see how serious things were. Luce seemed optimistic, confident, and Tessie and Milton began to be filled with hope.

  “That’s the biology. It’s a very rare genetic condition, by the way. The only other populations where we know of this mutation expressing itself are in the Dominican Republic, Papua New Guinea, and southeastern Turkey. Not that far from the village your parents came from. About three hundred miles, in fact.” Luce removed his silver glasses. “Do you know of any family member who may have had a similar genital appearance to your daughter’s?”

  “Not that we know of,” said Milton.

  “When did your parents immigrate?”

  “Nineteen twenty-two.”

  “Do you have any relatives still living in Turkey?”

  “Not anymore.”

  Luce looked disappointed. He had one arm of his glasses in his mouth, and was chewing on it. Possibly he was imagining what it would be like to discover a whole new population of carriers of the 5-alpha-reductase mutation. He had to content himself with discovering me.

  He put his glasses back on. “The treatment I’d recommend for your daughter is twofold. First, hormone injections. Second, cosmetic surgery. The hormone treatments will initiate breast development and enhance her female secondary sex characteristics. The surgery will make Callie look exactly like the girl she feels herself to be. In fact, she will be that girl. Her outside and inside will conform. She will look like a normal girl. Nobody will be able to tell a thing. And then Callie can go on and enjoy her life.”

  Milton’s brow was still furrowed with concentration but from his eyes there was light appearing, rays of relief. He turned toward Tessie and patted her leg.

  But in a timid, breaking voice Tessie asked, “Will she be able to have children?”

  Luce paused only a second. “I’m afraid not, Mrs. Stephanides. Callie will never menstruate.”

  “But she’s been menstruating for a few months now,” Tessie objected.

  “I’m afraid that’s impossible. Possibly there was some bleeding from another source.”

  Tessie’s eyes filled with tears. She looked away.

  “I just got a postcard from a former patient,” Luce said consolingly. “She had a condition similar to your daughter’s. She’s married now. She and her husband adopted two kids and they’re as happy as can be. She plays in the Cleveland Orchestra. Bassoon.”

  There was a silence, until Milton asked, “Is that it, Doctor? You do this one surgery and we can take her
home?”

  “We may have to do additional surgery at a later date. But the immediate answer to your question is yes. After the procedure, she can go home.”

  “How long will she be in the hospital?”

  “Only overnight.”

  It was not a difficult decision, especially as Luce had framed it. A single surgery and some injections would end the nightmare and give my parents back their daughter, their Calliope, intact. The same enticement that had led my grandparents to do the unthinkable now offered itself to Milton and Tessie. No one would know. No one would ever know.

  While my parents were being given a crash course in gonadogenesis, I—still officially Calliope—was doing some homework myself. In the Reading Room of the New York Public Library I was looking up something in the dictionary. Dr. Luce was correct in thinking that his conversations with colleagues and medical students were over my head. I didn’t know what “5-alpha-reductase” meant, or “gynecomastia,” or “inguinal canal.” But Luce had underestimated my abilities, too. He didn’t take into consideration the rigorous curriculum at my prep school. He didn’t allow for my excellent research and study skills. Most of all, he didn’t factor in the power of my Latin teachers, Miss Barrie and Miss Silber. So now, as my Wallabees made squishing sounds between the reading tables, as a few men looked up from their books to see what was coming and then looked down (the world was no longer full of eyes), I heard Miss Barrie’s voice in my ear. “Infants, define this word for me: hypospadias. Use your Greek or Latin roots.”