Jeffrey Eugenides tends more towards writing short fiction than he does full-length novels… but damn, when he turns it on, he really turns it on. Middlesex is his 2002 novel inspired by the 19th-century diary of a French convent student who was intersex. He worked for nine years, writing and re-writing, until he managed to weave together a story that was both epic and introspective.

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Middlesex begins with Cal, aged 41, looking back on “this rollercoaster ride of a gene through time”. Ostensibly styled as Cal’s memoir, the first half-or-so of the book is more of a family saga, the internal logic being that tracing the Stephanides family tree is essential to understanding the unique circumstances and coincidences that gave rise to Cal’s genetic 5-alpha-reductase deficiency.
See, Middlesex is a gender novel: Cal is intersex. They were assigned-female-at-birth (AFAB, in today’s parlance), due to their ambiguous-appearing genitals and the negligence of the family doctor’s examination. As such, they were raised as a girl. However, they have testes, and their secondary sex characteristics that emerge during puberty are typically male.
That’s the big ticket item, the reason most people come to Middlesex – but it’s a shame, because there’s a lot more to this story than Cal’s gender identity.
To take it all the way back to the beginning (as Cal does): their grandparents were, ahem, cut from the same branch of the family tree. Yes, they were brother and sister before they were husband and wife, before Game Of Thrones made it cool. They were displaced during the early 20th century conflict between Greeks and Turks, and managed – by the skin of their teeth – to emigrate to the United States. So, it’s an immigrant story, about ethnic identity and the American Dream, as much as it’s anything else.
The family saga is like Gabriel Garcia Marquez meets The Slap-era Christos Tsiolkas. Eugenides, through Cal, paints an incredibly detailed portrait of three generations (from conception to death) against the backdrop of major historical events, including the 1967 Detroit Riot and Watergate. Of course, this requires some funky twists and turns in Cal’s narration. Eugenides allows his protagonist unrealistic insight into other characters’ thoughts, a kind of omniscient-first-person at times, but somehow he makes it flow very naturally (think Melville’s narration by Ishmael in Moby Dick).
And, an important side note: in addition to being preternaturally insightful, Cal is FUNNY. Like, no one calls Middlesex a comedy, but I literally lol’d several times. It’s not all doom and gloom!
I suppose I can’t ignore the sex and gender themes of Middlesex forever. So, deep breath, here we go…
First off, no, Eugenides is not intersex himself. He drew a lot of details for Middlesex (particularly around Greek American families and geography) from his real life, but not the gender bit. As he explains it:
Because the story is so far from my own experience, I had to use a lot of details from my own life to ground it in reality, to make it believable for me and then hopefully for the reader, as well. So I would use my own physical appearance. I would use details from my grandparents’ life, the streets they lived on, the kinds of places they lived. And all this made it real for me because it was a tall order to write such a story.
Jeffrey Eugenides (On Middlesex)
Of course, adopting the voice of an intersex character for a novel is a controversial choice by today’s standards, but at least Eugenides took it seriously. It wasn’t a gimmick to sell books: Cal’s voice and identity are central to the story. Eugenides spent years researching intersex biology and politics. Learning about 5-alpha-reductase deficiency actually changed the shape and scope of the story (initially, Eugenides had envisaged Middlesex as a short fictional autobiography, but learning that this condition primarily arises in isolated inbred populations led him to explore the epic history of Cal’s family).
Also controversial is the language Cal (slash Eugenides) uses throughout the novel. By the end, Cal explicitly rejects the essentialism underlying “traditional” definitions of sex and gender – Cal is neither “really” a boy, nor “really” a girl, regardless of clothing or the assumptions of others – but Eugenides uses he/him pronouns to describe the character. I’ve chosen not to in this review, because it simply didn’t feel accurate or natural based on the days I’ve spent with Cal while reading Middlesex. I suspect, if the novel were written and published today, they would be using gender neutral pronouns.
Then, there’s the language Cal uses to describe their identity. They shift between using “intersex” (when talking in the abstract, regarding activism and so forth) and the now-objectionable “hermaphrodite”. Eugenides has been asked directly why he used this term, and I thought his justification was pretty sound: it’s used by Cal in the context of their identification and engagement with Hermaphroditus, among other characters of Greek mythology and history. “When speaking about real people, I should—and I do my best to—use the term ‘intersex’,” he said. He also pointed to the journal Hermaphrodites With Attitude (published by the Intersex Society of North America) as an example of the reclaiming of the word by intersex people, akin to the reclaiming of the word “queer”.
Nevertheless, even though the language is a bit outdated (twenty years is a long time in LGBTIQ+ politics and science!), there’s a ring of authenticity in Eugenides’ portrayal, and a sensibility that I think transcends nomenclature. He has been largely praised by queer and intersex reviewers for his sensitive and insightful depiction of an intersex character, which is more than most cis-het men could ever hope for. The exception would be the handful of reviewers and scholars who have criticised Eugenides for supposedly “erasing lesbian identities” (as Cal only openly explores their attraction to women once they begin presenting as a man). I think that’s a bit rich, to be honest; Middlesex is already a huge sweeping epic, and adding an extra hundred pages for Cal to explore lesbianism would have felt like inauthentic overkill.
But I circle back to my original point: Middlesex is much more than a gender novel. Adam Begley described it as “a hybrid form, epic crossed with history, romance, comedy, tragedy” in his review for the New York Observer, and that’s spot on. It’s a big book, in length, depth, and breadth, and yet it’s compelling and thoroughly readable. If you’ve held off reading Middlesex, feeling skeptical or intimidated, you really shouldn’t wait any longer.
My favourite Amazon reviews of Middlesex:
- “When the incestuous couple really started tucking into each other, I finally googled the author’s motivation in having incest as a major plot element, and it turns out he threw that in there just because he needed to explain the main character’s intersex condition. Ugh. C’mon Eugenides. There are a lot of other ways you could have peeled that banana.” – Julia
- “This is a horrible and dull book. Rotten in every way. It starts with a really stupid and misleading line. “I was born on an incredibly smogless day in Detroit”. There is NEVER any smog in Detroit. The rest of the book is just as bad. There should be a stack of these books about 1/2 of a mile high for the author to jump off of.” – Michael
- “Seriously? Incest stories about the protagonist’s grandmother is what makes good reading these days? No thanks.” – maranda green harris
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