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Middlesex
by Jeffrey Eugenides, 529 pp, $15 (paperback), ISBN 0-312-42215-6, New York, NY, Picador/Farrar, Straus & Giroux, 2002.
Arch Pediatr Adolesc Med. 2004;158:500.
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Early in my career, the treatment of an infant born with ambiguous genitalia was straightforward. To overcome the issue of phallic inadequacy, assignment to female sex was made even in genetic boys. It was thought that environmental influences along with hormones and reconstructive genital surgery would be most apt to produce a happy and healthy woman. That thinking has gone by the wayside. In a recent study of 14 genetic boys with cloacal exstrophy who were assigned to female sex at birth, Reiner and Gearhart1 found that 8 declared themselves as male during the course of the 8-year study. Philosophical differences about treatment still exist, as illustrated by the 2 commentaries appearing in this issue.2-3
A very different perspective is offered by the narrator of Jeffrey Eugenides' Pulitzer Prize–winning novel, Middlesex, who has the 5 -reductase deficiency syndrome:
I was born twice: first, as a baby girl, on a remarkably . . . [Full Text of this Article]
Abraham Bergman, MD, Reviewer
Department of Pediatrics
Harborview Medical Center and University of Washington
325 Ninth Ave
Seattle, WA 98104
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