None of the Above(72)

He sighed, and rubbed his hand across his stubbled chin. “Didn’t want to cramp your style,” he said finally. “Well, glad you’re home all right.” He started to go back up the stairs, and for some reason the sight of the frayed cuffs of his flannel pajamas made my eyes prickle.

“Dad?” I called out, just wanting him to be close.

He turned around and squinted at me again. But at first I couldn’t get the words out. Finally: “You know that I love you, right?”

He rubbed his eyes with his fists, and then blinked rapidly a few times. “You know I love you too, sweetie. Forever and ever, until the sun fades.”

I blinked too, as my vision blurred. “Forever and ever,” I repeated, and my dad walked down the last few steps and wrapped me in his arms. I burrowed into the soft, Irish Spring scent of his shirt.

“Dad,” I said, “remind me to make an appointment with Dr. Cheng on Monday.”

I felt him stiffen, but I went on. “She needs to fill out some paperwork so Coach Auerbach will let me start practice again once I go back to school.”

My father collapsed into himself with relief, hugged me tighter. I led him back up the stairs and kissed his salt-and-pepper cheek before going into my room.

But I couldn’t fall asleep.

So I turned on my computer and created a new Facebook profile using my high school email, instead of my middle school one. For my profile picture I chose a picture of me when I was ten years old and making valentines with my mother. I friended Gretchen, Julia, Darren, Jessica, and Quincy right away. Then I added Vee and Faith, remembering to forgive and be forgiven.

My blank timeline stared back at me. It was beautiful.





AUTHOR’S NOTE


I was a fifth-year surgical resident when I met my first intersex patient, and she haunts me still.

Like Kristin, my patient had AIS. Like Kristin, she was a teenager when she found out. After I helped with the operation to remove her gonads, I saw her postoperatively. She came from a very poor and disadvantaged background, and I think I was the first person to really talk to her about her condition and what to expect in the future. During our office visit, she was remarkably stoic—uninterested, almost. She had come to our clinic alone, so I worried about her support system. I also knew there were questions she would only think of after the appointment, so I made sure to give her information about the AIS support group. In retrospect, that was probably the single most important thing I did for her.

After that clinic visit, I never saw my AIS patient again, but she stayed in my thoughts. I’ve always wondered what became of her, and how she came to terms with her diagnosis. Did she have a boyfriend? What happened the first time she tried to have sex? Who did she tell—if anyone—about her condition?

It was early 2009. I was pregnant with my first child, a daughter. Just months later, Caster Semenya’s story hit, and it became clear to me that intersex was a perfect jumping-off point for a discussion of tolerance, feminism, and gender essentialism. It begged so many questions: What does it mean to be a woman? What happens when you don’t fit perfectly into the gender binary? And what role does your biology play not only in who you love, but who loves you?

As I began researching my story, it became clear to me that the great challenge of writing about intersex is that it encompasses so many different variations of biology and personal experience. There is no one intersex story. That said, it became clear that there were two controversies within the intersex community that I needed to address if I hoped to contribute responsibly to intersex awareness.

The first is the question of naming. While some in the medical community advocate use of the term Disorder of Sex Development (DSD), this phrase has been criticized because the word disorder suggests something inherently “wrong,” so it has been replaced by many with the term “Differences in Sex Development.” In None of the Above I chose to use the term intersex. I also made the difficult decision to have some of my characters use the word hermaphrodite in the pejorative sense because intersex awareness isn’t widespread enough to have eradicated the term. In recent years, though, some intersex people have reclaimed the word hermaphrodite in much the same way that gay men and women did the word queer. While this usage isn’t for everyone, it gives me hope that someday in the future the term will be freed from its stigma.

The second issue is that of surgery. Until the early 2000s, intersex children were operated on with some regularity, often as infants. There are countless stories of intersex children whose genitalia were “corrected” in a way that caused irreparable harm and suffering, all in the name of relieving parents’ stress by “normalizing” their babies’ anatomy with what is essentially a cosmetic surgery.

These days, due to the efforts of intersex-awareness organizations, including Accord Alliance (www.accordalliance.org), Organization Intersex International (www.oiiinternational.com), and Advocates for Informed Choice (www.aiclegal.org), the strong recommendation is to hold off on surgery until the child is old enough to a) have formed a gender identity and b) consent to surgery knowing the full risks and benefits. Unfortunately, despite these recommendations, some intersex children are still subjected to unnecessary surgeries, underscoring the urgent need to educate physicians and parents on changing guidelines.

If there is anything I know as a surgeon, it’s that every surgery has risks. So I struggled when I came to the part of Kristin’s narrative where she opted for a gonadectomy. In the end, with her family history of cancer, and the psychological space she was in, it was the right choice for her; importantly for me, she went in with her eyes wide open.