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Middlesex - Jeffrey Eugenides [211]

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diagnostic criterion of sex formulated by Klebs way back in 1876. Klebs had maintained that a person’s gonads determined sex. In cases of ambiguous gender, you looked at the gonadal tissue under the microscope. If it was testicular, the person was male; if ovarian, female. The hunch here was that a person’s gonads would orchestrate sexual development, especially at puberty. But it turned out to be more complicated than that. Klebs had begun the task, but the world had to wait another hundred years for Peter Luce to come along and finish it.

In 1955, Luce published an article called “Many Roads Lead to Rome: Sexual Concepts of Human Hermaphroditism.” In twenty-five pages of forthright, high-toned prose, Luce argued that gender is determined by a variety of influences: chromosomal sex; gonadal sex; hormones; internal genital structures; external genitals; and, most important, the sex of rearing. Drawing on studies of patients at the pediatric endocrine clinic at New York Hospital, Luce was able to compile charts demonstrating how these various factors came into play, and showing that a patient’s gonadal sex often didn’t determine his or her gender identity. The article made a big splash. Within months, pretty much everyone had given up Klebs’s criterion for Luce’s criteria.

On the strength of this success, Luce was given the opportunity to open the Psychohormonal Unit at New York Hospital. In those days he saw mostly kids with adrenogenital syndrome, the most common form of female hermaphroditism. The hormone cortisol, recently synthesized in the lab, had been found to arrest the virilization these girls normally underwent, allowing them to develop as normal females. The endocrinologists administered the cortisol and Luce oversaw the girls’ psychosexual development. He learned a lot. In a decade of solid, original research, Luce made his second great discovery: that gender identity is established very early on in life, about the age of two. Gender was like a native tongue; it didn’t exist before birth but was imprinted in the brain during childhood, never disappearing. Children learn to speak Male or Female the way they learn to speak English or French.

He published this theory in 1967, in an article in the The New England Journal of Medicine entitled “Early Establishment of Gender Identity: The Terminal Twos.” After that, his reputation reached the stratosphere. The funding flowed in, from the Rockefeller Foundation, the Ford Foundation, and the N.I.S. It was a great time to be a sexologist. The Sexual Revolution provided new opportunities for the enterprising sex researcher. It was a matter of national interest, for a few years there, to examine the mechanics of the female orgasm. Or to plumb the psychological reasons why certain men exhibited themselves on the street. In 1968, Dr. Luce opened the Sexual Disorders and Gender Identity Clinic. Luce treated everybody: the webbed-necked girl teens with Turner’s syndrome, who had only one sex chromosome, a lonely X; the leggy beauties with Androgen Insensitivity; or the XYY boys, who tended to be dreamers and loners. When babies with ambiguous genitalia were born at the hospital, Dr. Luce was called in to discuss the matter with the bewildered parents. Luce got the transsexuals, too. Everyone came to the Clinic, with the result that Luce had at his disposal a body of research material—of living, breathing specimens—no scientist had ever had before.


And now Luce had me. In the examination room, he told me to get undressed and put on a paper gown. After taking some blood (only one vial, thankfully), he had me lie down on a table with my legs up in stirrups. There was a pale green curtain, the same color as my gown, that could be pulled across the table, dividing my upper and lower halves. Luce didn’t close it that first day. Only later, when there was an audience.

“This shouldn’t hurt but it might feel a little funny.”

I stared up at the ring light on the ceiling. Luce had another light on a stand, which he angled to suit his purposes. I could feel its heat between my legs

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