Middlesex: Book 4: The Oracular Vulva Summary & Analysis

Cal reflects that while some people inherit material goods or a “famous name” from their ancestors, he inherited a recessive gene that prompted him to have particularly unusual genitalia. When the doctors in the emergency room tell Milton and Tessie about Cal’s condition, they don’t believe them, and insist on getting a second opinion from Dr. Philobosian, who is by now 88 years old. When Callie takes off her underwear she is initially embarrassed and covers herself, but in his old age Dr. Philobosian has little patience for this. Having briefly examined Callie, he tells her she can put her pants back on. He refers her to an endocrinologist. 

The endocrinologist tests Callie’s blood, and shortly after she and her parents head to New York. Milton has booked them into a shabby hotel in the East Thirties that he once stayed in back when he was in the Navy. Their room is small; Callie will be sleeping in a cot in the corner. Callie unpacks her suitcase, taking out the perfume and lip gloss she has brought with her. She can tell that they are in the midst of some kind of “crisis.” Later, Milton asks what Broadway show Callie wants to see,  and she replies that she doesn’t care. Her parents continue their attempt to seem upbeat.

The next morning, the go to see the specialist, whose office is marked with a sign that reads: “Sexual Disorders and Gender Identity Clinic.” Milton and Tessie act as if they don’t see it. The clinic is elegant, with a view of the East River. While Milton, Tessie, and Callie sit in the waiting room, they suddenly become aware of all the sexual books and imagery surrounding them. Milton comments, “Sort of unusual décor.” At this moment, Dr. Luce appears. Introducing himself, he asks if he’s right in recalling that Calliope was one of the muses. Callie confirms this, saying that Calliope was in charge of epic poetry.

Dr. Luce is a famous sexologist who is trying to play down how excited he is to meet Callie. When he invites Callie into his office for an examination, Milton and Tessie assure her that they will be right outside, waiting. Dr. Luce is “the world’s leading authority on human hermaphroditism” and the author of The Oracular Vulva. He also used to write a popular column in Playboy in which he impersonated the eponymous vulva. For a long time, medical knowledge about intersex people remained poor. Doctors assumed that a person’s sex could be determined purely by the external physical appearance of their genitalia.

This all changed in 1955, when Dr. Luce published an article in which he argued that gender is determined in a large variety of factors, and that a person’s reproductive glands do not necessarily “determine his or her gender identity.” Following the success of the article, Luce was invited to open a Psychohormonal Unit at New York Hospital, where he treated young intersex patients. During this time, he developed another argument: that gender identity develops in infancy, like a “native tongue.” He published this second theory in 1967, which was a booming period for sexology. The following year, he opened the Sexual Disorders and Gender Identity Clinic. The many patients he treats there serve as a giant array of test subjects. 

Dr. Luce asks Callie to change into a paper gown, then takes her blood. He then examines her genitalia, and rather than looking shocked, has an expression of “awe or admiration.” During the internal examination, Callie has an intense flash of pain, and he apologizes. After this initial examination, Dr. Luce is not yet able to determine what Callie’s “prevailing gender” is. Speaking in hindsight, Cal explains that later, Luce establishes that he is broadly genetically male, yet maintains that this does not mean Cal’s gender identity is necessarily male.

Dr. Luce brings Milton and Tessie into his office to talk to them. Tessie notices that he doesn’t refer to Callie using her name or any pronouns. Luce says he wants to perform a range of psychological tests, which will involve seeing Callie every day for 1-2 weeks. He also asks that they supply photographs from Callie’s childhood, as well as home movies. He says that he will be able to explain more about Callie’s condition once he has more information. On Tuesday, Milton flies to Florida on business, and leaves behind some money for Callie and her mother to go out to a “fancy dinner.” Tessie and Callie go to Bloomingdale’s, to High Tea at the Plaza, and to dinner at an ordinary Italian restaurant.

Every night, Tessie and Callie go back to the Italian restaurant together, and every day, they go to the clinic. Dr. Luce interviews Callie about herself, asking whether she has hobbies and whether she is sexually attracted to boys or girls. When she hesitates, he assures her that everything she says will remain private. He notes that Tessie has mentioned that Callie is very close to her best friend, and asks if Callie is attracted to her. Callie tells him that she had sex with the Obscure Object’s brother. Every day, Luce asks more questions, making note not only of Callie’s answers but also her body language and mannerisms. On Luce’s request, she also starts writing her own “Psychological Narrative.” 

As soon as she realizes how fun it is, Callie begins to lie. She realizes that whatever she writes, Luce will lap it up. She pretends to be “the all-American daughter my parents wanted [her] to be,” and recounts her early sexual fantasies and experiences while pretending that they involved boys instead of girls. One day, Dr. Luce plays a pornographic film for Callie, and asks which one of the actors turns her on—the boy or the girl. Lying, she says it is the boy. Callie feels extremely uncomfortable. One day, Luce introduces Callie to two other doctors. While she undresses, the doctors discuss the Sambia people of Papa New Guinea, who have a high rate of the same intersex condition that Callie has.

The three doctors examine Callie’s genitals and make comments. Dr. Luce tells the others that although Callie’s condition is extremely rare, it will nonetheless prove highly significant to the medical community. At another point, a photographer takes photographs of Callie for a medical textbook. In the published version, her face will not be shown. At night, Callie speaks with Milton on the phone and asks when she can come home. Milton replies, “Soon as you’re better,” although Callie doesn’t know what this means. In bed, Tessie has dreams that recall Desdemona’s own terrors about deformed children. Tessie is terrified that she might be to blame for Callie’s condition and that she should have rejected Milton all those years ago.