‘Because if it’s likely, he’ll probably need a hysterectomy.’
‘Why?’ asks Dad darkly.
‘To be realistic –’ Archie leans forward, thankfully butting in – ‘Max has one fully-functioning ovary. There’s no reason at all why he would be infertile.’
‘Woh,’ I whisper. ‘Seriously?’
‘Max,’ Mum says firmly, meaning ‘stop talking’.
I look down at my nails again and push the cuticles back.
Archie ignores Mum and answers me. ‘Yes, Max. The big surprise is that we don’t hear about this more often, but that’s because babies with your type of intersexuality are often operated on at birth. Because they present as male physically, doctors try to turn them into boys, which would mean that the ovaries and uterus get taken out.’
I think about this and feel sick.
‘As I explained earlier, quite often your intersex type is infertile, but not as a side effect of the condition, more as a side effect of surgery.’
I look up. ‘What type am I?’
‘Not now, Max, let’s not get into that.’ Mum shakes her head.
‘Wait, but . . . am I like a normal type?’
‘Max! Of course you’re normal!’ Dad lies, more to himself than me.
‘How many types are there?’
‘Max,’ Dad says firmly, meaning Enough. ‘This is something we can talk about at home.’
‘What?’ I feel my voice louder in the room. ‘Why can’t we talk about it now? I wanna know!’
Archie Verma’s almond-shaped eyes move from me to Dad, to Mum, then back to me. We catch each other looking and I look away, blushing.
I feel like shit. ‘Sorry,’ I apologise.
‘You know –’ Archie says, leaning her elbow on the desk – ‘I can talk about this at more length with Max another time, if he wants to.’
Mum and Dad look at each other doubtfully.
Archie tries again. ‘It’s important, as people get older, for them to know about their genitalia, for reasons of hygiene, and also to prevent accidents like this. Max needs the right contraception, perhaps some advice.’
Mum picks imaginary fluff off her skirt and looks at Dad. I feel Dad staring at me, and I busy myself looking at the wall charts and funny medical advice posters and imagining new ones. ‘If you are experiencing the menopause, don’t get in a hot flush – talk to your doctor . . .’; ‘Feeling itchy and scratchy downstairs? Don’t get your knickers in a twist – we can help . . .’; ‘Getting older? Urinary dysfunction? Fill your underwear with something else – our deluxe new incontinence pads . . .’.
We are simultaneously pretending it’s not happening, shirking the blame and avoiding responsibility. I wonder if I look more like Dad or Mum.
‘I collect those posters,’ Archie says with a smile. I look up at her and smile back. ‘Max, would you like to come in one day after school and I’ll explain about your condition?’
I nod. ‘Yeah, OK.’
‘OK, we’ll check in the diary and sort something out for next week. Before the assessment.’
‘What assessment?’ Mum tuts.
‘Max has to have an assessment at the hospital before he has the abortion.’
‘Will that take long?’
‘Not long. It’s standard procedure. They might give him an ultrasound.’
‘OK,’ Dad says.
‘Why’s he having an ultrasound?’ Mum keeps firing out calm, evil, lawyery questions like she’s the Gestapo. I just want this day to be over.
‘Because the doctors will probably want to determine, in Max’s case, where the foetus is, and how big it is, and how that corresponds to Max’s unique anatomy to decide what form of abortion to choose. Shall we go over the options now, so we’re all aware?’
Archie
‘If the foetus is up to nine weeks old, the procedure is quite simple, but I don’t think this is an option, in terms of our time frame.’
Max shakes his head. He’s still despondent but he’s paying attention now.
‘A surgical termination can be performed from nine weeks until thirteen weeks. Normally you’d be put under general anaesthetic. A tube goes into the womb through the cervix and suction is used to terminate the pregnancy. I think this would be the option to go for.’
Max stares at his knees, chewing his lip. ‘What if . . . What if we wanted to wait a bit?’
‘For what?’ Karen looks alarmed.
‘That’s a good question Max,’ I answer. ‘Some people do want to have a bit more time to become comfortable with the idea of abortion, and so there are procedures for late-stage abortions. From fourteen to nineteen weeks, the procedure is basically the same, except we call it surgical dilation, where the neck of the womb is stretched open and the doctor uses forceps to get the foetus out.’
Everybody nods, heads down like schoolchildren being told off. Only Steve meets my eyes. He smiles regretfully.
‘And after that?’ Max mumbles.
‘It probably won’t come to that in your situation.’
‘I just want to know.’
I hesitate, but continue. ‘Between twenty and twenty-four weeks, you’d be given different pills, and the baby would pass vaginally. It can be quite painful.’
Max nods nervously.
‘You’ll be kept in the hospital if this happens and given pain relief. The very last option is surgery – this is if the foetus is quite large. And again, the foetus is suctioned from the uterus, but first the neck of the womb is softened and the foetus’s heart-beat is stopped.’
‘I don’t want that one,’ Max whispers.
‘As I said, you shouldn’t need to.’
‘I don’t want to do that one,’ Max says, almost to himself.
‘I think we just want an abortion as soon as possible,’ interjects Karen.
‘Are we definitely ruling out the first option? Has it been nine weeks?’ says Steve, turning to Max.
Max shrugs.
‘I think it’s about ten weeks since Max came to see me.’
‘Why did you wait that long, Max?’ Steve asks him.
Max shrugs again. ‘Didn’t realise,’ he mutters.
‘Why didn’t you use contraception?’ Karen asks.
Max shrugs.
While Steve and Karen frown at each other, Max raises his head and looks at me through his hair.
I nod, meaning, ‘No, I won’t tell anyone’. He smiles gratefully, regretfully, relieved.
After a little while, Steve turns back to me. ‘Well, I think while we’re here with the doctor we should pick up some protection. Do you think so, Max?’
Max shrugs.
‘Max?’
‘Yeah, OK.’
‘OK.’ I turn to the computer, slipping some free Durex into the purple bags they provide for us, while I check my email. ‘The hospital will probably get back to me this afternoon with a date for the assessment and a likely date for the surgery.’
‘Great. Thank you, Dr Verma.’ Steve stands up, and Max and Karen take this as their cue to follow.
‘I’ll be in touch,’ I say, and I shake their hands.
As Max’s palm slips into mine, I feel a sudden temptation to say more, to offer some comfort. He seems so frightened. He gives me a little nod, as if to reassure me, then Karen puts a hand on his shoulder as Steve opens the door. Karen and Max walk through it. Before she leaves, Karen gives me a smile. Steve does the same.
‘Thanks again,’ he says quietly, and shuts the door behind him.
Karen
When Max was diagnosed, I couldn’t do anything but weep silently. I remember listening to doctors murmur to Steve about surgery. I nodded over and over again, hearing no real words, just hoping they could fix him, asking what I did, why it happened. They couldn’t tell us.
Max was obviously a little baby boy. He looked so boyish when he was born, with bruises on his face from the forceps. Steve nicknamed him The Little Thug, and that was the name he used until he los
t patience with me, and named him Max. I didn’t want a gender neutral name. I thought they all sounded strange and on purpose, like we wanted to name him something else, but we only had so many choices. I liked ‘Max’ because it felt like a boy’s name to me, but Steve felt it was gender neutral because it could always be short for ‘Maxine’, so we were both happy with it in the end.
The moment after Max was born, the nurse took him away from us. I knew something was wrong right then, because they usually put the baby on the mother’s skin.
It was the young nurse who took him. She was about my age at the time, twenty-six, and her name was Anna. Anna, who had a brown ponytail, little silver hoop earrings, and a cheer-leader-type zest during the labour, had only recently qualified. I wondered immediately if it was Anna who had done something wrong. As she cleaned the baby, she called the older nurse, Barbara, who was by my side. Anna waved her over like she didn’t want to say anything out loud.
Barbara went to stand by her side and started to rub the baby and talk to him. They had their backs to me. He was still gurgling so I couldn’t think what could be wrong. The doctor who had the forceps was still standing there, Dr Horvath, and he was talking to me, and then Anna came over and the doctor went to the baby.
Everything became slow motion. Not for minutes, or hours, but for years. Everything became slow and sickly and improbable. First, they thought it might be one of the diseases that can kill the baby without treatment. I’ll never forget the name: congenital adrenal hyperplasia. They said that the disease could present initially as ambiguous genitalia, then within weeks the baby could demonstrate poor feeding, lots of vomiting, dehydration. If untreated, it could die.
Then, after they had ruled CAH out, they thought he should be operated on to become a girl, because he had a small phallus, and internal sex organs. But we thought he looked enough like a boy. Steve baulked at them cutting him up. Then they wanted to give him hormones. They took pictures upon pictures. Later, they thought he should be a boy, because he seemed to identify that way. Above everything, they wanted us to choose. They said he would be mal-adjusted, sexually confused, or suffer from gender dysphoria. They said it was better to have the operations while he was young, that children were more resilient, that it was better we confirm his gender as soon as possible. I agreed with them, in part. Who would want their child to have to go through that? Shouldn’t it be us that bore this burden for him? But Steve wouldn’t hear it.
On the day of his birth, I remember I was on the bed, looking at the polystyrene tiles in the ceiling. Steve was holding me and I was shaking with fear and pain. My chest hurt. My stomach hurt. My ribcage felt broken, like every bone had caved in. I had failed the first task of being a mother. Something inside me had hurt my baby. I couldn’t look as the doctor examined him.
‘What is it?’ Steve said, standing up, letting go of my hand.
The doctor turned around and took off some plastic gloves I hadn’t seen him put on. He faced us both and spoke softly, but firmly – something about ambiguous genitalia. He said he was going to take Max and do some tests.
‘Yes,’ I nodded, anxious, terrified, still in pain. ‘Just take him.’
‘What tests?’ Steve asked.
‘Just some standard tests to decide if the baby is a boy or a girl. I wouldn’t want to say right now whether we would need to do anything surgically to better fit baby to his or her assigned gender, but we want to just check and make sure that that doesn’t have to happen.’
I nodded.
Steve spoke again. ‘Does it have to be done now? She hasn’t even held him.’
The doctor faltered, said something along the lines of, ‘baby might have something wrong internally causing this external ambiguity. I would really like to take baby now. I can leave baby with you for a minute while I ask the nurse to prepare the tests, but I’ll be back very soon.’ He picked up his clipboard. ‘Does baby have a name?’
He kept saying ‘baby’, like it was this thing, this monster, this anomaly that didn’t have a soul, a sex, a definition.
‘A name?’ He repeated, looking at me.
Steve looked at me, then back at the doctor. ‘We’ll decide later,’ he said.
Steve held Max for a bit, then sat on the edge of the bed. He tried to give him to me, but I couldn’t stop crying.
‘I know you’re tired,’ he said. ‘But you have to hold him. Come on, Karen. Pull yourself together.’
I sat up, choking, my hand on my mouth. It was the first time I looked at him, and I can’t see how, not in terms of height obviously, but in every other way, I can’t see how he has changed. The Max I saw then was indistinguishable from the Max of today or, rather, of yesterday. He was quiet, he was sweet, he was watching me, waiting for my reaction. He was warm, a little surprised, but he was looking at me as if I was the centre of his world. Those first few years, I felt, some days, sick with responsibility for him. When we used to talk about surgery, I would just baulk at the thought that I had to make such a huge choice for him and nod along with whatever the doctors said, thinking they knew best. I think Steve thought it was part of an ideology I had, but it wasn’t. We had huge fights about it; we couldn’t see eye to eye. But really, I just couldn’t make that choice.
I had gotten pregnant, accidentally, the year before finals and had an abortion. The boys don’t know that. After we graduated, I got pregnant again. I don’t know if I could call it an accident, because things between Steve and me were so passionate, and carefree. We were the golden children at college: we had both got the best jobs we could possibly get and graduated with excellent marks. Nothing could go wrong, and that was why it was all the more unnerving when we had Max.
The shock of having Max hovered over me like a cloud, but in the end, he was so bright, so good, so happy, that you just couldn’t be sad around him. We agreed that we would never let him become ‘the issue’. We agreed not to talk about it around him. So we didn’t, and we haven’t, and the bomb that I thought I was waiting on never went off. So I stopped waiting for it. I thought we were passed it.
We did have a number of difficult conversations with Max, but Steve always took the lead. We told Max he was intersex when he was six. The doctors had just started using the term, instead of hermaphrodite, and we thought it sounded OK enough to tell him about it. That sounds like a stupid reason, but there you go, that was the reason.
He took it at face value. He was more concerned with Pokemon; being intersex didn’t mean anything to him. He shrugged and said, ‘OK, Mummy, it’s alright’, because I was obviously upset, so I hugged him and sent him off to play, and he ran straight out of the conversation into a game of football with Steve.
Then when he was thirteen we had one awful night. Steve and I had a row, we weren’t agreeing on how to deal with it, and Max was upset. We came home from the hospital, from the hormone injections, and Steve starting shouting in the garden, roaring like he was losing his mind.
And I screamed at him, ‘What the hell are you doing? All the neighbours can hear you!’
‘What are we doing to him? What are we telling him with these injections? This isn’t right! It isn’t fair!’
‘Steve, shut up!’
Max was crying in the kitchen.
‘Steve!’
‘I’m so frustrated, Karen. I’m so angry!’
‘At who?’
‘I don’t know. At them, at us, at the world. What are we doing?’
‘Shut up and come inside! Everyone can hear you.’
‘Aren’t you frustrated, Kaz? Aren’t you? Don’t you just want to let it out? Come on, babe. Let it out. Don’t hold it in, talk to me about it, yell with me.’
I was walking in, waving him away. I was growing older, and I didn’t want to talk about Max being intersex anymore.
That was the only time I’ve seen Steve act truly out of line, out of order. That was what I liked about him: the order. He has always been reliable, steadfast, strong. He was grateful but he
never questioned our entitlement to the life we wanted. He never faltered. He was always sure of himself. It was what I had craved at home, when my father was away.
That night, Max cried and cried and wouldn’t stop crying. We dipped in and out of his room all evening. Steve had to leave around ten for an emergency with a murder case. I held Max until about 4 a.m. He cried himself to sleep. The next day, he’d forgotten about it. That’s been it. The extent of the drama. Until today.
I feel . . . so stupid. I thought he was going to become a terror teenager because of all the problems, but he never did. And then this happens, and I never – not once – expected this. Now Max is still uncomplaining, but he’s confused, quiet, shy and awkward and miserable.
What did we do wrong? What did Max do to deserve this? Nothing. I didn’t smoke or drink during my pregnancy. Max isn’t a drug addict, or a brat, or a bastard. What did we do?
‘Jesus,’ I murmur, holding my hand over my mouth.
‘Karen, that’s the fifth time you’ve said that since we got in the car.’
‘Steve, shut up.’
He tuts.
‘Sorry,’ I mutter.
‘Let’s not do this now,’ he says, which infuriates me.
‘Yes, you’re right. Why don’t we get back and you can go to work and then you can avoid dealing with this, and I’ll have to?’
‘I’m not going to work this weekend.’
‘We’ve got that Rotary dinner tonight. We said we would go.’
‘We can cancel.’
‘Oh god, Steve, let’s just go. It’ll take our mind off it. We’re not going to get parenting awards for staying home from one dinner. It’s over. We lost the good parenting badge.’
‘Don’t be dramatic,’ he says, taking my hand.
Oh no. The cracks are beginning to show. I feel like I’m back there again, waiting for them to tell me what’s wrong with our baby. I can’t relive that all again. I just can’t do it.
I look at Max in the mirror. He has his iPhone headphones in and is staring out the window. He looks ahead and I catch his beautiful green eyes in the rear-view mirror. I look away tearfully.
Golden Boy: A Novel Page 17