by Alex Morgan
“They covered me up before Mum could see. She says she knew right away something was wrong. She started shouting because they wouldn’t say if I was a boy or a girl.”
“Why wouldn’t they say?” Paula’s voice was almost a whisper.
“That’s what Mum wanted to know. She heard them all talking outside the room. They were saying I wasn’t right down there.” He pointed to his groin. “The doctor came in and looked at me, and after that, when they went out again, she tore my nappy off to see for herself. After that they had to give her an injection to stop her yelling. Next day, they took me away to do some tests and more doctors came. They said they’d decided that even though you couldn’t tell for sure by looking at me, genetically, I was a boy.”
“Blimey.” Paula massaged her forehead with the tips of her fingers. “I still don’t really understand.”
Sanders held up his right hand, the thumb and forefinger a small distance apart. “When a boy baby’s born, his penis is like this, right?” He moved his fingers until they were almost touching. “Mine was like this. It was so small it was like a girl’s thingy. The rest was a bit more like a boy though. That’s why they weren’t sure.”
He bit into another sandwich.
Paula waited for him to continue.
Eventually, he said, “The doctors told Mum I had a thing called partial androgen insensitivity syndrome.”
“Had?” Paula queried.
“Have. It doesn’t go away. It means one of my genes doesn’t work, so I don’t respond right to the stuff that makes you a boy.”
“Testosterone?”
“Aye, that’s it. When a baby starts to develop in its mum’s womb, at first it isn’t anything, but then it turns into a boy or girl. The doctors said I was meant to be a boy but, because I didn’t react enough to the testosterone, I didn’t develop right. I stayed sort of in the middle.” He scratched his ear. “Some people are much worse. Even though they’re boys inside, they’re exactly like girls on the outside, so they get brought up that way. Fran, my psychologist, says most of them grow up as happy as anyone else.”
“Maybe they’re the lucky ones then,” Paula observed.
“Mibby.” Sanders picked at one of his dirty, bitten fingernails.
“I still don’t see why you have to make a choice though. Can’t they just operate to make you look more like a boy? I mean, people have sex changes all the time, and it’s not as if they’d have to do anything that extreme, is it?”
“It’s not that simple. They can change a boy into a girl, but it’s much harder the other way round.” He fixed his gaze on the other side of the river. “I have to sit down when I go to the toilet. I can have an operation to change that, but I’ll always look different. They can’t make me exactly like a boy.”
“So what’ll happen to you?”
“You know how boys get muscles and go all hairy and their voices get deeper? I won’t grow muscles and hair, and my voice won’t change. I’ll grow a chest like a girl, and if I want to get rid of it they’ll have to cut it off. If I decide to stay as a girl, I’ll need other operations to make me right.” He indicated his groin again.
Paula shook her head. “Sanders, this is so awful I can hardly take it in. Does everyone at school know?”
“They know I have a medical condition but they don’t know what it is. I use the cubicles when I pee and I’m careful when I change for gym.”
“What about your close friends?”
He glanced down at his feet. “I told you, I don’t have any. It’s easier.”
“But haven’t people seen you dressed as Sandra?”
“I’ve only been out a couple of times and the first time it was getting dark. I don’t think anybody noticed apart from you. Mum says people don’t really look at other people because they’re too busy thinking about themselves. And if they did notice, they probably thought it was a visitor that looked a bit like me.”
“Mr Renton knows it was you. Shoplifting’s quite a good way to get yourself noticed.”
He shrugged. “I did it for a laugh. Told him it was a bet. That’s what I was going to say if anyone else recognised me.”
“What about Nora? She knows too.”
“That’s because she’s friends with Mum, but she’s all right.”
“Other people will notice when you start to change.”
He shrugged again.
“So what are you going to do?”
“Don’t know yet,” he said quietly. “I’m used to being me. I don’t want to change into somebody else.”
“Everybody changes at puberty,” Paula pointed out.
He glared at her. “Not as much as me. If I don’t have treatment I’ll turn into a girl, and if I want to be more like other boys, I’ll have to have treatment too – take extra hormones and stuff to sort out the muscles and the hair.” His voice rose until he was almost shouting. “But no matter what they do, I’ll still be different. I’ll never be a real boy or a real girl.”
“Of course, you’re right. That was a stupid thing to say. What does your mum think?”
He focused on the river again. “She says it’s up to me to decide when I’m ready.”
“But you’re twelve now, so you’re running out of time. I mean with puberty and everything …”
He nodded. “I start high school in Westwick next month and Fran says it would be best if I decide before then, so I can go as Sanders or Sandra.” Tears crept forward. “But I don’t want anyone mucking about with my body. I don’t want them cutting me up and filling me full of drugs.”
Paula remembered what Nora had said about his mother’s heroin addiction. “Hormones aren’t exactly drugs, are they?”
“What do you know?” he asked fiercely. “They’re all chemicals.”
“Nothing,” she admitted. “God, Sanders, this is huge! Most people don’t have to make a choice this big in their whole lives.”
“I know.” He sniffed miserably. “But I do.”
He seemed so vulnerable, she wanted to cry. Instead, she put her arm around his shoulders.
“Not today, you don’t,” she said.
Together they sat and watched the water dancing over the stones, and the little crusts of Sanders’ sandwich that had got caught in an eddy, moving first in one direction and then another, but never escaping into open water, until they sank.
Crossed lines
The first thing she noticed was the seagulls. They were everywhere. Circling and jostling and shrieking like something out of Alfred Hitchcock’s film The Birds.
“What on earth’s going on out there?” she exclaimed.
Sanders lunged for the back door. “Bovis,” he shouted as he scrambled down the steps.
Paula took in the devastation from the doorway. Potato peelings, old teabags, mouldy orange shells and all sorts of other rotting, unidentifiable things were spread across the grass, path and flowerbeds. Gulls hovered and strutted, picking through the morsels and squabbling over the tastiest. Two fought over the remains of what looked like a black rubbish bag, each flapping its wings and squawking at the top of its lungs in the hope of driving off its rival.
She glanced over the concrete slabs to the wheelie bin. It had been full when she took a bag out after breakfast. Now it lay on its side, lid half open.
“Bovis, where are you?” Sanders called as he ran round the garden.
There was a scrabbling sound from inside the bin and Bovis reversed out with a chicken carcass in her mouth. It was smeared with what looked like a mixture of strawberry yoghurt and tea leaves.
Sanders grabbed her by the collar. “You bad dog,” he scolded. “You smell like sick.”
Mrs McIntyre shouted from an upstairs window, “Never mind the dog. What about my garden? Yon delinquent animal has turned it into a midden. The next time I look out I want to see it immaculate again.”
“I’m really sorry, Mrs McIntyre,” Paula said. “It didn’t occur to me that Bovis would be able to get into th
e bin.”
“Aye, well, it should have,” the old woman said. “That dog is Houdini in a fur coat and it’s been digging up my flowerbeds. Now get it all cleared up. And when you’ve done, phone your father. He wants a word about your birthday.”
Mrs McIntyre ducked back inside and the window slammed shut.
Sanders clicked his heels together and saluted. “Yes, sir.”
“Sanders,” Paula hissed, “don’t make it any worse.”
Her dad answered on the first ring.
“You must have been sitting on the phone,” Paula said.
“I was in the study digging out a back copy of Cycling Plus for Ollie.”
“Ollie’s there?”
“He just popped round to see how your mum and I were. Do you want a word?”
“Not just now,” Paula said hurriedly. An email she could have coped with, would have welcomed even, but talking was something else entirely. What if he could hear the deceit in her voice, if he knew just from the tone or the words she chose that she’d been with someone else.
“Are you sure?” her dad tried. “He really …”
She cut him off. “My landlady said you wanted to speak to me about my birthday.”
“Yes. I tried your mobile but it seemed to be switched off.” His voice was tired.
“Didn’t Mum tell you it’s broken? That’s why I gave her this number.”
“Yes, yes, of course she did. I wasn’t thinking. Hang on. She’s here.”
There was the sound of the receiver changing hands and her mum came on the line. “Hello, darling,” she said brightly.
She sounded almost like her old self, but Paula knew she was putting on an act for everyone’s benefit.
“How are you?” Paula asked.
“We’re managing. Ollie’s here cheering us up.”
“Dad said.”
“We were all wondering what you’re planning to do for your birthday.”
“I hadn’t thought,” Paula said dully.
Her mum sighed. “Don’t leave it too late. It’s only ten days away. Do you think you might come down?”
“I don’t know, Mum. I doubt it. What’s there to celebrate?”
“Well, don’t decide yet. Think about it.” There was more movement. “Here’s Ollie to have a chat.”
Paula winced.
“Finally, we speak.” His voice was filled with relief. “How are you, babe? I’ve been missing you like crazy.”
“Fine, Ollie, getting by.”
“You don’t sound fine. You sound like shit. Look, I’ve got some holiday to take.” His voice took on a pleading tone. “Why don’t I come up and we can spend a bit of time together?”
“Up?”
“To Scotland.”
“How’d you know I’m in Scotland?” Paula demanded.
“Your mum told me.”
She twisted the phone flex around her hand. “She shouldn’t have done that.”
“Don’t worry, she didn’t say any more. Your dad leapt in before she could divulge the exact details of your whereabouts. Your secret’s still safe.”
He sounded irritated now and that wasn’t like him. Ollie made out that nothing ever annoyed or worried him. When she and Pete were a bundle of nerves before a race, he took it on himself to be the calm one. He would talk on and on about strategies and winning times, always measured, always utterly positive. His actions betrayed his true feelings though, as all the while he would be tapping one foot like a metronome or rubbing away at an imaginary bald spot on the top of his head. She and Pete had long ago realised that inside, Ollie was far more stressed than they ever were, but they knew how important it was for him to maintain the pretence that he was in control.
“Sorry, I’m sorry,” she said. “I hate being so secret squirrel. I know it’s not fair on you, but I need to keep things simple right now.”
“Paula, please, don’t push me away.”
“I’ve got to go.”
“But …”
The thought of seeing him was too much to contemplate – it was all too messy, too painful.
“Say goodbye to Mum and Dad for me,” she said. “My landlady needs to use the phone.”
The receiver was back in its cradle before he could respond.
Sanders’ choice
Paula switched on the laptop, clicked on Google and typed in partial androgen insensitivity syndrome. There were almost 20,000 pages to choose from. She opened the first one and began reading.
Sexual development is governed by a single pair of chromosomes. Partial androgen insensitivity is a carried on the X chromosome.
She scanned her brain for any fragments of information surviving from school biology lessons that might help make sense of this. Xs and Ys. The way we were made had to do with Xs and Ys. She willed something more to emerge from the mental fog. That was it: men have an X and a Y chromosome, and women have two Xs. She allowed herself a brief smile of satisfaction before returning to the page.
Although they may never realise it, some females carry the abnormal gene for PAIS on one of their X chromosomes. This gene affects the chemical receptor in cells which is intended to trigger their response to androgens. Since only one of each pair of chromosomes is passed on to children, half will inherit the faulty gene from a carrier mother. If the child inherits an X chromosome from the father, she will be genetically female and will also be a carrier. But if the sex chromosome from the father is a Y, the child will be genetically male and will suffer from PAIS.
Her head hurt. Paula wanted something even a science dunce like her could understand without having to read it six times. She closed the page and opened several others at random, but they were worse, full of references to karyotypes, probands and covert mutations. She tried another. It was headed PAIS: your questions answered. She scanned down to a section entitled Causes and physical features.
Partial androgen insensitivity is a rare genetic disorder which results in babies biologically meant to be boys failing to achieve normal male development. This is because their bodies are unable to respond appropriately to male hormones known as androgens. These chemical signals are secreted into the bloodstream by the testicles. Before birth, androgens are responsible for the development of male genitalia and, after birth, for the other physical and psychological characteristics associated with maleness.
At last, an explanation that made sense. She read on.
Babies with PAIS develop testicles which secrete normal quantities of androgens. But, because the androgen receptor is faulty, the cells can’t respond normally. As a result, these babies suffer varying degrees of abnormal genital development. Although genetically male, their appearance may be almost identical to normal female genitals or, at the other end of the scale, they may look normally male except that the urethra opens below the tip of the penis.
When they reach puberty, the development of children with PAIS is determined by their level of androgen resistance. They may develop breasts due to the small amount of oestrogen released by the testicles, but there is usually little or no growth of pubic or other bodily hair, as this is triggered by androgens. Nor will they develop facial hair or the muscularity and personality characteristics typical of normal adult males.
Paula felt queasy and light-headed. It was horrifying, alien. Yet it was Sanders’ reality. She took several long breaths, opened another page and forced herself to continue reading.
Individuals with the ambiguous genitals characteristic of partial androgen insensitivity were traditionally subjected to “corrective” surgery during infancy. Some hospitals still do this. However, an increasing number of experts now believe that such cosmetic intervention is both unethical and potentially damaging, because it is difficult if not impossible to reverse. More and more, surgery of this type is considered only when essential for the infant’s health and well-being.
But surgery is not the same as assigning a child a gender. This is merely an issue of labelling. It is done following genetic
and hormonal testing and is generally based on discussions between parents and doctors about which gender is likely to be more suitable for the child as he or she grows up.
Where possible, surgery to make the genitals appear more “normally” male or female is left until the child is old enough to make an informed decision for him or herself.
Everything Sanders had told her was true. The poor kid; it was utterly unfair. No wonder he didn’t want to talk about it. Paula shutdown the laptop. Enough. She couldn’t take in any more.
Opening the door, she waved Sanders down the hall and towards the kitchen.
“You look like crap,” he observed brightly. “What time did you go to bed last night?”
“I was up late reading. Have you considered a career as a diplomat?”
“I hadn’t thought about it. D’you think I should? I’ve always fancied being a novelist or a racing driver. Or maybe an actor. Or I was thinking about a pilot, or …”
She held up a hand to silence him. “Stop right there. Just put the kettle on so I can have some coffee. I’m going for a shower.”
He had woken her from a sweaty, restless sleep by tapping on the bedroom window. She’d opened her eyes to see him grinning through a gap in the curtains. The alarm showed half-past ten. She wondered briefly why it hadn’t woken her at eight. She had definitely set it when she got into bed. Then she remembered – she had had the dream again, and this time, when she went to follow her younger self through the gap between the garden walls, Paula had been shocked to realise they were not alone.
A man of about her own age, dressed in jeans and a green sweatshirt, stood slouched, hands in pockets, against one side of the alleyway. He looked like a young Bill Thompson. Little Paula had already run past, but when she went to do the same he stepped, smirking, into her path, barring the way.
She tried to dodge round him and he moved again to block her, hands still in his pockets. She could see over his shoulder that little Paula had already disappeared. Even if she could get past, it was too late. Little Paula was gone.