Multiple-Choice Test

Debut author I. W. Gregorio’s Young Adult novel None of the Above follows high school senior Kristin, who has high prospects for the future: she gets good grades, has an attractive boyfriend who she loves, a track scholarship to the nearby state university, and a small, but close knit circle of friends. This all changes after homecoming, when she and her boyfriend attempt to have sex—Kristin experiences searing pain that lasts into the next day. She knows something is wrong. Going to the doctor, she learns that she has an intersex condition, androgen insensitivity syndrome (AIS). Her doctor, in a flustered moment, tells Kristen that she’s a “hermaphrodite.” This slur reverberates through Kristin’s thoughts for much of the novel. In the events that follow, her life starts to fall apart. One of Kristen’s best friends lets her condition slip to someone else, and within days, it is fodder for the entire school. People call her Kristopher, write slurs on her locker, and create a Facebook page for “Pat Hermaphrodite,” which features images of Kristin edited with penises. Her boyfriend breaks up with her because it can’t be known that he had sex with a “man-whore.” In the confusion surrounding her condition, she is removed from the track team while they investigate the rules of her competing against other girls—it is implicit that they are not sure she should be running alongside “real” girls. As the novel progresses, Kristin learns more about AIS, talks to other young women who are intersex, and begins to accept her diagnosis. She even reconnects with an old friend and starts dating him.

Where the novel succeeds the most is in educating readers about AIS. Readers learn early on that Kristin never started menstruating, something she credits to being serious about track from the time she was thirteen. After her diagnosis, readers are given the specifics of Kristen’s condition: on a genetic level, people with AIS appear male with XY chromosomes, but they physically appear female. Kristen has two small lumps in her abdomen (small enough that she never noticed them and her doctor thought they were early hernias) that contain her testes. Olympian Caster Semenya’s case is also brought up as Kristin and her father look at NCAA guidelines for the remaining school year and her scholarship for college. Semenya actually served as part of the inspiration for the novel—Gregorio is a practicing surgeon who worked with an intersex teen around the same time Semenya’s case was in the news, showing the ignorance and scrutiny the public has around intersex conditions. Gregorio set out to educate a teen audience about AIS and portrays the complications—both medical and social—in engaging ways.

However, the strong educational moments are complicated by Kristen’s emotionally driven medical decisions. When Kristin and her father first talk to the specialist about her condition, the doctor mentions that there is the option of removing her testes, but it is controversial as estrogen therapy is needed following the surgery, and the benefits of removal are small. Kristin’s father advocates having them removed for both psychological reasons and the small chance that they could develop cancer. The doctor gives them more information about surgery, but insists that Kristin think about it before continuing with the procedure. Once Kristin spends two days at school being bullied, she calls her doctor back up to schedule the surgery as soon as possible. The risks of the surgery are laid out, but Kristen has her testicles removed within a month of her diagnosis. Later, the book does complicate this decision with Gretchen, a girl from the AIS support group, who is shocked that a doctor already performed the surgery and has a healthy point of view about her condition. She even states, “I heart my gonads.” Gretchen stands as a counterpoint to Kristin’s disgust of having boy parts, but does not change that Kristin’s surgery is completed rashly. By having Kristin demand the surgery so...