Introducing: I. W. Gregorio

Everyone always asks me: How did a urologist end up being a YA writer?

The better question to ask might be why an aspiring writer decided to become a doctor, but I won’t bore you with that, as I’ve already blogged about it a bit. Instead, I’d like to talk about the patient who got this urologist off her sorry butt and back to writing.

My debut novel, NONE OF THE ABOVE (Balzer & Bray, Spring 2015) is a YA contemporary story pitched as MIDDLESEX meets MEAN GIRLS. It’s about a girl who finds out mid-way through her senior year that she’s intersex – what in the old days they’d call a hermaphrodite – meaning that she has both female and male physical characteristics. And it was inspired by a patient I treated during residency.

I still remember my attending surgeon’s excitement when I walked into the OR; he couldn’t wait to tell me about our case. Our patient, he explained, had Androgen Insensitivity Syndrome (AIS). Briefly, AIS is one of those classic “zebras” that you learn about in medical school but never expect to treat in real life. It’s a genetic condition where individuals have XY chromosomes and develop male internal organs, but the cells in their body don’t respond to testosterone so they look like females on the outside.

Like Kristin, the main character in NONE OF THE ABOVE, my patient found out about her condition when she never got her period and was found to have hernias with gonads in them. I participated in the operation to remove her gonads and also saw her postoperatively, at which time I referred her to the AIS support group, which my senior doctors hadn’t even mentioned to her. She came from a very poor and disadvantaged background, and I think I was the first person to really talk to her about her condition and what to expect in the future. During my examination, she was pretty stoic – uninterested, almost. I never met her family, so I didn’t know whether her parents were involved with her health care and I worried about her support system.

Unfortunately, I was never able to follow-up with her because I switched rotations, but she haunts my memory still. I’ve always wondered what became of her, and how she came to terms with her diagnosis. Did she have a boyfriend? What happened the first time she tried to have sex? Who did she tell -if anyone- about her condition? Was she sad that she could never have children?

The year I treated that AIS patient was the same year that the Caster Semenya story hit, and the public outing of her ambiguous gender made a huge impression on me. It made me truly think about what it meant to be a woman. Was biology destiny, or was it just a suggestion? More importantly, what role do chromosomes play not only in who you love, but who loves you?

These thoughts stewed in my head for years. Meanwhile, I wrote my first novel and got an agent. Ultimately that book didn’t sell, and nowadays I like to tell people that I’m glad that it didn’t because it wasn’t my best work. In reality, I had a really hard time letting that first baby go, but what allowed me to finally move on was the prospect of writing that YA MIDDLESEX book that I’d been thinking about forever.

I’m glad that I did, and am so honored to be able to call the Fearless Fifteeners my people. I can’t wait to see all of our books hit the shelves.

I. W. Gregorio is a practicing surgeon by day, masked avenging YA writer by night. After getting her MD, she did her residency at Stanford, where she met the intersex patient who inspired her novel, NONE OF THE ABOVE (Balzer & Bray / HarperCollins, Fall of 2015). She lives in Pennsylvania with her husband and two children, and is a recovering ice hockey player. For more, visit iwgregorio.com or Tweet her at @IWGregorio.

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