Review: "Nobody Needs to Know" by Pidgeon Pagonis

Nobody Needs to Know by Pidgeon Pagonis
Published August 2023 via Little A
★★★★

My chromosomes chose intersex. My doctors chose girl. And I was left to endure the consequences. (loc. 1337*)

Pagonis was told a lot of things about their body as a child—some of which turned out to be true. Others turned out to be warped truths, and still others turned out to be blatant lies. And then there were the things that Pagonis wasn't told.

In Nobody Needs to Know, Pagonis chronicles a journey of surgeries and imposed otherness punctuated by revelations: as a kid just starting school, as a preteen, as a first-year in college. It was that last revelation, which led Pagonis to seek out their medical records, that set them on a route to activism—in particular, a drive to change the system that made Pagonis's body not their own for so long.

I'd learned early on, in the days after the surgery while lying in that hospital bed and during all the checkups that followed, that my body wasn't my own. It didn't belong to me. It belonged to everyone else. It belonged to the people who could "fix" it, to the people who wanted to study it, to the people who would use it. (loc. 945)

I've read enough about what it means to be intersex to understand one very simple thing: the best cosmetic intervention is no cosmetic intervention. There are too many stories of infants having parts cut off or sewn up so that they look more "standard," irrespective of what that might mean for identity or quality of life, and ignoring the fact that these infants will eventually grow up to be children and then adults with opinions and feelings about their own bodies. This is just one of those stories, and as far as I know such surgeries are still the norm rather than the exception. But Pagonis highlights some other devastating experiences as well—such as being a kid in hospital expected to strip down and bare all for any set of doctors who wanted to come by and take a look, without being told the truth about why they were in hospital and without an understanding that they could say no.

Two things that I would have really liked to see here: first, though there are some ties to trans activism, I'd love to know where the people fighting against intersex rights (such rights including the right to not have nonconsensual cosmetic surgery) stand on questions of trans rights. Pagonis touches on this a little, in terms of hospital policy, but I suspect that there's a different kind of enormous disconnect in how conservative politicians view the matter.

And second, research. I do not need the hard numbers to be convinced, but that doesn't mean I don't want to see the hard numbers anyway. Late in the book, when Pagonis is talking to doctors who perform these surgeries, the doctors' argument (as Pagonis tells it) boils down to "It makes the parents happy if their kids' genitals look normal!" I desperately wanted a retort of "Here's what the peer-reviewed research says about what those kids say about their own damn genitals when they grow up"—but I don't know what sorts of studies have and haven't been done, so barring that, I'd have liked some discussion about surgeries continuing despite the long-term impacts not having been studied in sufficient detail.

If you don't pick up the book, it's still worth checking out Pagonis's Wikipedia page and reading more about their experience and advocacy work.

Thanks to the author and publisher for providing a review copy through NetGalley.

*Quotes are from an ARC and may not be final.