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Annabel by Kathleen Winter

True hermaphroditism will occur only once in about 83,000 births, according to Dr Ho, the provincial paediatrician to whom Jacinta Blake takes her infant son, Wayne, at the start of Kathleen Winter’s remarkable first novel.

Wayne is that sexual anomaly and the rarity of his condition helps to explain why Dr Ho botches the remedial operation, condemning the child to a life as partial as a half-built bridge, one of the central metaphors of the book.

Winter traces Wayne’s growth from his confused boyhood in the small town of Croydon Harbour in Labrador to his burgeoning personhood in St John’s, the capital of Newfoundland.

His condition is a secret known only to three people: Jacinta, a former teacher; her husband, Treadway, a trapper; and their neighbour, Thomasina, who loses her own husband and daughter at about the time that Wayne is born and secretly calls him Annabel after the dead girl, a name that comes to symbolise his buried self.

The Labrador that Winter depicts is a world where gender roles are sharply defined: “Women of Croydon Harbour knew what was expected of them at all times, and they did it, and the men were expected to do things too, and they did these, and there was no time left.” This is no place for ambiguity, and Treadway is determined that Wayne should be raised as a regular boy so that he can, literally and metaphorically, hunt with “the pack”.

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To all outward appearances, Wayne’s development is normal. However, his suppressed femininity starts to emerge in his obsession with a swimmer and her spangled bathing suit, and his friendship with a classmate, Wally Michelin, so intense that “he wished he could become her”.

The crisis for Wayne and his parents comes when he reaches puberty and begins to have severe stomach cramps that stem from a build-up of menstrual blood in the womb that Dr Ho has failed to remove. Even more painfully, the close proximity of his sexual organs leads to him impregnating himself, the resulting foetus becoming trapped in a Fallopian tube.

Such is the lyricism of Winter’s writing that these and other extreme conditions become poetic rather than pathological. When a sympathetic doctor looks at Wayne’s burgeoning breasts: “It was as if he saw the apricots growing on their own tree, right where they belonged.” Likewise, when Wayne finds himself alternately attracted to, and repulsed by, a male teacher, he felt that “flowers were bursting open between his legs, but the flowers were ugly flowers that he did not like”.

Wayne’s final assertion of his unique, undivided identity, along with his refusal to submit to the surgery that will allow him to suit society’s expectations, is at once deeply moving and a powerful rallying cry.

In the final analysis, Annabel is about far more than one individual’s gender confusion. It demonstrates the need for us all to acknowledge our mixture of male and female characteristics, to be true to the rich complexity of our personalities and to respect the uniqueness of other people.

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Michael Arditti’s most recent novel, Jubilate, is published by Arcadia

Annabel by Kathleen Winter Jonathan Cape, £12.99, 480pp. To buy this book for £11.69 visit thetimes.co.uk/bookshop or call 08452712134.