Choice vs. Destiny
Eugenides addresses the debate between choice and destiny throughout the novel, from Lefty and Desdemona's game of "rock, paper, scissor" to determine which girl he will marry to the determination of Cal's gender. Cal playfully suggests that the gene that his family carries was destined to survive and that it manipulates people and loves to ensure its manifestation. If Lefty hadn't won both games of "rock, paper, scissor," would he have married one of the village girls and not his sister, Desdemona? Does the family's uninformed decision to raise Cal as a girl change what (s)he really is? Do the repetitions in the Stephanides family narrative showcase destiny at work, or convenient coincidences?
Genetics and Science
At the beginning of the novel, Cal wonders what it was like to live in a time before knowledge of genetics, when people's futures were not understood as being written in their biology. The developments (and failures) of science and genetics are central to Middlesex. Science and technology work against the Stephanides' Old World knowledge, for example when Desdemona struggles to predict Milton and Tessie's future child's gender. Science and technology turn humans into machines in Detroit's Ford Motor Company. Genetics turn Cal into a lab specimen, put on display for the whole world to see. Science also holds the truth for Calliope, however, the key to her late puberty and increasingly "freakish" nature. Genetics (nature) go up against nurture in the fight for Cal's gender, and Cal chooses the side of genetics, deciding to re-form himself as male. Whether positive or negative, science and technology are inseparable from modern life.
Circular and Linear Narrative Structures
Middlesex is experimental in its narrative structure. Told by Cal Stephanides as a near-omniscient narrator, it moves both circularly and linearly. Interrupted sporadically by stories of Cal's current life and search for love, Middlesex begins at Cal's birth before moving back to his grandparents' flight from Turkey. Cal emphasizes the importance of circles to Greeks as well as the importance of narrative, from the circles of the silk cocoons, to the circles performed in Greek marriage ceremonies. Through this emphasis on circular structures, Cal communicates the importance of looking to the past to understand the present. Events in Middlesex occur over and over again, from automobile accidents to dreams of monstrous children. These repetitive events are important in both shaping the character and story of the Stephanides' family and giving them insight into the future.
Gender
Morphing and contradicting notions of gender are scattered throughout the novel. As a genetic male raised as a female, Cal switches between "gendered" viewpoints, often settling somewhere in between. At different points in the novel, Cal performs gender, wearing the dresses and braids of a young girl or the suit and muscles of a confident man. In Middlesex, gender is never black or white, and while Cal chooses to live as a man, he admits that in many ways he is still "Tessie's daughter." This characterization problematizes the idea of defined gender characteristics, positing that people are their own amalgamation of traits and quirks.
Monstrosity
The Stephanides family struggles with notions of monstrosity, from The Minotaur play that Lefty and Desdemona see, to Desdemona and Tessie's nightmares about monstrous children, to Calliope's fateful trip to the library where she sees "monster" used as a synonym for her condition. As an insecure teenage girl, Cal is overwhelmed by the feeling that she is a freak, and she suffers, isolated from those around her. Even in the present, Cal feels uncomfortable in his own skin. Middlesex ultimately embraces these monsters, however, instead vilifying actions like the Turkish massacre of Greeks and Armenians and the U.S. Army's handling of the Detroit race riots. When the novel raises the question of what is monstrous, its sympathetic treatment of "freaks" and subtle condemnation of the above actions give a pretty clear answer.
Greekness and Other Nationalities/Races
Cal is not only a hybrid of genders, he is also a hybrid of cultural identities, both Greek and American. Middlesex is the story of the Stephanides family's struggle to assimilate into American culture while retaining their cultural heritage. "Greekness" invades much of Cal's story, from the plays featured - The Minotaur and Antigone - to his deus ex machina and muse invocations. This "Greekness" is often threatened, first by the Ford Motor Company and later by the family's own abandonment of it, culminating in Milton's disavowal of sympathy with Greece in favor of America. Middlesex is the story of other nationalities and races as well, as it dives into America's immigrant past. The struggles of African-Americans are addressed several times in the novel; the novel comments on the general discrimination that "ethnic" people face(d). In the present, Cal has become an ex-patriot living in Germany, where, more than ever, he grapples with what his cultural identity is.
History and the Past
Beyond the Stephanides' story, Middlesex becomes the story of many American families. Although the genetic anomaly is specific to their family, many of the events of the novel: immigration and Ellis Island, Prohibition, the Great Depression, World War II, race riots, the Vietnam War, etc. are common to many families. By situating the novel firmly within the historical community of many Americans, Eugenides increases its universality. The messages we take from here apply beyond this narrow circumstance and shed light upon our own pasts, which in turn shed light upon our presents and futures.