What are some conflicts and main conflict in the novel Middlesex by Jeffrey Eugenides?

Jeffrey Eugenides' epic novel, Middlesex, tells the story
of a hermaphrodite named Cal raised as a girl in the 1970's.  Cal's hermaphroditism is
the result of a mutated gene passed down by her grandparents.  The main conflict in the
novel, and in Cal's life, is obvious because it is physical.  As she grows up and enters
adolescence, she does not develop as normal girls do.  Instead, her body stays boyish.
 What's more, she begins to experience feelings of attraction for other girls.  Both of
these occurrences lead her to choose the life of a male rather than a
female.

Related to this is the conflict that many emigrants
to America face.  Because of their customs and their lifestyle, Cal's family are treated
as outsiders by the other suburbanites.  This only makes Cal's struggle to fit in even
harder.

There is also an underlying conflict in the novel
between fate and choice.  This conflict is first raised when Cal tells the story of her
grandparents' emigration from Greece to America.  Though they were brother and sister,
they fell in love with each other.  They may have been fated to fall in love, but they
choose to run away to America and live as husband and wife.  Because of their incestuous
marriage, they pass down the mutated gene which causes Cal's predicament--fate again.
 Yet again, Cal has a choice.  Rather than continue to live as a woman, she chooses to
have an operation and live as a man.