I read a cluster of about 6 or 7 novels by John Irving over a period of 10 years and this was just one of them. (This is my first John Irving review on LibraryThing.)
After reading a mix of unfavourable and favourable reviews below, the effect was to start to dampen my former untempered enthusiasm for John Irving.
While reading this and other John Irving books, one of the themes that I latched on to the most was the traumatic event in the life of a young person that catches him or her before he or she gets the power to cope with adult events and responsibilities. I guess that is really what happens to all of us. It is the suffering through a death or a personal attack or some unprecedented act of violence that cuts many of our childhoods short and throws us pell-mell into adulthood.
For a dwarf, the biological event that happens is at conception, but the impact of it on his or her life when trying to find a place in society is the trauma that usually makes life nasty and unbearable, or at the very least, extremely challenging. Similarly with the idea of sexual deviance, I believe that biologically there is a full range of possibilities that should develop normally without any external pressure from society, family,, and other sources of hangup anxiety. But when young people, disposed biologically, emotionally, aesthetically, or through a simple act of volition, toward transexual orientation, encounter a society that just cannot let people decide independently what to do with their lives, is it any wonder that things really start to get chaotic and contentious.
Society, go ahead and have your opinions and ideas that you love to promote, but equally promote the idea of individual choice.
By looking at a society somewhat removed from our North American society, the pathos of societal constraints placed on disadvantaged persons is even stronger. But I am sure that John Irving has a lesson for us: beware, North American reader--or reader from anywhere for that matter. Your society is hemming you in and you can barely escape the pervasive pressure to conform and do things that go against your most fundamental inner beliefs and desires.

I like Irving enough that I was extremely disappointed in this book! I'm ashamed I read as far as I did before I quit! Life is too short to waste any time on trash! I hate this book so much I was tempted to burn it, except that I can't bring myself to burn a book! What was Irving thinking? I have to assume that it must be full of severe sarcasm that I simply don't grasp. Otherwise, this book is surely worthless!

Have to agree with heidilove, I love Irving but did not enjoy this book. ( )

bizarre, funny, random, and unbelievably creative- Dr. Daruwalla is a man with no country and no religion, who keeps being drawn back to India to take blood from circus dwarfs. with a few secrets up his sleeve, he participates in the investigation of a transsexual serial killer when the life of his bollywood acting-stepson is threatened. it's about people who don't belong anywhere, for people who don't belong anywhere and like to read about other people who don't belong anywhere. ( )

funny and bizarre, I like it! Dr. daruwalla has no country (but keeps going to india to take blood from dwarves) and no religion, until a transexual bites his big toe while he sleeps. The rest is history. ( )