Reporters and critics noted that many characters and events in Middlesex parallel those in Eugenides' life. The author denied writing the novel as an autobiography.[26] In an interview by National Public Radio in 2002, he commented on the similarities:
Because the story is so far from my own experience, I had to use a lot of details from my own life to ground it in reality, to make it believable for me and then hopefully for the reader, as well. So I would use my own physical appearance. I would use details from my grandparents' life, the streets they lived on, the kinds of places they lived. And all this made it real for me because it was a tall order to write such a story.[27]
Eugenides blended fact and fiction in his book.[28] Like Cal, the author was born in 1960; unlike his creation, he is not intersex or transgender.[29] His family moved to a house on Middlesex Road in Grosse Pointe[12] after the Detroit riot in 1967.[26][30] Eugenides studied at University Liggett School, a private institution that served as a model for Callie's Baker and Inglis School for Girls.[31] He tapped into his own "locker room trauma", an adolescent experience of being naked among many other nude bodies, and used it to develop Callie's self-discovery of her body during puberty.[28] He based the name of the character the "Obscure Object" on a Brown University classmate whom he found alluring and to whom he gave that nickname.[12][note 5] Eugenides married a Japanese-American artist, Karen Yamauchi,[note 6] and moved to Berlin.[11][26][29]
Eugenides is of Greek heritage, albeit only through his father's side. Although his paternal grandparents were not siblings like the Stephanides, they were silk farmers like their fictional counterparts.[28] Also like Cal, Eugenides learned some Greek customs to help himself understand his grandparents better.[6] The Zebra Room and the bartender profession are other items shared by their grandfathers;[33] Eugenides said the inclusion of the bar was a deliberate "secret code of paying homage to my grandparents and my parents."[6] Several aspects of Chapter Eleven were based on Eugenides' elder brother, who withdrew from society during a "hippie phase" in his life.[29] While revising and editing the book, the author removed information that could be offensive to his relatives. Not all such material was excised, Eugenides said: "There may still be things in there that will sting."[34]