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Both prizes carry a 30,000 pound ($41,000) purse and are open to female English-language writers from any country.

Last year Van der Wouden became the first Dutch writer to be a finalist for the prestigious Booker Prize for “The Safekeep.� Set in the early 1960s, the novel centers on a Dutch family, their house, and the secrets they both hold.

Author Kit de Waal, who chaired the fiction judging panel, called it a "beautiful, shocking and sensuous� book that reveals “an aspect of war and the Holocaust that has been, until now, mostly unexplored in fiction.�

Van der Wouden told The Associated Press that the book is about “how we narrate history ... What is actively written out and what is written into it, and, indeed, what we actively choose to forget."

Van der Wouden said in her acceptance speech that “hormonally, I am intersex,� and that fact “defined my life throughout my teens until I advocated for the healthcare that I needed.�

She said the fact she was "receiving truly the greatest honor of my life as a woman ... is because of every single trans person who’s fought for healthcare, who changed the system, the law, societal standards, themselves. I stand on their shoulders.�

Previous winners of the fiction prize, founded in 1996, include Zadie Smith, and .

Last year, award organizers launched a companion nonfiction award to help rectify an imbalance in publishing. In 2022, only 26.5% of nonfiction books reviewed in Britain’s newspapers were by women, and male writers dominated established nonfiction writing prizes.

Clarke works as a palliative care doctor, and “The Story of a Heart� traces a transplant through the true stories of two children: one killed in a car crash, and one who could be saved by a new heart. Journalist Kavita Puri, who led the judges, said “Clarke’s writing is authoritative, beautiful and compassionate. The research is meticulous, and the storytelling is expertly crafted.�

Accepting the award, Clarke paid tribute to the families of both Keira, who died aged 9, and the recipient of her heart, Max – now a “strapping, 6 foot 2 16-year-old who likes kickboxing.�

“I knew that some people might feel daunted by the prospect of reading this book,� she told the AP. “It is a book about death, but it’s a book about life and what matters in life – and also something astounding, which is 100 years of medical breakthroughs that have enabled us to do this extraordinary, literally death-defying thing of transplanting people’s organs."

Clarke said she hoped the book would be a counterweight to the “utterly unscientific rhetoric� coming from some politicians in the United States and elsewhere.

To mark the prize’s 30th birthday, writer Bernardine Evaristo was awarded a 100,000-pound ($136,000) Outstanding Contribution Award for her “transformative impact on literature and her unwavering dedication to uplifting under-represented voices.� Evaristo won the Booker Prize in 2019, and was a Women’s Prize finalist the following year, for “Girl, Woman, Other.�