Caster Semenya and the Ethics of Gender Testing in Sports

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yolland

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I don't know if anyone else here has been following the World Athletics Championships in Berlin and the story of Caster Semenya, the 18-year-old South African runner who won the women's 800m gold and is now being forced by the IAAF to undergo a 'gender verification test.' The IAAF say they'd already requested, 3 weeks prior to the Championships, that the South African athletics federation (ASA) withdraw Semenya for this testing, and that their suspicions weren't based on her 'masculine' appearance--which has drawn the lion's share of media attention--but rather on her stunningly rapid rise from obscurity to record-setting times (she's already been tested for doping, and they're apparently confident it's not that). In response, the head of the ASA withdrew from the IAAF in protest, the South African government vowed to file a complaint with the UN Human Rights Commissioner, and Semenya's family have repeatedly condemned what they see as an outrageous public humiliation of their daughter motivated by little more than envy.
Runner Caster Semenya has heard the gender comments all her life

by Robyn Dixon
Los Angeles Times, August 21


Caster Semenya started to run almost as soon as she could walk. She played soccer with the boys in her rural village. At school races, she'd lap the other girls--sometimes twice or more. Even then, according to friends quoted by South African news reports, girls teased her about looking like a boy. Semenya shrugged it off and kept on running. But after she exploded onto the athletic stage Wednesday in the World Championships in Berlin, beating her nearest rival in the women's 800-meter race by a whopping 2.45 seconds, the question was back: Is she really a she? An Italian rival, Elisa Cusma Piccione, called her a man. Russian runner Mariya Savinova agreed. "Just look at her," she told journalists in Berlin.

...Semenya, who comes from a poor rural background in Limpopo province in northern South Africa, has grappled with the consequences of looking boyish all her life. She grew up with four sisters and a brother in the dusty village of Fairlie, about 40 miles from the nearest town. Being a girl in an African village meant girls' chores: fetching water, washing dishes, cleaning the house. But in her free time, she ran off to play soccer with the boys. The newspaper Beeld quoted high school principal Eric Modiba as saying that Semenya always wore pants instead of skirts, played rough-and-tumble with the boys and that he didn't realize she was a girl until she was in the 11th grade. Friends and family say Semenya went for long runs in the countryside, often alone. If the teasing hurt her, she kept the pain hidden, said her grandmother Maputhi Sekgala.

...Nick Davies, spokesman for the IAAF, said it was clear that whatever the results of the gender tests, "clearly it was not her fault...It's a medical issue. You're talking about someone's life. She was born, christened and grew up a woman," he said in an interview with the BBC. The aim of the tests, he said, was to discover whether anything gave her an unfair advantage.

South Africans have rallied around Semenya, angered by Western judgments over the appearance of an African woman. For many black South Africans, the questions about her gender and identity are culturally inappropriate and demeaning. Many feel the issue has been handled insensitively.
Where’s the Rulebook for Sex Verification?

by Alice Dreger
New York Times, August 21


The only thing we know for sure about Caster Semenya, the world-champion runner from South Africa, is that she will live the rest of her life under a cloud of suspicion after track and field’s governing body announced it was investigating her sex. Why? Because the track organization, the IAAF, has not sorted out the rules for sex typing and is relying on unstated, shifting standards.

To be fair, the biology of sex is a lot more complicated than the average fan believes. Many think you can simply look at a person’s “sex chromosomes.” If the person has XY chromosomes, you declare him a man. If XX, she’s a woman. Right? Wrong. A little biology: On the Y chromosome, a gene called SRY usually makes a fetus grow as a male. It turns out, though, that SRY can show up on an X, turning an XX fetus essentially male. And if the SRY gene does not work on the Y, the fetus develops essentially female. Even an XY fetus with a functioning SRY can essentially develop female. In the case of Androgen Insensitivity Syndrome, the ability of cells to “hear” the masculinizing hormones known as androgens is lacking. That means the genitals and the rest of the external body look female-typical, except that these women lack body hair (which depends on androgen-sensitivity). Women with complete Androgen Insensitivity Syndrome are less “masculinized” in their muscles and brains than the average woman, because the average woman makes and “hears” some androgens. Want to tell women with Androgen Insensitivity Syndrome they have to compete as men, just because they have a Y chromosome? That makes no sense.

So, some say, just look at genitals. Forget the genes—pull down the jeans! The IAAF asks drug testers to do this. But because male and female genitals start from the same stuff, a person can have something between a penis and a clitoris, and still legitimately be thought of as a man or a woman. Moreover, a person can look male-typical on the outside but be female-typical on the inside, or vice versa. A few years ago, I got a call from Matthew, a 19-year-old who was born looking obviously male, was raised a boy, and had a girlfriend and a male-typical life. Then he found out, by way of some medical problems, that he had ovaries and a uterus. Matthew had an extreme form of Congenital Adrenal Hyperplasia. His adrenal glands made so many androgens, even though he had XX chromosomes and ovaries, that his body developed to look male-typical. In fact, his body is mostly male-typical, including his muscle development and his self identity.

OK, you say, if chromosomes and genitals do not work, how about hormones? We might assume that it is hormones that really matter in terms of whether someone has an athletic advantage. Well, women and men make the same hormones, just in different quantities, on average. The average man has more androgens than the average woman. But to state the obvious, the average female athlete is not the average woman. In some sports, she is likely to have naturally high levels of androgens. That is probably part of why she has succeeded athletically. By the way, that is also why she is often flat-chested, boyish looking and may have a bigger-than-average clitoris. High levels of androgens can do all that. Sure, in certain sports, a woman with naturally high levels of androgens has an advantage. But is it an unfair advantage? I don’t think so. Some men naturally have higher levels of androgens than other men. Is that unfair? Consider an analogy: Men on average are taller than women. But do we stop women from competing if a male-typical height gives them an advantage over shorter women? Can we imagine a Michele Phelps or a Patricia Ewing being told, “You’re too tall to compete as a woman?” So why would we want to tell some women, “You naturally have too high a level of androgens to compete as a woman?” There seems to be nothing wrong with this kind of natural advantage.

So where do we draw the line between men and women in athletics? I don’t know. The fact is, sex is messy. This is demonstrated in the IAAF’s process for determining whether Semenya is in fact a woman. The organization has called upon a geneticist, an endocrinologist, a gynecologist, a psychologist and so forth. Sex is so messy that in the end, these doctors are not going to be able to run a test that will answer the question. Science can and will inform their decision, but they are going to have to decide which of the dozens of characteristics of sex matter to them. Their decision will be like the consensus regarding how many points are awarded for a touchdown and a field goal—it will be a sporting decision, not a natural one, about how we choose to play the game of sex.

These officials should—finally—come up with a clear set of rules for sex typing, one open to scientific review, one that will allow athletes like Semenya, in the privacy of their doctors’ offices, to find out, before publicly competing, whether they will be allowed to win in the crazy sport of sex. I bet that’s a sport no one ever told Semenya she would have to play.

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Alice Dreger is professor of clinical medical humanities and bioethics in the Feinberg School of Medicine at Northwestern University, and the author of “Hermaphrodites and the Medical Invention of Sex” (Harvard University Press, 1998).
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The IAAF's actions seem well-intentioned enough, but, weighing the arbitrariness involved in determining what constitutes "unfair advantage" against the potential emotional damage to the athlete, I'm not sure I can agree that what they're doing here is worthwhile. The Indian distance runner Santhi Soundarajan attempted suicide after 'failing' a gender verification test in 2006 (i.e., discovering for the first time that she was in fact a genetic male with Androgen Insensitivity Syndrome); the Spanish hurdler María Martínez Patiño, stripped of her medals after the same finding back in the 80s, has written eloquently of the trauma of losing her fiance, her college scholarship, several of her friends, and her running career to the discovery. In the 1996 Olympics--the only Olympics to date where DNA-based sex testing was mandated for all women competitors--seven women were found to be genetic males with AIS, though they were all reinstated after doctors ruled that none of them were deriving an unfair advantage from their condition. And the IAAF itself dropped routine gender verification testing more than a decade ago precisely because what exactly it 'proves'--and what significance to attach to that evidence--was so controversial.

At the same time, I do understand why some of her fellow athletes have expressed resentful suspicions that her presence on the scene 'wrongs' them somehow, whether that's ultimately rationally justifiable or not. Sports are sex-segregated for a reason, and there couldn't be elite female athletes without it. Does the possibility of occasional disadvantage to non-intersex women if these tests were to be banned outweigh the ethical dilemmas involved in 'outing,' possibly disqualifying, and emotionally traumatizing intersex athletes who've never known themselves as anything but women, based on what experts acknowledge is scientifically shaky ground?
 
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Apparently God couldn't decide.


ETA
I had second thoughts about that wisecrack being taken the wrong way, just to be sure...it's not her I'm making light of.
 
If she's not a transgendered person, and they confirm this-her medals should stay w her.

<>
 
I wouldn't call her transgendered-just because she wore pants and played sports with boys doesn't mean she was born female and lived as a male and identified herself as a male. From what I know about her that wasn't the case. That's not the same as being intersex and identifying yourself as one gender or the other.

A sports commentator I saw on tv actually suggested that one day there might be an "other" category in sports-not male and not female.
 
Definitely, they're not the same thing at all. Incidentally, the Olympics Committee, and I believe the IAAF as well, do allow post-op transgender women (i.e., men who became women) to compete as women--provided that at least two years have passed since the testes were removed and female hormones commenced, which is by consensus deemed adequate time for any unfair biological advantage to be eradicated.
A sports commentator I saw on tv actually suggested that one day there might be an "other" category in sports-not male and not female.
Pretty hard to take that one seriously, IMO. We don't treat intersex people as a 'third sex' in broader society; they generally aren't 'out,' and in fact often don't realize themselves that they're intersex unless and until medical problems (or, for an unluckier few, humiliatingly public sports tests) arise. They may or may not have some history of rude 'Are you a girl or a boy?!' challenges from others, depending on appearance, but then so do plenty of people who aren't medically intersex, and we don't normally read much into that beyond 'Wow, that would suck' (which it would; to say it's unlucky to appear ambiguously gendered in most societies would be an understatement).

Besides--and granted, this is the whole problem here when it comes down to it--it's no easier to determine with finality when an intersex athlete derives an 'unfair advantage' from whatever her underlying condition is, than it is to determine with finality what sex we 'should' classify her as for medical purposes.



Anyway...I just found the story interesting as an ethical dilemma. Caster Semenya may turn out to be completely biologically normal when all the tests are completed and interpreted, but, she wasn't the first to find herself at the center of an unwelcome media circus over her gender, and she doubtless won't be the last.
 
I didn't take it seriously, and it was a sports commentator-some of them are not the most enlightened..there were the typical joking comments and asking "why can't you just take the pants down", etc. They don't know much about what intersex means but the general public doesn't either.

I guess sports will just have to catch up to all of this some day-but it's just sad for her personally if she has to be some sort of test case and she's subjected to ridicule or harassment or embarrassment.
 
Let it be understood that I don't want a bunch of opportunistic athletic men to be whacking off their gentalia or appendages to win medals, for the record.

:angry:
 
I'm so glad he went on the record, I thought it would be strictly off the record :)

Could the Women's 800-meter World Champ, Caster Semenya, Be a Man? - TIME

"At the 1936 Berlin Olympics, in the very same stadium where Semenya won her world title, rumors swirled that 100-meter runners Stella Walsh (nicknamed "Stella the Fella") and her rival Helen Stephens were men. After Stephens took the gold metal, the Olympics committee performed a manual check on her external genitals — and concluded that she was, in fact, a woman. And prior to the 1966 European athletics championships, female competitors were made to walk in so-called nude parades so that a committee could confirm their gender.

But Dr. Rob Ritchie, a urological surgeon at Oxford University and the author of "Intersex and the Olympic Games," a recent article in the Journal of the Royal Society of Medicine, says that determining someone's sex is not so simple, and that external genitalia can be misleading. A post-mortem on Stephens' body in 1980 revealed that she had "ambiguous genitalia." The post-mortem didn't go into specifics, but those genitalia could have been a small penis that was mistaken for an enlarged clitoris, or a small scrotum that resembled labia.

Ritchie notes that female athletes who in the past have been suspected of being men may have suffered from Androgen Insensitivity Syndrome (AIS), a condition in which a person who is genetically male — that is, their 23rd chromosome pair is XY — is resistant to androgens, the male sex hormones that include testosterone. As a result, the testes present in that person's abdomen never descend, and neither they nor their parents ever realize they are actually boys. Those with complete AIS will have a totally female body on the outside, but will lack ovaries and a uterus. Others may demonstrate partial AIS. "They are partly sensitive to the male hormone so they might develop some male characteristics," he says. "They may well be a bit more muscular and have facial hair."

It's those characteristics that Semenya's competitors see in the world champ, leading them to predict — and hope — that her forthcoming gender results will leave her ineligible to compete with women. "Just look at her," barked Mariya Savinova, the fifth-place finisher from Russia, following Wednesday's race. Italian Elisa Piccione, who finished sixth, was equally severe: "These kinds of people should not run with us. For me, she's not a woman. She's a man." She also outran them both — and not even a gender test can change that. "
 
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