On Saturday night, Caster Semenya ran to victory in the Olympics 800 metres event. Some people were thrilled for her:
But not everyone was delighted. Not least Lynsey Sharp, interviewed shortly after the race, who complained a recent rule change had made it harder to race against Caster:
Sharp told the BBC after the race: “I have tried to avoid the issue all year. You can see how emotional it all was. We know how each other feels. It is out of our control and how much we rely on people at the top sorting it out. The public can see how difficult it is with the change of rule but all we can do is give it our best.
“I was coming down the home straight, we were not far away and you can see how close it is. That is encouraging. We will work hard and aim to come back even stronger.”
The rule change Sharp refers to had already split opinion long before athletes had arrived in the stadium.
Tests have shown than Caster has a higher level of testosterone than, on average, found in other competitors in the Olympics' womens events. Some athletes who exhibit similar levels of testosterone have been diagnosed with a condtion known as hyperandrogenism.
The perception that intersex competitors are getting an unfair advantage isn't a new one - in an interview with The Science of Sport, Joanna Harper described what was happening in the 1930s, and how little has changed in nearly a century:
While DNA hadn’t been sequenced in the thirties, scientists knew about “hermaphrodites” back then. Prior to 1936, there were two intersex athletes who had competed as female and then changed to living as male – Mark (formerly Mary Louise Edith) Weston and Zdenek (formerly Zdenka) Koubkova – who were cited by Avery Brundage when he called for sex verification rules in 1936. At the time, the two intersex athletes of that era that are well-known in 21st century, Stella Walsh and Dora (later Heinrich) Ratjen, weren’t on the radar.
Of course, what Brundage and others were really worried about was men invading women’s sport. And that is still the case today. I have been accused of “really” being a man who wants to profit in women’s sport, and there are several morons on the letsrun message board who continue to insist that Semenya is a man. Hence, the notion that 21st century followers of sport are more enlightened than those of the 1930s is seriously flawed.
The suggestion that men have ever cheated to get into women’s sport is completely unfounded. Ratjen was intersex and the Press sisters probably were too. In fact, there has never been a proven instance of any man ever competing in women’s sport. But that has never stopped the accusations.
Since 2010, Semenya and other intersex athletes had been allowed to compete in women's events, providing they took drugs to reduce their level of testosterone. This rule, though, was challenged in the run up to the Rio Games and overturned:
This all changed in July 2015 when a case brought by the Athletics Federation of India on behalf of hyperandrogenic runner Dutee Chand saw the Court of Arbitration for Sport (CAS) suspend the IAAF’s regulations pending the receipt of more evidence demonstrating the performance advantage of hyperandrogenic female athletes over female athletes with normal testosterone levels. Suddenly athletes like Chand and Semenya were eligible to compete at Rio and other international competitions without being required to artificially control their testosterone levels.
The IAAF has until July 2017 to gather more evidence, but Dr Silvia Camporesi, a bioethicist and lecturer at King's College London, is unconvinced further research will resolve this contentious issue. ‘What are we trying to prove? Science is driven by research and the binary division between female and male. The current system for sports competition is based on two categories, male and female, but we must realise that the boundaries are not binary. We need to be careful and need to be inclusive. If we set a threshold for [naturally occurring] testosterone it’s problematic because there isn’t a threshold for men and in that sense it’s discriminatory and unfair.’
Writing for Mother Jones, Samantha Michaels explains just how far short of creating a male/female dichotomy sciences falls:
Between 2011 and 2015, the IAAF had a rule that any woman with less than 10 nanomoles of testosterone per liter of blood could compete in women's events—a cap that it said left plenty of wiggle room for almost all female athletes. But not everyone agreed. Last year, the Court of Arbitration for Sport suspended the IAAF's "testosterone rule" after an Indian sprinter named Dutee Chand said it unfairly discriminated against women like her with higher levels. (Check out the New York Times Magazine's profile of Chand here.)
One of the main questions in Chand's case was whether it made sense to create separate "male" and "female" ranges for testosterone, and whether 10 nmol/L was the appropriate threshold. Expert witnesses for the IAAF pointed to two large studies in Russia and South Korea showing that most elite female athletes had much lower testosterone levels, between 0.1 and 3.08 nmol/L. In fact, they added, 99 percent of female athletes had testosterone below 3.08 nmol/L. If anything, they said, the 10 nmol/L cap for women was "arguably too generous."
But Chand, who will race the 100-meter dash at the Olympics on Friday, said plenty of women don't fit neatly within that range, and that there's overlap between the sexes. Testifying on her behalf, Richard Holt, a UK-based endocrinologist, pointed to a study showing that 32 of 234 female athletes had natural testosterone levels above 2.7 nmol/L, including 11 athletes who had more than 8 nmol/L. In the study of athletes in South Korea, he added, four male athletes had testosterone levelsbelow 3.08 nmol/L, and 198 men had testosterone below 10 nmol/L. This type of data suggests there's not necessarily a big gap between normal male and female ranges of the hormone, explained Dr. Katrina Karkazis, a bioethicist at Stanford University who also testified on Chand's behalf.
However, Martin Ritzén, a Sweden-based professor who specializes in pediatric endocrinology and testified on behalf of the IAAF, said the probability of a healthy woman reaching 10 nmol/L of testosterone was "zero." Another IAAF expert witness, Angelica Lindén Hirschberg, a professor of gynecology, noted that she had never seen such a high level of the hormone in someone with healthy ovaries and normal adrenal glands. Other expert witnesses told the Court of Arbitration for Sport that any healthy woman with more than 10 nmol/L of testosterone would likely have to be intersex. Still, Dr. Karkazis of Stanford criticized the threshold, which she said was based on the faulty premise that "men have the exclusive right to testosterone."
If the science has no definitive answer, then exclusion or inclusion becomes an ethical question.
Lindsay Parks Pieper, author of the book Sex Testing, says Semenya's treatment is typical of how the IOC treats people who don't fit into comfortable categories:
Once again the official Olympic policy targeted “deviant” female athletes. This time the IOC targeted women with higher than average levels of androgens. Androgenic hormones control muscular development, and women with hyperandrogenism typically create a greater amount of naturally produced testosterone.
Richard Budgett, sports physician and the current IOC medical and scientific director, argued that the group believed that testosterone was the deciding factor between male and female athletes. “It’s the hormone that makes the difference,” he explained. “If the thing that actually makes the difference in anybody . . . men or women, is testosterone, then it makes sense to look at that.” Therefore, the IOC required all NOCs to “actively investigate any perceived deviations in sex characteristics.”
Back in 2010, in the British Medical Journal Silvia Camporesi and Paolo Maugeri asked a fairly fundamental question - if people like Caster make us question the gender binary in sport, is there a different way of organising competitions?
Indeed, are there any alternative ways of organising track and field, if not on the basis of gender? Would weight be a better criterion, as it seems to work for boxing competition? Or would biochemical differences, such as the levels of testosterone, do the trick? Another option might be devised by anyone wishing to preserve strict sexual boundariesdnamely, to create a brand new category for any disorder or syndrome related to sex! We suspect this will not happen, because it would be both impractical and discriminatory. Reasons for preserving the myth of ‘purity’, in any context, have always proceeded hand in hand with making someone an outcast, as was also the case with Oscar Pistorius.
The debate spurred by Caster’s ordeal leads us to discuss not only gender categories in sports. It rather demands reflection on the meaning and aims of sportdin other words, its ethics and philosophy.We cannot expect science to provide ready-made answers on our behalf: decisions have to be taken, not found.
Kristin Hübner, writing at The Economic & Social Research Council blog, suggests that in half a century's time, we may have made those desicions:
I argue that this case perfectly illustrates the importance of feminist sociology and of incorporating its research findings and theoretical concepts into a wider scientific and social context. If this incorporation will continue to take place over the next 50 years, we might experience a utopia in which we would not encounter another case like Semenya’s again – or, at least, deal with it differently. By 2065, the political and social implications of categories such as gender and sex might in fact have become more widely acknowledged through the dissemination of feminist theory and the expansion of interdisciplinary research. By then, gender, which is usually associated with socially constructed ideas about femininity and masculinity, and sex, which commonly refers to a person’s ‘female’ or ‘male’ biological make-up, will be recognised as complex and yet somewhat arbitrary categories. It will be acknowledged that a person’s chromosomes, hormones, sexual preferences, behaviour and appearance (to name only a few highly gendered human characteristics) cannot and do not need to be consistently categorised as ‘female’ or ‘male’. By 2065, we might even question the use of these gendered distinctions altogether.
For The Conversation, Penn State's Jaime Schultz asks whether worrying about an 'unfair' physical advantage is missing the point anyway:
Elite sport is built on the back of inequality. We love the myth of a level playing field, but it doesn’t exist. Of the 207 nations competing in Rio, 75 have never won a medal. Wealthy, powerful countries dominate the Olympic Games, while conflicted, war-torn, impoverished countries simply lack the resources to promote sport to the level that will produce Olympic champions. That’s a clear disparity that raises little outcry.
But what we’re talking about in the case of hyperandrogenism is an innate condition that potentially enhances athletic performance. And, as scientists are just beginning to understand, elite sport is riddled with similar endowments.
Researchers associate physical performance with over 200 different genetic variations. More than 20 of those variants relate to elite athleticism. These performance-enhancing polymorphisms – PEPs – can affect height, blood flow, metabolic efficiency, muscle mass, muscle fibers, bone structure, pain threshold, fatigue resistance, power, speed, endurance, susceptibility to injury, psychological aptitude, and respiratory and cardiac functions, to name just a few.
We don’t disqualify athletes with these types of predispositions. We celebrate them.
Note: This article originally stated that Caster Semenya has been diagnosed with hyperadrogenism; although several sources claim this as a fact it has never been confirmed and the article has been redrafted to make this clearer.