Monday, December 4, 2023

Gender or Sex Verification of Athletes ÔÇô Why?

The International Association of Athletics Federations (IAAF) recently confirmed that the South African gold medallist Caster Semenya at the world athletic championships in Berlin, Germany is to undergo gender verification test.

Caster clocked the fastest time this year ÔÇô 1.55.45 in 800 m women’s final, finishing two seconds ahead of the defending world champion. The call for gender verification was requested three weeks ago, following another equally impressive run by Caster in the junior games in Mauritius, winning a gold medal in the 800 metres in 1:56, 72 ÔÇô then the fastest time by a woman in the world this year. Not so long ago, the same cloud that hangs over Caster Semenya hung over our own Tshotlego Morama.

The sad part of calls for gender verification is that they usually follow impressive displays by athletes. Therefore instead of celebrating, athletes, their families, coaches and nations are subject to barrage of media coverage ÔÇô where even their integrity is questioned.

Professor Malcolm Collins of the UCT/MRC Research Unit for Exercise Science and Sports Medicine was quoted by the Mmegi Monitor (Vol. 10 No. 31) of Monday 24 August 2009, as having told the Star Newspaper that “You can destroy someone’s life like this.
To grow up believing you are one sex only to discover you are another is terrifying.”

Caster’s parents raised her as a girl, and we all believe for now that is what she is.

Gender verification in sports is not new. It started during the 1966 European Track and Field Championships in response to suspicion that several of the best women athletes from the Soviet Union and Eastern Europe were actually men. For the Olympics on the other hand, it began at the Grenoble 1968 X Olympic Winter Games in south-eastern France.

Gender verification can virtually affect any sporting event, particularly single sex competition where the other sex appears to have an unfair advantage. The inclusion of the other sex in competition can be deliberate where the intention is winning at all costs; but it can also happen unintentionally when both the sport administrators and the athlete may be oblivious of the latter’s actual gender.

Gender and sex are loosely used interchangeably in our normal day discussions, but terms are different. Gender attributes, opportunities and relationships are socially constructed and are learned through socialization processes.

Gender determines what is expected, allowed and valued in a woman or a man in a given context. Sex in biological context is being male or female, as determined by chromosomes, and body chemistry. Gender in this article will be used loosely to mean sex.

On average, men are stronger than women due to a greater capacity for increased muscular mass as a result of men’s higher levels of testosterone; and men have a greater capacity for cardiovascular endurance – due to the enlargement of the lungs of boys during puberty, characterized by a more prominent chest.

However, women have more endurance than men. Therefore, when men compete in the same sporting category as womenÔÇô they will have an advantage over the female counterparts. Testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands, but as indicated earlier males usually produce more testosterone than females.

Testosterone’s androgenic effects include maturation of the sex organs, particularly the penis and the formation of the scrotum in unborn children, and after birth (usually at puberty) a deepening of the voice, growth of the beard and axillary hair.

Testosterone can also be produced as synthetic compound for treatment of some diseases. Since anabolic effects of testosterone include increased muscle growth, it has been used by athletes to enhance their performance, leading to its use being banned as it gives athletes unfair advantage. In 1988 at Seoul Summer Olympics, Canadian Ben Johnson exploded from the blocks to clock 9.88 seconds in route to breaking the world record in 100 m men’s final.
It was later found out that Ben Johnson used steroids, he was disqualified and the gold handed to the legendary Carl Lewis. The more recent case is the banning of Marion Jones for use of performance enhancing substances. The list goes on and on.

To many folks, sex or gender is simple, either one is male or female. Generally, therefore sex or gender classification in the majority of the cases can be done based on the physical appearance and more accurately at puberty. Therefore by and large, people fall into their gender groups without need for any verification.

However, nature is not always perfect. The final body appearance may not correspond with what is dictated by its genetic makeup, i.e. there are sometimes situations where genotypic (chromosomal) does not correspond to phenotypic sex. Under those circumstances, an individual looking physically like a woman may indeed be genetically male, and vice versa. The physical characteristics may not be clearly distinct for one reasons or another.

Such cases have been scientifically and medically defined, some are rare cases and some are common. The majority of them we never get to hear about, and are only known to the individual and family members. Now and then one case will catch the international headlines as is the case with Caster Semenya ÔÇô interestingly it only happens when such individual performs exceptionally well at international competition and in events where being powerful (potentially being a man) gives an advantage.

During human development, a normal sperm cell (male seed) carrying either an X chromosome or a Y chromosome will meet a normal egg cell (female seed) which only has one X chromosome. These meet up to form either an XX (female) or XY (male) embryo. Normal sexual development occurs in three stages: establishment of chromosomal (genetic) sex through meeting of the sperm and egg; development of gonad sex (gonads in males are the testes and in females the ovaries) and development of phenotypic sex (physical appearance).

Morphological sex differentiation begins six weeks after fertilisation, at which time the gonad begins to differentiate into either a testis or an ovary: until this time the embryonic gonads of either sex are morphologically indistinguishable.

Three weeks after gonadal sex- differentiation begins, the external genitalia begin to differentiate into either the male (penis) or female configuration (vagina). This process is under hormonal control particularly testosterone secreted by the foetal testis which is responsible for the imposition of the male phenotype.
If an ovary or no gonads is present, the resulting phenotype is female; it therefore appears that no gonadal hormones are required for female development.

The physical appearance or phenotypic manifestation of sex is largely determined by hormonal influences. Sometimes when things do not go according to the plan, the result may be intersex. Intersex is a group of conditions where there is a discrepancy between the external genitals and the internal genitals (the testes and ovaries).

In 2006, Dr Peter A. Lee and colleagues in collaboration with the participants in the International Consensus Conference on Intersex organized by the Lawson Wilkins Paediatric Endocrine Society and the European Society for Paediatric Endocrinology (Paediatrics 2006;118;e488-e500) made a consensus statement on management of intersex disorders wrote “Terms such as “intersex,” “pseudohermaphroditism,” “hermaphroditism,” “sex reversal,” and gender-based diagnostic labels are particularly controversial.

These terms are perceived as potentially pejorative by patients and can be confusing to practitioners and parents alike. We propose the term “disorders of sex development” (DSD), as defined by congenital conditions in which development of chromosomal, gonadal, or anatomic sex is atypical.”
There are two common conditions of disorders of sex development that can happen: (i) person is genetically a woman, as she has the chromosomes of a woman, the ovaries of a woman, but external (outside) genitals that appear male.

This usually is the result of a female foetus having been exposed to excess male hormones before birth, and (ii) person is genetically males, as he has the chromosomes of a man, but the external genitals are incompletely formed, ambiguous, or clearly female.

As can be noted, there is more to what determines sex or gender. I am not opposed to gender verification, I strongly believe in fairness and the rights of individuals.

I however feel the IAAF blundered by taking a decision to do gender verification for Caster Semenya immediately following her exceptional performance. The calls for gender verification are often heard after impressive displays by athletes and are often agreed to haphazardly and in the most hurtful way.

The whole saga of the gender verification for Caster Semenya has now become unethical, hurtful, and above all disgraceful. Winning at international meetings is everything as it brings fame and fortune (prize money, endorsements etc.) and national pride.

It is now difficult for an observer to distil whether calls are based on genuine concerns and or are just calls laced with petty jealousy and are vindictive. The process which could have been simple now has become political and is divisive in nature.

I strongly feel that IAAF needs to develop a policy on gender verification which will prescribe the modalities of systematically carrying out such a test in the most ethical way such that the rights of athletes are taken into consideration. We are well aware that IAAF and other international bodies continuously test athletes for banned substance.

A policy on gender verification will determine the age of testing, who gets tested (expensive as it may be, I personally recommend everyone to be fair and avoid prejudice), counselling and most importantly support for the athlete and family.

It should enforce the use of a team of health care professionals with expertise in disorders of sexual development. Issues must be addressed in ways that merit the 21st century devoid of influence from nationalists, commercialists and politicians.

We can borrow something from the Olympic spirit as expressed in the Olympic Creed: “The most important thing in the Olympic Games is not to win but to take part, just as the most important thing in life is not the triumph but the struggle.

The essential thing is not to have conquered but to have fought well.”


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