Sex, Gender, and Sport

At the Olympic Games this summer, competitors from around the world will present dazzling displays of athleticism and sportsmanship—that is, if they meet the International Olympic Committee’s (IOC) sex criteria.

On June 22nd, just five weeks before the opening ceremonies in London, the IOC ruled that testosterone levels will be used to determine the eligibility of Olympic athletes to compete in female-only events.

This ruling came as a result of the controversial and humiliating investigation of Caster Semenya, the South African middle distance runner whose muscular physique and brilliant win in the 800 meters at the 2009 World Championships raised questions about her sex. At the time these doubts were voiced, the International Association of Athletics Federations (IAAF) lacked a clear policy for investigating such concerns. Semenya was subjected to invasive medical testing and was banned from competition while the investigation continued. She was reinstated in 2010 and was recently named South Africa’s  flag bearer for the opening ceremonies of the London Games.

Sex verification is not new; questions about the “true” sex of Olympic athletes have been raised since the 1920s, when women were first allowed to compete. Tests—which counted the number of X chromosomes, or tested for the presence of SRY, a gene on the Y chromosome—looked for a single biological determinant of sex. In the 1960s, the IOC instituted universal testing, but ditched the mandate in 1999. Single-sex sporting events exist to create fair and equal competitive environments, and in theory, sex testing protects the sanctity of these events. However, in the long history of official and non-official sex testing of female competitors, only a few men have been “caught.” Instead, sex testing tends to uncover intersex characteristics and other disorders of sexual development (DSD) in women.

The IOC’s new policy will not impose sex testing on all female athletes, but will only focus on female athletes whose sex is called into question and who are thought by an IOC or National Olympic Committee Medical Officer to have hyperandrogenism—higher than usual levels of testosterone. Testosterone is a hormone naturally produced in men by the testes, in women by the ovaries, and in both sexes by the adrenal glands. If an athlete does not pass the exam, she will be prohibited from competing until she lowers her testosterone levels, either surgically or pharmaceutically.

The policy is based on the beliefs that normal male and female testosterone levels do not overlap and that excess testosterone gives an unfair advantage because of its muscle building properties. However, many have denounced the policy as scientifically flawed, questioning the supposed gap between male and female testosterone ranges. Furthermore, testosterone levels alone cannot predict athletic ability because every individual body responds differently to the hormone.

Although most people think of sex as a simple male-female binary, there is actually profound variation in the sex of even “normal” people. Sex can be identified using at least six markers: chromosomes, gonads, hormones, secondary sex characteristics, and external and internal genitalia. No two people have exactly the same combination of these characteristics.

The controversy over the IOC’s ruling is indicative of much larger societal uncertainties regarding gender and sexuality. Is our binary approach to sex out of date? The IOC’s new policy is flawed and unfair, but it has forced us to reevaluate our views. While it is tempting to think that anyone who doesn’t fulfill traditional sex and gender expectations is a rare exception to biological rules, we must remember that none of us are really normal. Sex isn’t just male or female, but a complex equation of factors.

There will always be athletes with natural advantages—height, musculature, mental toughness, better work ethic, the list goes on. And there will always be winners and losers, too—that’s a fact of sport. So should a higher than normal testosterone level disqualify a woman from competing? Probably not: hormone levels don’t necessarily confer an unfair advantage, and they certainly don’t determine sex on their own. Although the IOC’s new rule was an earnest attempt to save competitors from embarrassing physical tests, it is neither scientifically nor ethically sound. Testosterone testing isn’t the right solution.

Katrina Hacker is a summer intern at the Montefiore-Einstein Center for Bioethics. She is a rising senior at Princeton University, where she studies the History of Science. After graduation, she plans to complete a post-baccalaureate pre-med program and attend medical school.

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