A few short days before Caster Semenya won gold in the women’s 800m final in Rio de Janeiro, Sascoc president Gideon Sam told Sport24 that for both him and Semenya, the issue of her gender was “dead in the water”.

“We take that as one of the tricks to put her off,” he said. “She said to me yesterday that she’s as strong as can be. She told me she was a young girl back then, and that they could get on top of her, but not now.”

Semenya certainly looked confident in Rio, simply doing what she does best: running her heart out. But for critics and competitors, the debate seemed the very opposite of dead. A tearful Lynsey Sharp said she had “tried to avoid the issue [of intersex athletes] all year”, adding:

“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 our rule but all we can do is give it our best.”

Sharp, who media carefully noted wrote her dissertation on gender in sport, had run a personal best of 1 min 57.69 seconds. She came sixth.

The Crux

Distilling the gender debate to its bare bones delivers a handful of core questions. First, is it scientifically sound to argue that women with higher testosterone levels have an advantage? Second, is this advantage unfair, or simply one of the other physical and environmental advantages, like having long legs, or being born in a country with great sport facilities?

Third, and perhaps the most difficult to answer, is raised by Joanna Harper in an interview with Ross Tucker:

“If one believes that women’s sports are vitally important, and one has little regard for the rights of a small segment of humanity, then suggesting that women’s sport should only be for those who are 100% female is not unreasonable. On the other hand, if one is passionate about the rights of marginalised minorities such as intersex or transgender women, and one is not as invested in the benefits of sport to all women, then it is not unreasonable to suggest that anyone who considers herself female should be allowed to compete as nature made her.”

Harper, who describes herself as “a scientist first, an athlete second and a transgender person third”, is a medical physicist who consults the IOC on the matter of gender.

There are no simple answers to any of the above. So far, the best anyone has done is question them. And while the world attempts to settle on a solution, the IAAF’s rules dating to 2011 (which require female athletes with high levels of testosterone to undergo medical treatment and clearance before competing) were suspended for two years by the Court of Arbitration for Sport, which cited a lack of evidence of athletic advantage. The IAAF has until 17 July 2017 to appeal. With the burden of proof now being on the IAAF, the matter hangs.

The can of worms

The cases of cisgender female athletes, transgender athletes and intersex athletes are distinct, but related. All these groups are fighting various levels of stigma and/or social disadvantage. Add sport into the mix, and the results are explosive.

Speaking to Tucker earlier this year, Harper summed it up:

“I fear that that much of the anticipation for the… Rio Olympics will be overshadowed by the spectre of intersex athletes dominating some events in women’s athletics, the premier sport of the games. It is also unfortunate that many people will blame the medal-winning intersex athletes whose only crime is to compete with the gifts that nature gave them. The real problem is that sports need some policy governing intersex athletes, and currently there is none.”

Harper has nailed her colours to the mast fairly consistently. She believes that women with hyperandrogenism – like Semenya and Dutee Chand – should be allowed to compete, provided they are on medical treatment to lower their testosterone levels to within a more average range.

As a transgender athlete, Harper has also argued that, at least on longer distances, where greater muscle mass is unhelpful, male to female transgender athletes don’t have a notable advantage over their cisgender counterparts. This, together with her belief that female athletes should not be allowed to run if their testosterone levels are very high, are largely rooted in the realisation that, as a woman, she ran 12% more slowly than previously. According to Harper, this reduction in pace matched perfectly the average difference between men’s and women’s speeds (women typically being 10-12% slower than men).

But Harper is also sensitive to the social pressure surrounding gender. “I started hormone therapy in the summer of 2004,” she writes, “and I’ve raced as a woman since the spring of 2005. Although the IAAF, the world track and field association, allows it, and some of my fellow runners have been accepting, other runners are notably chilly towards me. Or they tell me that it’s fine for me to race — as long as I don’t beat them. Such comments leave me feeling incredibly defensive. How slow would I need to be for them to be happy?”

In a sense, Semenya could ask the same question. Her gender testing came up in the first place because she did not look feminine enough by conventional standards, and because she was fast enough to arouse suspicion – in a process Daily Maverick’s Antoinette Muller calls “incredibly un-PC”. Muller is also of the opinion that there are probably far more intersex athletes globally “than people want to believe” but that the process for finding them has, to date, been rather haphazard, leaving some stigmatised and others perhaps unaware that they may have an advantage. The problem is that “testing people willy-nilly”, as Muller puts it, is a violation of human rights.

And so, again, the matter hangs.

Semenya and Chand are certainly not the first sports people to raise the gender debate. Even prior to 1936, there were at least two well-known transgender athletes who sparked a call for gender verification (one form of this was the infamous naked parade). There have also been intersex athletes making waves over the years.

Women’s sport in any case is dogged by gender issues of varying magnitude, which is part of the reason some argue that intersex women should be subject to medical clearance – in order to protect the integrity of women’s sport. Tucker argues, “[If] you create a division to ensure performance equality based on a known performance advantage, then you absolutely must defend that division, however ‘arbitrary’ the line appears to be. The division between men and women is clear.”

There is some scientific evidence to support this. Among other functions, testosterone stimulates the production of haemoglobin, which means that men generally have a considerably higher concentration of oxygen in the blood.

The problem is, this kind of advantage doesn’t only come up in sex divisions. As much as the hormonal line between men and women is necessarily a little arbitrary, so is the fact that discussions around advantage have landed squarely on gender. Jaime Schultz wrote for New Scientist, “[M]any people are focused on the question of whether testosterone actually confers a competitive advantage. But the real question should be: if it does, so what?”

Schultz argues in a column that elite sport is “built on the back of inequality”:

“We love the idea of a level playing field, but it is a myth. Of the 207 nations competing in Rio, 75 had never won a medal before 2016. Wealthy, powerful countries dominate the Olympics, 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.”

Hyperandrogenism, as one of several possible intersex conditions, is but one potential athletic advantage of many, Schultz argues. “As scientists are just beginning to understand, elite sport is riddled with similar endowments.”

Apart from the role played by economic advantage, there are associations between physical performance and about 200 genetic variations, as noted by researchers Lisa Guth and Stephen Roth. More than 20 of those relate directly to elite athleticism. Says Schultz:

“These performance-enhancing variations can affect height, blood flow, metabolic efficiency, muscle mass, muscle fibres, bone structure, pain threshold, fatigue resistance, power, speed, endurance, susceptibility to injury, psychological aptitude, and respiratory and cardiac functions, to name just some.”

We don’t disqualify such athletes, argues Schultz – we celebrate them. Why the difference?

This is a good time to refer back to that link between testosterone and the role it plays in producing more haemoglobin. Finland’s late skiing legend Eero Mäntyranta had a genetic condition – primary familial and congenital polycythaemia – which allowed his body to produce some 65% more red blood cells than the average male. More oxygen? Check.

Scientific American ran an analysis entitled, “Why is Michael Phelps so good?” The feature pointed out that Phelps’ “wingspan” – the length of his arms in relation to his torso – was unusually long. He’s also double-jointed, with size 14 feet (as any swimmer can attest, he’s basically got natural flippers). But, in answer to the question of whether such biological advantages mattered, internist and former team physician H. Richard Weiner replied:

“When someone does something statistically impressive, like winning eight gold medals like Phelps, we try to come up with some far-fetched reason for it, like he or she has to have some bizarre physiological adaptation or freaky anatomy. But most things that you measure in human beings fall within predictable ranges.”

The trouble is that for someone like Semenya, her testosterone doesn’t exactly fall within predictable ranges. However, even if it did, there’s no guarantee among intersex athletes of who has what condition and whether it will benefit them. For example, Spanish hurdler Maria Jose Martinez Patino was initially banned from competing over her high testosterone levels; later, however, it was discovered that her Androgen Insensitivity Syndrome (AIS) meant she could not actually utilise the hormone. By the time this came out, it was too late for her to compete in the Olympics.

Biology, as countless scholars have pointed out, has not simply created two sexes. Just as gender does, biological sex also exists on a continuum, as does sensitivity to testosterone (partial AIS is also possible). “There are tens of millions of people on the planet who don’t fit easily into our standard definition of male or female,” notes Harper.

“It is a very fine line between legitimate determination of a high-T athlete and stigmatism based on stereotyping. Unfortunately, the press and public often use the obvious physical characteristics of some intersex athletes for cruel purposes.”

For this reason, as much as a policy on sex vs. gender in sport is needed, it’s also essential to evaluate each athlete on a case-by-case basis, should a blanket ban on gender testing not be instituted long-term.

The transgender issue

For transgender athletes, the question superficially seems simpler. The IAAF has a policy, for starters. But this policy – which recently included transgender athletes who had not had surgery – sparked an outcry. What, then, was to stop competitive men from simply declaring that they are transgender?

The IAAF’s rules also refer to athletes who are legally one sex or another, but that too is not cut and dried – in countries such as Argentina, for example, the sex on one’s passport is self-determined, no explanation required. Activists in South Africa are fighting for the same (our laws do allow people to change their sex in theory, but the process is cumbersome and involves medical checks and paperwork).

In this instance, the IAAF both simplified and complicated matters by including hormone levels in the equation. Harper, meanwhile, believes that there should be room for a distinction between one’s social gender and one’s sex as an athlete.

But this, too, is likely to be problematic. “I was born a girl, competed as a girl and won medals as a girl. And now you are saying that I’m not a girl,” a tearful Chand said in 2014. The trauma to athletes like her and Semenya is undeniable.

Where to from here?

Ultimately it boils down to a tug of war between competition and human rights, with east being east and west being west. Nobody can rightly dispute that athletes of all sex and gender descriptions should have the right to compete, and that no condition that already places them in a minority should add the burden of stigma to an already intensely pressurised field. At the same time, nobody can debate that it must be hugely frustrating as a female athlete with average hormone levels to have to compete against runners who it seems will simply be stronger, no matter how hard you train.

Currently it seems impossible that a solution will be found. Whatever the outcome, somebody will be unhappy. The real problem is that there was no clear policy in place when Semenya burst onto the scene; her case was bungled and she was globally humiliated, which resulted in raw feelings all round. By the time Chand’s case hit the headlines, the situation was little better. And the fact that we still haven’t found a solution since 1936 doesn’t bode well.

It’s possible that if Semenya’s case were handled a little more sensitively, a little more fairly, the global furore may also have been more contained. But the can of worms is open now, and if we start questioning performance biologically, it’s unlikely to end well for many athletes. Right now, the only thing that remains starkly apparent is that cisgender male athletes remain at an advantage, biologically, economically and socially. For everyone else, professional sport is fraught with questions. Perhaps the answer lies in looking again at biological anomalies outside of gender, and asking why Semenya was tested in the first place; why we remain suspicious when a woman is too fast, too strong, too good. DM

Photo: Caster Semenya of South Africa on her way to win the women’s 800m Final race of the Rio 2016 Olympic Games Athletics, Track and Field events at the Olympic Stadium in Rio de Janeiro, Brazil, 22 August 2016. EPA/YOAN VALAT