Do you know what you’re having? A question we all ask expectant parents. Even before we are born, being a boy or girl defines us in so many ways. These are the two discrete, foundational categories on which our understanding of being a male or female rests.

The ongoing issue people have with athletes such as Caster Semenya is that they challenge this notion – leading many to feel uncomfortable, and others to turn to simplistic, uninformed rhetoric. Let me be very clear from the beginning: this is not a simple issue. It is complex and sensitive. Only when approaching the debate with this in mind – and there must be debate – can any good come from essentially exposing athletes to very public scrutiny about a very private matter.

I am constantly dismayed at the misunderstanding that still exists when a name such as Semenya’s crops up in conversation. “She is like Bruce/Caitlyn Jenner” is often thrown out by well-meaning but misinformed individuals. This kind of opinion does nothing but perpetuate myths and prejudices.

To set the record straight, there is a big difference between transgendered individuals and hyperandrogenism or intersexed individuals. Sex is biological, gender is psychological (to simplify it a lot). Bruce Jenner was born a biological man – his sex is male – but felt, psychologically speaking, that he was a woman. In other words, his male body didn’t fit with his female gender, and so Bruce became known as Caitlyn. Transgendered people feel that they have the ‘wrong’ body, and some make the decision to transition, changing their body to fit with the gender they believe they are.

Semenya, and others like her, are not transgendered. She is not assigned male at birth, feeling she is a woman; or assigned female at birth, feeling she is a man. Semenya’s sexuality also has little to do with the issue – who a person is sexually attracted to is a separate issue to biological sex or gender. Semenya is a woman because she was brought up to be a woman and identifies as being a woman. She apparently (and let’s be clear that none of us truly know – and shouldn’t know – her full medical history) has a condition called hyperandrogenism, which is often a result of being intersexed.

Babies that are born intersexed have ambiguous genitalia, and even chromosome testing can’t fully determine if the child is biologically a boy or a girl. Very often it is left up to the parents to decide how they will raise the child, which can be based on whether the child looks more female or male; or what gender the parents were hoping for; or sometimes doctors simply make the best decision they can at the time. As we know, it’s extremely difficult, if not impossible, to raise a gender-neutral child until the teenage years, when they can hopefully decide for themselves who they feel most comfortable being.

This is where our categories of boy and girl begin to break down. Some people just don’t fit neatly into the boxes that society likes them to fit into.

The problem in sport is that the basic category of separation is based on sex – in other words, boys play against boys, and girls play against girls. This works well (and is fair) until someone doesn’t fit neatly into one of those biological categories. Someone like Semenya makes us re-think what we know about sex, gender, male and female categories.

It is a very important discussion because as we have seen with other categorisations over the years, people are not as black and white as we like to think. Take sexuality, for example. There used to be straight or gay, but now we know that these are probably two ends of a continuum, and people’s sexuality can fall anywhere along this line. Possibly sex (and gender) are the same.

As we learn more and know more, we can begin to see that people are not always neat and tidy, and we need to apply our minds to gain perspective on the messy parts of what it means to be human. However, when we debate issues without any real understanding, people get hurt. Just as we are redefining masculinity and femininity (both social constructs which change over time), so, too, we need to start redefining male/female, which we have assumed for a long time are biological certainties.

By thinking in this way, we can help so many people around the world who feel ostracised and misunderstood.

Where that leaves sport, and how we categorise athletes, I am unsure. A true, fair solution is probably a long way off, but it merits robust, yet sensitive debate and thought. DM