Article written by Katie Worth.
*DISCLAIMER: This article may be sensitive to some readers.
Over the course of less than a century, what defines and confines women as female athletes has changed radically. The category of “female” has undergone several alternative definitions since the introduction of female participants into international sport. While relying heavily on determining femininity on the basis of sex (biological characteristics), international sporting federations have committed themselves to gender policing and discrimination. The gender/sexual verification processes were imposed with the intention to make sport fair, ensuring male athletes were not masquerading as female athletes. Sporting organisations sought to verify that each female athlete was indeed what they categorised (or determined) as a “female”.
Proving femininity based upon sexual characteristics and imposed gender norms has created the situation where female athletes are considered not “female enough”. So, what exactly is a female athlete?
South African sprinter Caster Semenya stated “I am Mokgadi Caster Semenya. I am a woman, and I am fast”. Semenya’s statement reflects the growing controversy around her gender. Her current appeal to the European Court of Human Rights is to challenge the World Athletics (formerly known as the International Association of Athletic Federations, IAAF) 2018 ruling for athletes with Difference in Sexual Development (DSD encompasses chromosomal and gene abnormalities and atypical gonad and anatomy development). Semenya and other athletes with DSD have been affected by a restriction on the amount of naturally produced testosterone they are able to have in their body. The World Athletics have determined a testosterone level of 5 nanomoles per litre of blood (nmol/l) or more deems the athlete ineligible to compete as a female, regardless of their gender identity. Semenya, due to these imposed constraints upon athletes with DSD, is unable to defend her Olympic title in the 800m sprint at Tokyo.
As well as being intrusive and unethical, gender verification cannot prove with accuracy the gender of an athlete as it relies on the choice to reduce biological complexity into the simplistic binary model of male and female. The binary sex model is a heteronormative construct which assumes gender by oversimplifying biological features and exaggerating differences. Gender is different to sex as it encompasses the psychological identification of gender, which does not need to conform to sex nor the two binary forms of sex (male and female). The reliance on biological sex will exclude different groups due to such generalisations.
Many of the women affected by gender verification were those accused of being males but were born naturally either intersex, with chromosome abnormalities and/or had hyperandrogenism (a medical condition where women may have high levels of testosterone). Transgender athletes have also been caught by the regulations and discriminatory gender policing. These processes confine womanhood and generate outliers of female athletes who are believed to have an advantage because of the presence of a natural trait generally associated with “maleness”.
While sporting bodies continue to reinforce the gender division, the sociocultural constructions of femininity have altered, as have the attitudes concerning the requirement of gender verification. So, who decides if you are a female athlete? And how has femininity in sport been confined?
The first method of gender verification was a crude form of testing requiring women to march naked before a panel of doctors or submit to a genital examination. Proof of femininity was identified through physical characteristics. This testing arose after the Berlin Olympics in 1936 out of the need to “clarify sexual ambiguities” that were highlighted by the media.
During the 1930s women participating in competitive sport were frequently characterised as “mannish” because they did not conform to gender roles. By women in competing in sport, they challenged feminine ideals and invaded the masculine sporting space. These competitive female athletic pioneers confronted the sexist barriers and notions of the female’s athletic ability, physical appearance, and participation in sport.
Zdeňka Koubková (later known as Zdenek Koubek), Mary Edith Louise Weston (later known as Mark Weston), Stella Walsh and Helen Stevens were some of the athletes accused of being males at the time and all underwent physical inspections. Both Walsh and Stevens were determined as female after their test. But following Walsh’s death, her autopsy revealed she had “ambiguous genitalia” (likely she had an DSD condition). In response to this, the Athletic Congress attempted to strip her of her Olympic medals. Koubekwas stripped of his medals following his examination which determined “ambiguous genitalia”.
Of these only Koubek and Weston later underwent gender reassignment surgery. Neither Koubek and Weston competed as frauds or gender imposters – both athletes were identified and raised as women and believed themselves to be female when they competed.
The Cold War era marked the use of chromosome testing to replace the humiliating physical examinations. Gender verification was viewed as necessary especially with the rise of steroid usage affecting the bodies of female athletes. The basis of chromosome tests rests on the generalised theory that women have XX chromosomes and men have XY chromosomes. Using the buccal smear testing method, the inside of the athlete’s cheek is swabbed to identify the presence of Barr bodies (a mass only seen on XX sex chromosomes). This form of testing was made mandatory by the International Olympic Committee (IOC) from 1968 to 1998. However, geneticists in the 1970s recognised the tests provide an inconclusive identification of maleness. Nonetheless, the IOC and other bodies did not change.
The case of Maria José Martínez-Patiño, a former Spanish hurdler who was dismissed from the Spanish Olympic Team in 1986 for failing the gender test, highlights the unreliability of chromosome testing. Although passing a gender test in 1983 and receiving her “certificate of femininity”, Martínez-Patiño failed the sex chromatin test at the 1985 World University Games. She was later classified as a male, citing the sex chromosomes as XY. Rather, Martínez-Patiño had Androgen Insensitivity Syndrome (AIS) which is an DSD condition. As stressed by 1970s research, chromosome testing is insufficient and provides false accusations of maleness among female athletes. The tests overlooked women with medical conditions like AIS but also men who carry XX chromosomes.
During this 30-year period, female athletes who were screened out by the chromosome testing had to either withdraw or agree to undergo further clinical testing to see if they would be able to compete or be banned for life. Yet, having that Y chromosome was not proven to aid in sporting performance. A study from 1990/1992 concluded that gender-based screening should be abandoned and those raised as females (irrespective of having XY chromosomes) did not hold an unfair advantage. Only masquerading males (individuals raised and living as men) presented an advantage and need to be excluded.
After briefly halting testing due to widespread objections to sex verification in the 1990s, sporting bodies chose to limit the levels of testosterone in female athletes in 2011. Similar to the short comings in chromosome testing, hyperandrogenic and other DSD female athletes have been forced out of sport. Testosterone testing has proven inaccurate in determining gender as numerous natural conditions can affect the production of testosterone without making the person “male”. Hyperandrogenism regulations have restricted the ability for those who identify as female to compete internationally and have had psychological and physical effects.
Like many other intersex athletes, Semenya has a higher level of testosterone. With the current regulations, she is required to chemically lower her testosterone levels through the intake of medication. By taking the hormone suppressing drugs, scientists estimate it could add seven seconds to her 800m race time. This medication also increases risks of blood clots, cardiovascular disease, and infertility.
Dutee Chand, an Indian sprinter, faced similar scrutiny about testosterone determining her gender. In 2014 she was dropped from the Indian Commonwealth Games team, however successfully changed the ruling at the Court for Arbitration in Sport (CAS). The court ruled that the policy excluding athletes with high testosterone levels was not justified by current research and unjustifiably discriminatory to require women to change their bodies. However, this ruling did not initiate change in the gender verification processes of sporting bodies – and testosterone testing has remained.
📸: Dutee Chand
In response to Chand’s verdict, the World Athletics reintroduced a modified “Eligibility Regulations for Female Classification” (Athlete with Differences of Sexual Development, DSD) in 2018. The revised regulations were based upon a 2017 study which evaluated the effect of testosterone levels on athletic performance. As of November 1st, 2018, athletes competing in the female category in the 400m, 800m, 1 mile and hurdles needed to have a testosterone level below 5 nmol/l. The reasoning behind the regulation was the belief that high testosterone levels can provide a significant sporting advantage.
Despite that 2017 study, research has been unable to conclusively prove a direct relationship between athletic performance and testosterone levels. There are, however, over 200 other biological abnormalities that can offer specific competitive advantage. In comparing successful athletes, when is a natural ability considered unfair? The anthropometric advantages of Michael Phelps and Usain Bolt’s fast muscle twitching aided in their success but were not questioned as being unfair. Neither was the gender and ability of Katie Ledecky challenged as holding an unfair advantage. Yet, hyperandrogenic and intersex athletes were targeted as creating an unlevel playing field. Their nonconformity to binary sex challenged the entrenched structural reliance on gender divisions in sport.
Testosterone testing has targeted those who are intersex, but increasingly athletes from the global south have been testing positive to higher levels of testosterone in the body. This has led to athletes having female genital mutilation and sterilization because of testosterone testing revealing intersex conditions.
Gender in sport has become determined by hormone levels. But what is a normal level of testosterone? For males, testosterone levels vary and are occasionally low enough for the current regulations to consider them “female”, thus this does not provide an accurate point to determine “maleness”.
So why have international sporting bodies been reluctant to remove gender verification? There is no simple answer to this. While at the start, international sporting bodies may have introduced the sex verification as an equity process, it has systematically excluded women who do not fit a binary idea of womanhood. If we regulate differences of sex development, then we are excluding athletes without ethical or scientific evidence.
The tests have created another barrier for women participating in sport. A women’s right to participate in sport should not be confined to a patriarchal restriction on femininity. As encapsulated by Semenya, “This fight is not just about me, it's about taking a stand and fighting for dignity, equality and the human rights of women in sport. All we ask is to be able to run free as the strong and fearless women we are!”
Women should not be discouraged for competing in sports after so long waiting for the opportunity. Perhaps international sporting bodies should switch their focus from gender and the possibility of unfairness to doping, which creates an actual unfair advantage.
Thanks for reading 💚
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