On Wednesday, the new regulations of the International Association of Athletics Federations (IAAF) for Female Classification of the Athletes with Differences in Sex Development (DSD) came into effect.
We do not know yet who all have been affected, who all are being investigated and athletes of how many countries could be involved. It is unlikely we would come to know of it any time soon. Confidentiality would be the key word.
There has been widespread criticism of the decision of the Court of Arbitration for Sport (CAS) which ruled that the IAAF DSD regulations were valid. This ruling came on an appeal by the South African middle-distance runner Caster Semenya who has promised to keep the fight going. Expectedly, two of the Indians at the centre of the gender issue in athletics since 2006, Santi Soundarrajan and Dutee Chand, have come forward to express support to Semenya.
Semenya also has received support from her government and from followers across the world. One point that has been tellingly brought to the fore was, many people were unaware of how testosterone was being produced in considerable amounts in the ‘female athletes’ in question. Testosterone, as we know, is the important hormone normally produced by testes in males, and to a lesser extent by ovaries and adrenal gland in females, is in the focus once again as scientists argue out its performance-enhancing capability.
There is also a constant argument that testosterone is not a male hormone as had been made out. It is a fact that educated people generally are aware that testosterone is available in both males and females. Just by arguing that it is produced by females also it would not be established that females can produce above the prescribed limit of 5nmol/L without having an underlying condition. Exceptions should not be the rule.
Doriane Lambelet Coleman, a former 800m runner and currently Prof of Law in the Duke Law School, North Carolina, USA, has in this brilliant article that exposes many an argument by the Semenya lobby, explained how she came to realize many people had no understanding about the origin of extra testosterone in the female body.
“Hyperandrogenism means they have problems with their ovaries, right?” asked one of the athletes, says Coleman who was in the IAAF panel to give expert opinion before the CAS panel. Depending on which side they were, people have praised Coleman and slammed her for some “unscientific” arguments.
During the past five years, that is since the Dutee Chand case came up, this journalist has also realized that very few people in India with whom he had been in touch with, understood where the extra testosterone was being produced in such DSD athletes. The question “do you know from where the testosterone is coming from” would often be received by silence or an “I don’t” answer.
That testosterone in “46, XY DSD” athletes comes from testes, in all likelihood undescended at birth. Because of the perceived absence of testes at birth, the midwife or anyone who would have assisted the delivery, would have assigned the female sex to the child and the parents would have brought her up as that, a female child. Only at puberty does the individual or the parents or anyone else who could have been consulted, start understanding the significance of undescended testes and the lack of ovaries. Medical consultations might have been rare, if at all.
The anti-IAAF-DSD-regulations lobby has cried foul. For one thing, the IAAF seemed to have brought in “biological sex” as an afterthought. For another the pro-Semenya group once again finds the choice of testosterone as a determining factor wrong. More so, as it points out that the IAAF study which provided the data for restricting DSD athletes in events ranging from 400m to the mile was based on erroneous data.
The CAS panel apparently did not go back to the stipulation of the previous panel (Dutee Chand) that sought improvement in the “male range”, say between 10 to 12 per cent, to be shown by the IAAF through further study.
The CAS panel has, perhaps unwittingly, opened up a debatable issue by using the words “female athletes with 46, XY DSD” since the anti-IAAF-regulations lobby has argued that 46, XY female was an accepted classification by the World Health Organisation (WHO) and it was being caused by a mutant gene as explained in Swyer syndrome.
This is yet to established in the case of athletes in question. All the “relevant athletes” as the IAAF terms them have probably not even been identified. The IAAF, in response to a statement issued by the World Medical Association, urged doctors not to cooperate in the IAAF exercise has pertinently categorized the athletes as follows:
The DSD regulations apply to individuals who are: Legally female (or intersex) and who have one of a certain number of specified DSDs which mean that they have 1) male chromosomes (XY) not female chromosomes (XX), 2) testes not ovaries, 3) circulating testosterone in the male range not the (much lower) female range, 4) the ability to make use of that testosterone circulating within their bodies by having functional androgen receptors.
Note above that the IAAF has not mentioned “female” but “legally female”.
‘Legally female’ will indicate assigned sex, assigned at birth. It could have been by a nurse, a midwife, a doctor, a mother, a relative or anybody who had helped out during the delivery.
The scientists, who support DSD athletes or those in the media who do so, have no problem accepting the ‘legal sex’ determined by anyone including unqualified, perhaps uneducated persons. They, however, do have a lot of problems in accepting the terminology used by the IAAF or its medical experts or athlete-lawyers like Coleman.
This is the paradox that confronts the world of athletics, nay sport, today. Also thrown in are the claims by rights groups that human rights are being violated and that there is a racist angle to this whole hyperandrogenism issue.
True, Semenya is from Africa. She had been in the thick of it since winning her first World Championship title at the age of 18 in 2009. Ten years down the line, after having won at two World championships and two Olympics, she finds herself excluded from the middle-distance events unless she appeals to the Swiss Federal Tribunal and gets a reprieve.
This rule is not aimed at Semenya or Africa. One wonders whether Kenya is part of Africa as one understands it to be. Why has that country, that topped the medals table in the IAAF World Championships in 2017 and came second in the 2017 edition as well as the Rio Olympics a year later, not been “targeted” by the IAAF perhaps along with India (Dutee Chand in 2014).
In the wake of the Semenya decision, Kenyan Margaret Wambui who took the bronze in Rio, has come out in support of the South African and slammed the IAAF. It has been no secret that all the medal-winners in Rio were suspected to be hyperandrogenic, but rarely did anyone mention it. Now, it is being reported without compunction since Wambui has indicated that she belonged to the group. The silver medallist in the last Olympics was Burundi’s Francine Niyonsaba.
How will the IAAF go through with these investigations and procedures that look so complicated? Its medical panel will have to first determine the chromosome pattern, in itself a highly debatable method to determine sex, then find out whether the “relevant athlete” has any one of the seven listed DSD, also whether the individual suffers from complete androgen insensitivity syndrome that would prevent the athlete from utilizing the testosterone since specific receptors are not functional and son on.
The IAAF has an enormous task. It had earlier responded to the UN Human Rights Council. It has now responded and explained in great detail to the boycott call given by the WMA. The Semenya lobby wants doctors engaged even in the preliminary task of identifying the DSD athletes to keep away on ethical grounds. Forcing athletes to take medicines for a ‘non-existent disease’ is something that many, including doctors, scientists and activists cannot even think of. One presumes male-to-female transgender surgeries are ethical. In any case, the IAAF has left the choice of medication completely to the athletes.
In the meantime, comparisons of Semenya’s condition or that of the others with similar conditions with Michael Phelps, his wing-span and his body metabolism that produces less lactic acid which causes fatigue, have continued. The latest is a piece in the Washington Post.
No matter how much people, scientists, coaches, former athletes and media persons explain that the categorization is not between those producing less or more lactic acid or athletes who are taller or shorter or those having more (Usain Bolt) or less twitch muscles, but that between male and female the comparisons would not be fading away, one presumes.
An exasperated American athletic coach, Steve Magness tweeted: “I’m an exercise scientist. If I hear one more person refer to Michael Phelps and his production of “half the lactic acid” I’m going to scream.”
The IAAF’s late induction of the “biological sex” part into the argument has helped withstand the onslaught of the “Phelps wing-span brigade” with the counter-argument that this is not about natural attributes but about sex. However, that in itself may have opened up a pandora’s box since sex, as had been argued all these years, is not binary and cannot be determined by any yardstick or a combination of yardsticks. At least that is what scientists say.
There could also be challenges regarding restricted events (400m, 400m hurdles, 800m, 1500m, mile and combined events having any of these events) if and when the IAAF introduces more events into this list, a possibility that had been left open by CAS. There are former athletes who feel the IAAF should bring in regulations that would encompass the whole spectrum of athletics. If the present outrage is any indication, the IAAF would be extremely wary of even contemplating such a step. But it has said it would retain the 1500m and the mile, notwithstanding the advice of the CAS which wanted these events to be reviewed.
The question that scientists and activists on the side of the DSD athletes should be asking is, “if an individual is 46, XY DSD, has testes, has no ovaries, does not suffer from Androgen Insensitivity Syndrome and has no other medical condition that may remotely intervene in the classification, should such athlete be considered as female and allowed to compete with the rest of the women?”
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