Science vs sensitivity: Semenya runs into gender dilemma

Author: By Steve Connor, Science Editor

Semenya, who took gold on Wednesday in 1min 55.45sec, with Briton Jenny
Meadows winning bronze, grew up as a woman and, according to her coach
Michael Seme, has ?nothing to hide? ? Seme even offered inquisitive
journalists the telephone numbers of her room-mates in Berlin who, he said,
have seen her naked in the shower.

But her humiliation does not end here. Semenya now has to face a panel of
experts convened by the International Association of Athletic Federations
(IAAF) to adjudicate over challenges to her gender. The panel, consisting of
a gynaecologist, an endocrinologist, a psychologist, an expert in internal
medicine and another expert on ?gender-transgender issues? will not give
their final verdict on whether Semenya can keep her gold medal until a least
the end of the month.

Although Semenya, 18, is noticeably muscular and angular for a woman, the
people closest to her are in no doubt that she is female. So it may seem
strange that it can take weeks for a handful of experts to decide whether
someone is a man or woman ? but that?s because gender is not always a
clear-cut issue.

?The very term ?gender verification? suggests that we could get at the truth.
A team of experts will find out, but gender is complex. The current coverage
of Semenya?s case illustrates how troubling gender is in sport,? said
Professor Kath Woodward of the Open University, who has written a book on
gender in sport.

?Images draw upon stereotypes of what constitutes masculinity and femininity,
through comportment and appearance, even when they necessarily have very
different bodies from their female non-sporting counterparts,? Professor
Woodward said.

The importance of gender verification in sport comes down to the perceived
advantage of being a man. Males have between 40 and 60 times the amount of
testosterone than females, and testosterone, the male sex hormone, is
critical to building up muscle bulk and so providing the physical strength
that can determine the outcome of a competitive event.

In the early 1960s, when the first regular gender verification was introduced
in international sporting events by the IAAF, women were subjected to rather
crude physical examinations of their private parts, a humiliating procedure
that female athletes understandably resented.

Later on, during the Mexico City Olympic Games in 1968, the sporting bodies
introduced a genetic test based on a smear taken from the mouth. The cells
in the smear were analysed using a ?sex chromatin? test to determine whether
the person has the two XX chromosomes of a female, or the XY chromosomes of
a male.

In addition to being less demeaning to women, it was also meant to deal with
cases of ambiguous external genitalia. In some rare instances, men and women
can suffer from a congenital condition that interferes with the normal
development of their external sex organs.

The test, however, quickly fell out of favour, partly because of a shortage of
labs that could carry it out properly. The test was also dogged by false
positive and false negatives ? in other words results that turned out to be
wrong.

But an even bigger problem was the issue of women who were genetically male,
having the XY chomosomes, but were in every other respects female because
their bodies lacked a key protein that was able to recognise testosterone.
These women produce large amounts of testosterone, but the hormone simply
does not work.

The condition is known as ?androgen insensitivity syndrome? and very often
these women are unaware of it until they try to have children. About 1 in
20,000 women suffer from it, and although they look, feel and behave like
women, a chromosome test alone would reveal that they are genetically male.

Sex determination in humans begins in the womb at an early stage of embryonic
development. An egg normally carries one X chromosome while sperm carry
either one X or one Y chromosome. When sperm and egg fuse, they form XX and
XY embryos in a roughly 50:50 ratio.

During the first weeks of development, the male and female embryos are
anatomically indistinguishable with primitive gonads ? the male and female
organs ? beginning to develop in the sixth week of gestation. At this point
they are considered to be ?bipotential?, in other words they can go on to
become either female ovaries or male testes.

What determines the eventual developmental path is the presence of the
sex-determining gene on the male chromosome, called SRY. When this gene is
present, the embryo becomes male, when it is not, it becomes female. In a
way all embryos are by default female, and it is only when the SRY gene
kicks in that a ?female? embryo actually becomes male.

Part of the battery of laboratory tests that Semenya will now have to
undertake is likely to be a test for the presence of the SRY gene. Her blood
will also be tested for testosterone and her cells analysed for whether she
bears the usual pattern of XX chromosomes for a woman.

But the IAAF has said that gender verification will not be done solely on such
laboratory-based tests. A psychological profile is also likely to be done to
determine whether she ?feels? herself in her own mind to be a woman.

The IAAF?s policy on gender verification also states that there are medical
conditions where people should be allowed to compete even when there are
questions about their gender. Conditions such as androgen insensitivity
syndrome and gonadal dysgenesis ? when the gonads fail to develop or are
surgically removed ? are allowed because they confer no advantage over other
female competitors.

Even sex-change men who become women can compete provided a period of time has
elapsed since the operation, especially if carried out before puberty. It is
all part of the realisation that being a man or a woman is not always clear
cut.

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