‘Abomination;’ as in, “the new IAAF policy on hyperandrogenism is an abomination”

By Anna Posbergh

Over the past six months, I have been reading, researching, and writing about hyperandrogenism as it concerns sport and intersex athletes. And let me tell you, it has been an experience. The more I read, the more my own understandings of sex, gender, and sport become blurred and unclear. From Stella Walsh and Heinrich Ratjen in the 1936 Olympics, to the most recent ‘controversy’ around Dutee Chand, I am increasingly horrified, shocked, and fired up by everything I read and stumble across. For example, did you know that in early gender-verification tests, women were essentially forced to stand naked in a group and undergo a public gynecological exam? So basically, a woman’s “femininity” or “female status” was dictated by her external genitalia.

This degrading “verification” practice was short-lived, though, and one might think that it was because people found it to be a horrifying, discriminatory, and exploitative practice. You would be wrong. While the International Association of Athletics Federations (IAAF) admitted the ethical issues around this crude testing protocol, they deemed these tests ‘inadequate,’ and slightly shifted the policy so that all female athletes instead, “paraded past three female gynecologists.” The gynecologists verified whether or not the athletes were female, thus eliciting the informal title of ‘nude parades.’ Ultimately, the practice of mandatory sex testing on female athletes continued until 1991 for the International Olympic Committee (IOC), and 1999 for the IAAF.

Certainly, these issues come back to the representation and portrayal of women in sport and female athletes. Title IX was considered an important breakthrough for women’s sport forty years ago, but today we are still seeing strong evidence of discriminatory sex segregation in sport, with this ongoing hyperandrogenism ‘fiasco’ just one of countless attempts to temper women’s sports and police the boundaries between men and women.

A few weeks ago, I spoke with cultural anthropologist, and one of the leading researcher and advocate on the ‘issue’ of intersex, Dr. Katrina Karkazis, about intersex athletes and hyperandrogenism. During our conversation, I naïvely asked, “what’s the solution;” that is, how should we define sex in sport, balance the line between sex segregation and gender as a spectrum, and solve the ‘issues’ with athletes such as Dutee Chand and Caster Semenya? Dr. Karkazis’ answer was simple yet astute.

“What’s the problem?”

The “problem” that Dr. Karkazis implicates is twofold. First, the “problem” of testosterone giving women an unfair advantage. The view that testosterone unfairly benefits female athletes is reflective of a lack of understanding of the literature around this issue, as there is absolutely no evidence demonstrating that testosterone gives women a performative advantage. Considering the lack of correlative evidence between testosterone and performance, it is absurd to label elevated levels of testosterone as an “unfair” advantage, especially as women with hyperandrogenism have naturally occurring higher levels of testosterone, and have never engaged in behaviors with the intention of improving their chances of winning or improving their performance.

Secondly, these women have identified as girls and women their whole lives. If we take their subjectivity seriously, it is highly problematic to diagnose their sex identity as a problem for them, as they have understood themselves as girls and women their whole lives. This problem of “telling men from women” is completely irrelevant upon listening and understanding the personal stories of these female athletes. Dismissing the identification and stories of these female athletes reflects an entirely privileged enforcement of gender and sex. Whose experience are we going to privilege in this?

Sex is not a simple concept; rather, it is intensely complex. In asking “what is the solution,” we have already accepted some assumptions: namely, that there is some way to define the difference between male and female, when in fact we will never be able to answer this question. Sex is interpretable, and no matter how we, our peers, or the IAAF attempt to define this thing we simplistically call “sex,” there will always be another discussion of ‘have we considered this,’ or “what if we don’t have that” In attempting to guard this sex/gender divide, we endeavor to place our non-natural and socially constructed labels on our material bodies without adherence or knowledge of our societal needs for categories.

This past April, the IAAF proposed a new policy on hyperandrogenism. In 2014, the court of arbitration for sport suspended the IAAF’s original 2011 policy on hyperandrogenism, giving the IAAF two years to research and find supporting evidence for a fair, just, and scientifically-corroborated new policy on how to “deal” with athletes with higher levels of androgen. Whoever the messenger was to the IAAF must have left out the “fair” and “just” parts of that message, because this new policy is anything but. In 2017, researchers Stéphane Bermon and Pierre-Yves Garnier conducted a study, in which they tested and looked at the levels of testosterone in male and female elite track and field athletes in order to “characterize serum androgen levels and to study their possible influence on athletic performance in male and female elite athletes.” Sounds like a promising study, right? Especially with this apparent belief by the governing sports bodies that androgen and testosterone are the keys to separating the sexes.

The first time I glanced through this study, I will admit, I bought into what they were saying. A conclusion statement of, “in [the] female 400m, 400m hurdles, 800m, hammer throw, and pole vault, high [free testosterone] concentration is associated with higher…levels of athletic performance when compared with competitors with low [free testosterone]” seemed pretty concrete to me.

Until I started to closely read the study.

In the study, Bermon and Garnier essentially tested the levels of free testosterone (testosterone that is available to be utilized by the body) and overall testosterone, and looked at the performances of the athletes, knowing these two testosterone levels. They then separated their subjects by their sex category (i.e. female/male) the athlete competed under in the results tables (specifically, Table 3 on page 4 of the study), and looked at the performances by the athlete with the lowest and highest levels of free testosterone. My concern is not the layout of which the researchers presented their data – it is a clear and comprehensive visual. My concern is that, of the 1332 female athletes they observed, 24 were in the 99th percentile of testosterone levels, and among these 24 athletes, nine were found to have been doping. Yet, these athletes were still included in the results of this study.

Okay.

The thing is, endogenous (naturally occurring) androgens are not the same as exogenous (administered, orally or otherwise) androgens. They are two entirely different ballparks – sometimes in the case of endogenous androgens, the body cannot even synthesize the excess levels of androgen. Beyond that, endogenous androgens are naturally occurring. At no point did the athlete with these higher levels of androgens willingly and knowingly take a steroid in the hopes of improving her performance. The difference in causes behind the appearance of endogenous and exogenous androgens cannot be ignored, and the researchers admit that this is a major flaw in their study. Bermon and Garnier even go so far as to say that an explanation for their findings could very well be because of this higher prevalence of doping with exogenous androgens. How, then, can the IAAF base its new policy on hyperandrogenism on a study that is inherently flawed and does not account for blatant differences in the type of hormone being tested?

They didn’t.

The IAAF’s new policy proposes that only 800m and 1500m female runners undergo androgen level testing. Yes, that’s right: 800m and 1500m. In their study, Bermon and Garnier proposed a 1.8-2.8% advantage in the “long sprint and 800m races,” but in Table 3 of their study, the 1500m athlete with the highest level of free testosterone actually ran slower than both the average of all 1500m athletes and the 1500m athlete with the lowest level of free testosterone. Why propose testing both the 800m and the 1500m, then?

At the recent 2018 Commonwealth Games, Caster Semenya won gold in both the 800m and 1500m. As an advocate and burgeoning critical scholar on women in sport, it is hard not to notice the “coincidental” timing of the IAAF proposed policy after Semenya’s double gold crown. Really though, “coincidental” is far from accurate.

Through my further conversations with Dr. Karkazis, and in understanding her later explanations of “what is the problem,” I realize that this new IAAF policy, beyond using flawed science to support their new definition of “female athletes,” is more than just an attempt to simplify a complex issue. Rather, the IAAF is trying to draw an exclusive line between who is female and who is male, without any regard to how these women were raised and how they have self-identified their entire lives. Essentially, the IAAF completely disregards the personal narratives of these women, and unethically neglects previous medical or “scientific” sex identification of these women as women, in favor of its own flawed, sexist “science.”

Truly, the IAAF is up to its same old sexist and sex segregation policing tricks. Sort of puts a big asterisk on their “fair” and “just” rhetoric, huh?

Note: Thank you to Dr. Katrina Karkazis for her invaluable insights and feedback.