Is Intersex a Disorder or a Competitive Advantage? Elizabeth Reis, University of Oregon
Is intersex a disorder or a competitive advantage? The International
Olympic Committee (IOC) is implicitly considering this question as they
explicitly grapple with how to handle athletes who have an intersex condition,
a discrepancy between genitals, internal sex anatomy (ovaries or testes),
hormones, and chromosomes. Intersex bodies have always aroused suspicion on and off the playing
field. Now they are under scrutiny
again as doctors and sports officials debate whether some naturally occurring
factors, like an unusually high level of testosterone, would give certain
female athletes an unfair edge over other women in sporting events.
Castor
Semenya may be one such athlete. She is the women’s 800 meter world champion whose sex was questioned by
the International Association of Athletics Federations after a teammate
complained that Semenya was more male than female. Though whether she can continue to compete as a woman is
still undecided, the IOC
met in January to set up some guidelines for cases of indeterminate
gender. The head of its Medical
Commission, Arne Ljungqvist, recommended that
“strategically located centres of excellence should be established to which
athletes with a DSD (Disorder of Sex Development) could be referred and, if
necessary, further investigated and treated.”
The IOC’s rulings are misguided and will further perpetuate
several myths about intersex. The
most significant fiction is that there is a clear way to distinguish between
the sexes. Though deciding who is
male and who is female seems so simple and obvious, it is not nearly so
straightforward as we’d like to believe. Should someone born with typical external female anatomy but with
internal male reproductive anatomy be considered female or male? What about someone with both XX and XY
chromosomes? If a female athlete
has excess levels of testosterone in her body, is there a threshold beyond
which she should be considered male, despite her female genitals?
The second illusion is that intersex conditions are so
obvious that they can be spotted visually. How will the committee know which athletes to refer to these
centers? Many people are unaware
of their own intersex condition, particularly if it involves only hormones or
chromosomes and cannot be seen externally. Sending
pictures of the suspected athletes to these expert centers, as was
suggested, is not going to be conclusive and could harm the athletes personally
and professionally. Since the 1960s various forms of gender verification tests
have been tried, but ultimately they have been deemed degrading and prone to
yield false positives.
The third myth these recommendations promote is that
intersex is a condition that needs to be corrected, even at the expense of the
person’s basic health. The Committee wants intersex athletes to be “treated,”
which could mean hormone “therapy” or as Ljungqvist told the BBC,
“perhaps surgery, the removal of gonadal or testicular tissue.” Should female athletes with high levels
of testosterone have to take estrogen to make them more like “normal”
women? Such tampering with
hormones or tinkering with surgery might be dangerous to an individual’s
health, to say nothing of her psyche, and seems to be contrived solely to allow
the athlete to fit more neatly into a male or female box so that competition
can continue. Further, we should question the ethics of chemically or
surgically meddling with an athlete’s body. Isn’t that what the doping
scandals have all been about?
The impulse to guarantee a level playing field is admirable
(though perhaps unachievable), but to exclude or control those whose bodies are
atypical in some way will mean that we miss the performance of many
athletes. Should we also “treat”
the bodies of those who can process oxygen more efficiently, who are
inordinately tall, or who have especially long or thick leg muscles, just to
make things fair among the competitors?
It is ironic to consider the possibility that intersex could
be a competitive advantage in the sports world because intersex has long been
seen as a serious problem. Since
the mid-nineteenth century, doctors have tried to treat and manage such
patients, sometimes with hormones, sometimes with surgery, in an effort to
“normalize” unusual bodies. These
medical interventions do not typically cure the conditions. They are often simply cosmetic, and
this unnecessary enhancement continues today, often with devastating
results.
In fact, today the term “intersex” has been supplanted in
medical contexts in favor of “Disorders
of Sex Development (DSD).” Though some argue that human bodies are full of natural disparities,
including variant genitals and reproductive anatomies, others consider intersex
something that needs fixing. Perhaps the new term, with the inclusion of the word “disorder”
encourages this perspective. Though many doctors and hospitals throughout the country have heeded the
cautionary words of intersex activists about the harms of medical
interventions, particularly on infant patients, efforts to make the genitals
look “normal” and have their external and internal anatomy cohere still
exist.
The International Olympic Committee’s recent recommendations
place intersex squarely in the “disordered” camp by suggesting treatment before
an athlete could compete. Intersex
thus becomes a disorder with an advantage. But frankly, no one knows for sure if certain intersex
conditions facilitate an athlete’s success. It is impossible to separate out that specific attribute
from the myriad of other factors that produce winning results. Unusually tall women have an advantage
in basketball, and no one suggests that their extraordinary height be medically
investigated as suspiciously male. What is clear is that we continue to be profoundly unsettled by any body
that falls outside the parameters of “normal,” particularly in terms of sex
anatomy, and to me that’s what is unfair.
Elizabeth Reis is the author of Bodies in Doubt: An American History of Intersex (Johns
Hopkins University Press, 2009). She is associate professor of
women’s and gender studies and history at the University of Oregon in
Eugene.
