Sex verification in sports (also known as gender verification, or loosely as gender determination or a sex test) is the issue of verifying the eligibility of an athlete to compete in a sporting event that is limited to a single sex. The issue has arisen multiple times in the Olympic games and other sporting competitions where it has been alleged that male athletes attempted to compete as women, or that a woman has an intersex condition giving an alleged unfair advantage.
Contents
- Physical examinations
- Chromosome testing
- Hormone testing
- Sex verification in men
- 20th century
- 21st century
- Transgender athletes
- Notable cases
- References
The first mandatory sex test issued by the IAAF for woman athletes was in July 1950 in the month before the European Championships in Belgium. All athletes were tested in their own countries. Sex testing at the games began at the 1966 European Athletics Championships in response to suspicion that several of the best women athletes from the Soviet Union and Eastern Europe were actually men. At the Olympics, testing was introduced in 1968.
Initially, sex verification took the form of physical examinations. It subsequently evolved into chromosome testing, and later testosterone testing. It is not always a simple case of checking for XX vs. XY chromosomes, or sex hormone levels, to determine whether an athlete is unambiguously a woman or a man. Fetuses start out as undifferentiated, and the Y chromosome turns on a variety of hormones that differentiate the baby as a male. Sometimes this does not occur, and people with two X chromosomes can develop hormonally or phenotypically as a male, and people with an X and a Y can develop hormonally or phenotypically as a female.
Reports have shown how elite women athletes have been humiliated, excluded, and suffered human rights violations as a result of sex verification testing. Such cases have included female genital mutilation and sterilization. Not only have reports shown that the tests have physically affected women athletes, but they have also shown that such tests can cause pyschological harm to women. Sex verification tests can create sex and identity crises, demeaning reactions, social isolation, depression, and suicide. Essentially, research shows that the benefits to gender testing do not outweigh the disadvantages.
Physical examinations
United States Olympic Committee president Avery Brundage requested, during or shortly after the 1936 Summer Olympics in Berlin, that a system be established to examine female athletes. According to a Time magazine article about hermaphrodites, Brundage felt the need to clarify "sex ambiguities" after observing the performance of Czechoslovak runner and jumper Zdeňka Koubková and English shotputter and javelin thrower Mary Edith Louise Weston. Both individuals later had sex change surgery and legally changed their names, to Zdeněk Koubek and Mark Weston, respectively.
Sex verification tests began in the 1966 with the International Association of Athletics Federation (IAAF), using physical examinations. The International Olympic Committee followed suit two years later. Initially, women athletes "were asked to parade nude before a panel of doctors". For a period of time these tests were mandatory for female athletes, due to fears that male athletes would pose as female athletes and have an unfair advantage over their competitors.
Chromosome testing
Chromosome testing was introduced by the International Olympic Committee in 1968, at the Mexico City Olympics. This tested for the presence of the SRY gene, which is found on the Y-chromosome, and was designed to identify males potentially disguised as females. This method of testing was later abolished, as it was shown to be inconclusive in identifying maleness.
The International Association of Athletics Federations ceased sex screening for all athletes in 1992, but retained the option of assessing the sex of a participant should suspicions arise. A resolution was passed at the 1996 International Olympic Committee (IOC) World Conference on Women and Health "to discontinue the current process of gender verification during the Olympic Games." The International Olympic Committee's board voted to discontinue the practice in June 1999. Chromosome testing was last performed at the Atlanta Olympic Games in 1996.
The practice of chromosome testing came under scrutiny from those who feel that the testing was humiliating, socially insensitive, and not entirely accurate or effective. The testing is especially difficult in the case of people who could be considered intersex. Genetic differences can allow a person to have a male genetic make-up and female anatomy or body chemistry. In the Journal of the American Medical Association, Simpson, Ljungqvist and others stated,
Gender verification tests are difficult, expensive, and potentially inaccurate. Furthermore, these tests fail to exclude all potential impostors (eg, some 46,XX males), are discriminatory against women with disorders of sexual development, and may have shattering consequences for athletes who 'fail' a test...
Gender verification has long been criticized by geneticists, endocrinologists, and others in the medical community. One major problem was unfairly excluding women who had a birth defect involving gonads and external genitalia (i.e., male pseudohermaphroditism). ...
A second problem is that only women, not men, were subjected to Gender verification testing. Systematic follow-up was rarely available for athletes "failing" the test, which often was performed under very public circumstances. Follow-up was crucial because the subjects were not male impostors, but intersexed individuals.
Hormone testing
In August 2009, South African athlete Caster Semenya was subjected to mandatory sex verification testing. In the wake of the Semenya case, testosterone testing was introduced to identify cases where testosterone levels were elevated above an arbitrary level, termed hyperandrogenism, with national Olympics committees tasked by the IOC to "actively investigate any perceived deviation in sex characteristics".
In football, FIFA's current gender verification policy dates to May 30, 2011 In June 2012, in advance of the 2012 Summer Olympics, the IOC released IOC Regulations on Female Hyperandrogenism, which addressed cases of female hyperandrogenism. The regulation includes the statement, "Nothing in these Regulations is intended to make any determination of sex. Instead, these Regulations are designed to identify circumstances in which a particular athlete will not be eligible (by reason of hormonal characteristics) to participate in 2012 OG Competitions in the female category. In the event that the athlete has been declared ineligible to compete in the female category, the athlete may be eligible to compete as a male athlete, if the athlete qualifies for the male event of the sport."
As with previous forms of sex testing, testosterone testing has been regarded as humiliating, unnecessary and discriminatory. Katrina Karkazis, Rebecca Jordan-Young, Georgiann Davis and Silvia Camporesi argued that the new IAAF policies on hyperandrogenism in female athletes will not protect against breaches of privacy, will require athletes to undergo unnecessary treatment in order to compete, and will intensify "gender policing". They recommend that athletes be able to compete in accordance with their legal gender.
In 2013, it was reported by Patrick Fénichel, Stéphane Bermon and others that four elite female athletes from developing countries were subjected to partial clitoridectomies and gonadectomies (sterilization) after testosterone testing revealed that they had an intersex condition. Members of the same clinical hormone evaluation team report there is no evidence that innate hyperandrogenism in elite women athletes confers an advantage in sport. The case has been criticized as showing vulnerability of women athletes to unnecessary medical interventions under duress, with no evidence of cheating and no evidence of athletic advantage.
Policies on hyperandrogenism were suspended following the case of Dutee Chand v. Athletics Federation of India (AFI) & The International Association of Athletics Federations, in the Court of Arbitration for Sport, decided in July 2015. Chand had been dropped from the 2014 Commonwealth Games at the last minute after the Athletic Federation of India stated that hyperandrogenism made her ineligible to compete as a female athlete. The ruling found that there was insufficient evidence that testosterone increased female athletic performance. In doing so the court suspended the practice of hyperandrogenism regulation used by the IAAF. The practice will be declared void if the organization fails to present better evidence by July 2017.
In November 2015, the IOC held a meeting to address both its hyperandrogenism and transgender policies. In regards to hyperadrogenism in female athletes, the IOC encouraged reinstatement of the IAAF policies suspended by the Court of Arbitration for Sport. It also repeated an earlier policy statement that, to "avoid discrimination, if not eligible for female competition the athlete should be eligible to compete in male competition". In February 2016, it was made known that the IOC would not introduce its own policies that would impose a maximum testosterone level for the 2016 Summer Olympics.
In April 2016, the United Nations Special Rapporteur on health, Dainius Pūras, criticized current and historic sex verification policies, describing how "a number of athletes have undergone gonadectomy (removal of reproductive organs) and partial cliteroidectomy (a form of female genital mutilation) in the absence of symptoms or health issues warranting those procedures."
The cases of Dutee Chand and Caster Semenya were widely reported during the 2016 Rio Olympics. Immediately preceding the games, Genel, Simpson and de la Chapelle were again published in the Journal of the American Medical Association starting "One of the fundamental recommendations published almost 25 years ago ... that athletes born with a disorder of sex development and raised as females be allowed to compete as women remains appropriate":
Sex verification in men
Sex verification is not conducted on male athletes, those competing in the male category, and little data is available on their chromosomes or hormone profiles. However, a post-competition study of 693 elite athletes by Healy et al, published in 2014, found significant sex differences in many variables. The authors found that:
Using this data, Scientific American estimated that "almost 2 percent" of male competitors had testosterone levels in the typical female range. The study authors also stated that average lean body mass differences might account for performance differences between sexes.
20th century
21st century
Transgender athletes
In November 2015, the IOC held a meeting to address both its transgender and hyperandrogenism policies. In regards to transgender athletes it stated that transgender athletes cannot be excluded from an opportunity to participate in sporting competition. Transgender athletes who identified themselves as female, would be allowed to compete in that category as long as their testosterone levels were below 10 nanomoles per liter for at least 12 months prior to the competition. There would be no restrictions on transgender athletes identifying themselves as male and competing in that category. The IOC stated that requiring surgical anatomical changes as a requirement for participation may be considered as a violation of notions of human rights.