Rumours and poor understanding of science dog Semenya affair

14 September 2009

Alas, Caster Semenya's win in the women's 800m final at the World Athletics Championships in Berlin, Germany, on 20 August has not been greeted with national fanfare and celebrations, but rather with controversy, name-calling and a small media circus.

But much of the to-do is based on a poor understanding of the science, says Dr Ross Tucker, a sports scientist and sports management consultant at the Medical Research Council/UCT Research Unit for Exercise Science and Sports Medicine (ESSM). A sex test is not a matter of a quick bathroom check. (Although, apparently, Semenya has been subjected to a few of these over her short racing career.) "I can't think of a debate that's as complex as this one," Tucker says. "And I can't think of a story in which there's been so much misinformation provided."

"I also think it's about a deep ignorance about the complexity of our bodies and the narrowness of the global understanding of sex and of gender, and the very complex interface and dynamic between them," adds Professor Jane Bennett of the African Gender Institute at UCT.

It's no surprise that Semenya's performances over recent times would raise eyebrows, says Tucker.

After all, this is the same athlete who went from 2:11:98 at the World Junior Championships in July 2008, where she didn't even make the semi-finals, to 1:56:00 at the African Junior Championships in Mauritius in July this year.

Alarm bells went off because her 1:56:00 was the fastest time this year by almost a second. Also, because it's widely accepted that the world record of 1:53:28 was doping-related, it's not the kind of time that one still expects to see. (Today, questions would perhaps be asked about record-holder Jarmila Kratochvílová's sex.)

At the elite level, shaving 16 seconds off one's time in the span of a year is considered highly unlikely, says Tucker. And, going by her run in the finals, many think she can do even better.

"This kind of improvement immediately arouses suspicion," says Tucker.

Naturally, doping concerns were raised first, but suspicion quickly turned to gender. Rumours started doing the rounds that Semenya had been born a hermaphrodite, a rare condition in which a person is born with what is known as 'ambiguous genitalia', ie both male and female genitalia. Talk that she's never menstruated also fueled the flames.

Hence the tests. (Terminology remains problematic, and some groups prefer 'intersex' to 'hermaphrodite', while the medical fraternity and others have opted for Disorders of Sex Development, or DSD, as defined in the International Intersex Consensus Conference Statement of 2006.)

Sex tests for women athletes, while still controversial, are nothing new to women's athletics, and were especially common during the golden era of doping in the 1970s and 1980s. The sport is awash with women burdened with nicknames such as 'Hormone Heidi' (shot putter Heidi Krieger who, because of doping, eventually underwent a sex-change and became Andreas Krieger) and 'Stella the Fella' (Olympic champion Stella Walsh).

Tests have run the gamut from the crude (that bathroom check) to the scientifically nuanced and complex, but have by and large been discontinued by the IAAF. The organisation only calls for lab-based sex tests when a formal complaint or request is lodged. (The International Olympic Committee called an end to sex testing in 1996.)

The IAAF did recently announce that they have dealt with seven other such cases since 2005, and that four of the seven athletes had been asked to stop their careers.

The IAAF breaks DSDs into two broad categories - those conditions that give no unfair advantage, and those that do give some advantage but are still acceptable. As yet, the IAAF has not listed conditions that do give the athlete an unacceptable level of advantage, reports Associate Professor Malcolm Collins, chief specialist scientist with ESSM and the Medical Research Council.

Semenya will have gone through a battery of tests with a panel made up of a gynaecologist, an internal-medicine specialist, a geneticist, a psychologist and an endocrinologist, as well as a specialist on gender and transgender issues. The IAAF will not release these results, as per policy, and will discuss them only with Semenya and ASA, because of medical confidentiality.

But, as expected, the rumour mill did not abide by IAAF policy. Late last week, results of the test were supposedly leaked to the Australian press, suggesting that Semenya was indeed intersex. According to The Daily Telegraph's anonymous source, Semenya had no womb and ovaries, and had internal testes, the male sexual organs that produce testosterone. The latter condition carries grave medical risks.

These reports fly in the face of statements made by the IAAF, in which the organisation said that results would only be available in November, and that there can be no assumption that Semenya would be stripped of her medals - it's a medical case, not a doping one, the organisation said. According to the Telegraph, the IAAF is considering taking the medal away from the South African. Tucker's more concerned about what ASA did or did not know before they sent Semenya to Berlin. And about Semenya's right to privacy. "This case has certainly violated Semenya's rights, medically and legally," he says.

For the moment, the Telegraph reports are unproven, says Tucker. "The point is that even if the article is accurate, and the source is reliable, the actual decision around Semenya would not necessarily be disqualification," he notes. "The crux is that they have to establish that she has some sort of performance advantage as a result of the condition."

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