Haunted by hor­mone

Gen­der test­ing of ath­letes is tech­ni­cally not pos­si­ble

Down to Earth - - HEALTH - KAUSHIK DAS GUPTA

TILL JUNE this year, Dutee Chand was the next big thing in In­dian ath­let­ics. Touted as the next PT Usha, Chand had bro­ken a 14-year-old na­tional ju­nior record in the 100 me­tres race in May this year and won two gold medals at a ju­nior Asian ath­let­ics meet. But in June end, an an­dro­gen test sent her as­pi­ra­tions crash­ing.

The test is the lat­est means adopted by the In­ter­na­tional As­so­ci­a­tion of Ath­let­ics Fed­er­a­tion (iaaf ) to weed out what it be­lieves are male in­ter­lop­ers in women’s sport­ing com­pe­ti­tions. Adopted in 2011 by iaaf and rat­i­fied by the In­ter­na­tional Olympic Com­mit­tee a year later, the tests use testos­terone lev­els to de­cide whether an ath­lete is fem­i­nine enough to take part in women’s com­pe­ti­tions.An ath­lete can com­pete in this cat­e­gory only if her testos­terone lev­els are be­low the nor­mal male range— a lit­tle over 3 ng/ml.

Chand failed the test. In med­i­cal par­lance, the 18-year-old has hy­per­an­dro­genism, a con­di­tion in which a woman’s body pro­duces more than nor­mal lev­els of an­dro­gens— par­tic­u­larly testos­terone.

Both men and women’s bod­ies re­quire an­dro­gens, the lat­ter in smaller quan­ti­ties. Th­ese hor­mones are re­spon­si­ble for mas­cu­line fea­tures such as beard and deep voice.But they are also re­spon­si­ble for pos­i­tive pro­tein bal­ance, sex­ual de­sire,

and gen­eral well be­ing. They hold the key to mus­cle strength—a func­tion that iaaf has latched on to in its lat­est ap­proach to en­sure a level play­ing field in women’s com­pe­ti­tions.

An­dro­gen can't be sole cri­te­rion

An­dro­gen lev­els in some women can match that of men. Re­sults of the test Chand was sub­jected to put her in that cat­e­gory. “An­dro­genic hor­mones have per­for­manceen­hanc­ing ef­fects, par­tic­u­larly on strength, power and speed, which may pro­vide a com­pet­i­tive ad­van­tage in sports,” notes a Stan­dard Op­er­at­ing Pro­ce­dure adopted by the Sports Au­thor­ity of In­dia two years after iaaf’s rule came into ef­fect.

In­ter­na­tion­ally, the an­dro­gen test has faced crit­i­cism. “What makes sex test­ing so com­pli­cated is that there is no one marker in the body we can use to say, ‘This is a man,’ or ‘This is a woman,’ ”says Ka­t­rina Karkazis, a med­i­cal an­thro­pol­o­gist and se­nior re­search scholar at Stan­ford Univer­sity’s Cen­tre for Bio­med­i­cal Ethics. “iaaf is try­ing to get around that com­plex­ity by sin­gling out testos­terone lev­els as the most im­por­tant as­pect of ath­letic ad­van­tage. But ath­letic ad­van­tage can­not be re­duced to testos­terone lev­els,” she ar­gues. Re­becca Jor­dan-Young, as­so­ciate pro­fes­sor of women, gen­der and sex­u­al­ity stud­ies at Columbia Univer­sity and Karkazis’ col­lab­o­ra­tor on a Stan­ford Univer­sity pa­per on the iaaf pol­icy, ar­gues, “Hy­per­an­dro­genism is just another med­i­cal con­di­tion. There are many biological rea­sons some ath­letes are bet­ter than oth­ers. Sev­eral run­ners and cy­clists have rare mi­to­chon­drial vari­a­tions that give them ex­tra­or­di­nary aer­o­bic ca­pac­ity. Many bas­ket­ball play­ers have acromegaly ,a hor­monal con­di­tion that re­sults in ex­cep­tion­ally large hands and feet. Such biological dif­fer­ences don’t cause them to be barred from com­pe­ti­tion.”

Gen­der test­ing not new

The con­cern of sports bod­ies about men mas­querad­ing as fe­males in sports is not a new con­cern. It dates back to the late 1930s and early 1940s. Amongst those who earned bad press was Mary Louise Edith We­ston, whose ex­cep­tional per­for­mance in the women’s shot put, javelin and dis­cuss throws in the late 1920s and early 1930s earned her the nick­name “Devon­shire Won­der”. Upon re­tire­ment, the Bri­tish ath­lete un­der­went a se­ries of surg­eries. Now called Mark, the Devon­shire Won­der be­came the whip­ping horse of sport­ing au­thor­i­ties. Then there was Zdenek Koubek, the holder of the women’s world record in 800 me­tres in 1934 who, after giv­ing up com­pet­i­tive sports in 1936,took up a ca­reer in cabaret and asked to be recog­nised as a man.For many sports ad­min­is­tra­tors, ath­letes like We­ston and Koubek were in­ter­lop­ers in women’s sports.

There were de­mands for com­pul­sory sex tests in in­ter­na­tional com­pe­ti­tions. In 1946, iaaf in­tro­duced a rule re­quir­ing a gen­der

There are many biological rea­sons some ath­letes are bet­ter than oth­ers. Many bas­ket­ball play­ers have acromegaly, a hor­monal con­di­tion that re­sults in ex­cep­tion­ally large hands and feet. But they are not barred from com­pe­ti­tion

cer­tifi­cate from fe­male com­peti­tors. By the 1960s, this process was deemed too le­nient. Gen­der test­ing was in­tro­duced at the 1966 Euro­pean Track and Field Cham­pi­onship where fe­male ath­letes were asked to un­dergo a visual ex­am­i­na­tion of their sex­ual fea­tures.

Around the same time, iaaf also used rudi­men­tary chro­mo­so­mal tests to de­ter­mine the pres­ence of an X or Y chro­mo­some. Pol­ish sprinter Ewa Klobowska was amongst the first to have her fem­i­nin­ity ques­tioned on the ba­sis of such test. Klobowska, who won a gold and a bronze medal in the 1964 Tokyo Olympics, had an XX/XXY mo­saicism, a ge­netic or­der. She was dis­qual­i­fied in 1967 be­cause the test re­vealed that she had one “chro­mo­some too many”. The pre­cise na­ture of her anom­aly was never made pub­lic.

iaaf con­tin­ued with the chro­mo­so­mal tests. They were, how­ever, re­fined and called Barr Body tests, which rested on the premise that women have two X chro­mo­somes while men have one X and one Y chro­mo­some.

In the mid 1980s, the high pro­file case of the Span­ish hur­dler Maria Martinez Patino high­lighted this test’s short­com­ings. Patino failed a Bar Body test at the World Univer­sity Games in Kobe, Ja­pan, in 1985. She had an X and Y chro­mo­some, like a male, but due to a hor­monal prob­lem—an­dro­gen in­sen­si­tiv­ity disorder—her body did not pro­duce testos­terone, which caused her to de­velop as a woman. She was re­in­stated six years later. But her best days as an ath­lete were be­hind her. She missed qual­i­fy­ing for the 1992 Olympics by a whisker.

After the em­bar­rass­ment it faced in Patino’s case, iaaf dropped sex test­ing in the early 1990s. The Olympic Coun­cil fol­lowed suit in 2000. Tests were con­ducted only on com­plaints. The is­sue ex­ploded again in 2009 when a South African run­ner, Caster Semeneya, won a gold medal in 800 me­tres at the world cham­pi­onship in Berlin. Some play­ers com­plained that Se­menya looked ex­tremely mas­cu­line. iaaf or­dered sex test­ing, the re­sults of which were not re­leased. Se­menya was al­lowed to keep her medal.

In­dian ath­lete San­thi Soundara­jan’s fate was far grim. The 2006 Asian Games sil­ver medal­list failed a gen­der test and was stripped of all medals and records.

Karkazis and Young ques­tion the prac­tice.“There is in­suf­fi­cient ev­i­dence to set a bench­mark for nor­mal testos­terone lev­els in fe­male ath­letes, let alone per­sua­sive re­search show­ing that testos­terone lev­els are a good pre­dic­tor of ath­letic per­for­mance,” they ar­gue.

SORIT / CSE

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