Hazel McHaffie

Caster Semenya

Gender, sex, chromosomes and other details

In our family, the two generations below me are runners. With the Edinburgh Marathon Festival in a matter of days now, we’re all gearing up – in my case just to be there at as many vantage points as possible to cheer them on as usual. In their case to be in peak condition to stay the course and surpass their personal bests. And this year is exceptional in that one of them (son-in-law) is doing the 5K, followed by the 10K on the Saturday, then the half marathon followed by the full marathon on the Sunday. Now, that’s keen! Super fit. Totally focused.

Although the competitors all run together, divided at the starting point into bands according to speed and ability, the results are announced by gender – fastest male, fastest female. So, X and Y genes do matter! But what if there are question marks over one’s gender? And that’s what’s preoccupying part of the sporting world at this precise moment. The male-female definition isn’t as binary as people used to think; about 1.7% present with atypical patterns of chromosomes and biological characteristics. And the South African runner, Caster Semenya, is caught in this hazy overlap.

It seems that all her life Caster has been portrayed as ‘a frea’. Imagine the burden of that!  As a youngster, she grew accustomed to having to show her genitalia to a coach before a race. The mind boggles. And since she rose to fame as a gifted athlete her success has been overshadowed by doubt, vilification and abuse. As it’s reported anyway, she was born intersex. But she was brought up as, and identifies as, a female. In the sporting world however, now she’s an adult, there are questions about her right to compete as a woman. She produces unusually high levels of testosterone. Such a fact must be difficult enough to deal with in one’s own local community; but because she’s an Olympic champion gold medallist, and because these results got into the wrong hands, her personal information has been paraded world-wide. And now she has – again publicly – lost her case to compete in her natural state. Henceforth she must take medication to lower her testosterone levels if she wishes to race against women. No one knows what that medication would/will do to her, but in her world every second counts.

Shutterstock image

This is about much more than justice in sport; it raises huge ethical questions. In Caster’s case, the Court of Arbitration for Sport has decided the rights of the individual must be sacrificed to ensure the welfare of the majority. They say their decision is ‘necessary, reasonable and proportionate’ in the interests of fairness. Is it? From her rivals’ point of view, I’m sure we can all appreciate that it does seem unjust to lose to someone with such a huge inbuilt biological advantage. But what about other athletes with inbuilt advantages – eg. swimmer Michael Phelps with his massive arm span and double-jointed ankles and low production of lactic acid which means he doesn’t tire as quickly as ordinary men? Should he have been disqualified?

And what about Caster’s own perspective? After being cruelly ridiculed for her body all her life, here was something she naturally excelled at, for which she trained hard, and now she’s being denied the opportunity to compete as the woman she is. Lose, lose. What a monumental injustice this must seem. In fact she’s shown immense dignity in the face of this latest humiliation. She admits to feeling upset and degraded by this ‘unwarranted and invasive scrutiny of the most intimate and private details’ of her very being. At the moment she’s contemplating leaving the arena. ‘I’m finished’ she tweeted when the ruling came through. ‘Knowing when to walk away is wisdom. Being able to is courage. Walking away with your head held high is dignity.’ How desperately sad.

Why do I talk about this case on my blog this week? Partly because the questions it raises have been exercising my mind, and partly because it’s another example of the reality that there are very few absolute black and whites in the world of ethics – my world! And that’s before you start factoring in transgender athletes and self-assignment of gender and competing interests and … It goes on and on. Scrambles the mind, doesn’t it?

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Generosity and magic …

A friend of mine (now in her nineties) used to regularly cook drop scones (alias griddle pancakes) for our charity table at church. But sadly now the task is beyond her. Last week I visited her at home and to my astonishment, she handed me her precious griddle and her secret recipe.

I told her I devoutly hoped her magic was well embedded in the griddle because this particular culinary delight was not in my normal repertoire … well, it wasn’t then. But with a precious gift like this it feels incumbent on me to keep my side of the contract, so I’ve had a couple of stabs and been agreeably surprised by the results (although DJ says they’re definitely more anaemic than they should be). I guess it’ll take a bit of tweaking to get the balance of heat and time and consistency exactly right.

But in the process of all this beating and turning and tasting it occurred to me that authors bequeath us something of their skills and magic all the time, don’t they? Whenever we devour their goodies we can taste and analyse and mimic and learn from them even without knowing them personally; no special permission required.

I was reading a marvellous novel by Jeffery Eugenides at the time. MiddlesexMiddlesex tells the story of Calliope Stephanides who is an hermaphrodite (intersex is the preferred term nowadays), and starts with: ‘I was born twice: first, as a baby girl, on a remarkably smogless Detroit day in January of 1960; and then again, as a teenage boy, in an emergency room near Petoskey, Michigan, in August of 1974.’ Brilliant hook. A curiously topical choice of reading as it turned out, given this week’s verdict on the gender tests for the South African athlete, Caster Semenya.

When I was a midwife (about a hundred years ago) I delivered babies with ambiguous genitalia and agonised with the parents. What’s the first question everyone asks? Is it a boy or a girl? Imagine having to say, We don’t know. But as far as I’m aware, I’ve never encountered anyone with both male and female organs. And I knew precious little about the condition before I read this book.

Middlesex (neat title, eh?) explores the genetics, psychology, physiology, relationships, exploitation … oh, and so much more, in a wonderfully entertaining but thought-provoking tale. It deservedly won the 2003 Pulitzer Prize, in my opinion. I was gripped, but I also learned so much along the way. And Eugenides did all the slog, all the research, all the experimenting, so I can have it handed to me on a gold-rimmed platter. How generous is that?


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The prime minister and the athlete

I actually wrote this blog in Slovenia. It’s the end of their summer tourist season so pretty tranquil at this time of year, and conducive to reflection.

I was trekking through a forest in the spectacular Julian Alps and got chatting to a delightful Welsh lady who mentioned that her friend wasn’t up to a long walk that day. No detail. Fair enough; mountains aren’t everyone’s chosen terrain. But later I met the said friend who spontaneously explained the medical reason for her absence. I hadn’t asked; she elected to tell me. It was her right to do so, not her companion’s.

Ahah! Medical ethics. My domain. In this case, more specifically medical confidentiality. And as I tramped through the beautiful Slovenian scenery my mind returned to this subject.

Now, I know that with fame comes a certain amount of prurient interest, and entering the public eye carries penalties. Even medical matters are not exempt from the list of details to be broadcast – cosmetic surgery, spells in rehab, diagnoses of serious illnesses – you know the kinds of things that sell newspapers. But where should the line be drawn? We’ve had two glaring examples of flagrant disregard of the basic principle of medical confidentiality recently here in the UK – one speculative, one based on scientific fact – that prompt me to pontificate on my blog.

Is the prime minister, Gordon Brown, mentally ill? Why? Apparently because he bites his nails, looks hung-over, ‘lacks emotional intelligence’, and isn’t allowed a wedge of Stilton cheese, a splurge of sauerkraut, or a glass of Chianti, which are known to react with his alleged form of anti-depressants. Hello?

Is the South African athlete, Caster Semenya, really a man? Why? Because she is exceptionally tall, has a deep voice, masculine features, and runs like a cheetah.

If indeed Gordon Brown were to be on anti-depressants, isn’t he entitled to have that fact, and his diagnosis, respected, as the rest of us are? OK, I hear you cry, but he’s sending our troops to war; he’s making or breaking international relationships; he’s responsible for our financial crisis. Fair enough. But surely the rest of the team who might well be told on a ‘need-to-know’ basis, could manage the consequences of such a disclosure without divulging the detail. The whole country doesn’t need to know. Do we? Our level of concern is: Is he or is he not fit to run the country? No, on second thoughts, let’s not go there!

In the interests of justice and fair play we might be entitled to know that Caster Semenya underwent tests. To allay damaging and widespread suspicion and speculation, if for no other reason. But why should intimate details about her internal organs become public knowledge? Why isn’t it enough to know she is not barred from racing in the categories she enters, and she’s earned her gold medal fairly? I’ve delivered babies of indeterminate gender and it’s hard to think of anything more harrowing for new parents than being unable to answer that first question: Is it a boy or a girl? And the child has enough to contend with without the taunts and innuendoes of a cruel world.

I guess I feel these matters more keenly because I can identify with them in odd ways. I’m not allowed to eat cheese (which I love) – for very different reasons. I can’t run like the wind, but I’m tall and rangy too. But because I’m not famous, no-one is speculating about me. And you are certainly not entitled to know my medical diagnoses. Even if it influences the material I generate for my blog which you may read … !

There is merit after all in being an obscure scribbler. A cautionary tale for all those young people who, when asked what they want to be when they grow up, say, ‘famous’.

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