Testing athletes for “too much” testosterone shows how inadequate the sex binary really is

As if elite women athletes don’t suffer enough indignities just from media coverage, journalists who would rather see them twirl than ask about their tennis game, and being either hyper-sexualized or having their sex and sexuality challenged and questions. No, that’s not enough. Because people are so convinced that women have more limited athletic potential than men, even at the elite level, women who do excel must prove that they do not have “too much testosterone.”

Caster Semenya knows all about this type of challenge. In 2011 her fellow athletes challenged her accomplishments by questioning her sex. This led to mandatory sex testing, and the whole thing was handled badly. Initially banned from competition, Semenya has since been allowed to return. But her treatment left a permanent mark, and the major governing bodies in international sport, including the International Olympic Committee, the Fédération Internationale de Football Association and the International Association of Athletics Federations, recognized that they needed a new approach.

According to this New York Times report, that new approach, has made things worse:

Rather than trying to decide whether an athlete is “really” female, as decades of mandatory sex tests did, the current policy targets women whose bodies produce more testosterone than is typical. If a female athlete’s T level is deemed too high, a medical team selected by the sport’s governing bodies develops a “therapeutic proposal.” This involves either surgery or drugs to lower the hormone level. If doctors can lower the athlete’s testosterone to what the governing bodies consider an appropriate level, she may return to competition. If she refuses to cooperate with the investigation or the medical procedures, she is placed under a permanent ban from elite women’s sports.

No longer do they need to prove they’re women. Instead, it’s a simple test for the amount of testosterone in their bodies.  The idea that there is a “normal” amount of testosterone beyond which competitors have an unfair advantage is questionable at best, and simply pushes the question “is she really a woman?” back a step.

The new test has so far “caught” four athletes, all from what the NY Times article describes as “developing countries.”  These athletes are not being accused of doping. Rather, they have been deemed to have naturally occurring testosterone at higher levels than is acceptable for elite competition. Here’s what happened:

Sports officials (the report does not identify their governing-body affiliation) sent the young women to a medical center in France, where they were put through examinations that included blood tests, genital inspections, magnetic resonance imaging, X-rays and psychosexual history — many of the same invasive procedures Ms. Semenya endured. Since the athletes were all born as girls but also had internal testes that produce unusually high levels of testosterone for a woman, doctors proposed removing the women’s gonads and partially removing their clitorises. All four agreed to undergo both procedures; a year later, they were allowed to return to competition.

The doctors who performed the surgeries and wrote the report acknowledged that there was no medical reason for the procedures. Quite simply, these young female athletes were required to have drastic, unnecessary and irreversible medical interventions if they wished to continue in their sports.

One of the main things this state of affairs challenges is the very simplistic sex binary that our world operates under. If and when we do recognize that sex is a continuum not a binary, it’s used against. If nothing else (and there is a lot else), the recurrence of this type of challenge in sports is excellent evidence that our normative sex, as expressed in the male-female binary, isn’t right. Read on:

Many conditions can lead to naturally high testosterone, including polycystic ovarian syndrome or an ovarian tumor during pregnancy, but women with intersex traits tend to have the highest T levels. And it is these intersex traits that sports authorities want “corrected.”

In other words, you only get to play if you conform with the M-F binary.  The microcosm of elite sports on this issue is a perfect parallel for how things go in every sphere for people who don’t fully conform to the false picture we have that everyone is either male or female, and that fitting into one of these so-called biological categories is a (minimum) requirement for full global citizenship. I emphasize that it’s minimum, because even then you’re not guaranteed full entry.

Where sports is concerned, the argument has always been that testosterone is the key factor distinguishing men’s athletic potential from women’s. Male elites usually outperform female elites. Men have more testosterone, so, as the reasoning goes, women with higher testosterone have an unfair advantage over other women. But not so fast, the article reports:

…these assumptions do not match the science. A new study in Clinical Endocrinology fits with other emerging research on the relationship between natural testosterone and performance, especially in elite athletes, which shows that T levels can’t predict who will run faster, lift more weight or fight harder to win. The study, of a sample of 693 elite athletes, revealed a significant overlap in testosterone levels among men and women: 16.5 percent of the elite male athletes had testosterone below the lower limit of the so-called male range; nearly 14 percent of the women were above the female range.

This calls into question the assumption that testosterone levels are responsible for the differences in performance. The authors of this study suggest that it’s lean body mass rather than testosterone that makes the difference. The article goes on to say:

Some might argue that the procedures used to lower T levels are simply part of the price athletes must pay to compete at the elite level. But these choices aren’t temporary hardships like training far from home or following a rigorous diet. The required drug and surgical treatments are irreversible and medically unjustifiable. Clitoral surgery impairs sexual function and sensation; gonadectomy causes sterility; and hormone-suppressive drugs have side effects with potentially lifelong health risks.

Moreover, the policy places a disproportionate burden on poor women who may have limited career opportunities and are likely to face enormous pressure to submit to these interventions in order to continue their athletic careers. Under the current policies, more and more female athletes with naturally high T levels will be confronted with these harsh choices — and not just at the elite level. The I.O.C. requires that each country’s Olympic committee investigate cases of female athletes with high T levels before naming them to national teams. Some countries, like India, now apply such policies to all female athletes, not just those competing internationally.

As we can see, there are lots of inequities at play here, and the burdens are falling more heavily on women whose economic standing limits their opportunities and perhaps forces them to undertake a drastic intervention to be able to compete.

At the very least, the obsession with sex and testosterone levels is yet more evidence of the gender policing that women are subject to, and that our fixation with the need for everyone to fall neatly into strict normative categories before we can take them seriously.

3 thoughts on “Testing athletes for “too much” testosterone shows how inadequate the sex binary really is

  1. Lean body/muscle testing would be another tough one if it isn’t hormone based testing.

    I will ask the question that is the big elephant in the room: So for transgendered folks, after man surgically becomes woman, her estrogen levels are always same as all normal woman estrogen levels?

    I’m just trying to get to the root of real concerns here with changes in medical advances, etc.

    Or maybe it’s economic –imagine a woman beating a guy in ie. Tour de France one day. She would get the money purse.

    Strange about India’s approach — a near obsession /concern or even fear.

Comments are closed.