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Thursday, December 31, 2009

Number 1: Caster Semenya

Number 1: Caster Semenya's saga

Less than a day remains of 2009, and we've spent the last week recapping the biggest sports science stories of the year.  And it comes as no surprise that the number 1 science of sport story of the year is that of Caster Semenya.

There is little more that can be written about Semenya, so intense was the media spotlight on her during a two month period following her world title in Berlin.  In fact, more has been written than she would have ever wanted, following what was a meteoric rise to the top of the world - at the start of 2009, her personal best was 2:04, and within 8 months, she had cleaved 9 seconds off that and ascended to the summit of women's 800m running with one the most dominant performances seen at the championships.  To revisit our very first post on the Semenya story, written the day the leak was first reported, click here.

However, the real story was only just beginning.  The night before that final, the first reports emerged that the IAAF had begun an investigation into Semenya's gender.  A media firestorm erupted, punctuated by the finger-wagging (and now revealed as deceitful) president of Athletics South Africa, Leonard Chuene, who, backed by other politicians here in South Africa, managed to turn the issue into a racial and political one overnight.

We would eventually learn that this was done deliberately, and 'pre-empted' the announcement of any testing on Semenya.  A local TV show, 3rd Degree produced by Debra Patta, revealed that Athletics South Africa DID in fact know of the controversy surrounding Semenya BEFORE the World Championships and had even received an expert medical opinion that she should be withdrawn from the race.  They refused, instead telling the IAAF in a hastily arranged meeting that they would "Oscar Pistorius look like a picnic" compared to the fallout if Semenya was not able to run.

The science of sex verification

The drama continued when the team arrived back in South Africa.  Political leaders threw their weight behind Semenya, telling the world to pull down her pants to check, since it was, after all, this easy.

Scientifically, it was anything but.  We did a series of posts trying to clarify why sex verification was in fact not so simple.  The issues and some explanation can be read in this post, for those who are interested in learning more (and didn't learn more than they ever wanted to in September this year).  Incidentally, I also co-authored a scientific paper on this topic with Prof Malcolm Collins, which will be published next year, and am working on another such paper for a journal next year, for those who want the journal article version (and will wait a while...).

To sum it up, the simple biology that a male has an X and Y chromosome which directs the development of testes, while females have two X chromosomes which result in the formation of ovaries, is rather oversimplified.  Any number of 'errors' can occur, either genetically or hormonally, resulting in XY females or XX males (or XXY mosaicism, or XY mosaicism).  Each condition, termed a Disorder of Sexual Development, is complex and has far-reaching effects on the physiology.  Some are incompatible with athletic performance, whereas others may confer performance advantages.

That performance advantage lies mainly in the effects of the hormone testosterone - known as the 'male hormone', it is produced by the testes and is responsible for, among other things, muscle and skeleton development.  Semenya's muscular appearance, along with hirsutism (hair growth), deepening of the voice and skeletal structure all pointed towards such a condition in her case.

Simple science, complex interpretation and no value of experts in SA

Ironically enough, as complex as this physiology is to interpret, it's actually remarkably easy to obtain a fairly accurate picture of an individual's biology.  I was fortunate enough to get in touch with a few experts in genetics and endocrinology, and within minutes, the entire picture was made clear.  No need for textbooks or scientific journals - an endocrinologist will tell you instantly what the typical female levels of testosterone are, how various conditions may affect it, and how this may influence muscle and skeleton development.  This is not so complex an issue that it is unsolvable - the legal implication of the biology is certainly complex, but knowing it is not.  And this is the reason that officials in South Africa should be held to account for their willful ignorance of the facts, and the complete and utter disdain for expertise.

Leonard Chuene publicly announced that he would not accept the opinion of a "scientist from some stupid university", which tells you all you need to know about the now former president of ASA.  Meanwhile, the Minister of Sport, our highest ranking sports official, declared that the questions about Semenya meant nothing.  His words? "That means nothing. There are many hermaphrodites in the world so what does it matter. This girl is running as a girl who has been accredited as a girl. Nobody has questioned that  (this comes after the whole world was questioning it, I might point out). She doesn’t have a womb, so what?". 

He went on to declare that if anyone tried to take her medal or stop her from running, it would be the "Third World War".  I was embarrassed to be South African, and wrote as much, for which I received a letter from the Minister saying that if I knew something he didn't, I should say so.  Perhaps the Minister will in future consult an expert endocrinologist, geneticist or doctor?  Or maybe he'll even read this website in 2010...

The origins of the investigation - reports, rumour and requested tests

It eventually transpired that the investigation from the IAAF began as a result of Semenya's physical characteristics, PLUS reports in South Africa of her gender being questioned, PLUS the magnitude of her performance improvement - 9 seconds in a year is possible, but when it takes an athlete from 2:04 to a top-20 of all-time performance, then it is suspicious.  A good high-school male athlete, for example, could reasonably expect this jump in a year.  An elite female?  It was cause for concern, and the IAAF began prodding around for some facts.

The rumors from within SA were interesting.  Inside athletics circles, it has been widely known for about three years that all was not well with Semenya.  In fact, three years ago, at the SA Junior Championships, ASA officials informed all competing teams that they knew of the problem and were investigating, so they should please not lodge any protests.  Needless to say, nothing was done, until the IAAF acted on these reports, and requested an investigation from ASA (which is what they should do, according to their own policy).

ASA complied, under the guise of doping control, and Semenya found herself undergoing invasive physical examinations in South Africa, a few days before the team left for Berlin.  Those results were enough to cause the ASA doctor, Harold Adams, to request that Semenya be withdrawn from the team.  We may never know what was found by those tests.  However, it is relatively easy to perform physical exams to confirm that an individual possesses no womb and has ambiguous genitalia.  Genetic testing would follow and the picture would become clear very quickly.   I would be very surprised if ASA did not know everything at that point.  However, they refused to withdraw her, and the rest is history.

If all this was not bad enough, the IAAF then decided that if ASA would provide them with the results of the investigation, they would perform their own, and so Semenya underwent a second round of testing, this time in Berlin.  This investigation should have remained confidential, but was leaked to the media.  To this day, I do not know the source of the leak, but it seems to have come from within the IAAF, and it has resulted in the greatest invasion of privacy of any athlete I can imagine.  Semenya has not been heard from since her arrival back to South Africa, first retreating to her home in Limpopo and then writing exams (though she eventually had them deferred) under the care of the University of Pretoria.

The facts dry up as the IAAF close up on Semenya

The IAAF have pretty much retreated themselves, bitten not once but twice by a leak.  The second one coming a few weeks after the race, when a reporter in Australia, Mike Hurst, obtained information that Semenya was a "hermaphrodite" who possessed testes.  It was the wrong word (offensive as well as inaccurate), but it seemed that much of the content report was accurate, and Semenya's position in the spotlight was sealed.

The leaks have also had an indirect effect on how information will flow from now on.  The fear of future damages have set up a firewall of protection around Semenya, which means that we may never know the outcome of the case.  The medical results will not be announced, which is correct, since these are private.  The problem, however, is that Semenya may wish to continue to run.  If she does, then a hard decision must be made - one option is that she is allowed to run in her current situation, which will require that everyone be informed of just what her physiology is.

Alternatively, she'll be barred from competing until she has surgery to remove the alleged testes.  If this happens, the world would still need to be informed, because Semenya's presence on the international scene would demand answers to these questions.  No athlete, sponsor or meeting organizer would entertain the idea of inviting her unless the air was properly cleared, and so at some point, facts must be disclosed.  What we have seen is that the media want the truth, and will dig for it, resulting in many false or inaccurate claims, and I would suggest that the only way to control this is to manage the information before it leaks.  Whether that happens or not, 2010 will tell us.

The closing point then is that this story is nowhere near finished.  2009 may be drawing to a close, but Semenya will be a name heard again in 2010, without a doubt, though quite what the context will be, no one knows.


P.S.  Incidentally, the piece on Semenya brought us the most comments we've ever received for a post, and so I'd like to end of the year by thanking everyone for their inputs, even the highly critical!  As I've said before, we don't aim to have the last word, but rather to start the debate and present our thoughts, and to all who have contributed to this and all the other issues (cycling, Tour de France, doping, Pistorius and Bolt), thank you and have a wonderful New Year's Eve!


Sanjeev said...

Hello, just found this blog. Interesting stuff.

Are there reasons for sometimes using the term "sex verification" instead of gender?

Or are the terms generally interchangeable in the field?

Ross Tucker and Jonathan Dugas said...

Hi Sanjeev


Good question - there is a difference between sex and gender. Sex is biological, gender is social.

So when one talks about Semenya and the investigation, the process is to verify whether her biological sex is the same as her gender. That is, socially, she has lived as a female, and entered as a female. The question is around her biology - her sex.

So in this instance, one can use either term, because you're either verifying that her gender is accurate (gender verification) or whether her sex is male or female (sex verification).

It's really just semantics, I guess. Most of the scientific literature uses "gender verification", but I think sex verification is more accurate when you start to talk about the actual biology. When the conversation shifts to the management and policy, then I'd say gender is acceptable, hence the use of both terms.


Ray said...

Happy New Year,

I was just wondering, given her quick rise in 2008, did anyone suspect Pamela Jelimo of being ambiguous sex?

She didn't do much in 2009.


Ross Tucker and Jonathan Dugas said...

Hi Ray

They did, yes. We debated that earlier this year, in one of the Semenya posts and also in the discussion forum on one of the posts.

A reader, Frans Rutten, picked up on it in a big way and we discussed it a lot. Questions were asked, yes, and some of them did relate to her gender. I can only assume that the IAAF did investigate and presumably cleared her to run, because she did compete in 2009. She had a bad year, yes, and I guess people will read into that as they wish. Did she have some medical 'intervention' in the off-season? Could that be the reason she slowed down?

I don't know and it's probably not fair to speculate and deduce based on so few facts, which is why I haven't written more about it. All I know is that she dropped off a lot in 2009, and I "think" she was investigated just like Semenya.

2010 will tell us more - perhaps she'll bounce back and be as good as 2008. One last thing - she did get married in the off-season between 2008 and 2009.

Happy New Year to you too!