Kate Johnson's Medical Musings

Life through the eyes of a medical journalist

Caster Semenya: Sex and Gender – When the Twain Don’t Meet

By Kate Johnson

My heart goes out to Caster Semenya, the 18-year-old South African sprinter who just dashed the 800m world record only to have her self-identity rocked to its foundations by a worldwide question mark of her femaleness.images

There she is in the sports section of my newspaper – flat-chested, rippled abs and all – looking every bit a man.

The doubts have followed her most of her life, apparently. But she and her family have always dismissed them. “That’s the way God made her,” they have said. And Semenya herself has apparently lightheartedly offered to drop her pants to quell the rumours.

But jokes aside, this is now serious business.

A world record has been made, a gold medal awarded, and other women have been left her in dust. Complaints have been made, tests have been ordered, and the whole world waits voyeuristically for the news that will no doubt rock her world.

As a medical reporter who has written about this before, my best guess is that Semenya does indeed have some form of intersexual condition. Today, Britain’s Daily Telegraph reports that preliminary testing has revealed she has triple the expected levels of testosterone for a female.

My fear is that neither she or her family has had any idea of this until now. And what a way to find out!

What if this is a huge cultural disconnect?

I was born and lived a good chunk of my life in Africa, trailing after my anthropologist mother through tiny villages while she interviewed women about their work, family and culture. Caster Semenya’s story is hitting a lot of buttons with me.

Unfortunately, in Western society, intersexuality  – meaning a physical condition, as opposed to a life choice (transsexuality) – is often regarded as a problem that has to be fixed. While the Intersex Society of North America and other groups have made great strides in educating the public otherwise, westerners, in general tend to react with shame and secrecy to this phenomenon.

But not all cultures are this way. Intersexuality, formerly referred to as hermaphroditism, is revered in certain religions such as Hinduism (Ardhanarishvara), and in the cultural histories of certain countries, such as the African country of Mali (Faro).

If Semenya and her family are to be believed (and that is a whole other question, given the sad history of sports and steroids),  questions about her gender have followed her throughout her life, but she and her family have never had doubts.

How could this be, you might ask?

It could be that her genitalia appear feminine, and so her behavior and appearance were simply chalked up to tomboyishness. Rather than being forced to conform, she was simply respected for who she was. This is where rural African culture and the western world may clash.

Or it could be that her genitalia have an ambiguous appearance – but being more feminine than masculine her parents “assigned” her as female – a decision that their society accepted and respected. Again, a potential flashpoint between cultures.

At least publicly, Semenya identifies herself as female – despite being known as a tomboy. If medical tests uncover a question mark, her privacy will be tragically violated. It will be a long fall from the gold medal podium into what will inevitably be an identity crisis of mammoth proportions.

Why thrust her into such discord? If it weren’t for her athletic aspirations she could have remained blissfully ignorant. But she has been running competitively for some time. How could these questions not have come up before? Why was she not tested privately before being sent to represent her country in international competition?

“In many non-Western societies intersex conditions are recognized as such and the individual lives as a sort of outcast, or something special, but knows that he/she is different,” Dr. Ursula Kuhnle told me today in an e-mail interview. Dr. Kuhnle, from the Center for Child and Adolescent Health in Munich, Germany, is co-author of a paper entitled Intersexuality and Alternative Gender Categories in Non-Western Cultures

“Semenya must have known that she is different from the other girls and that this will be recognized in international events,” says Dr. Kuhnle. The fact that Semenya has reached this level of athletic achievement indicates a high level of training and involvement of experts, casting doubt that she was completely ignorant of her difference, she added.

The manager of her University of Pretoria athletics club is reported to have made sure “things were fine” with Semenya before she entered the international scene, whatever that means.

Probably things were fine. She was happy in her skin, accepted by her family and peers, and running like the wind.

If only she could continue just to run free, to stun the world with her amazing human strength, to inspire and amaze.

But then there’s that frustrating question of fairness in competition and those who are genetically typical and in this case less gifted. Testosterone is a banned substance, if it is unnaturally present. But what will be the decision if  “that’s just the way God made her”?

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August 25, 2009 - Posted by | Uncategorized | ,

2 Comments »

  1. Hi Kate, Bob forwarded the info to me about your website — and he’s right: I find your posts really interesting. I’m going to put a link to your blog on the “Contacts” page on my own site which is moniquepolak.com
    I’ll look for you in the neighbourhood. I’m on sabbatical this semester so I hope to be in less of a mad rush than usual. Best from Monique

    Comment by Monique Polak | August 26, 2009 | Reply

  2. Very interesting and insightful piece Kate–Mitch

    Comment by mzoler | August 26, 2009 | Reply


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