The Winter Olympics have begun, and LGBT activists have a lot more to lose than medals.
LGBT activists primarily work in conventionally political spheres, but regulatory bodies for athletics are doing a great deal to define the terms of the debate over sexuality and gender identity. A new recommendation by a panel of medical experts from the International Olympic Committee, meant to open the door to allow intersex or ambiguously sexed athletes to compete, does a great deal to stigmatize them.
Gender testing in female sports began after men were caught pretending to be female, in order to gain a competitive edge. Runner Caster Semenya is still under investigation, ever since doubts were raised about her biological gender following her gold medal win in the 800 meter dash at the 2009 World Championship. Today, Semenya and others are not accused of deception but are suspected to have benefited from higher levels of testosterone, as the result of genetic abnormalities.
To address these cases, the International Olympic Committee, according to the New York Times ("I.O.C. Panel Calls for Treatment in Sex Ambiguity Cases") has decided that, "Athletes who identify themselves as female but have medical disorders that give them masculine characteristics should have their disorders diagnosed and treated." After treatment, eligibility to compete would be decided on a case by case basis.
The idea of trying to titrate an athlete's hormones down to level the playing field is, at best, hideously complex and, at worst, impossible. How do you know when the hormone level is 'fair?' Once the athlete stops winning? All athletes are physically and genetically exceptional, drawing advantages from differences in height, metabolism, sleep requirements, or anything else that could have an impact on training or performance.
The I.O.C. can require these women to reduce the amount of testosterone that they produce, but it should not pretend that it is doing them a favor. A woman is referred to doctors by other players or coaches (the panel did not specify) who suspect that she may be of ambiguous gender. These women are not seeking out medical remediation for their "conditions;" indeed, the assumption is that their genetic abnormalities are giving them an advantage in their chosen field.
The new recommendation defines people who are intersex or of ambiguous gender as deficient and requiring treatment. Any abnormalities are defined as problems, not by the people whom they affect, but by external groups who are distanced from any experience of them. Even more worrying, the new recommendation medicalizes not only genetic abnormalities but any testosterone level that deviates from the norm. It suggests that all women should fall within a certain range of hormone expression in order to be women; it implies that deviance requires intervention.
We should be wary of attempting to use our imperfect understanding of endocrinology to try to 'correct' biological "problems" that don't impinge on the lives of the people who have them. In the book, Normal at Any Cost: Tall Girls, Short Boys, and the Medical Industry's Quest to Manipulate Height, Susan Cohen and Christine Cosgrove describe how, beginning in the 1950s, doctors used hormone therapies to try to 'fix' the heights of anyone who fell outside the norm. These treatments sometimes carried extremely serious side effects (Creutzfeldt-Jakob disease, cancer, and sterility), but the risks were justified by weighing the physical consequences against the stigma of deviation from the accepted ranges of heights.
Gender is usually considered to be a strict dichotomy, but this is not necessarily so in fact. Our fashion and media celebrate androgyny as an aesthetic, yet we react with discomfort when confronted with someone who appears truly to defy traditional characterization. As we develop medical responses, we must remember that they exist to promote the health and well being of the person with the condition, not for the comfort of the rest of society. If people who do not fit the gender binary are upset by their condition, it is appropriate to offer hormone therapy, but it is wrong to assume that every difference is a flaw, every deviation a disease.
The question of how to create a fair playing field for gender-segregated sports is complicated, and no perfect answer seems to be within reach. As we work to develop solutions, we must not stigmatize intersex athletes or assume that they wish to be cured. Far better to recognize them for what they are: physically gifted, phenomenally successful, and genetically abnormal. Just like every pro athlete.