Still no 'justice for all' for female athletes

Spanish hurdler María José Martínez-Patiño, who in the 1980s endured harsh global media attention when she was subjected to unscientific gender tests, is co-author of a study that takes stock of current sexual verification policies in athletics. While such policies were originally designed to weed out men who impersonate women at female-only events, issues of privacy and confidentiality remain paramount to safeguard athletes from unnecessary embarrassment, says Nathan Ha of the University of California Los Angeles in the US, lead author of the review in Springer's journal Archives of Sexual Behavior.

The International Olympic Committee (IOC) and the International Association of Athletics Federations (IAAF) have since 1966 had various sex verification policies in place – from demeaning physical inspections of female competitors to scientifically and ethically flawed genetic tests to verify the presence of male or female chromosomes.

Such policies have caused great embarrassment and injustice especially to female athletes who were born with disorders of sex development (DSD) which cause the atypical development of their chromosomes, gonads, or reproductive anatomy. Patíño, for instance, has complete androgen insensitivity. This means that, although she is genetically male, she is physically and outwardly female. She was disqualified from the 1985 Kobe Universiade after a genetic test showed that she had XY (male) chromosomes. The news was later leaked to the press. Patíño said the ensuing "almost unbearable" media attention made her feel "like being raped." She openly challenged the ruling.

Since 1999, medical evaluations of an athlete's sex are done only when there is so-called reasonable suspicion about a person's sex, but this can still cause embarrassment. For instance, in 2009 South African athlete Caster Semenya received damaging global media attention after an official broke the IAAF's confidentiality policies by confirming gossip about an assessment of her sex. The hyperandrogenism policy of 2011 sought to rectify the situation by setting standards around the upper hormonal limits allowed for athletes taking part in women's sporting events.

Ha and his colleagues believe this new policy should be improved even further to ensure greater justice for all athletes. Equitable administration and eligibility standards for male and female athletes must still be set, along with policy on transgender athletes and those who have undergone sex-reassignment surgery. Privacy and confidentiality clauses should specify which officials must be informed of an evaluation, and also consider legal action when information is leaked. Informed consent should be an explicit right, while a neutral ombudsperson could be valuable to help an athlete make informed choices throughout the process. Psychological counseling is especially important when an athlete is found ineligible to compete further. The initiation of assessments must also be revisited.

"The International Olympic Committee should continue to monitor and revise the hyperandrogenism policy with diligence in the near and distant future," says Ha.