Feminists For Choice

Guest writer Elliott Weiss sent me a very though-provoking e-mail in response to my post this week about Caster Semenaya. Elliott is a fourth year med student who will start a pediatrics residency next year and most likely a neonatology fellowship after that. Elliott studied English & Biology in college, but also took courses in feminist theory and philosophy. Here’s what Elliott had to say about what the term “intersex” means.

Especially in the past two decades, physicians have become increasingly aware of and sensitive to the complexities surrounding issues of gender and sex. It is well established that there are at least three distinct levels of sex: chromosomal (e.g. XX vs XY), internal organs (uterus and tubes vs. testes), external organs (vulva vs. penis). Add to these secondary sex characteristics (breast development vs. facial hair) which results in from a combination of above factors and external environment. Add also gender identity.

Most dramatic is the newborn with ambiguous external genitalia which is not uncommon, especially in pre-term babies. Most of these are simply underdeveloped babies, who will go on to become “normal” adults with chromosomal, internal organs, external organs, and secondary characteristics all of a single gender. In these cases, testing is done quickly to enable parents to answer the first question everyone asks.

But it’s often not that simple. “Hermaphrodite” refers to an extremely rare condition in which an individual has internal and external female and male genitalia. This is what people outside of medicine generally think of as “intersex” and is pretty easy to wrap one’s head around: boy and girl. Far more common are a variety of conditions called “intersex” (a much improved name over the former term “pseudo-hermaphrodite”) in which there is a “mismatch” between the various levels of gender/sex. Among the more common forms is Androgen Insensitivity Syndrome (AIS), which is most likely Ms. Semenaya’s condition. These individuals have XY (“male”) chromosomes and undescended testes (“male” internal organs) that produce androgen, the key hormone responsible for the things that make a person a boy. But the cells in these folks do not respond to the androgen, which results in a vagina (“female” external organs) and “female” secondary sex characteristics.

Insensitivity is a common biological phenomenon: the situation in AIS is similar to adult-onset diabetes, in which a person’s cells no longer responds appropriately to insulin.

Likely in this woman’s case, she has “partial AIS” in which some of her body’s cells do respond to androgen. This results in a chromosomally “male” individual with “male” internal organs, “female” external organs, and “ambiguous” secondary sexual characteristics.

What is one to do?

Although the easiest and most tempting may be to do away with doing away with “sex discrimination” in sports (as the recent f4c article suggests), this is neither feasible nor a satisfactory solution. At best it would propel a few top women into currently existing leagues; at worst it would simple eliminate the so recently created and fought for female professional athlete. There is no doubt that professional women leagues may be terribly under-appreciated, fiercely competitive, and quality entertainment, but the recent f4c article implicitly suggests a dissolution of these organizations. Really?

Let’s return to Ms. Semenaya. It’s easy to demonize the IAAF for its narrow-minded views and apparent attempts to disqualify Caster Semenaya; let alone act as her doctor. I agree that non-random “female sex testing” of those who may be highly successful and make people nervous is highly problematic. Ms. Semenaya is a woman who should be allowed to compete against other female athletes.

But the fundamental problem is that woman’s professional leagues (as the current system stands) require its athletes to, at the very least, not be men. No one would be happy if the WNBA was suddenly overtaken by individuals with “male” chromosomes, internal organs, external genitalia, secondary characteristics and self identification.

Again, I ask: what is one to do?