A brief history of sex verification

Before embarking upon this brief history of sex verification it is necessary to deal with some terminology and make clear the difference between being transgender (or transsexual) and having an intersex condition. 

People who identify as transgender or transsexual are usually people who are born with typical male or female anatomies but feel as though they’ve been born into the “wrong body.” For example, a person who identifies as transgender or transsexual may have typical female anatomy but feel like a male and seek to become male by taking hormones or electing to have sex reassignment surgeries (and vice versa).
People who have intersex conditions have anatomy that is not considered typically male or female. Most people with intersex conditions come to medical attention because doctors or parents notice something unusual about their bodies. In contrast, people who are transgender have an internal experience of gender identity that is different from most people.

In spite of these similarities, these two groups should not be thought of as one. While "gender" is a social construct, "sex" refers to biological differences. Thus in this post we will be talking about sex, rather than gender, verification. 

In an article, "Comparing the best athletic performances of the two sexes", published in New Studies in Athletics (New Stud. Athl. 29:4, 2014, p. 37) Y. Charon and myself estimated the ratio of women top performances to those of men. We found that for running events women were performing at 90 % of men, while for jumps the ratio was close to 85 %. (The situation of throws is more complicated due to the different weights of the implements but, based on results of powerlifting, one expects women's upper-body force to be around 60 % of that of men's). So it is essential that men, who have an appreciable biological advantage over women not be allowed to participate in women's competitions. 

A well-known case of a man masquerading as a woman is that of Herman (Dora) Ratjen who participated  for Germany in the high jump competition at the 1936, Berlin, Olympics. Although Dora managed only a 4th place at the Olympics `she' went on to establish a world record two years later. 

A mugshot of Herman/Dora Ratjen when arrested for transvestism

But the best story from the '36 Olympics is that of Helen Stephens and Stella Walsh. The latter was the 1932 Olympic champion over 100 m but in the Berlin final Stephens beat her roundly. A Polish journalist (Walsh, although residing in the US, was running for Poland under the name of Walasiewicz) suggested that Stephens was of questionable femininity. 

H. Stephens and S. Walasiewicz at the berlin Olympics

Stephens had to undergo a crude examination which confirmed her female sex. The juicy detail is that when Walsh was accidentally killed in 1980 it was discovered during the autopsy that she had ambiguous genitalia and abnormal sex chromosomes and should not have been allowed to participate in women's competitions. (Curiously her medals have not been re-allocated). 

H. Stephens and A. Hitler

However not everybody considered that Stephens was lacking femininity. Apparently when Hitler met her in order to congratulate her, he told her that she was an Aryan and should run for Germany and, for emphasis, he pinched her fanny. He went on to invite her to spend the weekend in Berchtesgaden, something that Stephens refused. Looking at the photos and given the way she dominated the 100 m (her best time was 11.5 s while the second best, excluding those of S. Walsh, was only 11.9 s) I cannot help thinking that she was a hyperandrogenic one. 

In the post-war period rumours started circulating concerning essentially eastern bloc female athletes. The best known case is that of the Press sisters, Tamara and Irina, multiple world record holders with 6 olympic gold medals between them, who were also known as the "Press brothers".

The Press sisters/brothers

The persisting rumour was that they were hermaphrodites and the fact that they suddenly retired in 1966 when sex verification became mandatory just added fuel to the fire.

Under the pressure of the media the IAAF introduced a sex verification in 1960 which became compulsory, in the form of a gynaecological examination, just before the 1966 European Championships. Women reacted vehemently to that degrading `nude parade' and a more acceptable process was sought. Thus in the 1968 Olympics the criterion of Barr body detection was introduced, deemed simpler, more dignified and objective. While the first descriptives are spot-on, the third one turned out to be debatable. The Barr body is a dark staining body only found in the nucleus of cells with XX sex chromosomes. Its detection was thus proclaimed to be the solution to gender misrepresentation. Unfortunately that proved a too naïve an approach, which neglected the complications of the disorders of sex development. The first victim of this new criterion was the polish sprinter Ewa Klobukowska.

E. Klobukowska winning  the 4x100 m relay at the Tokyo Olympics

She had passed a gynaecological test in the 1966 Europeans but, in 1967, she failed the Barr body test. She was subsequently excluded from women's competitions and her world records were annulled (but at least she got to keep her olympic medals). It is believed today that she had what is known as XX/XXY mosaicism. However this genetic abnormality did not make her a man and in fact Klobukowska became pregnant in 1968 and successfully bore a son.

It soon appeared that the Barr body/chromatin test created more problems than it solved. Women with complete androgen insensitivity syndrome would have been barred from competing due to the presence of XY sex chromosomes despite an entirely female phenotype. The best known case is that of the spanish hurdler Maria José Martínez-Patiño. 

Maria José Martínez-Patiño

While she passed a sex text in the 1983, she failed the chromatin test in 1985, during the Kobe World University Games and was ruled ineligible to participate in women's athletics. She was reinstated in 1988 but, alas, too late for the Seoul Olympics.

In 1991 two things happened. First, the IAAF decided to stop compulsory sex verification, reserving themselves the right to proceed to tests on a per case basis. Second, the IOC decided to replace the Barr body analysis by a polymerase chain reaction (PCR) analysis for the sex-determining region Y (SRY). The PCR analysis for the SRY locus was performed on DNA extracted from buccal smears (just like the Barr body test). The test was applied to the participants at the 1992 and 1996 Olympics. In the latter case 8 positive (out of a total of 3000) test were reported but 7 out of those eight had androgen insensitivity syndrome (which was most probably the case for Martinez-Patiño) and the last one a deficiency in the testosterone conversion which allowed her to compete as a woman (but notice that the presence of elevated levels of testosterone might have conferred some performance advantage).

However the test for the SRY has also its limitations. It is known today that other genes are also required for testes development and, what is more troublesome, individuals with XX sex chromosomes (and thus no SRY gene) can have testes. Finally, the IOC decided to abandon mandatory sex verification in 1999, while still keeping the authority to request sex verification on an individual basis.

So, where do we stand now? Since 2005 out of 7 tested athletes four have been driven away from athletics while the remaining three were allowed to pursue their careers. Among the latter we find the famous C. Semenya. In fact this article was initially conceived as a warm-up to the Semenya article I am going to write in a near future. While researching for it I came to realise that sex verification in athletics and sports in general is a particularly complex issue. It was initially welcomed by female athletes as a method of preventing cheaters but its proponents soon became disillusioned realising that discrimination against persons with disorders of sex development was unfair and perhaps detrimental to the sport.

I beleive that it is Semeya's presence that is detrimental to the sport

The IAAF Medical and Anti-Doping Commission published, in 2006, the Policy on Gender Verification. It makes clear that no mandatory sex verification will be in place and that problematic cases will be resolved albeit not solely through a laboratory-based sex determination but rather through an evaluation by a multidisciplinary panel of experts.

I have already written on the question of hyperandrogenism (and will write again in the future). Since the matter has yet to be resolved at the Court of Arbitration for Sport I guess that we'll have to wait a little bit more before drawing final conclusions of the situation. But as I was titling my article from last year: hyperandrogenism is a plague for athletics.

Bruce and Caitlyn Jenner

The whole article was, till now, focusing on intersex athletes. However the question of transgender athletes must also be addressed. These cases are rather rare to date but it is to be expected that more and more male to female transsexual athletes will seek to compete in their acquired sex. The one name that springs to mind is of course Bruce Jenner, who recently switched gender and became Caitlyn. Had he decided to pursue his career after Montreal as a woman he could have been world record holder of both men's decathlon and women's pentathlon.(Warning: the previous sentence was written tongue in cheek). In order to be allowed to compete the athlete must submit to an endocrine assessment and his/her case is then reviewed by a Expert Medical Panel. If the athlete is declared eligible his/her eligibility for competition will be subject to ongoing monitoring. It will be interesting to see how things evolve in the future. In the meantime, if you are interested in the question of transgender athltes you can read the excellent interview of Joanna Harper (who describes herself as a “scientist first, an athlete second, and a transgender person third”) to Ross Tucker at the web site on The Science of Sport.

Women athletics in ancient Greece

The common lore is that women were prohibited from attending the Olympics. And, of course, everybody has heard of Kallipateira who, disguised as a man, a trainer, did attend in order to follow her son's successful contest in boxing. When she rushed to congratulate her son her garment got tangled and she was found out. She defended herself saying that she of all women should be allowed to attend the games having had a father, three brothers, a son and a nephew who had among themselves won eight times. Her life was spared but in the aftermath the trainers had to attend the games in the nude. Speaking of women not attending the Games, the only exception was that of the priestess of Demeter, who traditionally attended the Games at a place of honour. Some authors claim that hetairai (prostitutes) were allowed to attend the Games but I think that they were only allowed to the city of Ellis and not to the stadium itself.

Kallipateia congratulating her son Peisírrhodos

Does the fact that women were excluded from the Games mean that they were not allowed to participate in sport events in Ancient Greece? What is true is that the structure of the ancient greek society did not allow much freedom to women. They were not recognised as citizens and it was considered that their place was the household. With the exception of Sparta, women were not really encouraged to participate in athletics. Still Plato (an excellent wrestler himself) was a fervent defender of sports for women. He writes "I will unhesitatingly affirm that neither riding nor gymnastics, which are proper for men, are improper for women". And in his Laws he stipulates that, "In the case of females, we shall ordain races of a furlong, a quarter-mile, a half-mile, and a three-quarters for girls under the age of puberty, who shall be stripped, and shall race on the course itself; and girls over thirteen shall continue to take part until married, up to the age of twenty at most, or at least eighteen; but these, when they come forward and compete in these races, must be clad in decent apparel”.

Still, women did have their own competitions. Most famous among the latter were the Heraean Games, a kind of Olympic Games for women. They were established  by the queen Hippodameia in the 6th century BC, a mere two centuries after the Olympics for men. Just like the Olympics for men that Heraean Games consisted of foot races (at least at the beginning). The women competed in the Olympic Stadium divided in three age groups, the youngest starting first. The distance was shorter than that for the men, around 160 metres. While men competed nude, the participants to the Heraean Games wore a light chiton that reached to a little above the knee, with the right shoulder bare as far as the breast. Was this (and the fact that they competed with their hair hanging down) a kind of gender verification? Like men, the winners of the women's races were crowned with an olive wreath and could inscribe their names on the stele of Hera's temple. Unfortunately these names are not saved and the only recorded victor is the mythical Chloris who was supposed to be Zeus' granddaughter.

An athlete (supposedly Atalanta) wearing the chiton

This article on ancient sportswomen cannot be complete without mentioning two famous women. The first is the mythical princess Atalanta. She had taken an oath of virginity to Artemis and thus, when pressed by her father to marry, she agreed to accept only a suitor who could outrun her in a footrace. The ones who lost payed with their life. Many young men died until Hippomenes asked the help of Aphrodite. She gave him three golden apples. (Aphrodite has a thing for golden apples. Remember the judgement of Paris which was at the origin of the Trojan war and, indirectly, to the creation of Rome. Well, this is an other story). So, whenever Atalanta got ahead of Hippomenes the latter would throw a golden apple at her feet and Atalanta would slow down in order to retrieve it. Long story short: Hippomenes won and did marry Atalanta. However they did not live happily ever after since they managed somehow to offend the gods who turned them into lions.

One of the many representations of the Atalanta and Hippomenes race

The other famous ancient sportswoman was Kynisca of Sparta. Women in Sparta enjoyed a special status and while they were not considered full citizens they could own property and, as young girls, they were encouraged to participate at the same physical activities as boys. Upon her father's, king Archidamus, death Kynisca inherited his wealth which included racing horses. She entered her horses at the tethrippon race in the 396 BC Olympics and won. The statutes of the Olympics stipulated that the winner of the race was the owner of the horses and not the racer (who, most of the time, was a lowly slave). 

A greek post-stamp of a charriot race

So Kynisca became the first woman to win an Olympic event. (In fact she did this twice since she won again four years later). While she was not crowned with the olive wreath in the olympic stadium like the male winners (was the ceremony carried out in Hera's temple, nobody knows), she could place her statue at the sanctuary of Zeus with an inscription claiming that among all greek women she was the only one to have won the olympic crown.

The Kynisca inscription

In case you are wondering why all of a sudden I interested myself in women sports in ancient Greece, the explanation is simple. While planning for my next Semenya article I decided to learn more about sex verification in athletics, and, as a warm-up, to give a brief account on how sex verification has evolved over the years. Then I asked myself what was happening in ancient Greece, since I knew about the Heraean Games, and this post was born.

Age factors

One important question that all master athletes ask themselves is how fast will their performances decline with age. Because decline they do. Once a athlete is past his prime (which is situated around an age of 25-30) performances start waning. The rate varies enormously from one individual to another but the tendency is there. A look at the men's long jump world records is telling. From a 8.95 m world record, held by a 28 years old, we arrive at 1.78 m for a 100 year old athlete. (Women's records follow the same tendency, declining, in the case of long jump, from a 7.52 m by a 26 year old athlete to 1.28 m for a 92 year old one).

What is most interesting is that the rate of decline is constant. When one considers the whole population of master athletes it looks as if every year between 40 and 80 is bringing an 8 cm loss in performance. (By the way, this appears to be equally true for men and women). The straight line of the graphic is indeed passing through the world record points for the 40-80 age bracket and is very close to the curve of best fit already for ages of around 30 and all the way up to 90. Of course, when it comes to individuals the corresponding evolution curve may have different rates but we expect it, barring accidents along the way or premature death, to have a universal behaviour starting from zero at birth and reaching zero again at some hypothetical maximal life span that should be around 120 years.

Given that the decline in performance as a function of age is perfectly regular, one can try to adjust the performance, correcting for age. This is exactly what the World Masters Athletics association is doing with the famous age factors. How does the empirical age factor compare with one that would be based on the straight-line decline model? In the figure below I give such a comparison. The basic formula is

F=C/(A-a)

where F is the age factor, a the age in years and A,C two parameters to be determined by the best fit. In the case of men's long jump the result of the fit of the empirical data by the formula above is excellent and leads to the values C=95 and A=126. 

Similar results hold for all athletics disciplines. A more detailed analysis can be found in my publication "Scoring athletic performances for age groups", New Studies in Athletics 24 (2009) page 63.

Age factors can be proposed also for young athletes, below 20 years of age but I am not going to address this question here. However an almost linear progression appears to be true also for junior athletes. In the case of men's long jump the world record goes from slightly over 3 m at age 5 to over 8.5 m at age 19. This is a slightly less than 40 cm progression per year. Thus young athletes appear to speed up roughly five times faster than old athletes slow down.