Policing the sex binary: gender verification and the boundaries of female

embodiment in elite sport

Sonja Erikainen

University of Leeds, United Kingdom

School of Sociology and Social Policy

Final report for

the IOC Olympic Studies Centre

PhD Students Research Grant Programme

2016 Award

31/12/2016

Contents Abstract ...... 2 Executive summary ...... 2 1. Introduction ...... 3 2. Background: core concepts and the importance of context ...... 5 3. Methodology and sources...... 6 4. Academic significance ...... 7 4.1 Limitation of existing literature ...... 7 4.2 Contributions to knowledge ...... 11 5. Impact on the Olympic movement ...... 11 6. Results ...... 12 6.1 The emergence of gender verification: hermaphrodites, metamorphoses and normal females ...... 12 6.2 Cold War concerns: pure versus polluted bodies ...... 15 6.3 On-site gender verification: the construction of a diagnostic paradigm for sex ...... 17 6.4 The emergence of scientific opposition and the male masquerade concern ...... 18 6.5 Re-defining the aims of gender verification: male masquerade versus sex abnormalities ...... 20 6.6 Health and gender examinations, PCR tests, and the emergence of suspicion-based gender verification...... 22 6.7 The ‘grey area’ of sex and the testosterone concern ...... 25 6.8 Present concerns: hyperandrogenism and androgenic advantage . 27 7. Conclusion ...... 31 Bibliography...... 33

1 Abstract This report presents the findings from a research project analysing the history of the IOC’s and the IAAF’s gender verification policies from the 1930s till the present. The report outlines how the boundaries of the sex binary (i.e. female/male) and the borders of the female category have been navigated by the IOC and the IAAF through gender verification policies, and how the IOC and the IAAF responded to threats or challenges posed to the female/male division by bodies that did not fit neatly into the confines of the binary categories. The report concludes that when the IOC and the IAAF police the sex binary, they in effect police that female athletes’ bodies adhere to cultural ideas about what ‘normal’ female embodiment is taken to imply in specific temporal contexts.

Key words: gender verification; the female category; sex binary; policing; IOC; IAAF

Executive summary This report presents the findings from a research project analysing the history of the International Olympic Committee’s (IOC) and the International Association of Athletics Federations’ (IAAF) gender verification policies from the 1930s till the present. Only applied to athletes competing in the female category, gender verification policies have performed two interlaced regulatory functions: they have policed the categorical boundary between ‘female’ and ‘male’ in sport, and they have drawn definitional borders around the female category by delineating which bodies do and which do not count as female. The project examined how the boundaries of the sex binary (i.e. female/male) and the borders of the female category have been navigated by the IOC and the IAAF through gender verification policies, and how the IOC and the IAAF responded to threats or challenges posed to the female/male division by bodies that did not fit neatly into the confines of the binary categories.

Methodology: The methodological framework applied is Foucauldian genealogy, conceptualised as a history of discursive objects. The project constructed a genealogy of the female category in elite sport regulatory policy, examining continuities and discontinuities in the meanings that have been ascribed to ‘female’ as an object of knowledge and policing by sport regulators. This enabled a contextual analysis of these different meanings at different temporal periods. Primary sources for analysis were archival documents held at the following archives and collections: IOC Historical Archives, the Albert de la Chapelle collections, the Malcolm Ferguson-Smith collections, and digitised newspaper archive collections. In additions, analysis of academic journal articles in online journal databases was conducted.

Academic significance: The research contributes to historical knowledge on how contextual conditions at different temporal periods shape regulatory decision making, and it sheds new light on the epistemology and ontology of sex difference by providing a contextualised example of how definitions of ‘female’ or ‘normal female’ are navigated over time in relation to sexed and gendered threats.

Impact on the Olympic movement: Findings presented here provide understanding of the IOC’s and the IAAF’s historical policy making processes, and this history can inform the making of sustainable regulatory decisions in the present. Understanding how and why sex-binarising and exclusionary regulations have historically been, and are still maintained is key to formulating inclusive strategies around participation in the sex-segregated context of elite sport.

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Findings: The findings of the research show that the sex binary and the borders of the female category were constructed and rigidified into policy responses by IOC and IAAF officials as a response to the presence in sport of female-categorised bodies that contested prevalent ideas about what ‘normal’ female embodiment should look like, in accordance with cultural ideas around gendered embodiment held during different temporal periods. These bodies claimed a female status, but also embodied characteristics associated with maleness in ways that rendered this claim in doubt. They were conceptualised by sport regulators as ‘masculinised’, ‘hermaphroditic’, and ‘hybrid’ among other things, and relegated into the realm of sex category ‘pollution’. When faced with such bodies, IOC and IAAF officials expressed anxiety over sex category disruption, and responded with policing efforts to safeguard the sex binary. At different temporal periods, the sex binary and the boundaries around the female category were re-drawn in response to new challenges to prevalent ideas about sex or gender, carried by contextual changes and newly emerging gendered threats. Policy-defined borders around the female category have thus been erected by sport regulators to safeguard the sex binary against bodies that carried sex binary-pollution.

Conclusion: The report concludes that when sport governing bodies like the IOC and the IAAF police the sex binary, they in effect police that female athletes’ bodies adhere to cultural ideas about what ‘normal’ female embodiment is taken to imply in specific temporal contexts. Rather than regulating pre-exiting or necessary biological truths about sex difference, they police gender norms; social ideas, often re-enforced by scientists, about socially or culturally desirable female embodiment. The exclusion of some athletes due to their failure to adhere to these norms stands in contrast to the fundamental principles of Olympism that foreground the right to practice sport without discrimination of any kind.

1. Introduction Since the 1900 Paris Olympic Games, where female athletes took part in modern Olympic competition for the first time, the vast majority of Olympic events have been divided into separate and mutually exclusive female and male categories. The core justification for sex-segregated competition is so widely accepted that it seems commonsensical: female bodies have weaker athletic performance potential than male bodies and therefore separate female events are necessary to provide female athletes a fair competition. Despite significant temporal changes in how this justification has been articulated, the core message has remained the same throughout the history of the modern Olympics: 1950s observers, for example, noted that a “woman is built physically different from a man” (Bilik, no date) in ways that meant that a woman “is constitutionally weaker and does not possess the same endurance, nor can she produce the same physical output than men” (Messerli, 1952: 9). In the 1980s, IOC officials stated that female bodies were afflicted, among other things, by “tiredness, and poor performance, weak muscle and ligament tone [and] Hormonal cycles” (Hay, 1988), while medical commentators argued in 2016 that the statement “that men and women are different is a biological reality, and in sport, the difference has obvious performance implications” (Tucker & Harper, 2016). Despite being articulated at different temporal periods these comments share two principal ideas: firstly, female and male bodies are fundamentally different and, secondly, in the context of sport this difference manifests as female performance inferiority.

3 For decades, sport governing bodies have had in place regulatory policies most commonly called ‘femininity control’, ‘sex testing’, or ‘gender verification’ (for consistency, I will use the term ‘gender verification’1). Only applied to athletes competing in the female category, these policies have performed two interlaced regulatory functions: they have policed the categorical boundary between female and male, and they have drawn definitional borders around the female category by delineating which bodies do and which do not count as female in sport. The use of gender verification policies is foregrounded by the principle that females have weaker athletic performance levels than males, and therefore athletes with female performance levels must compete only against others at the same level for competition to be fair. Even though the explicit rationales given for gender verification have changed over time, the application of gender verification policies has always relied on this foregrounding principle, and indeed the policies have been used to ensure that the principle holds true in practice. However, the problem that has troubled sport regulators has been the fact that the principle is not categorically true: some elite level female-categorised athletes perform at higher levels than some or even most males, and indeed at higher levels than all or nearly all other females. Such female- categorised athletes have caused trouble for sport regulators: their bodies, in particular when they appeared masculine or had male-like bodily attributes, seemed to pollute the categorical dividing line between female and male in sport that has been taken as foundational. In other words, these athletes’ masculine bodies that seemed to possessed male-like athletic potential threatened the ontological necessity of the sex binary in sport. The history of gender verification is, most of all, the history of how elite sport governing bodies navigated the threat posed to the female/male division by bodies that called the ontological necessity of the division in doubt. The research project presented in this report examined how the boundaries of the sex binary and the borders of the female category have been navigated by the International Olympic Committee (IOC) and the International Association of Athletics Federations (IAAF) through their gender verification policies. The findings outlined here demonstrate that sexed boundaries were constructed and rigidified into policy responses as a response to the presence in sport of female-categorised bodies that contested prevalent ideas about what ‘normal’ female embodiment should look like, in accordance with cultural ideas around gendered embodiment held during different temporal periods. These bodies claimed a female status, but also embodied characteristics associated with maleness in ways that rendered this claim in doubt. They were conceptualised by sport regulators as ‘masculinised’, ‘hermaphroditic’, and ‘hybrid’ among other things, and relegated into the realm of sex category blur or ‘pollution’. When faced with such bodies, IOC and IAAF officials expressed anxiety over sex category disruption, and responded with policing efforts to safeguard the sex binary. At different temporal periods, the sex binary and the boundaries around the female category were re-drawn in response to new challenges to prevalent ideas about sex or gender, carried by contextual changes and newly emerging gendered threats. Borders around the female

1 The choice of terminology is not neutral because different labels carry different connotations. My choice to use the term ‘gender verification’ reflects my theoretical approach to these practices: rather than policing a biologically ordained sex division (suggested by ‘sex testing’), I will argue that these regulations police and produce social gender norms around normative female embodiment.

4 category have thus been erected by sport regulators to secure the purity of the sex binary against bodies that carried sex binary-pollution. This report outlines the conceptual background of my research project, the methodology used, the academic significance of the research, limitations of existing literature on gender verification, the project’s impact on the Olympic movement, and the results obtained. The results section presents the core anxieties, debates, and gender verification policy responses connected with IOC and IAAF sex binary-policing practices in a temporal order that beings from the late 1930s and culminates in the present.

Research aims and objectives: The core objective of the project was to understand how and why boundaries around the female category are constructed, and how and why the sex binary is solidified in specific contextual and temporal conditions in differing ways. It aimed to provide understanding of why and how the definitional boundaries around ‘female’ have changed over time. The project also aimed to shed light on how these different boundaries are and have historically been constructed in relation to threats posed to the sex binary by bodies that polluted its borders.

2. Background: core concepts and the importance of context My analysis of the history of gender verification builds on five core theoretical concepts that are used as tools for analysis: the sex binary, purification, pollution, normality, and abnormality. These intertwined concepts also help to contextualise the regulatory decisions made by IOC and IAAF officials by placing these decisions in the broader context of science-based knowledge production. The female/male sex binary is part of a broader system of binarisations whereby meaning is structured through oppositionality (Latour, 1993): ‘female’ and ‘male’ are seen to form a binary pair of two oppositional and mutually exclusive categories, despite the fact that some bodies do not fit within the confines of the binary. Such bodies include intersex bodies, which often have characteristics that cannot be easily categorised as neither male nor female, and thus come to be conceptualised as sex ‘ambiguous’. Bruno Latour (1993) has argued that the binary system is maintained through ‘purification’ practices. These practices protect the dividing line between the binary categories of female and male against category blur or ‘pollution’ that threatens the binary. Exemplary of this is the medical management of ambiguously sexed bodies, which are frequently ‘corrected’ or purified at infancy through medical and surgical means, even though such ambiguity often carries no health risks. As scholars of intersex have argued (Karkazis, 2008; Kessler, 1998; Morland, 2001), the frequently practiced surgical correction of ambiguous genitals on intersex infants, for example, is often unnecessary for health reasons. Rather, it is a form of social panic around genitals that pollute binarised ideas about what female or male genitals should look like. Their surgical correction aims to return the female/male binarisation of genitals by removing sex ambiguity, or by purifying bodies from such ambiguity surgically. Sex binary policing practices aimed at protecting binarised sex against bodies that pollute the binary can be understood as practices of purification, including sex binary-policing in the form of gender verification by elite sport regulators. Central tools for purification practices are notions of ‘normality’ and ‘abnormality’ that are mobilised to render category polluting bodies as abnormal, and in need of normalisation. In his genealogy of the ‘abnormal’ (2003), Michel Foucault demonstrated that since the end of the 19th century, scientific and medical models of sex normality and pathology have delineated various diagnostic categories of

5 scientifically analysable pathologies or abnormalities in human sex development, which can now be subjected to normalising medical treatments. Bodies that exist at the borderline between the female and male categories, historically labelled ‘hermaphrodites’ for example, can now be diagnosed as specific abnormalities in sex development. The correction of sex abnormality can be understood as a form of sex category-purification through scientific technologies: the ambiguous and thus sex binary-polluting bodies are classified as abnormal through scientific practices of diagnosis, and then normalised with medical technologies. In other words, the sex binary is purified from category pollution by conceptualising binary sex as normal and binary polluting sex as abnormal, whereby the latter is medically normalised so that the sex binary is maintained. Where exactly the boundary between female and male is taken to lie, however, is temporally and contextually variable: it has shifted and been subject to historical changes. As Alice Dreger has demonstrated in her history of hermaphroditism, the decision to define females, males, or indeed hermaphrodites in particular ways has depended “on contemporary concepts and available technologies and the tolerance and intolerance of a given definition’s larger implications” (1998, p. 9-10). What it means to be a normal female or male, and what is means to be hermaphroditic for example, is ontologically open and temporally adjustable, whereby ‘hermaphrodite’ has connoted myriad subjects of fixed, blurred, mistaken, or doubtful sex or gender in different contexts.2 The same is true for ideas about what masculine or masculinised female bodies actually look like and for concepts such as ‘sex change’, both of which matter for the history of gender verification as the results section of this report will show. The history of gender verification thus requires a contextual understanding of prevalent ideas around sex difference at different temporal periods.

3. Methodology and sources The methodological framework of the project is genealogical analysis developed by Michel Foucault (2000), conceptualised as the study of the history of discursive objects of knowledge, how they came to be objects of knowledge and how they have changed. ‘Discourse’ can be understood as a system of meaning making which is realised in a form that can be interpreted, such as written documents. My project constructs a genealogy of the female category in elite sport regulatory policy, where ‘female’ is the object under investigation. Rather than presuming to know in advance the meaning of the discursive object, Foucauldian genealogy is aimed at producing analysis that accounts for the constitution of the object within a historical or contextual framework. It is a form of analysis that accounts for how objects emerge in discourse, without presuming that these objects have any cross-temporal or cross-contextual meaning. The genealogical framework thus enables analysis of both continuities and discontinuities in the meanings that have been ascribed to ‘female’ as an object of knowledge and policing by sport regulators, enabling a contextual analysis of these different meanings at different temporal periods. To construct a genealogy of the female category, archival documents were analysed as primary sources, the most important of which were documents held at the IOC historical archives. To avoid conceptualising the IOC as an autonomous unit

2 The term ‘hermaphrodite’ has been applied not only to bodies born with ambiguous sex anatomies, but also to what we would now call homosexuals, transvestites, transsexuals or feminists (Dreger, 1998).

6 outside of its historical context, I also analysed documents from the archives of key scientists involved in gender verification debates; relevant academic journal articles; and newspaper articles held in online newspaper archive databases. Rather than conceptualising archives merely as locations for storing historical facts, I conceptualise archives themselves as historical products because archiving processes and technologies enable and constrain what is and can be archived, and thus what can be researched (Derrida, 1995). For example, the current availability of remote-access digitised documents enables the production of new histories and knowledges: my ability to access digitised archives using fast key word searches enabled me to bring into dialogue documents in ways that would not have been possible before digitisation. Bringing these documents together is itself a process of archivisation; the coming into existence of new archived events. Archival research can thus be seen as a process that re-makes the past in the present. Documents only gain significance through being interpreted and placed in context. The starting point for my research was thus that examining archived documents constitutes “a set of complex processes of selection, interpretation, and even creative invention”, shaped by the researcher’s “personal encounter with the archive, the history of the archive itself, and the pressure of the contemporary movement on one’s reading of what is to be found there” (Burton, 2005: 8). Key IOC collections consulted were IOC Medical Commission Files, IOC Medicine and Medical Matters files, Women in Sport files, the Russian National Olympic Committee files, and the Avery Brundage files. The correspondences and article collections in these files proved the most useful. The meeting minutes of the IOC Executive Board, IOC Sessions and the IOC Medical Commission also held vital information. Key consulted collections other than the IOC collections were the Albert de la Chapelle collections at the University of Helsinki archives, the digitised Malcolm Ferguson-Smith collections at the University of Glasgow archives, and the following digitised newspaper collections: ProQuest Historical Newspapers, UK Press Online, Time Magazine Online Archives, the Times Digital Archive, Google Newspaper Archives, and Nexis newspaper database.

4. Academic significance 4.1 Limitations of existing literature The history of gender verification in sport has been extensively analysed by scholars (for a starting point, see Elsas et al., 2000; Pieper, 2016; Ritchie, 2008; Simpson et al., 2000; Wiederkehr, 2009). However, despite the widespread interest there are significant issues with how this history is commonly represented in academic accounts. As Vanessa Heggie has argued, due to “the sensitive nature of this subject, histories of sex testing are difficult to write and research”, which “has led to the repetition of inaccurate information and false assertions” that fail to appropriately “differentiate between mythologies and histories” (2010: 157). Indeed, the history of gender verification as it is commonly narrated by scholars has been reinvented, reimagined and reconstructed in ways that not only lack proper evidencing, but also blur the dividing line between fabrication and source-based history. Motivated by Heggie’s observations, I examined 105 academic journal articles across disciplines about gender verification. The articles were collected through key word searches of journal databases as well as through citation tracing, and selected according to the sole criteria that a core topic of discussion was gender verification in sport. My analysis of the articles confirmed Heggie’s observations, and I identified two key patterns of historical claims that are reproduced by scholars without proper

7 evidencing,3 the first of which is the original rationale for the institution of gender verification given by the IOC and the IAAF. Scholars frequently claim that gender verification was instituted in the late 1960s in response to rumours of male masquerades in the female category; i.e. to prevent “men binding their genitals to compete as women” (Amy-Chinn, 2012: 1298). As worded by one scholar making this claim, at “its inception, gender verification … was envisioned as a way to catch cheaters: men disguising themselves as women to win fraudulently” (Hercher, 2010: 551). This is provided as the original rationale even by Lindsay Piper (2016) in the most comprehensive history of gender verification written to date. Secondly, as Heggie (2010) also observed, the history is usually told through the use of widely repeated illustrative cases of past gender ‘suspicious’ or masquerading athletes. These cases are then mobilised to explain or contextualise the institution of gender verification. Among the most widely repeated cases are stories about Dora Ratjen, Helen Stephens, and Stella Walsh, all of whom competed in athletics in the 1936 Berlin Olympics. There are two different versions of Ratjen’s story: in the first version, Ratjen is represented as a case of fraudulent gender masquerade whereby the German high- jumper is said to have been a male in disguise. Exemplary is the following wording: “during the … 1936 Olympic Games, Dora Ratjen … was in fact Hermaan Ratjen. The young man had been forced by the Nazi Party to compete with women, hiding his real sex, to increase the number of German medals” (Ferez, 2012: 278). The second version of the story is more nuanced and suggests Ratjen had been assigned female at birth: “he had ‘ambiguous’ genitalia and that was the reason why Nazi sport leaders forced him to compete with women. In fact, he … was intersex” (Bohuon, 2015: 968). The story about Helen Stephens and Stella Walsh, on the other hand, is usually told as follows: the two rivals competed against each other in the 100-meter race where Stephens won and Walsh finished second. After the race, “German officials ‘examined’ Stephens when a journalist claimed she was a man. Ironically it would turn out that it was Walsh who would have failed the sex test. Following her death in 1980 … an autopsy revealed that Walsh had the sex organs of both a man and a woman” (Wrynn, 2004: 217). While Stephens passed the ad hoc sex examination, the emphasis is usually placed not on this, but on Walsh and her ‘male-like’ body. Some go as far as claiming that Walsh, like Ratjen, was a more straightforward case of male masquerade and that the autopsy “revealed that she had been hiding a secret. As it turned out, … Stella Walsh was a ‘man’” (Jönsson, 2007: 240). These widely reproduced patterns of historical claims are intertwined, and they perform a specific narrative function: they produce a history of male or male-like bodies in women’s sport. This history is then mobilised as an explanatory context for the introduction of gender verification, claimed to have been instituted to deter fraudulent male masquerade: the IAAF and the IOC began searching for males infiltrating in women’s sport, because there were precedent cases like those of Ratjen and Walsh that seemed to prove such had happened before. In the words of one scholar, “there is reason to suspect that such sex fraud may have been systematically perpetuated … dating back to the 1936 Berlin Olympics”, and thus the IAAF “intervened in order to protect track and field from the reoccurrence of similar transgressions by requiring that

3 There exist articles that do not reproduce the patterns I discuss, and many articles reproduce some common claims but not others. There are also some articles that tell an entirely different history. My focus, however, is on examining patterns that are widely reproduced.

8 female participants in the 1966 European Track and Field Championships … confirm their ‘femininity’” (Reeser, 2005: 696). There are three core problems with this mainstream historical account: firstly, the first gender verification policies were not instituted by the IAAF in 1966 but in 1937. Secondly, the widely reproduced stories about Walsh and Ratjen had very little to do with their introduction. Ratjen’s story was not made public until 1957,4 by which time these policies had already been in place for two decades, while Walsh’s death and the consequent autopsy revealing her ‘sex secret’ occurred in 1980 – over four decades after the introduction of gender verification. Yet, academic accounts about Ratjen and Walsh frequently associate their ‘male’/male-like bodies with the 1930s context by claiming them as part of a history of early sex transgression in women’s sport that took place before gender verification was begun. I have found no convincing evidence to suspect that Ratjen’s or Walsh’s sex was considered any more suspicious before 1957 and 1980 than the sex of female athletes’ in general who participated in athletics at the time. I expand on this in section 6.1. To imply that their stories contributed to the introduction of the policies is misleading. Thirdly, archival sources show that gender verification was not instituted to detect straightforward male masquerade, where ‘male’ would imply individuals assigned male at birth and raised as men binding their genitals. Rather, the IAAF and the IOC responded to worries over masculinised, hermaphroditic or hybrid bodies in women’s sport that blurred the (normative) lines between female and male. I expand on this in sections 6.1, 6.2 and 6.3. The male masquerade concern, on the other hand, provided as a formal rationale for gender verification by the IAAF and the IOC, originates in the late 1980s and early 1990s. I argue this in section 6.4.5 The most noteworthy characteristic of the collective academic production of the history of gender verification is a disregard for primary sources by scholars. Some scholars offer no sources whatsoever, most cite older academic sources which in turn do not offer sources, and two scholars (Tucker & Collins, 2009, 2010) go as far as citing Wikipedia. There are also inconsistences between different accounts and some sloppy case outlines which confuse facts about different cases with each other or even invent entirely new ones.6 Indeed, illustrative case-stories like those of Walsh and

4 The earliest evidence I found about Ratjen’s case are newspaper articles published 1957. For example, one newspaper reported that the IAAF “gave a British woman a world high jump record today – 18 years after the jump – upon finding that the former record holder was a man”, noting the IAAF had learned that Dora Ratjen “actually was Hermann Ratjen” ("18-Year Error", 1957: C6). 5 It is true that occasional accusations of women athletes being men did exist in the 1930s: regarding Stephens, American newspapers reported that a Warsaw-based newspaper had published accusations that she was a man ("Polish Writer Calls Helen Stephens 'Man'", 1936, p. A9). The concerns that motivated IAAF and IOC officials to institute gender verification were, however, much more complex as I will show. Accusations about Stephens’ sex must be contextualized with reference to other female athletes of the 1930s who had turned into men. As one 1930s observer commented, the “Poles … accused Miss Stephens of being Mr. Stephens. There had been two cases … where a masculine lady had, with the aid of a surgeon, succeeded in transforming herself into a not too feminine gentleman. The Poles thought they had spotted number three” (Gallico, 1938, p. 233-234). 6 For example, one scholar confuses facts about Stephens and Walsh by implying that it was Stephens who was killed and autopsied (Ferez, 2012: 278), while two

9 Ratjen are re-told repeatedly in such a way that they appear to have gained an aura of legend, to the extent that reference to sources is made to seem almost unnecessary as ‘everyone knowns’ what happened (i.e. these stories are common knowledge). While tracing the citations in search of primary sources, I was left to navigate a web- like chain of citations that crossed each other and led me around in circles. Illustrative of the problem of evidence is a remark made by Malcolm Ferguson-Smith in response to a reviewer’s critique of an article he wrote with Elizabeth Ferris, which has become one of the most widely cited articles on gender verification since its publication. In this article, Ferguson-Smith and Ferris claimed that since “males have the advantage [in sport], it is understandable that occasionally males might be tempted to masquerade as female athletes”, and to support this claim, they provided an anecdotal list of “well documented examples” (1991: 17). In response to a reviewer criticism of their list being based on innuendo rather than sources, Ferguson-Smith responded that “we need to provide … evidence of the problem and, unfortunately, the only evidence we have is in the well-documented and referenced anecdotes” (1990). The references they provided (Donohoe & Johnson, 1986; Ryan, 1976; Tachezy, 1969), however, offer no primary sources to support the claim that straightforward males had in the past masqueraded as females in sport. Most scholars reproduce the above discussed and largely un-evidenced historical narratives as a ‘background story’ for the purposes of contextualising their own arguments. This kind of reproduction of common knowledge claims creates a common-sense understanding of the past, in many ways because the past is narrated only as a prelude to authors’ own insights rather than taken as an object of in depth investigation in its own right (see Hemmings, 2005). Moreover, journal articles are not only the result of the author’s work, but also reflect collective practices of knowledge production: in Clare Hemmings’ words, which “aspects of an article are flagged by peer reviewers as in need of more work, which teleologies pass unnoticed and so on are collaborative decisions” (2005: 118). The mainstreaming of the historical narrative has been made possible by its collective acceptance. My approach to historical analysis derives from observations relating to the above. The common-sense understanding of the past that is produced in academic articles is interesting, not only because it is historically problematic by being disloyal to primary sources, but also because it illustrates the function that the telling of history occupies in academic discourse about gender verification. In Hemmings’ words, as scholars, “we make and remake stories about the past to enable a particular present to gain legitimacy … which stories predominate or are precluded or marginalized is always a question of power and authority” (2005: 118). Academic preoccupations allow certain stories and historical narratives to gain authority and legitimacy, while others are side-lined. In section 6.4, I argued that the male masquerade rationale for gender verification and the corresponding history of male/male-like bodies in women’s sport originates with Malcolm Ferguson-Smith and colleagues in the 1980s and their argumentative strategies against chromosome-based gender verification. It was Ferguson-Smith and colleagues who brought the above discussed historical narrative

scholars cite both the Ratjen ‘masquerade’ story and another story about a 1930s high jumper “who was barred from competition when it was discovered that she had both female and male genitalia” (Kirby & Huebner, 2002: 36, 42). The latter case appears to be a combination of ‘facts’ about both Ratjen and Walsh, merged together to create a new person.

10 into broader academic discourse, and their prolific positions as experts on gender verification enabled it to become mainstreamed as others followed their lead.

4.2 Contributions to knowledge Historical: My aim is not merely to produce a ‘corrective’ account of the history of gender verification, whereby one would build a more objective history by correcting the record, or supplementing it with information that has been excluded (for in depth critique of the corrective approach, see Spivak, 1999). Rather, this research contributes to historical knowledge by examining how and why certain issues come to be accepted as the focus of concern while others fall out of focus. The project contributes to understanding how contextual conditions at different temporal periods shaped IOC and IAAF officials’ regulatory decision making, and how debates between sport officials and scientists shaped how gender verification and the sex binary were conceptualised. By focusing on debates and decisions in relation to the rationales and aims of gender verification, the project sheds light on how the aims shifted over time in response to new contextual circumstances that rendered the sex binary in doubt.

Theoretical: The project sheds new light on the epistemology and ontology of sex difference by providing a contextualised example of how definitions of ‘female’ or ‘normal female’ are navigated over time in relation to sexed and gendered threats. By examining how ideas around binarised sex have shifted and how these ideas have been navigated by the IOC and the IAAF, the project contributes to understanding how the sex binary is both disrupted and maintained in regulatory conditions. The project also contributes to knowledge on how scientific methods and concepts are employed towards social ends in regulatory ways by examining the IOC’s and the IAAF’s sex binary-maintenance policies that utilised scientific methodologies and theories.

5. Impact on the Olympic movement The core findings of the project are especially significant in the present context where the IOC and the IAAF are facing challenges directed against their hyperandrogenism regulations, which I analyse in section 6.8. The hyperandrogenism regulations, which are currently suspended for review, have noteworthy continuities with past gender verification practices, and consequently share many of the limitations of older policies. I will argue that like past policies, the hyperandrogenism regulations are centrally targeted at eliminating sex binary-pollution and rely on culturally delineated conceptualisations, supported by scientific discourses, of what normal female bodies should be like. Yet, my findings show that what normal female embodiment implies is contextually and temporally variable (rather than biologically ordained). Consequently, as long as the IOC and the IAAF rely on such conceptualisations to formulate their regulatory policies, they effectively protect cultural gender norms rather than preordained sex differences; namely, they protect normative female embodiment. In the present context, there is an increasing call for policies that produce gender equity, and the Olympic movement supports this call through its fundamental principles of Olympism which foreground lack of discrimination, including sex-based discrimination (IOC, 2014: 11-12). Yet, the conclusions of this research show that gender verification as well as hyperandrogenism regulations fail to respect this ethical principle because they rely of implicit assumptions about female athletic inferiority. These assumptions are based on binarised conceptualisation of sex difference that are not supported by empirical and biological realities. Findings presented here provide understanding of the IOC’s and the IAAF’s historical policy making processes,

11 and this history should inform the making of sustainable regulatory decisions in the present. Understanding how and why sex-binarising and exclusionary regulations are maintained is key to formulating inclusive strategies around participation in sex- segregated contexts.

6. Results 6.1 The emergence of gender verification: hermaphrodites, metamorphoses and normal females The first gender verification policies emerged in the late 1930s in the context of early/mid-20th century discourses around female bodies and sport, characterised by conceptualisations of athleticism as an inherently male-like or masculine quality. Since the beginning of the 19th century and well into the 20th century, female bodies were considered by many to be intrinsically physically frail and constitutionally unbuilt for athletic efforts (Cahn, 1994; Hargreaves, 1994). Despite some challenges to these ideas from women’s sport movements, the commonly shared perspective of elite sport officials and many medical observers was that ‘strenuous’ or physically demanding efforts including strength-based sports were understood to constitute a threat to the female body and her reproductive capacity, because female bodies were considered to be determined and weakened by their childbearing function. In the words of one 1950s observer, “Science has proved conclusively that girls are unsuited to athletics”, among other things because their “Lung power is reduced considerably by tendency for fully hips and narrow shoulders” and because “feminine muscle development interferes with motherhood” (Sharpe, 1938: 29) However, during the 1930s/40s, women were taking part in sport in increasing numbers, and among these newly visible women athletes were females who demonstrated aptitude for ‘strenuous’ sports. Due to their ability to endure the demands of physical strain, such females failed to exhibit the presumed female bodily frailness and consequently some observers considered them to be suspiciously male- like. This was the case in particular for females participating in sports such as athletics, considered to require pure bodily strength understood to be a fundamentally male- like/masculine attribute (Cahn, 1994: 114). In the 1930s/40s, increasing visibility of these athletes contextualises the emergence of gendered concerns in sport, centred around perceived overtly masculinised or even ‘hermaphroditic’ bodies, and over female bodes that were changing into men. In 1936, future IOC president Avery Brundage remarked the following:

I don’t know whether hermaphrodites are as common today as they evidently were two thousand years ago … but I do know that the question of the eligibility of various female (?) athletes in several sports has been raised because of apparent characteristics of the opposite sex. Recently considerable publicity was given … to the case of an English athlete who after several years of competition as a girl announced herself (?) to be a boy (Brundage, 1936, parenthasised question marks in original).

Similarly, during a late 1940s meeting among sport officials concerning the participation of women in Olympic competition, participant Norman Cox stated that “Certainly the ‘child-bearing’ type of woman – large or largeish breasts, wide hips, knocked knees, and so forth – is under a handicap when up against the hermaphrodite” ("Competitions for Women", no date). This remark had been preceded by another participant suggesting that Olympic spectators should “be spared the

12 unaesthetic spectacle of women trying to look and act like men” ("Competitions for Women", no date). The context in which these comments about ‘hermaphrodites’ emerged was structured by the above discussed ideas around what normal female embodiment implied: because normal female bodies were conceptualised as the frail ‘childbearing type’, female athletes who failed to have such attributes or who demonstrated ‘characteristics of the opposite sex’ (i.e. bodily masculinity) were easily seen to be insufficiently female-like physiologically, to the extent that they had flatter chests, narrower hips or straight legs. Illustrative of this is a worry expressed by one observer cited by Brundage, who was concerned about an un-named American female athlete (who may have been Helen Stephens7) whose “deep bass voice, her height and 10½ inch shoes surely proclaim her a border-line case … rules should be made to keep the competitive games for normal feminine girls and not monstrosities” (Brundage, 1936). The kind of ‘borderline’ sexed embodiment represented by this athlete, relegated as so abnormal as to be monstrous, caused concern for observers because she failed to embody physical characteristics considered normal for females. When female athletes demonstrated ‘male-like’ athletic embodiment, they polluted the presumed boundaries of binarised sex, particularly when they also carried bodily attributes associated with maleness like tallness or lower voice. In some cases, these male-like females were rendered figures of sex binary-transgression pronounced enough to be ‘hermaphroditic’. Worries over sex binary-polluting bodies were reinforced by publicity around athletes who explicitly crossed sexed physiological boundaries. The concern expressed by Brundage over an English female athlete who announced herself a boy concerned Mary Weston, a successful field athlete. In 1936, newspapers reported that Weston had experienced a “metamorphosis into masculinity” ("Medicine: Change of Sex", 1936): Weston had become a man and changed his name to Mark. To fully understand Brundage’s worries over Weston, his ‘metamorphosis’ must be placed in the 1930s context of emerging scientific discourses around sex hormones, which brought new possibilities of changes in sex. In the 1930s, strings of newspaper articles reported sensationalised stories about spontaneous sex changes involving female athletes suddenly turning into men (see also Oram, 2011; Tebbutt, 2015). One magazine, for example, reported that “Sex is no longer immutable” and “science had actually succeeded in changing the gender of two female athletes” (Wickets, 1937: 16), while another conveyed that “being male or female is not a matter of one element completely excluding the other, but rather of one element dominating the other” ("Medicine: Change of Sex", 1936). These news stories were embedded within new endocrinological theories about sex hormones that were reshaping dualistic notions of sex specificity into a conceptualisation where bodily masculinity could manifest in females due to hormonal fluctuations (Oudshoorn, 1994). Sex change stories like Weston’s portrayed popularised but scientifically inspired ideas of latent masculinity in females, caused by the newly discovered presence of androgenic (i.e. male) hormones in female bodies. Such latent masculinity could occasionally break through by hormonal disturbances, to the extent that sudden

7 The description of the athlete’s attributes (deep voice, unusual height, large feet) coincide with newspaper descriptions of Stephens, who was also one of the most well-known American track athletes (and thus many were aware of her appearance). However, as most athletic females were considered un-feminine, the un-named athlete could plausibly have been almost anyone.

13 sex changes occurred.8 Even though news stories often mentioned that some (usually unspecified) surgical ‘sex operations’ were performed for the sex change cases, such operations tended to be portrayed as supporting a change that was already underway anyway. These changes were represented as wondrous ‘sex metamorphoses’ or as quite random changes of sex in relation to “women who find themselves changing into men” ("Miss Mary is Now Mr. Mark", 1936: 19). News about Weston’s and other athletes’ sex changes were embedded within this broader context of popularised interpretations of hormonal theories about sex instability, but nearly all news articles also emphasised the athletes’ sporting backgrounds which were used to contextualise their metamorphoses. Their athleticism was provided as an explanatory framework for the sudden masculinisation, giving the impression that athletic participation may awaken the (hormonal) masculinity that lays latent in female bodies anyway, or that such participation is an expression of this masculinity coming to the fore. These connotations were easily intelligible in the context of prevalent ideas around female bodies in sport, as prowess in ‘strenuous’ sports like athletics was understood to be unnatural for female bodies and itself a male-like sign. These sex change stories profoundly worried some sport officials. Indeed, Avery Brundage “recommended that all women athletes entered in the Olympics be subjected to a thorough physical examination to make sure they were 100% female”, giving as the reason that “athletes who recently competed in European track events as women were later transformed into men” ("Sport: Olympic Games", 1936). Such reference to percentages of femaleness made sense in this context where femaleness and maleness could manifest in degrees across bodies, and it was not only cases of fully fledged sex change that signalled a ‘high percentage’ of masculinisation. The perception that some female athletes seemed so male-like as to be hermaphroditic was taken in combination with the metamorphosis stories to imply that there was a gender problem in women’s sport. The emergence of new endocrinological theories of sex instability not only incited sensationalised stories about female athletes’ sudden masculine metamorphoses, but it combined with existing ideas about athleticism being a male-like attribute to render the perceived masculinity of female athletes in ‘strenuous’ sports as a site of gendered concern. This concern resulted in a direct regulatory effort to police the sex binary in sport. In response to Brundage’s call for physical examinations, the IAAF instituted the first gender verification rule in 1937,9 requiring female athletes to submit to physical examinations “should any protest regarding their sex be made formally” ("Man-Woman Athletes Test Decision", 1936: 2). The new rule was added under the IAAF’s ‘protests’ policy, stating that if a “protest concerns questions of a physical nature, … a physical inspection [will] be made by a medical expert” (IAAF, 1937: 40). Anxieties over sex

8 Note that these 1930s portrayals of sex change did not have the connotations of transsexuality to which the concept is attached in the present. It is almost certain that Weston and other sex change cases from the 1930s would today be medically diagnosed as disorders of sex development. For an in depth analysis of this, see Meyerowitz (2002: 14-50). 9 Evidence exists of spontaneous ‘physical inspections’ carried out before this rule. In addition to the more well-known 1936 Stephens case, Kinuye Hitomi underwent inspections during the Amsterdam Olympics “where the investigating committee was out two hours before it decided the predominant sex” ("Separate Olympics for Sexes in 1940 Planned", 1936: A9).

14 category instability were thus translated into formalised sex binary-surveillance based on protest made in the face of male-like/masculine bodies in the female category, and the sex binary became written into policy. In the late 1940s, this protest-based system was supplemented with a rule for medical sex certificates signed by local practitioners required for high-stakes events, including the Olympic Games (Pallett, 1955: 68). The presence of male-like/masculinised bodies in women’s sport – some of whom were so masculine that they seemed hermaphroditic or were actually turning into men – profoundly threatened prevalent ideas about normal female embodiment and sport in the 1930s/40s. It was concern around these bodies rather than worries over explicit male fraudsters masquerading as females by ‘binding their genitals’ that roused the first gender verification policies, aimed to ascertain that female bodies were indeed 100% female rather than male-like/masculinised, in accordance with prevailing discourses around what normal female embodiment implied. The first policy-defined efforts to secure the sex binary in sport were thus instituted in response to concerns around female-categorised bodies that rendered the sex binary unstable. In the late 1960s, enduring worries over sex category-pollution became re-contextualised by new concerns incited by the geopolitical context of the Cold War.

6.2 Cold War concerns: pure versus polluted bodies During the 1950s/60s, enduring concerns over masculinised or hermaphroditic bodies became embedded within Cold War geopolitical dynamics. When the USSR entered Olympic competition in 1952, it brought into the international sporting landscape unapologetically strong and muscular Soviet female athletes who incited new worries among Western observers. Western Cold War political rhetoric had been erected upon a gendered form of nationalism, where heteronormative and gender-binarised family ideals were mobilised as a stabilising force of Cold War instabilities (Pieper, 2016: 35- 46). Ideals of Western women’s (white middle-class) heteronormative femininity and domestic morality were mobilised to represent the gender and sex(ual) purity of Western nations, and transferred onto the bodies of female athletes who represented the nation in international competition. This gender-binarised imaginary of appropriately feminine Western female athletes was, however, constructed in direct opposition to the strong, muscular and highly successful Soviet female athletes who were seen to pollute gendered boundaries: the communist political system was imagined to be perverting the binary-purity of gendered embodiment. This gender- pollution was implied to be the result of the communist political system that aimed (unduly) to make everyone the same: in Western discourse, the USSR and its dominions were perceived as one huge ‘human sausage machine’, a grim consequence of which was that behind the Iron Curtain women looked like men (Wagg, 2007). Ideas around communist gender-pollution were entangled with concerns over Soviet political ‘dubiousness’. Dominant Western Cold War ideologies were structured by ideas of good versus evil, whereby the evilness of the Soviets was identified with the communist/totalitarian system that was thought willing to sacrifice the well-being of its subjects to demonstrate communism’s political superiority (Dimeo, 2007). In the Olympic context, observers worried that the Soviets were using dubious means of success involving deliberately entering into sport not only athletes doped with performance-enhancing substances (see Beamish & Richie, 2007), but also ‘abnormally’ sexed athletes into women’s sport, in order to win more medals. In the words of IOC official Monique Berlioux,

15 nature can play some funny tricks and … a baby can be declared of masculine or feminine sex at birth because its physical structure is such that it is possible to make an error. … it is the duty of everyone to make sure that the situation is not abused. … is there a voice raised against the person responsible for such cheating? … Nothing is more prejudicial to female sport than this charlatanry (Berlioux, 1967: 2).

For Berlioux and others, the responsibility for such charlatanry lay in the hands of what one reporter called “ambitious selectors” who were “turning a blind eye to possible [sex] abnormality and giving their teams an unfair advantage” (Doyle, 1967: K26). Some years later, IOC Medical Commission (IOC-MC) official Arnold Beckett noted that rumours had been circulating that “the not completely female was competing in women’s sport” and that the “countries concerned were probably aware of the doubts about the female characteristics of some of the competitors they were allowing to represent them” (Beckett, no date). Concerns over ambitious selectors and sex abnormalities formed in a context where Soviet female athletes were dominating women’s strength-based sports. Exemplary were the highly successful sisters Irina and Tamara Press who competed in athletics in the 1950s/60s. In Western media representations, the Press sisters came to embody the gender binary-pollution of ‘excessively’ muscular Soviet females in ways that endured for decades. For example, one 1970s reporter, discussing “why you WON’T look like Tamara if you take up sporting life”, celebrated the (Westernised) femininity of some female athletes by contrasting them against a picture of “giant” Tamara Press’ strong body in full swing, showing her grimacing with physical effort (O’Flaherty, 1975: 2, original capitals). This masculinised image of Soviet athletes like Tamara Press carried simultaneously two kinds of gendered threats: it carried the pollution of binarised, heteronormative gender upon which Western Cold War rhetoric was erected, and the ‘dubiousness’ of the Soviet government seen willing to enter abnormally sexed bodies into sport to (unfairly) attain success. In response to these concerns, the IOC and the IAAF considered it imperative to institute a more rigorous on-site regulatory paradigm to police the sex binary. IOC-MC official Guiseppe La Cava, for example, considered the existence of dubious government motives to mean that sex certificates signed by local medical practitioners (some of whom were working under communist governments) were no longer trustworthy: “this method does not permit a sufficiently strict control since such certificates are often very easily obtained” (IOC-MC, 1967). I return to analyse these on-site paradigms in section 6.4. Worries over abnormally sexed bodies heightened during the 1966 IAAF European Championships where all females were gender-verified on-site. Newspapers reported that some prolific communist female athletes had, suspiciously, withdrawn from competition. Commenting on “the absence … of several leading Russian women athletes from the championships”, one reporter noted that such absences had “caused a great deal of discussion … on the subject of physiologically ‘borderline cases’ in women’s athletics” ("European Championships: Medical Tests for Female Athletes", 1966: 3). It was implied that these absent athletes (including the successful Press sisters) had withdrawn from sport due to ‘borderline’ sex characteristics, which would have caused the athletes to ‘fail’ gender verification. Indeed, one reporter commented after these withdrawals that “the female members of the Russian team … were far more feminine than before … and not the husky mannish types such as the Press sisters [who] have reportedly refused to take the sex test” (Daley, 1968). Thus, for some observers, on-site gender verification translated into the

16 feminisation of women’s sport more generally: the withdrawal of presumed borderline athletes enabled the blossoming of appropriately (i.e. normatively) feminine bodies in women’s sport, where borderline, binary-polluting sex was identified with the communist bloc. The 1950s/60s concerns over borderline sex, despite gaining new politicised meanings in the Cold War context, shared continuities with the 1930s/40s anxieties over sex binary-pollution. Despite the withdrawal of some ‘suspicious’ Soviet bloc athletes, these anxieties proved remarkably persistent, and they were given new fuel during the 1970s/80s by the outstanding success of East German female athletes. As one observer noted retrospectively, in “1973, a handful of East German women shocked the swimming world by winning ten of a possible 14 gold medals at the first World Swimming Championships” (Shuer, 1982), probably aided by a large-scale, state sponsored doping system that one biologist much later called “one of the largest pharmacological experiments in history” (Longman, 2002: A21). The bodies of East German female athletes incited suspicions in ways that intertwined worries over dubious governments using illicit performance-enhancing substances with gendered concerns over sex binary-pollution. One American swimmer commented, for example, that East German female athletes “had very deep voices, they were masculine. … They … had completely developed muscles that we didn’t have” (Shuer, 1982). The continued presence in women’s sport of bodies that were perceived to be suspiciously masculinised thus carried over anxieties around the sex binary across decades, despite the introduction of on-site gender verification.

6.3 On-site gender verification: the construction of a diagnostic paradigm for sex The IAAF begun their on-site gender verification paradigm in the 1966 Jamaica Commonwealth Games. In high-stakes events, “a panel of three women medical doctors” was appointed and all female athletes were mandated to “appear before the panel, who will be required to certify that they are qualified to compete in such events” (IAAF, 1967). Like the earlier mandates for ad hoc protest-based examinations but now carried out for all female athletes on-site, the new system used physical examinations, referred to by many as ‘naked parades’. Since its inception, however, the IAAF faced uncomfortable commentaries on what some observers perceived to be a problematic practice of mandating women to parade in the nude. One coach, for example, observed that “some girls … would simply not feel happy about undergoing [physical] examinations – it is a difficult matter psychologically and there may be a few who would prefer not to compete … for fear of embarrassment” ("Medical Test for Female Athletes ", 1966: 3) Partially due to critiques of the IAAF ‘naked parades’, the IOC’s first on-site gender verification paradigm instituted in 1968 was constructed as a chromosome- based screening test, conducted under laboratory conditions, thus implying no need for nudity. The IAAF also changed to a chromosome-based system in 1968 for similar reasons. The screening method chosen was the buccal smear for the Barr body or ‘sex chromatin’, which was supplemented with a fluorescent body test for Y- chromosomes in 1972. These tests involved the scraping of cells from the inside of the mouth, analysed to ascertain the presence of the Barr body indicating the second X chromosome and the absence of the fluorescent body indicating the Y chromosome, based on XX chromosomes implying femaleness and XY chromosomes implying maleness. The intention of this chromosome-based screening was not, however, to exclude athletes based on the screening results alone, but the on-site paradigm was

17 intended, in IOC-MC official Jacques Thiebault’s words, to be “carried out by progressive phases, in order to confirm the diagnosis [of sex] completely” (1968: 3). The buccal smear was to function only as the screening phase, and in cases of ‘suspicious’ findings, athletes were to be subjected to further investigations: firstly, a karyotype test (complete chromosome mapping) was to be conducted, and secondly, if “the diagnosis is still doubtful, … a complete hormonal check-up of the athlete [needs to] be carried out [including] the study of the menstrual cycle [and] the athlete’s anatomical and physical structure” (Thiebault, 1968: 3). The plan of action designed by the IOC illustrates the medicalised approach taken towards sex difference. IOC-MC officials drew from broader scientific epistemologies of sex pathology by constructing a diagnostic paradigm applying several sexed components that could be separately analysed to ascertain the sexed ‘truth’ of the body under investigation. With the aid of concepts of normal or normalised health in relation to sex, the IOC paradigm could assign (diagnose) for each athlete either normal or abnormal sex, and bodies assigned (or diagnosed as) abnormal could then be subjected to interventions to re-integrate them into the sex binary through medical technologies. Illustrative of this are the two official rationales for the institution of the on-site paradigm provided by Thiebault. The explicit aims were, firstly, to “dissuade [sex] hybrids from participating in the Games” and, secondly, to “help such an ‘indetermined’ creature to become aware of its true situation and of the eventual therapeutics” (1968: 16). Thiebault argued that what he called a “hybrid discovery” of sex during Olympic competition, especially if made at a young age, would likely be positive because “all therapeutics can still be applied” and “it is not too late to do something about psychic reintegration into the true sex, if necessary” (1968: 8). Thus, gender verification was designed to function as a paradigm for sex binary-purification more generally: the binary-polluting bodies – labelled ‘hybrid’, ‘indetermined’, ‘creature’, and ‘it’ – could not only be dissuaded from participation and detected through diagnostic tools, but they could also be purified with medical treatments. Since its inception, however, the paradigm faced criticisms from medical observers who considered it to have important limitations. They argued that it failed to appropriately delineate which bodies should and which should not be allowed to compete as female, and they called for clarification and re-articulation of the aims that gender verification intended to achieve.

6.4 The emergence of scientific opposition and the male masquerade concern The earliest scientific critiques of the IOC’s on-site paradigm were outlined during the first few years after its institution, and were based on the argument that chromosome- based screening was not appropriate for sex identification. This was because in some cases, chromosome-based screening fails to accurately identify female or male phenotype. In 1972, a group of Danish scientist asked for the paradigm’s discontinuation on the grounds that the IOC “has made its own definition of sex, defining a female as a sex chromatin positive individual and excluding sex chromatin negative individuals as non-females” – a definition which was contested by alternative somatic and psychological definitions (Stromgren et al, 1972: 1). Three years earlier, Malcolm Ferguson-Smith had refused a request by the British Olympic Association (BOA) that his laboratory conduct buccal smears during the Edinburgh Commonwealth Games, because he considered chromosome-based screening inappropriate (Ferguson-Smith, 1969b). The reason for these objections was the following fact: in some individuals, the postulation that XX chromosomes imply

18 femaleness and XY chromosomes imply maleness does not hold in relation to phenotype. For example, individuals with androgen insensitivity syndrome (AIS) have female phenotypes due to insensitivity to androgenic hormones even though, in Ferguson-Smith’s words, these women “have XY chromosomes and a Buccal smear test appropriate to males” (1969a). Reversely, men with Klinefelter’s syndrome have XXY chromosomes and male phenotypes, but due to the second X chromosome they would be identified as females by the Barr body test (although the fluorescent body test instituted in 1972 would have identified them as male). Moreover, in 1972, Albert de la Chapelle, who would become one of the most vocal critics of chromosome-based screening, outlined the characteristics of XX male syndrome, where individuals with XX chromosomes have “a male phenotype, male psychosexual identification, testes or gonads of testicular type … and absence of female genital organs” (de la Chapelle, 1972: 71). Yet, these men would be identified as female by chromosome-based screening. The existence of these individuals came to structure definitional debates between scientists and IAAF and IOC officials over sex and the aims of gender verification. These debates mark the emergence of the detection of male masquerade as an explicit rationale for gender verification. When Ferguson-Smith critiqued chromosome-based screening in 1969, his core argument was that the screening might unfairly exclude some phenotypic women (like women with AIS) from the female category, while it could unfairly enable some phenotypic men (like XX males and men with Klinefelter’s) to compete in women’s sport by masquerading as females (Ferguson-Smith, 1969a, 1969b). Centrally, he made the following presumption and suggestion: “The whole purpose of a ‘sex test’ … is to disqualify the male athlete who attempts to masquerade as a female in women’s events. … this purpose is most simply and economically achieved by physical inspection” (1969a, my emphasis). His argument then took the following form: chromosome-based screening did not achieve this objective of disqualifying males, because males with chromosomal abnormalities could pass the screening “despite … male external genitalia” (Ferguson-Smith, 1969a). Physical inspections, on the other hand, would achieve this aim, because male genitals and overall male phenotypes would be revealed. During the 1970s, however, the IOC-MC failed to directly engage with Ferguson-Smith’s and other critics’ objections, and they failed to directly communicate their rationales for gender verification to these scientists. Indeed, the BOA’s reply to Ferguson-Smith’s critique was an inability to supply him with an account “of the relevant discussions which preceded this decision” to use chromosome-based screening (Owen, 1969). Consequently, Ferguson-Smith and some other critics continued to assume throughout the 1970s that the explicit rationale for gender verification was to detect male masquerade. The male masquerade concern as an explicit rationale for gender verification originates with the scientific opposition that emerged against chromosome-based screening after its introduction in 1968, and it originates not with IAAF or IOC officials but with the scientists who advanced the opposition. After his refusal to carry out buccal smears during the Commonwealth Games, Ferguson-Smith became one of the most authoritative critics of gender verification. His publications have had a key role in mainstreaming the common-sense narratives of the history of gender verification discussed in section 2.1. Indeed, many of the citation tracks I analysed in search of primary sources for un-evidenced historical claims lead to articles published by Ferguson-Smith and colleagues, which are some of the most widely cited relevant articles (see Elsas et al., 2000; Ferguson-Smith & Ferris, 1991; Simpson et al., 1993; Simpson et al., 2000). By the late 1970s, Ferguson-Smith had materialised this

19 narrative form in a text titled The Sex Test in International Sport,10 where he argued that the need for gender verification “has arisen because there is evidence in the past that men have fraudulently masqueraded as women” (Ferguson-Smith, 1976?: 1). In this text, Ferguson-Smith produced the historical claims that have now become ‘common knowledge’, including illustrative cases of male masquerades such as Ratjen and others who “may have been masquerading as women” (Ferguson-Smith, 1976?: 2). For his purposes, these claims performed a strategic function in support of his arguments, because they provided a historical justification for his preferred physical inspections method: since gender verification seemed to him to have been instituted due to concerns in the past over males/men (i.e. individuals with male/male-like phenotypes) competing as women, physical inspections would better address these concerns because this method would detect males/men much more accurately than chromosome-based screening. The emergence of the male masquerade justification is thus located within specific contextual conditions, where it was mobilised because it performed an important legitimating function for critics’ arguments.

6.5 Re-defining the aims of gender verification: male masquerade versus sex abnormalities In 1982, de la Chappelle circulated a critical address against the IOC’s gender verification paradigm, arguing for its discontinuation in ways that mirrored earlier arguments by Ferguson-Smith. Centrally, however, de la Chapelle observed that he had “not been able to find a concise definition of what exactly is the aim of the ‘femininity control’ practiced” (1982: 4). Indeed, the earliest account I found of an IOC official attempting to offer an in depth explanation of the rationale for gender verification to critics was written in 1981, by IOC-MC official Eduardo Hay. Writing to Ferguson-Smith’s colleague Elizabeth Ferris, Hay stated that gender verification was used as a “means of detecting the genetic abnormalities which interfere with the conduct of the competitions”, adding that “the I.O.C. must continue to eliminate from the competitions athletes who exhibit problems from the area of sexual differentiation” (1981). Hay failed, however, to elaborate exactly which ‘genetic abnormalities’ were targeted, or what the sexual differentiation ‘problems’ might be. It was this un-clarity, however, that was the core subject of the scientists’ critiques in the first place. During the 1980s, de la Chapelle and colleagues exerted significant and increasing pressure towards the IOC-MC in relation to the problems of chromosome- based screening. In response, IOC-MC president Alexander de Merode attempted to offer further clarification on the rationales. He informed the scientists that on-site gender verification was begun to end “incessant denunciations … accompanied by persistent rumours widely echoed by the media” presumably relating to the sex of some female athletes, adding that “we were being informed that in certain regions, a systematic search was taking place for young people presenting sexual anomalies, which were then knowingly aggravated instead of any attempt being made to correct them” (1987). This vague response, like that provided by Hay, failed however to offer clarification on which ‘sexual anomalies’ were the object of concern. As late as 1988, de la Chappelle lamented that a key obstacle for his efforts to engage with IOC-MC officials was this ambiguity, as the IOC had “never defined what they want to achieve with the test” (de la Chapelle, 1988b), failing to delineate “precisely which groups of individuals they did, and which they did not, believe should be allowed to compete as

10 Possibly written for a Scottish sports conference addressing sex testing and doping.

20 females” (Bobrow, 1988). Unlike Ferguson-Smith had presumed, however, de la Chapelle observed that the IOC was “not out to get males masquerading as females”: this had “been stated several times … by people from the IOC” (1987a). In 1988 and 1990 respectively, the lack of clarity over the aims of gender verification finally culminated into two meetings organised by the IOC in Lausanne and the International Athletic Foundation (IAF) in Monte Carlo. During these workshop meetings which they attended, de la Chapelle and colleagues organised an opposition to chromosome-based screening structured by the core arguments that had been outlined by Ferguson-Smith two decades earlier: firstly, chromosome-based screening might unfairly screen out some phenotypic females as ‘male’ such as women with AIS and, secondly, it “fails to distinguish XX males … and XXY males … from normal females” (de la Chapelle, 1990). In relation to the first concern, Hay retaliated that the buccal smear was only a screening test and, in accordance with the IOC diagnostic paradigm, athletes with ‘suspicious’ findings were offered the opportunity to undergo further inspections that “look for anatomical masculinity (android pelvis, male genitalia, male muscular configuration)” (Hay, 1990). If such ‘anatomical masculinity’ was not present, Hay claimed that the athlete would be allowed to compete as female, including cases on AIS. There were practical problems with Hay’s defence however. During the Lausanne meeting, de la Chapelle cited a case that had come to his awareness concerning “misuse of the screening tests” where “a female swimmer had been obliged to leave the US team due to the fact that she had had an abnormal result on the screening test. There had been no further physical investigation” but, importantly, the original ‘abnormal’ result was later found to be a testing error (IOC, 1988). Somewhat similarly, Maria Martínez-Patiño underwent and passed the screening in 1983, and was granted a certificate as proof. During the 1985 World University Games, however, she forgot her certificate, and had to re-take the test, but this time she ‘failed’. Without any further inspections being offered, she was asked to withdraw from competition by her national delegation (Carlson, 1991b). It was later determined that Martínez-Patiño had AIS and should thus, per Hay’s claims, been eligible to compete. Centrally, for de la Chapelle’s purposes, these cases showed that the further inspections clause was not always respected. In relation to the second argument by de la Chapelle and colleagues about XX/XXY males who could pass chromosome-based screening, according to de la Chapelle, during the Lausanne meeting de Merode re-affirmed his concern over “‘certain countries’ … sending ‘hermaphrodites’ to compete as women” (de la Chapelle, 1989). De la Chapelle, however, argued that as long as the IOC was using chromosome-based screening, XX/XXY males “could readily be picked up by coaches or sports clubs, trained, and sent to competitions as females” since “these males are both frequent and easily detectable by medical examination” (de la Chapelle, 1988a). Thus, in opposing chromosome-based screening, de la Chapelle and colleagues constructed an argument centring individuals with male phenotypes. Because these men would pass the screening, they would never be subjected to further investigations of ‘anatomical masculinity’, and would (unjustly) be eligible to compete in the female category. Therefore, de Merode’s and others’ worries over unscrupulous governments sending athletes with anatomical masculinity into women’s competitions was not addressed since some governments might send athletes who were so masculine that they were phenotypical males. By centring chromosomally ‘abnormal’ bodies with male phenotypes as the object of concern, the scientists effectively re-drew the issue as one over overt male bodies being infiltrated into women’s sport.

21 This argument was partially successful. During the Lausanne meeting, de Merode confirmed that he wished to avoid “premeditated use of the XX/Y male” and “men masquerading as women” (IOC, 1988). It was agreed that the aim of gender verification should be “to prevent male imposters from participating in female competition” and that chromosome-based testing “is not fully accurate in discriminating between males and females” (IOC, 1988). It was also “agreed to define male as follows: ‘a person with a penis and testes in a well-formed scrotum’” (de la Chapelle, 1988a). This genital-centred definition was reaffirmed at Monte Carlo, and it was recommended that chromosome-based screening should be abandoned (IAAF, 1990). However, as de la Chapelle had observed previously, the main reason why sport officials were unwilling to consider a change was that “they feel that another test must be instituted before the sex chromatin screening can be dropped” (1987c). It was thus recommended that

a medical examination for the health and wellbeing of all athletes … should be performed responsibly under the auspices of the national federation … This medical examination would preclude the need for any genetic ‘sex test’. … the criteria of eligibility for women’s competition … should include a description of the external genitalia (IAAF, 1990).

This ‘health and gender’ examination was to replace chromosome-based screening and, in accordance with Ferguson-Smith’s suggestions made two decades previously, the examinations were to incorporate ‘external genitalia’. The consequence of these negotiations was that the concern over sex abnormalities was re-located and became, momentarily, attached to bodies with male phenotypes. Since this was the new location of concerns, the sex binary in sport was re-drawn around genitals, which became the site where maleness or femaleness and consequently male masquerade could be detected. The scientific opposition to chromosome-based screening carried by Ferguson-Smith, de la Chapelle, and colleagues eventually compelled IOC and IAAF officials to clarify their aims and delineate more precisely which kinds of sex abnormalities they aimed to exclude. Despite the IOC’s diagnostic paradigm aimed ‘to confirm the diagnosis of sex completely’, critics argued that chromosome-based screening was erroneous because some phenotypic males could pass the screening while some phenotypic females (e.g. Martínez-Patiño) had been screened out as male. While Ferguson-Smith had in 1969 presumed that the rationale for gender verification was to exclude male masquerade, de la Chapelle and colleagues argued in the 1980s that the rationale should be to exclude male masquerade, building on IOC officials’ concern over unscrupulous governments possibly abusing the system by sending out XX/XXY men.

6.6 Health and gender examinations, PCR tests, and the emergence of suspicion-based gender verification In 1991, the IAAF adopted the Monte Carlo meeting’s recommendations. However, despite having agreed to the new definition of the aims of gender verification in Lausanne, IOC-MC officials declined to fully adopt the ‘health and gender examination’ scheme. This was largely because the Monte Carlo meeting had recommended that the examinations be performed ‘under the auspices of national federations’ rather than on-site of competitions for all female athletes (thus leaving open the possibility that some national federations might cheat). The IOC-MC thus decided that all Olympic participants “shall be subjected to a health check in the countries of origin” per Monte

22 Carlo recommendations, but in addition, “female participants will … be subjected to Y- chromosomal determination by the PCR-technique” at the competition site (Ljungqvist, 1991b). The PCR-technique (i.e. polymerase chain reaction for the Y-chromosome- linked SRY gene) is a more sophisticated and arguably less error-prone, but still a genetic chromosome-based sex determination method. As one opponent of chromosome-based screening noted, “obviously, substituting one chromosome measure to another misses the point” of de la Chapelle’s and colleagues’ critiques (Carlson, 1991a, original empasis). Yet, according to the IAAF medical commission president and IOC-MC member Arne Ljungqvist, it was “quite clear” that

any female … who may come out with a Y-chromosome in the PCR will be subjected to a physical examination at the olympic site. Such an examination will … simply confirm the accuracy of the health check conducted at home and the athlete will be eligible to compete … [the PCR] is therefore, in fact, a totally unnecessary intermediate step but it should not result in the same disastrous consequences as [previous chromosome-based tests] (Ljungqvist, 1991a).

While the IOC instituted this ‘unnecessary intermediate step’ to maintain its control over the policing of the sex binary on-site, the IAAF trialled the health and gender examinations scheme during the 1991 IAAF World Championships in Tokyo and the 15-km road race World Championships in Nieuwegein. The new IAAF scheme faced immediate criticisms from those involved, however. Many were concerned that it mirrored the IAAF’s late 1960s ‘naked parades’ that had been considered humiliating. For example, during a 1992 IAF gender verification seminar in London, Elizabeth Stolk, who was involved in trialling the procedure in Nieuwegein, noted that “the procedure left me feeling that some athletes might have been embarrassed or shocked by the procedure” (Stolk, 1992), while British team doctor Malcolm Brown outright refused to conduct the IAAF examinations on his athletes, arguing that “the invasion of privacy of a physical examination to determine gender is unnecessary” (Bowell, 1991: 32). Faced with such critiques, the IAAF re-considered their new system only a year after its adoption. Upon reflecting on the issue, however, Ljunqgvist had the following idea:

Nowadays when doping control is routine … it is highly doubtful that men would take the chance at masquerading as women since they run a great risk of being selected for doping control. During the control … the voiding of the urine [is] carefully watched by an official to make sure that the urine actually comes from the urinary bladder … Therefore … man masquerading as female would probably be identified (Ljunqgvist, 1991).

Ljunqgvist’s idea was thus to mobilise doping controls for the detection of male masquerade: due to the necessary unveiling of genitals during these controls, explicit mandates for genital examinations would become moot. Since athlete generally accepted to undergo doping controls, the criticisms of physical examinations implying ‘invasions of privacy’ would lose their force. During the 1992 IAF gender verification seminar, it was consequently decided that the health and gender examinations should no longer be compulsory, because “the procedures which have to be followed during doping controls are quite sufficient for also making sure whether the athletes are male or female” (Ljungqvist, 1992b).

23 However, while this abolition of compulsory examinations appeared at the surface to eliminate explicit gender verification by transferring sex binary-policing onto doping controls, enduring anxieties over suspiciously masculine bodies in the female category halted this shift from becoming total. Illustrative are deep seated concerns around masculine female bodies expressed by de la Chapelle. Discussing the benefits of physical examinations, de la Chapelle had argued that the examinations would not only detect explicit male phenotypes, but they would also “pick up” women with hormonal disorders of overproduction of androgenic hormones, as “a few are so masculine-appearing that their competing as women might well be at least questioned” (1991b). De la Chapelle’s concerns over ‘masculine appearance’ were centred, in particular, around the highly successful Czechoslovakian athlete Jarmila Kratochvílová who set world records in the 400 and 800-meters in the early 1980s. Kratochvílová’s perceived masculinised embodiment had been a site of gendered anxiety for many observers, one medical commentator claiming outright that Kratochvílová’s body “is not a normal physiological female body” ("Tracking Down the Drug Users", 1984). While much suspicion around Kratochvílová centred on doping accusations, almost equally strong were accusations that rendered her gender in doubt, despite her having passed the IOC’s chromosome-based gender verification screening. In the words of one reporter, “as masculine as the Czechoslovak superstar may seem, there is no doubt that she is a woman. The IOC has given her a certificate affirming that. … But a look across the field at the world championships brings one to wonder whether the chromosomes are telling the truth” (Christie, 1983). The suspicion that chromosome-based screening was inept to identify all gender-suspect athletes was, of course, shared by de la Chapelle, not only relating to XX/XXY men, but also to what he called “hypermuscular women” (de la Chapelle, 1987b). Indeed, de la Chapelle suspected that Kratochvílová’s ‘hypermuscularity’ “was a typical example of so called adrenal hyperplasia; anyone could see that she had a male type-body” (1987b). He stated that he “agreed with her competitors who said ‘she does not look like a woman’”, and argued that Kratochvílová should have “been subjected to a ‘case by case’ analysis” of sex to determine her eligibility to compete (1991a). When the IAAF transferred explicit gender verification onto doping control 1992, they added a clause for case-by-case examinations mirroring de la Chapelle’s suggestions: there was “still provision within the IAAF system for dealing with any questionable case, including gender. This means the medical delegate of a competition … has the full right to investigate any case that he may deem necessary” (Ljungqvist, 1992a). Geneticist Martin Bobrow had suggested some years before that adding such a clause would mean that “if a lady was able to hurl a javelin for some ridiculous distance, and had very hairy legs, a question could be raised by some mechanism” (Bobrow, 1987). The IAAF’s abolition of compulsory examinations thus marks a move from compulsory gender verification applied to all female athletes to a suspicion-based system applied on a case-by-case basis to masculine-appearing bodies, mirroring the much earlier 1930s protest-based policy remarkably closely. Bobrow’s comments about which bodies should be seen as ‘suspicious’ is illustrative of the underlying concerns over preserving normative feminine bodily appearance (e.g. smooth rather than hairy skin) and ‘feminine’ performance levels (i.e. high- achieving female bodies ‘able to hurl a javelin for ridiculous distances’ are suspect because they are suspiciously ‘good’, including Kratochvílová whose outstanding 800- meter world record still stands today). While the IAAF had moved to suspicion-based testing, the IOC persevered in their use of the PCR method until 1999. This was despite the fact that there was close

24 to unanimous agreement amongst scientists that the system was unethical, mainly due to its erroneous reliance on chromosomes as indicators of sex. For example, during the 1994 Lillehammer Olympics, not one scientist from any Nordic country agreed to perform PCR-testing for the IOC (de la Chapelle, 1993), and the IOC was compelled to send the Albertville Olympics gender verification team to Lillehammer to conduct the screening (Ljunqgvist, 1997). In 1996, the IOC conference on women and sport urged “the IOC to discontinue the current process of gender verification during the Olympic Games” (Ferris, 1996), and during multiple IOC meetings in 1998, Ljunqgvist argued for the removal of gender verification from the IOC medical code. At the advent of the 2000 Sydney Olympics, the IOC finally decided to abolish compulsory on-site gender verification, but like the IAAF, they reserved “the right to intervene in any suspicious individual case, and then conduct a scientifically proper investigation” of sex (Ljungqvist, 1999). To ensure that a ‘scientifically proper investigation’ could be conducted, the IOC was to organise “a team of specialists standing by (including a female gynecologist) should a case need to be examined” (Ljungqvist, 1999). Indeed, one reporter observed during the Sydney Olympics that “a ‘flying squad’ of specially selected Olympic medical experts, including a team of gynaecologists” was present at the Olympic site “to target individual athletes if they are deemed suspicious” (Pittaway, 1999). Similarly, during the Beijing Olympics eight years later, one reporter noted that organisers had “set up a sex-determination laboratory to evaluate ‘suspect’ female athletes” on their “external appearance, hormones and genes” (Thomas, 2008: D1). While the male masquerade objective for gender verification was explicitly embraced by IOC and IAAF officials, enduring anxieties over perceived masculinised or sex binary-polluting bodies such as Kratochvílová’s resulted in the institution of regulations that allowed the targeting of not only straightforward male masquerade but also masculine-appearing female-categorised bodies. From 1992 and 1999 onwards therefore, the IOC and the IAAF mobilised two kinds of policing to ensure that binarised sex was safeguarded: the observation of genitals during doping controls to detect male bodies, and suspicion-based examinations to detect binary-polluting bodies. The need for suspicion-based examinations illustrates how defining gender verification only in relation to genitals – ‘penises in well-formed scrotums’ – was not sufficient to combat sport regulators’ and observers’ anxieties over the boundaries of the female category. Reminiscent of the ad hoc gender protests-based gender verification paradigms of the late 1930s, the new suspicion-based system was built on worries over the ‘masculine appearance’ of some female athletes who contested normative ideas of what female bodies should look like and be capable of in the context of sport. In other words, boundaries around the sex binary drawn around genitals were insufficient because it was not just male bodies that incited concern, but gendered anxieties persisted around athletes perceived to be in the ‘grey area’ of sex.

6.7 The ‘grey area’ of sex and the testosterone concern During the mid-1990s, the IAAF’s abolition of compulsory on-site gender verification faced a backlash which continues to resonate in the present. In 1994, a group of 16 female athletes headed by Janet Heinonen campaigned for the re-introduction of compulsory on-site gender verification, arguing that the purpose of gender verification should be to “identify athletes who fall in the ‘grey area’ of sex” as well as male masquerades (Heinonen, 1994). They claimed the ‘grey area’ of sex included “individuals who have medical conditions such as ambiguous genitalia or congenital adrenal hyperplasia, which may confer an athletic advantage”, caused by higher than

25 ‘normal’ female levels of testosterone ("A Decent Proposal", 1994). Notably, the ‘Heinonen 16’ campaign was contextualised by two key concerns of the 1990s: firstly, a sudden prominence of highly successful Chinese female athletes in international sport incited gendered concerns amongst Western observers. For example, one 1990s reporter expressed in relation to “the unbelievable performances of the Chinese female runners in 1993” that he was “not alone in believing that when a woman’s athletic performances are extraordinary and not predicted by previous results, then the woman isn’t natural. She’s a wannabe man wearing the essence of man: testosterone” (Connolly, 1994). Secondly, during the 1990s, there were increasing concerns over the success of former East German female athletes, culminating in the publication of Stasi files which, in the words of one reporter, proved that since “the mid-1970s, East Germany embarked on a relentless, state-sponsored campaign of using anabolic steroids” (Cowell, 1998: 65). The story of one former female competitor in particular was widely covered by the press: in the late 1990s, newspapers reported that the East German 1986 women’s European shot put Champion Heidi Krieger sued her former doctor “after allegations that he turned her into a man by over-prescribing anabolic steroids. … She had developed masculine features, including facial hair and an Adam’s apple, and had suffered severe psychological problems”, after which Krieger underwent surgery and changed his name to Andreas (Mackay, 1997). Concerns over prominent Chinese female athletes and former East German female athletes were intertwined in two ways: firstly, “China, with its own version of the state-supported, behind-closed-doors sports system” ("Give-and-take on Gender Verification ", 1994) renewed older Cold War anxieties over unscrupulous governments using illicit means of success, in particular as some newspapers noted that “Coaches from eastern Germany have helped establish the Chinese program” (Longman, 1994: B16). Secondly, both concerns centred around androgenic hormones. While the emphasis was on anabolic androgenic steroid doping, the fact that androgens and testosterone in particular were seen as ‘the essence of man’ rendered these doping concerns foundationally gendered, identifying androgens as the arbiters of male-like athletic advantage in sport. These sex binary-polluting hormone substances not only seemed to stimulate male-like athletic prowess in females, but they also masculinised the appearance of female athletes’ bodies, in Krieger’s case so intensely that he ‘turned into a man’.11 Centrally, in campaigning for the re-introduction of compulsory gender verification, the Heinonen 16 group did not argue for the re-introduction of chromosome-based screening, but for gender verification based on blood testing for total testosterone levels (Heinonen, 1994). In the words of Alison Carlson, who had numerous discussions with Heinonen, “the 16 Group … are most concerned [with] testosterone levels” and “see this as the unifying theme as far as unfair advantage is concerned” (1994). The Heinonen 16 wanted regulations on “what ‘grey areas’ [of sex] constitute unfair advantage. They want this to be satisfactorily explained, decided and formally defined in policy” (Carlson, 1994). While these 1990s concerns did not result into direct policy responses, they are significant for the history of gender verification because these concerns brought androgens explicitly into debates about the aims of gender verification. While androgenic hormones in general and hormonal disorders in particular had been

11 Notably, despite newspaper suggestions that steroids caused his gender transition, Kreiger himself noted that “doping probably didn’t directly cause my transsexuality but it certainly intensified it” ("Woman Athlete Turns Male", 1997).

26 debated before, it was the concern over high androgen levels in female bodies and the suggestion that such levels could be used to police the sex binary that significantly shaped sex binary-policing in sport in the early 21st century. Most significant was the idea that female bodies with high levels of androgens are ‘wearing the essence of man’, which implied that such females were not within the confines of ‘normal’ female capacity.

6.8 Present concerns: hyperandrogenism and androgenic advantage In 2009, the women’s 800-meter world champion Caster Semenya was compelled to undergo gender verification based on the IAAF’s suspicion-based policy. Clarified in 2006, the IAAF procedure applied to Semenya consisted, after an athlete had been identified as gender-suspicious, of “a medical evaluation before a panel comprising gynecologist, endocrinologist, psychologist, internal medicine specialist, [and an] expert on gender/transgender issues” (IAAF, 2006: 2). Semenya’s case is a notable event in the history of gender verification because the information that she was compelled to undergo this medical evaluation was leaked to the media, and gathered unprecedented interest in the globalised online media space of the 21st century. Multiple news outlets publicised sensationalised stories about Semenya, rendering her femaleness in doubt with headlines such as “Could This Women’s World Champ Be a Man?” (Adams, 2009). Some declared (without support) that “Semenya has male sex organs” (Hurst, 2009), while others cited remarks that explicitly claimed her as male: “For me, she’s not a woman. She’s a man” (Clarey, 2009: B13). Although Semenya’s eligibility to compete was reinstated after lengthy deliberations, the way in which her case was handled by the IAAF and in particular the media leak was widely criticised by commentators both in the academic and public media spaces as an example of malpractice (for a starting point, see Dreger, 2009a, 2009b, 2010; Schultz, 2011; Wiesemann, 2011). A core subject of critique was that by mandating Semenya to undergo gender verification, the IAAF was not only explicitly rendering her gender in doubt (reinforced by media speculations in ways that disrespected her identity as female and woman), but the case-by-case policy did not offer any clearly delineated idea of how exactly the line between female and male was drawn in suspicious cases. Reminiscent of the 1980s scientific critiques of gender verification, bioethicist Alice Dreger observed that “Nature doesn’t actually have a line between the sexes. If we want a line, we have to draw it on nature. … But the IAAF … doesn’t specify which conditions disqualify an athlete from playing as a woman. So the line is essentially still missing” (2010: 23, original emphasis). In response to the Semenya controversy, a closed meeting was convened between medical specialists and sport regulators in Miami in 2010 to re-discuss the issue of which testing methods should be used for sex (IAAF, 2011: 1; Kolata, 2010: D2). Embedded within the Miami meeting conclusions, which were developed into new IAAF and IOC regulation on ‘female hyperandrogenism’ instituted 2011 and 2012 respectively, were three related key ideas that both recalled earlier debates around gender verification and diverged from them: firstly, largely in response to the media gossip that had rendered Semenya’s gender in doubt, the IAAF and the IOC entirely abandoned the male masquerade justification for sex binary-policing. To the extent that this was used as an explicit rationale, cases like Semenya’s could incite speculations that athletes identified as ‘suspicions’ were actual men rather than females with sex abnormalities – indeed, it was such accusations that roused critiques of the IAAF having disrespected Semenya’s identity as woman and female. The IAAF and the IOC consequently abandoned their use of terms like ‘gender verification’,

27 stating now that the hyperandrogenism regulations were not “intended to make any determination of sex” (IOC, 2012: 1) and “if an athlete is recognised as a female in law, she is eligible to compete in women’s competition” (IAAF, 2011: 2). Yet, despite such declarations, the IOC added that the regulations were “designed to identify circumstances in which a particular athlete will not be eligible … to participate in [the Olympics] in the female category” (IOC, 2012: 1), while the IAAF noted that eligibility was still subject to compliance “with IAAF Rules and Regulations” including hyperandrogenism regulations (IAAF, 2011: 2). Both regulations thus continued to be targeted at policing the boundaries of the female category. Secondly, the IOC and IAAF constructed a rhetoric which moved the focus of sex binary-policing away from sex determination by centring ‘medical disorders’ rather than sex identification. This emphasis on ‘medical conditions’ and ‘diagnosis’ mirrored the earlier late 1960s rhetoric of treatment advanced by Thiebault and others in relation to their ‘diagnostic paradigm’ aimed ‘to confirm sex diagnoses completely’, but the search for abnormalities was now directed not at sex explicitly but at androgen levels (measured by testosterone). According to the IAAF, ‘hyperandrogenism’ describes “the excessive production of androgenic hormones in females”, and athletes whose testosterone levels are in ‘the male range’ are not eligible to compete as female (IAAF, 2011: 1). The IAAF ruled that in such cases, to be eligible to compete, athletes could be mandated to undergo “treatment … to normalise her androgen levels” (IAAF, 2011: 3). Thus, in the words of one observer, the athlete was conceptualised as “a patient who needs medical advice” (Kolata, 2010: D2). This kind of treatment-centred approach, like the one advanced by Thiebault, is centrally targeted at sex binary- purification whereby binary-pollution is rendered abnormal, needing medical ‘normalisation’ to re-integrate polluting bodies into binarised sex. Illustrative of this is a report published after the introduction of the hyperandrogenism regulations, concerning the normalising treatments provided for four athletes identified through these regulations as hyperandrogenic. These athletes underwent medical interventions consisting of “a partial clitoridectomy with a bilateral gonadectomy, followed by a deferred feminizing vaginoplasty and estrogen replacement therapy”, even though the responsible medical professionals acknowledged these interventions were not necessary for health reasons and were only performed to allow the athletes “to continue elite sport in the female category” (Fenichel et al., 2013: E4). Particularly illustrative are the surgical interventions of vaginoplasty and clitoridectomy, the aim of which is to normalise genitals that do not conform to the aesthetic standards of (culturally) desirable female genital appearance. When it comes to gonadectomy and hormone treatment, albeit also unnecessary for health reasons, these were performed with the conviction that they “would most likely decrease [the athletes’] performance level” (Fenichel et al., 2013: E4). The third key idea embedded within the hyperandrogenism regulations was related to this notion of performance levels: the treatment-centred approach towards hyperandrogenism functions as a sex binary-purification paradigm in the context of sport precisely because of the conflation of high androgen levels with (male-like) athletic advantage. The IOC and IAAF regulations were built on the underlying assumption, highlighted during the 1990s, that high androgen levels “have performance-enhancing effects … which may provide a competitive advantage in sports” (IOC, 2012: 1) because testosterone is a “performance enhancing hormone” (IAAF, 2011: 1). The IOC suggested that the performance-enhancing qualities of testosterone were, indeed, the reason for sex categorisation in sport in the first place (IOC, 2012: 1), while the IAAF stated that athletics “is divided into separate men’s and

28 women’s classifications” because men “benefit from higher levels of androgens” (IAAF, 2011: 1). This conflation of androgens, performance enhancement, and sex categorisation in regulatory policy had the following effect: enhanced or high level performance come to be explicitly regulated as a male sex characteristic. As androgens were understood to enhance performance, and as male bodies were understood to have enhanced performance due to higher levels of androgens, ‘androgen enhanced performance’ came to be regulated as a male characteristic that could be used to police the sex binary by excluding female-identified bodies with ‘androgenic advantage’ from the female category. Thus, the sex binary was re-drawn around hormones, and ‘androgenic advantage’ was not only conceptualised as a male attribute, but also pathologised in female bodies as ‘hyperandrogenism’. To safeguard the sex binary, this hyperandrogenism could then be subjected to ‘normalisation’ through treatment, which would bring the athlete’s (male-like, enhanced) performance down to the (presumed lower) female levels. Thus, the underlying but implicit ideas upon with the hyperandrogenism regulations were built actually aimed to render enhanced or high level performances of female-categorised athletes as pathological. However, the key idea that higher endogenous levels of androgens in females carry performance-enhancing effects has not been scientifically proven in the first place, despite the fact that exogenous steroid doping is banned in sport due to performance-enhancing effects (see Karkazis & Jordan-Young, 2015). In 2015, this fact resulted into a historically notable ruling by the Court of Arbitration for Sport (CAS). In 2014, Dutee Chand was ruled ineligible to compete in the Glasgow Commonwealth Games based on her being identified as hyperandrogenic. However, supported by medical and bioethical critics of the hyperandrogenism regulations, Chand refused to undergo treatment and appealed her case to CAS, which issued an interim suspension on the regulations. Due to the lack of scientific evidence about “the quantitative relationship between enhanced testosterone levels and improved athletic performance in hyperandrogenic athletes”, CAS granted sport governing bodies two years to produce this evidence or “the Hyperandrogenism Regulations will be declared void” (CAS, 2015). Due to the CAS ruling, the 2016 Rio Olympics faced a historically remarkable situation whereby there were no explicitly defined regulations applied to police the sex binary. Significantly, this resulted into a panic over the breakdown of the sex binary that incited the re-surfacing of old concerns, largely centred on Caster Semenya. After the 2009 controversy, while Semenya’s right to compete was reinstated, the reinstatement was accompanied with rumours about her having undergone medical treatments with ‘weakening’ effects (Hurts, 2010). In 2016, however, no treatment mandate was enforced, which led one medical observer to speculate that “Semenya could, and should, break the 800m world record … held by one Jarmila Kratochvilova” adding that “if you know anything about the sport, you know that whoever it was who broke that record was going to be faced with a few probing questions” (Tucker & Harper, 2016). This remark directly links Semenya’s athletic prowess with the gendered anxieties around Kratochvílová in the 1980s, centred on ‘suspiciously’ masculine appearances and performance levels that motivated de la Chapelle to advocate suspicion-based gender verification (while Semenya won the gold medal, she did not break the record). During the 2016 Olympics concerns over dubious governments also re- surfaced, as the lack of explicit sex binary-policing coincided with the publication of the ‘McLaren report’ on large-scale doping in Russia. Just before the Rio Games, newspapers reported that the McLaren report showed Russia had “operated a state-

29 sponsored doping programme” proving “a mind-blowing level of corruption within … Russian sport” ("Russia State-sponsored Doping Across Majority of Olympic Sports, Claims Report", 2016). The International Paralympic Committee (IPC) president Philip Craven stated, not only that the “doping culture that is polluting Russian sport stems from the Russian government”, but that such “medals over morals mentality disgusts me” (IPC, 2016). Building on such commentaries, track athlete Paula Radcliffe remarked:

We’ve seen the lengths that countries like Russia will go to … have major success on … the Olympic stage. … what worries me is we know that there are certain communities where the condition of … hyperandrogenism, is more prevalent … We don't want to get to the situation where people are actively going to those communities to seek out girls who look like they’re going to be able to go out and perform, and to run fast, and then take them away and train them. It becomes a manipulated situation ("'No Longer Sport': Paula Radcliffe Wades Into Semenya Debate", 2016).

One observer added that it “is very possible that we could see an all intersex podium in the 800 in Rio, and I wouldn’t be surprised to see as many as five intersex women in the eight-person final” (Tucker & Harper, 2016). Indeed, one reporter noted that not only Semenya but also the 800-meter silver and bronze medallists had “faced questions about their testosterone levels” (Morgan, 2016). Relatedly, another reporter commented that only two hours before the 800-meter event in Rio which Semenya won, “the IAAF’s president, Sebastian Coe, said … that the [IAAF] will soon go back to Cas to try to overturn [the hyperandrogenism regulations suspension] decision. Officials are confident that the move will succeed” (Bull, 2016). The unusual context of the Rio Olympics brought to the fore the core anxieties upon which gender verification mandates have been erected, which continue to shape sex binary-policing in the present. Concerns over the perceived masculine/masculinised bodies of athletes like Semenya who simultaneously exhibit high level athletic prowess contest (culturally prescribed) notions of normal female embodiment which, despite important temporal discontinuities, have precedents in the 1930s/40s. As sex-segregated sport is built on the idea that female bodies cannot offer the same athletic potential as male bodies, female-categorised bodies that appear to have male-like potential challenge the boundaries of ‘normal’ female embodiment and consequently threaten to pollute the sex binary. Sex binary-policing has secured the binary by policing normal female embodiment, by relegating non-conforming bodies as masculinised, ‘hermaphroditic’ or ‘hybrid’, or indeed by relegating female bodies with high endogenous testosterone levels as ‘abnormal’ or ‘pathological’ – i.e. as not normal females. These policing practices in turn have been intertwined with politicised fears over non-Western governments and their corrupt officials who have been thought motivated to fraudulently abuse such ‘abnormal’ bodies towards their own dubious political ends. These anxieties have been and are in the present still centred on concerns over sex binary-breakdown, mostly identified with athletes and governments outside of the West. These anxieties are seen to mandate policing, even when it is recognised that such policing is arbitrary: in the words of Eric Vilan, who was involved in the formulation of the hyperandrogenism regulations, “you have to draw the line in the sand somewhere” (Macur, 2012: SP6), because without such an arbitrary line, the binarisation of sex cannot be maintained.

30 7. Conclusion The results of my research show that gender verification was not instituted nor continued over time to prevent explicit male masquerade, but it has always been targeted at policing the boundaries of the female category against sex binary-pollution, where what ‘female’ means has been defined in relation to (Western) cultural ideas about ‘normal’ or normalised female embodiment. What normal female embodiment means has meant somewhat different things during different temporal periods: in the 1930s/40s, normal femaleness implied the fragile childbearing body, while during the Cold War, it was delineated in relation to ideas about Western gender-pure bodies contrasted against communist gender-polluted bodies. During the 1980s/90s, scientist critics attached normal femaleness with female phenotypes and genitals, regardless of chromosomal characteristics. The continued presence of ‘masculine-appearing’ bodies in the female category, however, rendered genitals insufficient and centred bodily gender-appearance, whereby normal femaleness was attached to feminine bodily attributes. Finally, the hyperandrogenism regulations centred normalised androgen levels, rendering high levels in females ‘abnormal’. Thus, the meaning of ‘normal’ female embodiment has shifted over time, but it has always been built upon pre-existing ideas that foreground binarised sex. While the existence of binarised sex has been foregrounded, the sex binary has required policing because its ontological necessity was rendered in doubt by bodies that contested the ideas through which normal femaleness was delineated. In the 1930s/40, strong, masculinised, and sex metamorphosing bodies in women’s sport rendered in doubt the presumption of female bodies’ frail femininity, and mandated the policing of bodies who challenged these presumptions. During the Cold War, communist female athletes were not only highly successful but also appeared masculinised, in some cases so masculinised that they were considered to be sex ‘hybrids’. They polluted the purity of (Western) gender categories and required on-site policing to detect such pollution. In the 1980s/90s, phenotypic males with XX/XXY chromosomes rendered in doubt chromosome-based definitions of sex, while some prolific ‘masculine-appearing’ female athletes with XX chromosomes and female genitals seemed to challenge singular sex definitions based on chromosomes or genitalia. To police against masculine appearance, suspicion-based gender verification was instituted, while the adoption of the hyperandrogenism regulations eventually emphasised females with high androgen levels, because they challenged the presumption that females have lower athletic capacity due to lower levels of androgens. Thus, while the emphasis has shifted, gender verification has always policed the sex binary against those bodies that were seen to render the ideas upon which the binary was constructed in doubt. In other words, the sex binary and the borders around the female category were policed because the ontological existence of binarised sex was threatened. While the rationales and aims of gender verification have shifted over time, they shifted because the location of the binary-threat shifted (e.g. away from ‘sex hybrids’ and towards XX/XXY males, or away from ‘masculine appearance’ and towards high androgen levels). The shifts in the rationales and aims in turn functioned to re-draw the boundaries of the sex binary, to address the new location of the threat: in the 1930s/40s, ad hoc physical inspections and medical sex certificated located sex upon bodily characteristics, inspected to assess the ‘percentage’ of femininity and masculinity of the body concerned. Chromosome-based screening located sex upon chromosomes in the first instance, and secondarily upon a ‘diagnostic paradigm’ used to diagnose sex abnormality conceptualised as ‘hybridity’. The ‘health and gender examinations’

31 scheme centred phenotypic sex and genitalia, while the doping control-based policing of sex centred genitalia, suspicion-based testing centred ‘masculine appearance’, and the hyperandrogenism regulations centred androgen levels. These changing locations of sex show how where the border between female and male is taken to lie is contextual: the location has been re-drawn in response to new threats presented to binarised sex, by bodies that consented the ability of previous gender verification paradigms to safeguard the sex binary against pollution. The core conclusion that arises from the above is the following: when sport governing bodies like the IOC and the IAAF police the sex binary, they effectively police that female athletes’ bodies adhere to contextual ideas about what ‘normal’ female embodiment is taken to imply. The fact that these ideas change over time shows that the ideas are not ontologically static, nor do they express any necessary ‘truths’ about female or male being. Rather, they express norms; they express social ideas, often re-enforced by scientists, about socially or culturally desirable female embodiment. In other words, when the IOC and the IAAF police the sex binary, they protect cultural ideas about gender. The most important of these ideas has been the idea that female bodies have lower performance levels than male bodies. Indeed, this is the rationale for sex-segregated sport, despite widespread acceptance in the present of the fact that this idea is not categorically true as some female bodies have higher athletic capacity than some male bodies, and Olympic level female athletes have higher athletic capacity than most male bodies. Yet, because the belief in general female athletic inferiority has been taken as foundational in sport, the effect has been that ‘female’ has often been defined as inferior, relative to males: for example, by excluding hyperandrogenic females from the female category based on the conviction that hyperandrogenism provides superior (male-like) athletic capacity, the boundary between female and male is defined by assuming female inferiority, and by excluding from the female category those females that threaten this definition. The effect is that those females who are thought to have the capacity to be superior rather than inferior in sport are defined as not female or as ‘abnormal’ females. In sum, female bodies are a prior inferior to male bodies in sport, only to the extent that the boundary between male and female is defined in those terms, by excluding from the female category those females that threaten this definition. Cultural and social ideas about sex difference are useful, because they make sense of biological realities: they make biological realities intelligible to us by conceptualising them as female or male. Yet, cultural ideas also shape biological realities, for example by defining endogenous conditions such as high levels of androgens in female-identified bodies as abnormal conditions that are then ‘corrected’ with medical interventions. These interventions are often only necessary because of the cultural desirability of a clearly delineated sex binary. However, sex is only binarised in cultural and not biological terms, as the variously sexed bodies that became to object of gender verification practices at different temporal periods illustrate. As Vilan phrased it in relation to the hyperandrogenism regulations, when the IOC and the IAAF draw a line between the female and male categories, they draw this line ‘in the sand’. The question that arises is how this line is to be drawn in the present context, characterised by anxieties around hyperandrogenism. To the extent that sport regulators draw the line in order to police bodies that challenge the conviction that female bodies have lower athletic capacity than male bodies, their aim will effectively be to draw an upper threshold on females’ performance levels. This would contradict the fundamental Olympic principles that emphasise the right to practice sport “without discrimination of any kind” including sex, in the spirit of

32 “solidarity and fair play” (IOC, 2014: 11-12). Findings presented in this report provide understanding of the IOC’s and the IAAF’s historical policy making processes, and this history should be used to inform the formulation of more inclusive strategies of sport participation in the present. Older concerns that motivated the formulation of gender verification policies in the past continue to embed the contemporary context of elite sport. Understanding of the implicit motivations for the institution and maintenance of sex-binarising and exclusionary regulations should inform to what extent policies aimed at drawing a line between female and male ‘in the sand’ can be justified in the present.

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Cited collections

IOC Historical Archives, Lausanne

Avery Brundage Collections, University of Illinois Archives. Microfilm copy held by the IOC Historical Archives

Albert de la Chapelle Collections, University of Helsinki Archives

Malcolm Ferguson-Smith Collections, University of Glasgow Archives. Digitised copy held by the Wellcome Library as part of Codebreakers: Makers of Modern Genetics

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