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Gender Game

Crazy chromosomes

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Indian runner Santhi Soundarajan and South African athlete Caster Semenya have much in common. Both are non-typical women, both belong to poor families, and both athletes were stripped of their medals as they 'failed' gender tests. Middle-distance runner Santhi won silver at Doha's Asian Games in December 2006 at age 25, while 18-year-old Caster won gold in the 800m at Berlin's World Championships last year. The ban and subsequent slur pushed Santhi to attempt suicide;Caster was under watch. Both came to know of their atypical condition only after they had won the silver and gold respectively. And both asserted with dignity that they knew they were women and didn't need outsiders to confirm their gender identity.

But today, ahead of the 2010 Delhi Commonwealth Games, there is one big difference between Caster and Santhi: sports authorities have allowed Caster to run again as a woman, overruling their own decision taken 11 months ago barring her from world sports. South Africa fought for Caster and negotiated for her identity as a woman with world bodies. No one has come forward yet in India to take Santhi's case forward.

So, what makes Caster eligible now? It's not as if she has changed physically, nor have tests thrown up anything new. The world knows nothing more about her than it did last September when her medal was taken away. The only change then is the decision taken by authorities to tag her female.

Gender identity is not a simple issue. Science has long established that sexuality is a spectrum. Gender tests, from physical checks to DNA tests, may be straightforward but the results are anything but, say experts. Many variations and inconclusive findings can emerge when tests fail to push a person towards either end of the sex spectrum, they point out.

Delhi-based psychiatrist Dr Kavita Arora has worked extensively on gender dysphoria or gender-identity disorder. She says gender is an outcome of four coordinates: genetic, biological, social construct and individual awareness or psyche, the latest field of study. When all four coordinates are in sync you are clearly male or female. But there are cross-connections in development so that even a twitch in any of the four coordinates can lead to some gender diversity. Moreover, sexual development may be interrupted at any point along the way from conception to adulthood, leading to a range of sexualities.

The typical chromosomal make-up for a female is XX and for male, XY. Other common variations include XXY type, or Klinefelter syndrome, which has an extra X, and XO, where an individual has only one X chromosome (XO). Then comes the physiology/biology part, where hormones, primarily estrogen and testosterone, combine to give a person sexual characteristics such as breasts, hair growth, masculine voice and so on.

But biological development does not necessarily follow chromosomal direction. For instance, an XY can be a female if a particular gene is suppressed and does not respond to the testosterone produced. So, a person can grow as a woman with high testosterone levels, or have undeveloped sex organs. This is the Androgen Insensitivity Syndrome (AIS), said to be the case with Santhi.

As transgender Canadian cyclist and sports activist Kristen Worley says, "Santhi is, in fact, disadvantaged as she cannot respond to testosterone (the performance enhancer) in her body. "

An XO person, too, can have ambiguous sex organs, as can an XXY. These fall under the inter-sex category. Social construct defines gender in terms of feminine and masculine behaviour. "For instance, India is comfortable with tomboy girls, but does not accept feminine boys, " says Arora. She recalls a recent case where parents of five girls came with the eldest, a 16-year-old tomboy, and the youngest aged 6 ready to change sex. "Both kids were clearly girls. It was simply a case where male gender was preferred according to social construct, " she says.

And finally, there is the question of the individual psyche. "The genetic, biological, social constructs may be in sync, but a boy can believe that he really is a girl. Similarly, a biologically-looking girl can feel that she really is a man, " says Arora. These individuals are the transgenders. This is when a man believes he is trapped in a woman's body or vice-versa.

India's first inter-sex autobiography, The Truth About Me: A Hijra Life Story, written by A Revathi, surprises, because it is about a boy named Doraiswamy who believes in his heart of hearts that he is really a 'girl'. Doraiswamy finds solace in the hijra community. Hijras, strictly speaking, are only the inter-sexed. Yet, in India, anyone of a different sexual type is classified as a hijra.

Doraiswamy writes how he/she couldn't identify with the hijra community's 'work' as she was completely a 'woman'. Turning into a woman post-operation, Revathi's is a telling account of how confused we are about gender. Revathi had no psychiatrist or genderspecialist to help her. She went straight to a surgeon.

But with awareness growing, more and more people are finding their way to gender specialists. Urologist-surgeon Dr S V Kotwal has operated on 22 cases in the last few years. But his surgery is the last stop. Before a sex change operation, an individual must go through detailed counselling and treatment.

Arora recalls a 22-year-old who believed she was lesbian as she 'liked' a girl. The youngster showed signs of possessing a male identity, says the psychiatrist, her psyche possibly that of a male. But being a girl, she believes she is lesbian.

Yes, it's complicated. Suffice to understand, really, that gender is a spectrum of which 'male' and 'female' are only two ends. At the frontier of scientific research today is the area of neuronal sex or 'sex of the brain', says Dr Kotwal.

Male and female brains are wired differently and scientists, says Arora, are now figuring out "just how the functionality of the brain varies". Standard scans are like taking a building's photographs. "It looks fine from outside, but we don't see whether the wiring in the house is fine, or if connections are working right, " she points out. Functional MRIs and SPECT scans now do just that - map the wiring/brain activity. "Different areas get fired with different thought or triggers, and there are male-female differences here, " she says. Research in this field is at early stages.

Sportspersons are tested for testosterone levels in their bodies because hormone supplements are often used to boost performance. Both Caster and Santhi 'look' mannish, are heavy-voiced and flat-chested. But you only need to see both girls smile to 'know' they're women. Sadly, they have little reason to smile.

During gender tests, both Caster and Santhi were found to have higher testosterone levels than an average woman. But at the time of the tests none bothered to counter that Santhi could not respond to the testosterone her body produced. Or that Caster's glands over-produced the hormone, a treatable condition. Instead, their gender was called into question.

We know nothing about Santhi's tests or what her condition is. Reports from the time when she was stripped of her medal suggested her type is AIS. Worley, who plans to take up Santhi's case with the IAAF, says the Tamil athlete is, indeed, AIS. That means she has XY (male) chromosomes, but the Y never got expressed. So, she grew up as a girl, never responding to the high testosterone levels - the 'added advantage' that the hawks in sports bodies talk about. Santhi, on phone from her village six hours from Chennai, says she knows nothing of all this. The test results weren't shared with her. She's a girl - that she knows.
Caster, says a report by the Coalition of Athletes for Inclusion in Sport (CAIS), has Congenital Adrenal Hyperplasia. She is XX. Her problem, said the report, is that she has hyper-performing adrenal glands that cause her ovaries to over-produce natural testosterone in quantities above a woman's average level.

Worley co-founded the CAIS in 2009 to address IOC's Gender Policy. At this year's IOC Gender Meet in Miami, she presented 'The Guiding Principles for Inclusion in Sport'. It suggests blanket testing for all men and women athletes for hormonal levels every two years. Says Worley: "Cases such as Caster's are presented to the uninformed as unique, although they are not. "

For sportswomen, having their gender doubted can be a crippling experience. Media reports also note that allegations of not being 'woman' enough drive sportswomen to pose nude in magazines and to adopt exaggeratedly feminine clothes. Semenya, with her masculine voice and build, got accustomed to the comments on her sexuality. A report in The New Yorker said that many South Africans felt that "white foreigners" were "scrutinising a black female body as though it did not contain a human being. "
Neither Caster nor Santhi broke any records but they were nonetheless tested. Caster's family, community and country rallied around her. Today, she's back on the tracks, where she belongs. But Santhi has no hope yet for a groundswell of support. India can begin to understand the gender spectrum by questioning Santhi's case.

HISTORY OF HARASSMENT


Early 1960s:

Naked parade of women athletes before panel of male doctors

1966 Olympics:


Naked parade discontinued. Replaced with sex-chromatin /Barr Body tests: cheek swabs tested

1984:


Los Angeles Olympics. Six female competitors fail Barr Body test

1992 :


Barcelona Olympics. DNA test replaces Barr test

2000:


Sydney Olympics. Gender verification stopped. Tests only against complaints

2004:


Athens Olympics. IOC permits transgender athletes to compete only if they have had appropriate surgery and were legally recognised as members of their new sex. The ruling covered both, male-to-female and female-to-male, cases

December 2006:


At the Doha Asian Games, 1981-born Santhi Soundarajan wins silver in the 800m. Stripped of her medal after she fails gender tests. She's only told she is "banned forever".

August/ September 2009:


At the Berlin World Championships, middle-distance runner South African Caster Semenya (18) wins gold at her first international senior competition. A blog doubting her gender triggers battery of tests. She fails. Her country protests.

November 2009:


South African Sports Federation and Olympic Committee suspend the entire board of national body for track and field

January 2010:


IAAF meets to review gender policy

July 2010:


IAAF restores Caster's medal with a terse press statement. Ban revoked

GENDER MYTHS


A person with XY chromosomes can only be a man. Wrong. With a malfunctioning gene, XY can grow to be more woman Women do not have testosterone, the 'male' hormone. Wrong. Women have testosterone but the levels are lower than those among men Inter-sexed and transgender are the same. Wrong. Inter-sexuality is where there's variation at genetic or biological level. Transgenders identify with the opposite sex, at the neural level Only man-woman gender types are normal. Variations are 'abnormal'. Wrong. On the contrary, variations are 'types', not disorders of sexuality Inter-sexuality is rare. Wrong. A Brown University study concluded that 1. 7% of population develop in a way that varies from standard definition of male-female. Inter-sexuality is much more common than Down's Syndrome or albinism

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