New clue in gender-bending mystery

Posted on Friday, September 11, 2009 1:48 PM PT

By Brian Alexander, contributing writer

After South African runner Caster Semenya came out of nowhere to zip past a track of world-class athletes in the women’s world 800-meter race in Berlin last month, spectators starting speculating that the muscle-bound 18-year-old was no lady. Her low voice and broad shoulders raised eyebrows and suspicions.


Now, newspaper reports from Australia say testing has determined that the running star has both male and female sexual organs – in other words, that she’s a hermaphrodite, and likely didn’t even realize it.

The International Association of Athletics Federations, which ordered the testing, refused to confirm or deny the reports and said it won’t issue a final decision until the next meeting in November.

In the meantime, there is worry about how the 18-year-old from a poor village in South Africa will handle the scrutiny, and widespread curiosity about what “hermaphrodite” means, exactly.

The popular notion of hermaphrodite comes from the Greek myth of Hermaphroditus, the offspring of Aphrodite and Hermes. Hermaphroditus, the Zac Efron of his day, was so pretty that a nymph named Salmacis fell madly (literally) in love. In her desperation, she jumped into a pool of water, grabbing Hermaphroditus on the way in and pleading with the gods to unite them forever. The gods did exactly that, which is why statues of Hermaphroditus depict a figure with a woman’s breasts and a man’s penis.

But such pure she-males are more myth, or the result of partial transsexual surgery, than reality.

That’s why, these days, the proper word is “intersex,” a recognition that there are a range of conditions between rigidly “male” and “female” and that gender is as much a product of society and self-perception as it is a matter of what gear you have or chromosomes you possess. 

An intersexed condition can arise in a variety of ways, from a number of syndromes, but so called “true” hermaphrodites are often chimeric. In other words, instead of having cells with 46 chromosomes that include either an XX pair in women or an XY pair in men, they possess both 46XX and 46XY cells. Some may have one testicle and one ovary, or what are called ovo-testes, combo gonads comprised of both ovarian and testicular tissues. True hermaphrodism is thought to be rare, but according to the World Health Organization, no prevalence data is available.  

In Semenya’s case, the Australian report says she has no ovaries and instead has internal testes, which produce large amounts of testosterone, explaining her muscular physique. It’s likely she and her family may have been unaware of the condition because the male organs are on the inside. In many cases of the intersexed condition, the external genitalia appear to be female.

In the past, it was common for doctors delivering babies with ambiguous genitalia to simply assign a gender and order up a surgery to make the child match that gender. But as intersex conditions have come out of the shadows, there is much more discussion about appropriate options. These can include hormone replacements, counseling, surgery, or doing nothing at all, a path favored by many intersex advocates.

Intersex athletes have been an issue before. Stella Walsh, the 100- meter champion in the 1932 Summer Olympics in Los Angeles, turned out to be intersexed, a discovery made after she was murdered in 1980 in a Cleveland parking lot during a robbery.

The 1966 world women’s downhill ski champion, Erika Schinegger of Austria, was discovered to have a version of a penis and testicles inside her abdomen. She later became a he, changing his name to Eric and becoming a father. Other famous “hermaphrodites” may include the Pardoner in Chaucer’s Canterbury Tales, and Queen Christina of Sweden in the 1600s.

Comments

VERY interesting!
What about Jaimie Lee Curtis? Any truth to that one? I've also read on other sites Stella was killed in Cleveland, Ohio.
Oh this is by far one of the best news reads I have had this week!! heheheh
I am sorry that this has come out so publicly for this young girl.  For any girl or woman this could be psychological devastating experience.  It is time that the world realizes that there are many gender blended biological issues that are just that, biology.  People need to know and understand that and not cast stones.
I love the science behind this. Categorizing people is something I dislike...but understand the need for it. This just shows how nature can triumph over us all - and in the end - nature, will do just exactly what she wants.
So how come we don't check male champions to make sure they're not really women?  Oh, right.  The sexism.  Silly me.
Unfortunate.  Life is so unpredictable in so many ways.  Hope she can deal with the scrutiny.  
I pray that people all over the planet will be kind to this young woman.  This is so personal; I cannot imagine the difficulty this could possibly be for her and her family.  
Given that Caster is a man's name, and given the fact that Caster has always appeared in man's garb and was called a man by his former schoolmaster, makes me suspicious that family and coaches knew about his condition and decided to exploit it.

This particular type of condition is more common in South Africa than in any other part of the world. It must have crossed their mind at some point to consider it.

At any rate, the medals should be stripped and given to the appropriate women runners.
I don't have any answers on the issue of categorizing for sports.  But these folks need to be treated with respect, not made light of or laughed at.  They are precious human beings just like anyone else.
Excellent, professional explanation of a physiological issue that has been shrouded for centuries.  Certainly nothing to be ashamed of.
Read "Middlesex" for more enlightenment on this subject.  A fascinating novel.
Technically, "sex" and "gender" have two slightly different meanings.

"Sex" refers to the physical attributes, whether of biological organisms, or of electrical connectors.  The primary sexes are "male" and "female".

"Gender" is originally a linguistic term, and is used for the cultural aspects commonly associated with sex.  "Masculine" and "feminine" are genders.

Therefore, it is proper to speak of the penis as the "male organ" (sex), and of skirts as "feminine garments" (gender).
The information released describes "testicular feminization syndrome" or androgen insensitivity.  It is an X linked recessive trait with an incidence of 1 in 20,000.  The individual has a male genotype but usually a female or intersex phenotype.
WOW..I NEVER KNEW...I AM SORRY PEOPLE MAKE IT SO HARD FOR OTHERS.
If miss Semenya does not have ovaries she is likely to be aware that something was wrong because she would not have a period each month. If she does indeed produce testosterone, then she had unfair advantage over the other female runners.
I find this article disturbing for a variety of reasons: 1. the content suggests that Androgen Insensitivity Syndrome (AIS) is a disorder that primarily characterizes women who are quite masculinized in appearance and likely to display tom-boy like qualities, which is incorrect and misleading; 2. The ridiculous and outrageous reality that contemporary sports industries have an apparent right to make public one's sex chromosomes is a notion that I have a difficult time wrapping my head around. Okay, so let's get to the facts. If Semenya has AIS, which would seem to be the case given the info present, here is what happens:
-XY Genotype with Female Phenotype. Androgen is a precursor to testosterone. AIS is an X-linked recessive disorder, meaning the patient's mother is a carrier for the disease, and the condition is only expressed when paired with a Y chromosome. The recessive X carries a gene that results in an androgen receptor dysfunction, so that the body fails to recognize it's own androgens (i.e., it's own testosterone). Gonads are pluripotent, and so can develop into testes or ovaries, based upon circulating hormonal distributions during the embryonic phase of development. The Y chromosome releases 'testes determining factor', which transforms the undifferentiated gonads into testes. Now, in order for the testes to descend and become testicles, the body needs to respond to androgens, which does not happen in this case (androgens remain undescended and internalized). All humans in the embryonic phase of development have the ability to develop either Male (Wolffian Ducts) or Female (Mullerian Ducts) internal reproductive systems. The Wolffian system requires androgen responsivity in order to develop (e.g., vas deferens, seminal vescicles). So, this does not happen with AIS patients. However, when testes develop (even if undescended, as in this case), they release 'anti-Mullerian' hormone, which degenerates the Mullerian system (accounting for the absence of uterus and fallopian tubes among AIS patients). So, we have a person with XY gentoype, female phenotype, and symptoms including sterility, scant pubic hair (develops via function of androgens, even among normal women), and failure to menstruate. Truth be told, most AIS patients are 'hyper-feminine'. Although they have as much circulating testosterone as your average male, NONE of the cells in their bodies recognize or respond to androgen, and so they remain on average rather feminized. So, it is incorrect to state that Semenya's internalized testes account for her masculinized appearance. It is disheartening to me finding this condition so misrepresented. Let's stop reinforcing such archaic stringent gender stereotypes.
Didn't her family become suspicious that something was irregular when she never grew breasts or  started her period?  That should have gotten someone's attention.
God, Creator, or Mother Nature: There's a lesson here. Respect and Accept those things we can't understand. Boy / Girl Still a Human Being!!! As for the medal, Caster Semenya won. For those that don't think it's right then give the second runner a medal also. What's so hard about being fair. They've put the hard work in and they deserve to have the glory.
I think that how Semenya views herself is of the most importance.  Her external physique shows that she is female and that is how we should treat her..so she has a little more testosterone doesnt make her any less female.  There are plenty of normal women who dont exude femininity.  Do we check them for ovaries and a uterus as well?  Extremely poor and distasteful approach by the Olympics officials.
Technically, 1 in 60 people are neither 100% male nor 100% female, biologically. They have one or another Intersex condition. The majority of such conditions though are asymptomatic - there's no external signs and it would take a lab test to determine their existence. And what does it matter of you find out that 10% of your cells are 46XX when the rest are 46XY anyway? Such a minor syndrome won't even affect fertility.

Many other conditions are only detected when the patient visits a specialist fertility clinic to find out why they've not had any periods yet, or appear unable to have children. It can come as a traumatic shock for a man to be told that he's got the 46XX chromosomes normally only found in females, but has De La Chapelle syndrome, so is fully male externally. Or for a teenage girl to be told she has the 46XY chromosomes normally only found in men, but has Turner syndrome, so has a normal female reproductive system, cervix, womb... but dysfunctional streak gonads instead of ovaries.

As part of the Australian National University's volunteer ALLY program, I have to council students in these situations. It can be heartbreaking.

However... for about 1 in 1000... the Intersex condition isn't subtle, isn't asymptomatic, isn't hidden. It's blatantly obvious from birth.

In the past, it was the practice to arbitrarily surgically change the body of such people to match the parent's and doctor's wishes. Sometimes the parents weren't even informed.

When the doctors used every tool in the medical arsenal, MRI scans, chromosomen tests, the works, they got it right 9 times out of 10. Of course, the tenth time they surgically created a transsexual child, a boy trapped in a girl's body, or the reverse.

When they didn't use every single tool they had, they only got it right 2 times out of 3.

There are a lot of very angry men who were castrated shortly after birth simply because their genitalia wasn't considered large enough by the surgeons. Again, I have to council such people, and I'm heartily sick of trying to clean up the mess caused by this barbaric practice.

Most Intersexed people don't advertise their condition. From the brouhaha in this case, and even some of the comments here, I think you can see why.

Some who can't hide are the protogynous dichogamous pseudohermaphrodites with 5alpha-reductase-2 deficiency (5alpha-RD-2) or 17beta-hydroxysteroid dehydrogenase-3 deficiency (17beta-HSD-3). They all look somewhat, mostly, or completely female at birth, but masculinise to look somewhat, mostly or completely male later. Some can even father children after the natural change. Commonly mistaken for female-to-male transsexuals, for the 2/3 who are boys, the change is a miraculous cure for transsexuality. For the other 1/3, the girls, it's a descent into nightmare.

Not many people know this stuff. It's not taught at schools, and barely even touched on even in medical schools. I know, I've been called on by Psych and Medical professors to give lectures on the subject.

There are far more of us than is commonly realised. I'm Intersexed too, you see, and I do what I can to try to place the facts before the general public,in comments on blogs, in newspapers, and the like.
She has male musculature and, therefore, she does not have "androgen insensitivity syndrome." I do feel sorry for her, though.
If he's physiologically male, let her compete with the guys.
If she has no ovaries, how does she have any female characteristics?  My heart goes out to her IF she truly didn't know.  No period by age 18?  In a country where young girls are considered women at the onset, come on.  Until I hear an interview with her, I am suspicious that this was not known and used to their advantage.    
She looks like a man with her wide nose and bushy eyebrows. It isn't her fault that she was born with this condition. I feel so badly for her because of her upcoming future in the sport field. God bless her!
Caster probably has 5 alpha reductase deficiency given the muscular development and male bone structure.
She was raised a female and believes she is female and has the plumbing to prove that part... It is cruel that others have made all public to embarass her and hurt her.. She was born that way and created that way.. She is different so it is right to publicly defame her.. To treat her so.. What has happened in this world it is important to do what has been done to her.. What make its right that because she is different that we make a point of what God gave her..She is from creation not man made.. When does she get an apology for what has been done to her... Today society finds fascination in public review of destroying peoples charaters and making them smaller than their own.. It is a shame that some who are jealous of others go to great length to hurt others can get away with and feel so proud of what they have done to someone else.. Just so they can feel superior to others..
Where is the sanity in all this - this young woman needs to be left alone right now by all of us and the media. The International Association of Athletics Federations should be ashamed for how they have handled this situation and not supporting this young women.
Christina of Sweden was never crowned as a queen she was crowned as king and that is the title she used.
So how come we don't check male champions to make sure they're not really women?  Oh, right.  The sexism.  Silly me. Saintme Pa (Friday, September 11, 2009 3:51 PM)

Silly you, and ignorant you.  Men have a physical advantage over women because of testosterone - why do you think there are gender-separated sports?  If a woman had an abnormal amount of testosterone for some reason, it would put her on *equal* footing with male athletes, not at an advantage.  Got it?
i feel very sorry that she has to undergo the scrutiny of her most private parts in front of the international community.  this is a condition that brings with it confusion, and unfortunately, shame and embarrassment.  i feel sorry for the pain this will bring into her life, when she should just be able to celebrate her talents.
Quote-- "So how come we don't check male champions to make sure they're not really women?  Oh, right.  The sexism.  Silly me."

---Because it's unfair competition for a male to compete against females.  There are physiological differences that would potentially give a male an advantage.  It has nothing to do with sexism, it's all about fairness.  

The reverse situation of testing allegedly male competitors for female gender would be pointless.  Why would someone enter an athletic competition that they expect to lose?  If a female DID enter a male competition she's want the whole world to know she's female when she bested the males... If the allegations in this article prove to be accurate and Semenya IS male, then HE should be competing against other males.

This isn't sexism or any other "ism".  This whole controversy is based on the same concept of fair play we apply all across the board to everyone.  It's why a featherweight boxer doesn't fight a heavyweight, or an 8th grader doesn't play football with high school seniors.  It's about athletic competition between similars rather than dissimilars.  What's the point of competition if someone has an unfair advantage?  

If you were one of the female competitors would you want to lose because someone had a hidden advantage over you or would you prefer that "may the best woman win" prevail?  This isn't about persecuting Semenya, it's about being fair to the other athletes.
It's unfortunate that this has happened to this young girl. I can only hope that those in her homeland will not view her as a curiosity or push her away due to something that she had no knowledge or control over.
I guess it is all up to her what she does with it.  My understanding is that Caster was unaware of this and was raised as a female.  The last information I knew, she simply indicated that God had made her whatever way she is and she accepted it.  I don't think the medals should be taken away for this.  If the authorities were so unsure they should have questioned it before the race not after.  I just hope she finds the same happiness she had before all this  stuff.  It will be difficult enough to determine what kind of family she will or may want to have, besides getting a medal taken away.  If they had not tested her her life would have been different.  Now she will have to decide, if she is interested, in what her role will be for the future.
Caster is NOT a male name in S. Africa, but Castor is.  I couldn't find any statistical evidence of frequency of intersex in South Africa or anywhere else for that matter.  I also failed to find any evidence of her former Schoolmaster referring to her as a man.  There's no reason to be angry at Caster and she should NOT be stripped of her medals unless males are also made to undergo testing for intersex status after winning.  What an awful way at 18 to learn you're infertile.
Has anybody bothered to check Serena Williams, Venus Williams, Martina Navratilova?
Wow, Cheryl... either you work for the World Health Organization or you've done more research than the fact-checkers who approved this article.  Interesting that in med school, no one ever mentioned South Africa as a hot bed for people born with androgen insensitivity.  Also, before you assume that the name Caster indicates everyone knew about her condition, look at what some of the celebrities name their kids...  I like that girl the best of luck in life, however she chooses to live it.
What the article appears to describe in this woman is Androgen Insensitivity Syndrome. The article fails to note the extremely important point that in AIS the body is genetically unable to respond to testosterone. This causes such high testosterone levels but at the same time means that testosterone has little or no effect on the muscles. So most of her ability came from her own hard work, not from any unfair advantage
I've never heard the name Caster and nowadays many girls have what used to be "boy only" names. Looked what happened to Tracy, Lynn, Ashley, even Jordan.  Just because they referred to her as a boy doesn't mean they knew she had internal male tests.  


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