interesting times

Who Should Be Allowed to Compete in Women’s Sports?

Photo: Francois Nel/Getty Images

I don’t know about you, but I’ve never really questioned the existence of separate sports leagues and competitions for men and women. It’s always seemed obvious that distinguishing between male and female athletes is a no-brainer if women are to have a real chance of winning medals and tournaments in most sports, and if they aren’t going to be gravely injured in some contact sports. That simple distinction doesn’t say anything normative about either sex (although resilient, if narrowing, pay differentials are evidence that sexism hasn’t disappeared). It doesn’t say that Billie Jean King couldn’t beat a man at tennis. She famously did, after all. The whole point of separate contests, to my mind, is to empower women. Title IX, for example, is designed specifically to ensure equal access to sports for women, who had previously been sidelined in college athletics. In this case, separate is the only way to be fully equal.

Then along comes the fascinating case of Caster Semenya. She’s the extraordinarily talented South African world champion middle-distance runner, who has dominated her sport for some time now, and for good reason. Check out this video of her cruising to victory in Doha earlier this month: It’s a beautiful thing to watch her shift gears as she closes the second lap. What makes Semenya different, however, is not just her superior skill and strategy, but that she belongs to the tiny minority of humankind that displays intersex characteristics. She has lived her life as a woman, but her chromosomes are believed to be XY — or to be precise, what is now called “46, XY DSD.” It’s a rare variation in humans, previously called “male hermaphroditism” or “pseudohermaphroditism.” She isn’t doping; she has played and is playing by the rules; she has been the subject of some invasive and ugly attention which she doesn’t deserve; but the upshot is that her body produces more testosterone or responds in ways different than women with XX chromosomes.

Does that give her an unfair advantage? This month, in a 2–1 ruling, the Court of Arbitration for Sport ruled that it did, and she (and any other high-T female athletes) could no longer compete in 400-meter or 800-meter track events unless they reduce their testosterone levels. Most women have T levels between 0.3 and 2.4 nanomoles per liter (npl). The new rules require all competitors to lower their testosterone to a maximum of 5 npl. We don’t know what Semenya’s levels are, but to compete in the future, she will have to take meds that bring hers into that range. Some argue that this is only fair to other runners; others that this is discrimination against Semenya for simply being different and actually winning.

I’m torn, to be perfectly honest. There is no satisfactory conclusion here: Semenya has done nothing wrong, and neither have her competitors. The CAS acknowledged that it was forced either to discriminate against Semenya or against all the other women in her sport. So they worked out a compromise that doesn’t really please anyone, but that’s designed to keep competition as fair as possible. It seems a reasonable balance to me, but it has been widely excoriated, especially in the mainstream media.

A bevy of arguments against the compromise have been provided. The first is that testosterone is no big deal when it comes to athletic ability. Men and women both have testosterone after all, and some in each sex have naturally higher levels than others. So why force someone to take meds — with side effects — when they are merely above average in one particular characteristic among the many that ultimately affect athletic performance? This appears to be the driving point behind a recent New York Times op-ed, “The Myth of Testosterone.” The authors — both professors who adhere to social-justice ideology — make some decent points. They usefully complicate the impact of testosterone on performance in differing sports, note that its effects are far more varied and subtle than mere physical strength. They then argue that “the International Association of Athletics Federations’ own analysis of testosterone and performance, involving more than 1,100 women competing in track and field events, shows that for six of the 11 running events, women with lower testosterone actually did better than those with higher levels.” Then this: “In other words, for most sports, testosterone levels do not correlate with superior performance.”

To put it mildly, this is bonkers. Women have a range of 0.3–2.4 npl, and we know that Semenya must have more than 5 npl, or the regulations would not apply to her. Men, in contrast, have a range from 10–38 npl. There’s not even an overlap. The range among women is tiny compared with the difference between men and women. Of course testosterone correlates with superior performance! That’s the entire reason we have separate contests for the two sexes. And the entire reason we forbid doping. How the New York Times could publish this deeply misleading sentence (to be polite) is beyond me.

Current testosterone levels per se also don’t account for the effect of the hormone throughout a man’s life. Doriane Coleman, Duke law professor and former 800-meter running champion, notes how profound the effects are:

Compared to females, males have greater lean body mass (more skeletal muscle and less fat), larger hearts (both in absolute terms and scaled to lean body mass), higher cardiac outputs, larger hemoglobin mass, larger VO2 max (i.e. a person’s ability to take in oxygen), greater glycogen utilization, and higher anaerobic capacity.

A physician who ignored these differences would lose her license. Gender studies professors apparently make careers out of denying it. So take the top female runners in the world right now: Literally thousands of boys and men would beat them. Coleman elaborates: “In the single year 2017, Olympic and World Champion Allyson Felix’s lifetime best in the 400 meters of 49.26 seconds was surpassed over 15,000 times by boys and by men.” Remove the distinction between male and female testosterone levels, and no women will be in any major athletic contest for the foreseeable future.

The other argument is that all humans have natural inequalities and we don’t penalize a swimmer, say, who has an unusually wide wingspan, or whose body produces much less lactic acid than most, or a basketball player because he’s more than seven feet tall. Why penalize one natural advantage over others? The answer to that is that the natural advantage of males’ levels of testosterone over females’ outweighs anything else that might be pertinent within each sex’s range. Among the members of each sex, you can have natural advantages that can confer an edge, but most are quite subtle (the case for much lower lactic acid helping Michael Phelps, for example, is highly debatable) and they are nowhere near as powerful a determinant as testosterone. Yes, of course, plenty of women can outrun plenty of men. But the average difference in performance in most sports between men and women after puberty is 10 to 12 percent. At an elite level, that all but wipes out female victories in coed sports. It would end women’s athletics.

And, of course, this relates to the entirely separate controversy over trans inclusion in sports. There is no question that developing as a biological male under the influence of testosterone substantially improves athletic performance, even if subsequent T levels are suppressed. Including someone in the female category who was biologically male until a couple of years before the contest gives her a real advantage, however suppressed her current T levels are. Like Semenya, these trans women have done nothing wrong. And it’s a genuinely painful thing that they might be excluded, or have their achievements qualified in any way. But reality is a stubborn thing. At some cosmic level it may be unfair that I cannot have a child by having sex with another man. But I still can’t. And it is simply biologically and empirically unfair that women who have T levels in the male range — or physically developed with them — should compete with those who do not. This is not transphobia. No one is worried that trans men who were once biologically women will dominate their events.

The deeper question for me is why anyone would try to insist that biology is largely irrelevant in, of all arenas, sports. I can see trying to minimize biological sex differences in many, many areas where the distinction is trivial — but something as obviously physically rooted as athletics? It’s almost perverse. An ACLU blog post defending the participation of trans girls in school sports states that there is “ample evidence that girls can compete and win against boys,” but somehow avoids the conclusion that there should therefore be all-sexes leagues or contests, where men, women, and intersex people can all compete together. Or you can have an article in Deadspin which ridicules any idea of a testosterone advantage for trans women:

The thing about all this talk equating hormone replacement therapy to doping, and the threat to “biological females,” and the “unfair advantages” of “male puberty,” is that it’s based entirely on social perceptions of gender. “There’s absolutely no scientific evidence at all that supports their position,” said Rachel McKinnon.

McKinnon is a philosophy professor. The idea that there is “absolutely no scientific evidence” that male puberty dramatically increases the physical strength of boys compared with girls is, well, unhinged. It’s the left’s version of climate change denial.

And for what? Why are the differences between men and women on average so offensive? Why is it problematic that men are physically stronger on average than women? Why should strength have some kind of normative value? I honestly cannot understand.

I suspect it’s related to postmodernism’s attempt to turn everything in the world into something humans have created and can therefore control. “Nature” is outside that rubric and so must be interrogated and deconstructed until it has been whittled away to nothing. Even science is a social construction, the argument goes, and so any advantage conferred by testosterone must be entirely a function of patriarchy. “Gender” absorbs “sex” altogether. But even if you end patriarchy, you are never going to end sex difference.

Then there’s the well-intentioned pursuit of equality. All inequalities, we are told, are socially created and need to be eradicated for full human freedom to flourish. Accepting natural differences seems like a backdoor to bigotry. And, yes, discrimination is often rooted in a crude idea of “nature.” That’s why making such distinctions requires nuance and exactitude.

There is a distinction between equality and sameness, just as there is a crucial distinction between inequality and difference. If the social-justice ideologues attempted to make all sports coed, there would be a universal outcry. Outside a few pockets of wokeness, it would seem absurd. And yet we are stuck in a discourse that presents this unreality as if it has some kind of science behind it. It doesn’t. We should be able to accept our inequalities as part of human diversity, and celebrate them, while treating each other as political and moral equals. The deeper laws of nature establishing this core human equality are enshrined in America’s Declaration of Independence. They do not mean we are all substantively the same, or will all end up in the same place. We are just morally and politically equal.

Who, after all, would want to live in a world like this — where we are all interchangeable, where nature is irrelevant, where men are the same as women, and where acknowledging the variations of humanity is relegated to the precincts of bigotry? How much drearier than the actual, diverse, fascinating natural world we live in.

Bad News, Worse News

I read the news these days with the usual dread. If you’re tracking the quickening decline of the American republic, you’re swamped with stories. The president continues to ignore or defy the Congress in its constitutional oversight functions in every relevant case; the attorney general is intent on being the president’s personal shield and sword; ten illustrated cases of obstruction of justice by the president remain on the table without punishment or even censure; and Trump’s approval ratings remain … exactly where they’ve long been.

I absorb all this and then stumble onto another story, on the same websites, with the same fonts, jostling for attention with the latest leak from, say, the Justice Department. This time, it’s about a new U.N. report about the high risk of extinction of a million different species in the near future at the hands of humans:

The current global rate of species extinction is already “at least tens to hundreds of times higher than it has averaged over the past 10 million years,” and it’s expected to keep accelerating. All in all, human action has “significantly altered” about 75 percent of the world’s land environment and 66 percent of its marine environment, according to the report. Insect populations have plummeted in tropical forests, grasslands are increasingly drying out into deserts, and pollution along with ocean acidification is driving many coral reef ecosystems to the brink.

What am I supposed to do with that? How does it even belong in the same news categories as everything else? Yes, I know life goes on … and the primaries are coming up, but really. How is this not our entire conversation right now?

If you read my colleague David Wallace-Wells’s book on climate change — if you can steel yourself for the grimness of it all — you’ll know how catastrophic our current climate present and future is. And I understand why much of the commentary focuses on the terrible impact on human beings themselves, especially the poor and the indigenous.

But for me, the issue is a deeper one. What right do we have to do this to Creation? We humans have screwed ourselves up time and time again, and we’ve decimated other life forms in the process. Mass extinctions have happened on this planet, and what we face may not be the worst in its history. (That asteroid was a serious bummer.) But this is the first mass extinction caused by one single species. And the first one crafted by highly intelligent, self-conscious inhabitants of the Earth who know exactly what is happening, how to stop it, and yet … keep failing to rise to the occasion. Meanwhile, our president never mentions it or denies it, and our secretary of State salivates over the new shipping and trading possibilities created by the destruction of the Arctic ice pack.

I have nothing to add to this grim scenario, except to lament it some more, and to note the criminal negligence and environmental vandalism of the GOP. One of these stories is not like the other. It is the worst crime against creation in the history of humanity.

The Right Path for Pharma

The one thing we know about HIV is that we have the capacity to end it in America. If you’re infected, you can now take a pill or two once a day and you’ll never give it to anyone else. If you’re negative, you can take one pill a day and you’ll never contract the virus. Put those two strategies together, get every man who has sex with men on one or the other regimen, and the virus is largely checkmated. San Francisco has led the way on this and has a right to brag about their success: “94 percent of San Franciscans living with HIV are aware of their infection, 89 percent are linked to medical care within 90 days of their diagnosis, and approximately 85 percent of all San Franciscans living with HIV are receiving antiretroviral treatment.” For those of us who lived through the darkest days of this disease, this is, quite simply, incredible.

But elsewhere, the picture is not so great. Minorities, especially black men who have sex with men, disproportionately don’t have access to the HIV drugs, and for many, it’s too expensive or their insurance is complicated, or they don’t even know they have the virus. That’s why Gilead Science’s new offer to donate their Truvada HIV-prevention drug to 200,000 people for the next 11 years is great news. My friend Peter Staley, an ACT UP alum, is nonetheless angry that the company doesn’t just produce generic Truvada and give up its $3 billion a year business with the drug. I take his point, and if Gilead had provided free treatment on this scale seven years ago, many lives would have been lengthened.

But I remain in awe of the pharmaceutical mastery that gave us these medications that now keep so many of us alive and healthy. There’s a convenient notion that the AIDS epidemic was stopped by activists. But, as even those activists will tell you, it was much more complicated than that. The kind of research that solved the riddle of the first retrovirus ever conquered in human history was not risk free or cheap. The emergence of several different options — and now new miracle drugs for hepatitis C as well — came out of highly expensive trials that always ran the risk of getting nowhere. The task, it seems to me, is to retain a financial incentive to invest in this research, while compassionately attempting to get it to the truly needy if it’s out of their reach. Big Pharma has a lot to answer for, and I’m not excusing its excesses. But few other countries are innovating the way America’s private sector has.

There’s a trade-off here. And this kind of donation at this scale can really thread the needle on this, if it’s followed up with aggressive outreach by health authorities, especially among the poor and black. It’s a compromise that makes sense to me, and that it was the Trump administration that pulled this off shouldn’t deter us from cheering it on.

See you next Friday.

Andrew Sullivan: Who Should Be Allowed in Women’s Sports?