The Problem With Asking, "What Are You?"

["Corset de grossesse vu de côté." Image source.]

Categorization is one of the fundamental skills of our human intellect.  When we learn to categorize, we are able to organize, understand, and interpret our perceptions of the world around us.  Categorization helps us establish standards and form sound judgments, without which we wouldn't be able function well in community.

The problem is that in establishing standards and making note of common patterns, we run the risk of forming very, very bad judgments when people or objects fall outside the perceived norm.

This is particularly true, to my mind, with issues of race and gender.  In the case of race, the arguably neutral intellectual skill of categorization has become a savage tool for oppression and a justification, albeit fallacious, for the hatred of difference.  In the case of gender, categorization has led to injustice and personal suffering for those whose gender neither science nor philosophy can easily define.

I am thinking now of Caster Semenya.  I am disheartened by my impression that we as a human community are still willing to look askance, and coldly, at "outliers" and treat those who cannot easily be categorized as specimens in a global freak show.  Why does it seem so easy for the rest of the (white) world to treat her like a circus act, subject her to the probings of medical experts, and put her private matters on display?  I hope those experts are at least advising her on the potential clinical dangers she may be facing and concerning themselves with her health and safety. 

Semenya's case is problematic on so many levels.  It forces us to ask,

• What is a woman supposed to look like, to have, to be able to do?
  
• If a woman has some male traits, are her achievements as a woman - in this case, a female athlete competing in women's events - rendered invalid?
• If athletic ability is in any way influenced by gendered traits such as hormone levels, should everyone then get their hormone levels examined and made public? Should competitions only occur in the presence of a chemically level playing field? Should we question the participation of athletes with biomechanical "advantages" as well, such as height and leg length?  But aren't many competitive athletes gifted with what might be considered physical advantages?
• What makes someone a man or a woman?
  

I live in a multiracial family and work in a sexist subculture.  Issues of race and gender are of a deeply personal interest.  I am also intensely interested in cultural, religious, and sociopolitical definitions of human identity.  Which race box should my white daughter who is genetically part-Filipino and who feels Asian check off on her medical forms?  Medicine has taught me that while labels can be useful, boxing people into categories can be completely useless and perhaps even tragic.  

My church takes the medically uninformed position, "Everyone, man and woman, should acknowledge and accept his sexual identity."  As a physician I see that norm as wrong on so many levels.  What would the Church tell the boy I anesthetized so his uterus could be removed, or a girl undergoing surgery to remove her internal / undescended testes?  What would it advise people who are externally female but genetically male, as in the case of pure gonadal dysgenesis or male pseudohermaphroditism / androgen insensitivity syndrome?  Or genetically female, but externally masculinized, as in congenital adrenal hyperplasia?

  

If you can't necessarily define gender with physical structures or chromosomal identity, you're left with the strong, deep, neuropsyschological needs and inclinations of the individual.  But granting those validity would mean the unraveling of so many other questionable assumptions.  Semenya's situation and our response to it teach us so much about ourselves and our assumptions.  By questioning her validity as a woman, we indirectly challenge her humanity and perhaps diminish our own. 

I don't envy the IAAF.  At the end of the day I don't think there's a scientifically reliable "bright-line" test for gender validity.  This opens up a whole can of worms for athletics regulations and workplace gender issues for which I don't think a clear solution exists. 

For more medical information on intersexuality, please visit this Children's Hospital website.