PROPOSAL FOR THE 2005 IAAF CONGRESS

                                                                   DANISH ATHLETIC FEDERATION

  IAAF TECHNICAL RULES

PROPOSED CHANGES ARE IN BOLD AND UNDERLINED

Rule 113

Delete the last sentence.

Comments

The sentence in question is the only available information whatsoever within IAAF concerning determination of gender. This means that athletes and officials have no knowledge as to how, and by whom, such determination may be performed, nor as to which criteria a determination will be based on, and that there are absolutely no rules or guidelines as to how such a serious case should be conducted. In fact there is not even a single rule saying what should be the consequences of any such determination.

From a legal, and human rights, point of view this is absolutely unacceptable, and even more important, a great, and ever increasing, number of medical experts around the world have arrived at the conclusion, that in a considerable number of cases it is just not  possible to determine a persons gender with certainty. Recent estimates are that 1 out of every 100 newborn are born with some kind of ambiguous genitals, a so called intersex condition.

In all probability there are not many persons who would like his or her daughter to be prosecuted, convicted and sentenced for life, on the basis of such an arbitrary system, completely lacking everything that – in a civilized society - must be required, in terms of legal and medical security and protection of each individual.

The very same reasons why there, in stark contrast to gender verification, are such extremely comprehensive rules and regulations when it comes to doping control.

It should also be remembered that, according to Article 3 – Rule 4 in the IAAF Constitution, the IAAF shall strive to ensure that no gender discrimination exists within our sport.

Therefore, the only correct and decent thing to do, is to remove that sentence in Rule 113 from the rules of the IAAF.

Reference is given to appendix A and Appendixes B1 - 12 which offers more in depth information about the whole issue.

January 2005

APPENDIX A

THE MAJOR MEDICAL BLUNDER OF THE 20^TH CENTURY

As one of the consequences of the Cold War from the end of World War II and up to 1989, the competition on the battlefield of sport became fiercer and fiercer, and at some point rumours started circulating in the west about female athletes, mainly from the eastern countries, who were not THAT female. Stories were told about specific athletes who never undressed together with other athletes, but came directly from their hotel, and went straight back for a shower, and of athletes who had a number of male features as for example a fast growing beard.

Worse still, they achieved stunning results on the sports field, which, especially in athletics, could be measured and compared directly.

Perhaps understandably a cry soon rose about unfair competition and downright cheating, followed by demands to bring an end to this intolerable situation in international sport.

So, something had to be done, and in accordance with medical experts, gender verification was introduced in athletics by the International Association of Athletics Federations (IAAF) in 1966, at the European Championships in Budapest, where all female athletes were required to parade naked in front of a panel of physicians.

I was present in Budapest, and being at that time president of my club, I had a rather nervous and embarrassed female high jumper attending this (something similar was repeated at the 1967 Pan American Games in Winnipeg and on other occasions).

Another female athlete in Budapest was a Polish sprinter E.K. who passed the examination. However, later after the introduction of a new test, sex chromatin testing, she was found to have one chromosome too many to be declared a woman for the purpose of athletic competition.

A six man medical commission who subsequently investigated her case, discovered that she had a genetic condition known as mosaiicism, whereby some of her cells had an XXY sex chromosome make up, the remainder having a normal XX sex chromosome composition. She was aware of the condition and had not only undergone surgical treatment to remove intra-abdominal testes, but was also being treated with female sex hormones.

 Nevertheless she suffered public disgrace by being disqualified from further competition in women´s events and her name was later (in 1970) removed from the record books and she was forced to return her olympic and other medals, and retired from competition surrounded by controversy.

At the 1966 Commonwealth Games in Kingston, a manual examination of the external genitalia was carried out by a gynaecologist on all female athletes, and I 1967, at the E-cup final in Kiev, close-up visual inspection of genitalia was used to establish eligibility.

Mary Peters, gold medallist in Munich 1972 in pentathlon, is quoted as having described her experience with the gender verification test as “the most crude and degrading experience I have ever known. The doctors proceeded to undertake an examination which, in modern parlance, amounted to a grope”.

This new practice quickly, in fact already from 1966, brought about that a number of prominent athletes did not show up at the big events, and vanished from the international scene of athletics, which in turn was interpreted widely as a great victory for the introduction of gender verification, and certainly, in some events, competition became less fierce.

In 1968 at the Olympic Games in Mexico, the IOC introduced the sec chromatin test (buccal smear screening test) which could indicate inactivation of one of the two female X chromosomes. It was the intention of the IOC that, should the screening test prove negative, or inconclusive, a full chromosome analysis would then be conducted and blood hormone levels measured. If inconclusive results were again obtained, a gynaecological examination would follow.

Nevertheless, the IOC´s intentions have rarely been carried out in practice. Shocked athletes, having failed the sex chromatin screening test shortly before a major competition, have tended to withdraw rather than undergo further investigations which might have proved them eligible. Indeed, these athletes were often advised by their own officials and team physicians to feign illness or injury and retire immediately to avoid public humiliation.

From that time, every international female had to have a gender verification certificate with photo etc., stating that she had passed the sex test used by the IOC.

At the 1985 World Student Games a female Spanish hurdler M.P. was publicly disclosed after failing her sex test, at the cost of public disgrace and loss of her athletic scholarship. It took two years and the active intercession of a number of medical authorities for her, to be reinstated – it turned out that she had Androgen Insensitivity Syndrome. By that time though, her sporting career was over.

Similar examples are to be found within other sports.

Having used the sex chromatin testing in sport for well over 20 years (1968-1991), the medical experts stopped using it, because of its inadequacy, and because it has been realised that some women, who have genetic abnormalities that offer no conceivable strength advantage, are disqualified unfairly, some men with genetic disorder would pass the sex chromatin test, and it is an established fact that a number of genetic disorders in women and men can make the test results point in whatever direction, for example: Androgen Insensitivity Syndrome, Gonadal Dysgenesis, Turners Syndrome, Klinefelter´s Syndrome etc., etc.

To my knowledge, following an IAAF workshop in 1990, the IAAF Council in 1991 adopted recommendations from the workshop that laboratory based gender verification testing be abandoned, alternatively introducing general medical examination, including simple inspection of the genitalia, to be performed by physicians accredited to each national federation. However, due to lack of unanimity regarding the exact content of the examination a second working group discussion took place in 1992. The result was to eliminate gender screening in any form at IAAF competitions.

However, provision remain to this day in the IAAF Rules that -

 “The medical Delegate shall also have the authority to arrange for determination of the gender of an athlete should he judge that to be desirable”

 - except, that now everything related to how such an investigation is to be performed is hidden completely from the athletes and officials, as opposed to the preceding some 20 years of free and open information. Alas, this lead to criticism and embarrassing exposure of the mistakes and shortcomings of the scientific methods used, and subsequently to changes. That cannot easily happen now when everything is kept behind a white coat.

All along the IOC kept on conducting laboratory testing for gender verification purposes. In 1992 in Albertville the new polumerase chain reaction (PCR) technique was introduced, only to be criticised for not eliminating all the issues surrounding the accuracy of the test by having the same shortcomings as sex chromatin testing, and being merely a test for presence of a DNA sequence and not a test for sex or gender.

At the 1996 olympics in Atlanta, the IOC reverted to the buccal smear test, and a comprehensive process for screening, confirmation of testing, and counselling of individuals “detected”, was carried out. Out of 3387 female athletes 8 had positive test results. Eventually however, all of these were ruled “false positive” as it was established that 7 had androgen insensitivity, 4 incomplete, and 3 complete. The last one had previously undergone gonadectomy (removal of internal testes) and is presumed to have 5-alpha-steroid reductase deficiency (deficiency of an enzyme necessary to activate testosterone in responsive tissues). All individuals were permitted to compete.

For the 2000 olympics in Sydney  it was again intended  to conduct the more and more controversial gender verification. However, shortly before the games,  the IOC was forced to back down over its plans, mainly because the IOC Athlete´s Commission demanded the test being scrapped. However, the IOC described the suspension of compulsory gender verification as merely an “experiment” with no guarantees that it would become a permanent arrangement.

And, sure enough, the IOC still has a clause in its rules which -

 “gives the IOC Medical Commission the authority to conduct any necessary investigation in order to verify the gender of an Olympic participant, should that be judged desirable”.

 - exactly along the same lines as IAAF, and with exactly the same problems and shortcomings.

In the late 1990´ties a number of relevant professional societies in USA called for elimination of gender verification, such as the American Medical Association, the American Academy of Pediatrics, The American College of Physicians, the American College of Obstetrics and Gynecology, The Endocrine Society, and the American Society of Human Genetics, stating that the method used was uncertain and ineffective.

So, what is the true story behind all this ?

Some of the best kept secrets within the human race, from ancient times and up to today,

can be described by two words: Intersex condition.

Every embryo has the possibility to develop either towards male or female, and therefore the possibility exist that it develops to something in between, within a vast number of variations. Such “cases” have always been hushed up, by the medical experts and, often on their advice, by the families, and in most cases the doctors have advised the parents that surgery be performed immediately to make the child look like a girl.

Why a girl ?

Because, until very recently, that was the easiest, in fact the only thing, they could do. To make such a baby look like a boy was much too difficult, and still is more difficult. So, the doctors decided on, which sex a baby should live with for the rest of its life, and the shocked and wretched parents, placed in this tragic situation, could do little but follow the doctors advice.

The pain and agony, when later in life some people find themselves caught in a body, to which they cannot relate, is beyond comprehension.

But surely this concerns only a few isolated cases ?

With all the hush up that has always surrounded these problems, the extent on a national or global basis has not been known publicly, and statistics is hard to come by, whereas the medical world surely should have had some grasp of it.

Only within recent years, some people, some parents and some persons with intersex conditions themselves have started to talk about it more freely and publicly, but as of today, no one can say how many people this has affected, only that it is an almost unbelievable high number.

Recently it has been estimated that in Great Britain alone there are living more than 100.000 with some kind of intersex condition. For example 1 in every 4.000 is born with Androgen Insensitivity Syndrome (AIS), and 1 in every 10.000  with Adrenogenital Syndrome (AGS), which is yet another of the numerous variations in gender. There is no reason why these figures should not relate to most other countries too.

Other estimates are that in general at least one in a few thousand people are born with a body which deviates so much from the two accepted genders, as to place them at serious risk of parental rejection, stigmatisation, emotional pain of secrecy, shame and isolation and often harmful medical intervention, based not on scientific research, but for sociological and ideological reasons.

All through the 20^th century they have been hidden away as a dark secret, and their existence hushed up for a number of reasons, including the standards set by society, by relatives, and yes, by sport – the last big taboo of mankind.

In fact, besides the male and the female gender, I think it should be considered to talk about a third gender, the Double Gender encompassing all those who are neither female nor male, but both and. As a matter of fact there is information that at least one person in Australia has been officially registered as being double gendered. It is long overdue for society, to accept these facts of life, which, in relation to sport are of minor consequence compared to the ever flourishing problem of doping.

As a very small part of this huge, global issue, the double gender has, as specified above, caused confusion in the world of sport, where the medical experts have decided how to divide those with the double gender  between the two officially accepted genders. They have, in their ignorance, performed this with various procedures and various medical techniques, which, one by one has proven to be inadequate, insufficient or just plain impossible. Procedures and techniques which the officials in sport have had to accept, as obviously they were not experts in this field.

It is obvious that there are reasons why, after some 30 years of nude parades, groping, scraping, screening, testing and certifying, all of a sudden the compulsory gender verification is completely abandoned, and all the comprehensive activity and attention that has surrounded this has suddenly vanished, so that all that is left is a “sleeping” rule saying that it can be performed when “judged desirable”, with no further information added. (Within doping control, which is also a medical matter, this would equal that the only rule and information needed would be: “Doping control may be performed when judged desirable”. Period.)

That this unspecified rule concerning gender verification has been preserved at all, by the IOC and the IAAF, combined with the fact that I have not been able to obtain any information from the chairman of the IOC Medical Committee, Arne Ljungqvist, as to the details behind this, as he only wishes to state that it “is ruled by the ethical and scientific standards that prevail in medical practice”, and “that it is not for sports people to rule how medical persons should exercise their profession” points to the obvious conclusion that this is about saving face.

Nobody would be eager to stand up and admit that “for 30 years we have been doing this wrongly”.

These some 30 years of consternation, suffering, humiliation, shattered  sports careers and broken lives, and this enormous BIG BROTHER set up, causing all this, has been, and apparently still is, based completely on inadequate and inconclusive grounds.

With the knowledge we have today, no one, but absolutely no one, with any sense of what is just and fair, can say that what was done, was done with methods and procedures which were, or has later been, proved to be beyond any reasonable doubt.

What all this leaves us with is the fact that those who were excluded for not passing the gender verification, or femininity test which it was unpleasantly also called, were excluded wrongly on inadequate and inconclusive grounds, and therefore they should be exonerated. Those who were “just” scared away it is, unfortunately, not possible to make it up to.

But then, what now ?

Obviously international sport will have to relate to double gender, to intersexuality, to transsexuality and to all other related issues. However, I think they should find some other people to do it than those who have handled this up till now.

Georg  Facius   

August 2004

ORAL PRESENTATION

AT THE 2005 IAAF CONGRESS

PROPOSAL No 40  -  RULE 113

Unfortunately It has not been possible to get a fair treatment of this proposal prior to the congress. In the set of proposals for the congress that we all received in May, the explanatory comments, the reason for the proposal, was cut down from 30 lines to only 5 lines stopping in the middle of a sentence, and not only that, the accompanying information and documentation was completely omitted.

At long last, after a lengthy correspondence of mails back and forth, finally, about two weeks ago the missing material was issued from IAAF. Some of you may have studied it, but probably most of you have not had time for that.

However, in the material forwarded by IAAF, and the material lying before us here today, those missing 25 lines of explanatory comments have still not been included.

So, for mysterious reasons – which reminds me of the incorrect count of votes, which I disclosed at the congress in Seville - it has turned out to be, not an easy task to stand here today, with a limited time to inform you about this proposal.

However, what worries me the most, is that the Council, at its meeting in April, also did not have all this missing information when discussing the proposal and taking a stand on it. If that had been the case, maybe we would not have to spend time on it now.

So for the benefit of the Council, but first and foremost for the benefit of you, my fellow delegates, I will read those 30 lines to you, of which you only have the first small part in your congress material. (See above under "Rule 113")

 
FINAL PART OF ORAL PRESENTATION
 

IAAF was the first big international federation to abandon compulsory gender verification or sex text. A number of international federations have followed, and prior to the Olympic Games in 2000 even the IOC was forced to do so

-          and why, because it was realized that the different test methods used over the years were inadequate, insufficient or just plain impossible.

Fine, but then how can we ophold a rule based on the same mistakes and shortcomings, saying that an athlete must undergo such a test, when “a medical delegate finds that desirable”

I suggest that IAAF once again takes the lead, and disposes of this last rule of the completely mistaken system used over the last 30-35 years.

One out of one hundred are born with some kind of ambiguous genitals, and intersex condition – One in a few thousand are born with a body that deviates so much from the accepted genders, as to place them in serious risk of parental rejection, stigmatisation, emotional pain of secrecy, shame and isolation, an often harmful medical intervention, based not on scientific research, but for sociological and ideological reasons.

Would anyone of you, want any member of your family, or any athlete of your federation, to undergo such an arbitrary investigation, based on a mistaken system, and risk to be marked and branded for life.

If you don’t want that, you should vote yes to delete the sentence that makes that possible.

Whatever the outcome, I hope that later you will take time to read the information, we have provided about this issue.

Georg Facius