Participants at the second Australian/Aotearoa-NZ intersex community retreat

There are many misconceptions and generalisations about intersex people, in sport and elsewhere in society. Often these are based on assumptions that intersex people are a homogeneous group, and an identity group, a sexual orientation or a gender identity. The reality is different, both more complex and more mundane. Regulations by international sporting bodies target some intersex women, inhibiting some people from participation in sport, but many intersex people are likely to be completely invisible across sporting codes and in amateur and professional settings. Particularly for those people that don’t participate fully in sport, body shaming may be the most significant barrier.

Intersex people are born with sex characteristics that don’t fit medical norms for female or male bodies, and we can suffer stigma, discrimination and medical interventions without our personal informed consent as a result1. These sex characteristics can relate to our chromosomes, genitals, gonads (such as testes or ovaries), and hormone response. Importantly, this definition (based on a widely accepted definition by UN bodies) does not specify anything about sex classifications, gender identities or sexual orientations; these all vary from person to person. The definition focuses only on what we share in common: experiences that arise from our physical characteristics.

The intersex population is extremely diverse, with more than 40 relevant genetic traits known. Because intersex traits are innate, they can be identified at any age, including prenatally, at birth or in early childhood, during puberty or when trying to conceive a child. Intersex people who are old enough to express our identities can be heterosexual or not, and cisgender (identifying with sex assigned at birth) or not2.

As the author of this article, I’m an intersex man. Like many intersex women and folks with other gender identities, I’m not directly affected by the substance of new IAAF regulations3. These essentially target women with one of a small subset of intersex variations in a small subset of athletics events where a small performance advantage is claimed. However, all of us are impacted by the regulations’ focus on people with “differences of sex development”, a clinical term for intersex variations, and all of us are impacted by media and institutional representations of who intersex people are.

Those representations include assumptions that birth-assigned identities are deceptive or inaccurate, and that we are not “real” women or men. Other representations suggest that we are a threat to women’s sport, even though earlier IAAF regulations were suspended in 2015 without subsequent evidence for this. Misrepresentations also include assumptions that we have necessarily transitioned gender role, or that we need to, when sporting regulations have targeted women who have always been women. Some news reports have suggested that women athletes with intersex variations necessarily have, or had, testes. Some do, and sporting bodies have a terrible history of exclusion and partial inclusion4. The situation is further complicated by inaccurate reporting on trans athletes, suggesting that “XY women” have necessarily transitioned gender, when some women with intersex variations also have XY sex chromosomes. The truth of our bodies is often mundane or traumatic5. The impact of such misconceptions is profound, and this does not encourage public disclosure.

The 2018 regulations on women with intersex variations are based on limited, “sparse and mostly uncontrolled” evidence, and they have been questioned by a range of commenters for their statistical validity and ethics6. A case is now being taken to the Court of Arbitration in Sport to contest their validity.

Unlike the big name athletes that are the target of the new IAAF regulations, most people directly affected by those regulations will have received forced medical interventions in childhood that will affect their participation in sport and, potentially, their capacity for elite competition. Australian research published in 2016 identified that bullying, stigmatisation, and medical interventions during puberty affected school attendance and outcomes7.

The words we know and use to describe our bodies also vary widely, depending on our experiences of medicalisation and medical interventions, disclosure of this information to us, and also in response to stigma and misconceptions. Some people may be unaware of the word or its relevance to them, because of either the medicalised ways that their bodies have been described to them, or associations of intersex with LGBT populations8. Other people may not use the word intersex because it has borne the weight of public misconceptions about our bodies and identities, but fundamental concerns about regulations of bodies affect all of us nonetheless.

In many cases we lack access to the information and peers needed to help us form affirmative self-conceptions. Forthcoming data and recent Family Court cases have shown that children born with variations of sex characteristics have been subjected to labioplasties and clitoral surgeries without court oversight; hormone treatment may also imposed without consideration of our actual identities9. These clinical management approaches are contested, with human rights institutions describing them as harmful practices and violations of children’s rights10. Intersex advocates have been raising these issues for decades11, but they remain standard12.

In many cases, sports clubs simply will be unable to know if a player has an intersex variation: it will not be obvious, the player will not know or use language around what it means to be intersex, and their variation is unlikely to have any impact on their playing ability. Having said that, some of the most significant barriers we face are about body shaming and the stigmatisation of our physical characteristics. That is, shaming and stigma based on ideas of what men should look like, and what women should look like. Whether relating to post-surgical scars, developmental delays, height, or intimate sex characteristics, body shaming is pervasive. Policy frameworks that address intersex issues as matters of personal identity will fail to address these issues.

Any guidelines limiting access to sporting events need to be evidence-based, and avoid generalisations about intersex people13. They should never pressure individuals to undergo medical interventions. Any guidelines should not assume that intersex people are LGBT, or have any particular identity, sexual orientation or gender identity. Best practice guidelines will address body shaming as a concern. Some good model policies exist, such as by the Women’s Sport Foundation14. Here in our region, an Australian and New Zealand community consensus statement, the Darlington Statement, offers a good starting point to find out more about intersex people in Australia15.

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Morgan Carpenter

Morgan Carpenter is a co-executive director of Intersex Human Rights Australia and a graduate and PhD candidate at Sydney Health Ethics, Faculty of Medicine and Health, University of Sydney. He is a member of a current Australian Human Rights Commission expert reference group on protecting the rights of people born with variations of sex characteristics in the context of medical interventions. Find out more at morgancarpenter.com