By Morgan Carpenter
This article was originally published by Play By the Rules and is reproduced with permission. It can be cited as Carpenter, M (13 September 2018) Intersex people: not invisible in sport but inadvertently excluded. Play By the Rules. Retrieved from https://www.playbytherules.net.au/resources/articles/intersex-inclusion
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 result. 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. Intersex traits are innate, but they can be identified at any age, including at birth or in early childhood, during puberty or when trying to conceive a child. Intersex traits can also be diagnosed prenatally. Intersex people who are old enough to express our identities can be heterosexual or not, and cisgender (identifying with sex assigned at birth) or not.
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 regulations. 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 girls or 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 inclusion. 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 traumatic. 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 ethics. 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 outcomes.
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 populations. 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 the regulation 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 identities. These clinical management approaches are contested, with human rights institutions describing them as harmful practices and violations of children’s rights. Intersex advocates have been raising these issues for decades, but they remain standard.
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 people. 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 Foundation. 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 Australia.
 Office of the High Commissioner for Human Rights, African Commission on Human and Peoples’ Rights, Council of Europe, Office of the Commissioner for Human Rights, Inter-American Commission on Human Rights, Special Rapporteur on torture and other cruel, inhuman, or degrading treatment or punishment, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Special Rapporteur on violence against women, its causes and consequences, and Special Representative of the UN Secretary-General on Violence against Children. ‘Intersex Awareness Day – Wednesday 26 October. End Violence and Harmful Medical Practices on Intersex Children and Adults, UN and Regional Experts Urge’. Office of the High Commissioner for Human Rights, 24 October 2016. http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=20739&LangID=E
 If you’re looking for it, there is now a word for “non-intersex” and it’s “endosex”
 International Association of Athletics Federations. ‘Eligibility Regulations for Female Classification (Athletes with Differences of Sexual Development)’. IAAF, 23 April 2018.
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 Karkazis, Katrina, and Morgan Carpenter. ‘Impossible “Choices”: The Inherent Harms of Regulating Women’s Testosterone in Sport’. Journal of Bioethical Inquiry, 16 August 2018. https://doi.org/10.1007/s11673-018-9876-3.
 Carpenter, Morgan. ‘The “Normalization” of Intersex Bodies and “Othering” of Intersex Identities in Australia’. Journal of Bioethical Inquiry, 7 May 2018, 1–9. https://doi.org/10.1007/s11673-018-9855-8.
 Intersex Human Rights Australia. ‘Submission to the Australian Law Reform Commission on the Review of the Family Law System – Issues Paper’, 7 May 2018. https://ihra.org.au/32111/alrc-may-submission/.
 Committee on the Elimination of Discrimination against Women. ‘Concluding Observations on the Eighth Periodic Report of Australia’, 20 July 2018. Human Rights Committee. ‘Concluding Observations on the Sixth Periodic Report of Australia’, 1 December 2017.
 Carpenter, Morgan. ‘Intersex Variations, Human Rights, and the International Classification of Diseases’. Health and Human Rights 20, no. 2 (1 August 2018). https://www.hhrjournal.org/2018/08/intersex-variations-human-rights-and-the-international-classification-of-diseases/. Australian Human Rights Commission. Protecting the Human Rights of People Born with Variations in Sex Characteristics in the Context of Medical Interventions Consultation Paper. Sydney: Australian Human Rights Commission, 2018.
 Puras, Dainius, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. ‘Sport and Healthy Lifestyles and the Right to Health’, 4 April 2016. http://ap.ohchr.org/documents/dpage_e.aspx?si=A/HRC/32/33.
 Women’s Sports Foundation. ‘Participation of Intersex Athletes in Women’s Sports, The Foundation Position’, 20 September 2011. https://www.womenssportsfoundation.org/advocate/foundation-positions/lgbt-issues/participation-intersex-athletes-womens-sports/.
 Androgen Insensitivity Syndrome Support Group Australia, Intersex Trust Aotearoa New Zealand, Organisation Intersex International Australia, Eve Black, Kylie Bond, Tony Briffa, Morgan Carpenter, et al. ‘Darlington Statement’. Sydney, NSW, March 2017. https://darlington.org.au/statement.
Morgan Carpenter is a co-executive director of Intersex Human Rights Australia and a graduate and PhD candidate at Sydney Health Ethics, 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.