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A Sprinter's Fight to Prove She's a Woman

India's most prominent young sprinter is fighting for her career after being suspended due to high naturally occurring testosterone levels.

In a matter of two months, Dutee Chand went from being hailed as India's "sure shot Olympic medalist" to studying to become a train ticket collector.

It all began last summer, a few days before a team of more than 200 Indian athletes was set to leave for the 2014 Commonwealth Games in Glasgow, Scotland. Chand, the 18-year-old 100m national champion sprinter, was dropped from the list.

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She hadn't doped. She wasn't unfit. She hadn't underperformed. She was found ineligible to compete as a woman, against other women. Information leaked out that Chand had failed a "gender test."

This was the same athlete who had returned with a medal from almost every event she competed in between 2012 and 2014. In 2013, Chand became the first Indian to reach the 100m finals at the World Youth Championships. She won the bronze medal for the 200m event at the Asian Championships. The same year, she won the 100m gold medal at the National Senior Athletics Championship in India. With two more gold medals, she was at the podium again at the Asian Junior Championship in June 2014.

Image via Agdashloo, WikiMedia Commons

But something didn't seem right to someone. A still anonymous person who saw Chand run at the Asian Junior Championship asked the Athletics Federation of India that she be tested. Chand was forced to give blood and urine samples, and to undergo imaging tests. She was not told why. She wondered why doctors said she needed ultrasounds. That's not how you're tested for doping, she thought.

It didn't make sense until Chand was watching television at home one day. The multiple tests in multiple cities. The mysterious silence of the sports establishment. She wasn't being screened for doping. The TV report said she had failed a gender test. "You're not a woman," the news seemed to be telling her. And the IAAF, the world governing body for athletics, was saying the same thing: Chand was banned from competing against other women.

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Chand's parents, Chakradhar and Akhuji Chand soon found themselves in the middle of a storm. Reporters and cameramen crowded outside their house, neighbours started talking, and the extremely conservative community in their village turned their daily life into a nightmare. Everyone wanted to ask the same harrowingly uncomfortable question to Chand's parents—"Is Dutee a boy or a girl?"

Chand's parents had lived on about $8 per week for their entire lives as weavers. They had raised seven kids in a small village house. For many years, they had to walk a mile to the nearest communal toilet. But none of the hardships they had faced prepared them to deal with this moment—strangers and people they had known forever coming to their door questioning their daughter's identity.

"No one knows better than a mother," Akhuji gathered the courage to tell a reporter. "I sent my daughter to training. How can they call her a man?"

Chand locked herself up and cried for three days while her fellow athletes warmed up in Glasgow. She had suddenly gone from star athlete—used to welcome ceremonies at airports, garlands, cash awards, and media praise—to discarded teenager, shunned by the same sports establishment that had once propped her up.

"All sorts of strange questions were coming to my mind," she said in Hindi in a recent phone call. Of course I'm a woman, I've always been one, she kept telling herself and her friends. "I can't imagine going back to thinking about that time."

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Gopalpur, Odisha, India. Image via Jagadhatri, WikiMedia Commons

In 2011, the IAAF introduced the hyperandrogengism (HA) rule. It deemed that if a woman's body produces testosterone that is considered by them to be in the male range, that woman would be barred from competing in women's events. A similar policy was adopted by the International Olympic Committee (IOC) before the London Olympics. The IAAF and the IOC's reasoning is that testosterone builds muscle, and excess of this hormone is an "unfair advantage" for women, even if their bodies are producing it naturally.

The IOC also wrote in its London Olympics release that, if these women wish to, they could try to qualify for the men's events and compete against men. Which, on the face of it, is a bizarre suggestion because testosterone alone is not the differentiating factor between men and women's athletic performances.

"If people are born as women, raised as women, lived as women their whole lives, trained as women athletes, let them play as women," says Alice Dreger, a professor in the medical humanities and bioethics program at Northwestern University. "We should just recognise that these categories we have are gender categories, not sex categories. Allow them to be gender categories—that's a self-identity, and a social category, not a biological category—and not try to force sex on to a gender category."

Eric Vilain, a UCLA geneticist who worked on formulating the IOC's ruling on HA, has acknowledged multiple times that the system is not perfect. But in elite sports, he contends, you have to draw a line somewhere. For the IOC and IAAF, that line—which decides who is allowed to compete in the women's category—is testosterone.

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"If we agree that men and women should be separated in sports—that's something that doesn't have to be, but—if we agree that it is a good idea, the next question would be how do we place men and women in two different categories?," Vilain said in a phone call. "One way is to simply ask. And that is a possibility, but there would be questions about men who say that they are women, and also about transsexual athletes who would identify as women but would have not undergone any physical transition. Biologically, they could be completely male but they would identify as a woman. Should they be able to compete as women?"

But others argue that there is more to the HA rule. They feel the policy discriminates against women. With this ruling, the IOC puts the burden only on women to prove their gender. For one, there is no such "unfair advantage" rule among men. What if a male athlete's testosterone levels are significantly higher than the average male range? There are no rules to disqualify men on that ground.

"Where will we put them?" Vilain says. "There's no third category—women, men, and supermen."

Others find this logic of keeping an upper limit ridiculous. Dreger, who also consulted with the IOC on their policy, believes that their HA rule is "unscientific and sexist."

When the IAAF and IOC issued the ruling, they didn't even specify what was the desired testosterone range they were looking for. So if any women athletes wanted to get tested in private beforehand and avoid the public humiliation of a hyperandrogenism test, it was impossible to do so. The governing bodies decided that they will set the limit once cases start coming in. The lower end of the male range is now set at 10 nanomoles per litre, and women are not eligible to compete until they lower their testosterone levels, often through quite invasive methods.

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"Women are not allowed to have a certain level but men are allowed to have as much as they want. It's unclear to me why androgens are considered a property of men, when in fact women make androgens as well?," Dreger says. "There's no upper limit for men, there's only an upper limit for women, and that's basically sexist."

The other reason why Dreger thinks the rule is unfair is because not every woman athlete is tested for it. The investigations are irregular and selective, and only pick on a few women on the basis of certain external characteristics. Since everyone isn't under the same level of suspicion, there could be cases where women have high testosterone levels that are not noticeable through physical attributes—perhaps because the high levels are masked by sophisticated medical interventions at an early age. It's possible, Dreger says, that athletes from the first world, where there is better and more accessible medical technology, have an advantage when it comes to staying under the radar.

This is exactly what Chand and her supporters insist is the problem here. "Such cases always come up against athletes of the third world. I've never heard of an athlete facing a similar ban from the developed countries," says Jiji Thomson, who was the Sports Authority of India director general when Chand was tested and banned. "This is definitely discriminatory against the athletes of third world countries."

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Dreger can see why some people would feel that way. "We know very well that girls and women who are raised in developed countries have much better access to health care, nutrition, public health, and medical services.

"We don't exclude other women because of other natural advantages like height, more oxygen processing, more muscular development. We don't decide that that's an unfair biological advantage," she says. "So it's particularly ironic then that you're going to tick them (third world athletes) off for having a natural advantage when they've had these other unnatural disadvantages."

Chand's coach N. Ramesh says that this is how Dutee feels as well. And she believes she trained hard to make up for the advantages she didn't have. "She often says that an elephant has more strength than a horse but he can't run as fast. It's because the horse trains to run," And that's what she does too, she trains every day," Ramesh said in Hindi in a phone call from Hyderabad.

When the ban came, Chand was at a stage where her life, and that of her family, depended on her running. She's financing her two younger sisters' education, and planned to use her running income to get her family house plastered. Backing out of the sport would mean undoing everything that she had ever committed to.

"Since as long as I can remember, all I've known is to run. Everything I've ever had is because of running. When girls are three or four years old, they study. I used to run," says Chand.

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She recalls those times when she had to walk almost two miles to get to her school. Running was the only distraction she and her elder sister Saraswati had while growing up in Gopalpur, a village in the eastern state of Odisha. No television set, games, or Barbie dolls like the city kids.

"We didn't have bikes or cars to go to school," she says. "So we made a game out of it." Chand and four of her friends raced against each other every day when the school broke for lunch. Whoever reached home first, won. Chand was fast even then.

That's what made Saraswati take her nine-year-old younger sister to athletics coach Ramesh. From then on, Chand began living in hostels and was on her own. Saraswati didn't need to guide her.

But now, she once again does. After the news broke, Chand called home crying, describing the glances, sniggers, and comments she was getting over her gait, her muscles, and her physique ever since things spiralled out of control. Saraswati and Ramesh tried to lift her spirits by telling her about the life and struggles of leaders like Mother Teresa and Mahatma Gandhi. Saraswati reminded her about the mythological story of the Hindu god, Lord Rama, who was sent on a 14-year long exile a day before he was supposed to be crowned king.

"We told her that if that could happen to Gods, we are mere humans," Ramesh said.

While Saraswati put on a brave face for her sister, she was worried too, at what the news would mean for Chand's future in a community that is already so unforgiving towards women. "Can someone be a girl for 17 years and 11 months and suddenly become a boy in the 18th year," she told The Indian Express.

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At that time, Jiji Thomson and the Sports Authority of India took an important step in putting an end to all the speculations about gender binaries. They released a statement that said Chand's gender is not what's in question. And the tests weren't done to put a gender label on her. The press release went a long way in setting the tone for how her story was covered in India after that.

But they had yet to find a solution for the other hurdle. How to get Dutee to run?

Chand started to draw inspiration from Ramesh and Saraswati's motivational stories. She remembered a famous slogan from India's independence movement. Freedom fighter Subhas Chandra Bose had made a call to people in the 1940s, "You give me your blood, I will give you freedom." Ramesh says that Chand slightly modified it, "You give me your support, I will give you an Olympic medal," she would say.

The only way back into a sport that had deemed her ineligible to compete would be to change her natural body. It seemed preposterous to her, but if she wanted to run again, she would have to do something.

Thomson and Dr. Payoshni Mitra, a gender and sports activist, were the first people to offer their support to her. Together they sat with Chand to discuss her options. One way to fall in line with IAAF's standards of how women should be was to undergo long-term hormone suppression therapy. But sometimes things don't stop there.

An oft-cited study published in The Journal of Clinical Endocrinology and Metabolism describes four athletes, between 18 to 21 years of age from "rural mountainous regions of developing countries" who were flagged at the 2012 Olympics because of hyperandrogenism. They were tall, slim, muscular, and flat-chested, but did not show any "male sex behaviour."

The study does not name the athletes, but they were brought to a hospital in France for evaluations, and their gonads were surgically removed—so that they could continue competing as women. Then they underwent further completely unnecessary and highly criticised cosmetic treatments like partial removal of the clitoris and "feminizing vaginoplasty," making it clear that looking like a "normal" woman was an important criteria as well. The policing didn't stop at just hormones.

"When I read that my condition is treatable, I thought they meant that I could take a medicine, like you take a painkiller," Chand told Mint. "But when I was told that it would involve changing my body in some way, I didn't want to."

So Chand decided to stand up for her right to run. She is the first athlete to appeal a hyperandrogenism ruling to the Court of Arbitration for Sports (CAS), a quasi-judicial body that is considered the ultimate authority in the sports world. A hearing on March 26 in Lausanne, Switzerland will decide if she can run among elite athletes again. A judgement in her favour has the potential to change the lives of numerous athletes out there who are being forced to do what many have done before them: meekly consenting to surgeries just to be able to compete.

Meanwhile, Chand got a breather. On December 18, the CAS accepted her plea to compete in national events. She had been itching to come out of the little hostel room near Mumbai where she was training for a train ticket collector's position, and had grown her nails for the first time. Once she got a chance to hit the track again in January, her big smile slowly found its way back. At the 2015 National Games in February, she won the 100 meter gold medal again. "She showed everyone that Dutee is Dutee," says Ramesh.

But the tracks of India aren't her final destination, and the battle isn't won yet. Ramesh says she gave her all for the event thinking it could be her last race: "She feels like she's standing at a traffic signal. The light turned yellow when she got the permission to compete nationally. But she's waiting for it to turn green."