December 2009
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“Games of Truth”?

A Foucauldian Commentary on the Objectivation of Caster Semenya






Norman K. Swazo, Ph.D., M.H.S.A.

Professor of Philosophy and Biomedical Ethics

College of Science and General Studies, Alfaisal University

PO Box 50927, Riyadh 11533, Kingdom of Saudi Arabia



Mobile: +966 562736025

Office Telephone: +96612157726






Gender verification analysis has long been a contentious practice in the regulation of athletes competing in international competitions.  In recent time, consequent to her victory in the 800 meter race in Berlin, held in August 2009, the South African teenager Caster Semenya’s long-lived sexual and gender identity as a woman was challenged and Semenya subjected to gender verification testing.  Unofficial disclosure of the results by the public media has immersed the teenager into an international “game of truth” having untold consequences for Semenya’s personal life, with a need for revision of policy on gender verification such as implemented by the International Association of Athletic Federations (IAAF).  In this paper, the thought of French poststructuralist Michel Foucault is appropriated to highlight what is centrally problematic in prevailing practices of gender verification, thereby to call for reform of policy and practice.





“Games of Truth”?

A Foucauldian Commentary on the Objectivation of Caster Semenya




It is fatal to be a man or a woman pure and simple: one must be a woman manly, or a man womanly.

--Virginia Wolff




Introducing a Scandal

In August 2009, the South African teenager Caster Semenya competed in the women’s 800 meter race at the 12th International Association of Athletics Federations (IAAF) World Championships in Athletics held in Berlin.  As Ryan Lucas reported, “Semenya took the lead at the halfway mark and opened a commanding lead in the last 400 meters to win by a massive 2.45 seconds in a world-leading 1 minute, 55.45 seconds.  Defending champion Janeth Jepkosgei was second and Jennifer Meadows of Britain was third in 1:57.93.” (Lucas, 2009) If the truth be told as Virginia Wolf would have it, one must be a woman manly lest one meet the fatality of being simply a woman.  For Semenya, however, it is precisely because she presented herself in the setting of the world championship race as “a woman manly” that she was forced to endure the fatality of regulatory interrogations that would determine whether she is, in fact, a woman pure and simple.

Semenya presents a global event—her presence on the world stage converted suddenly from that of a gold-medal champion athlete to that of a problem, viz., a perceived indeterminate sexuality despite her having been reared in the rural environs of South Africa as a girl and now a woman.  Semenya’s mother stated unambiguously: “She is my little girl.  I raised her and I have never doubted her gender.  She is a woman and I can repeat that a million times.”  The grandmother asks, “What can I do when they call her a man, when she’s really not a man?”  Indeed…  What is anyone to do when denomination flies rudely, abruptly, violently, in the face of a personal history in which self-identity is held long secured by herself, her family, and her local social relations?

The world championships are what they are—they identify champions within the categories stipulated by various regulatory governance structures such as the IAAF.  But it is precisely this fact of governance, of regulation, that brings to the fore what is centrally problematic in what is now a scandal.  As Jenny McAsey opined, “It was simple enough for Caster Semenya’s rivals at the recent world championships in Berlin.  As far as they were concerned, she looked like a man and ran like a man.  She was a cheat, and should be barred.  To the millions of people watching around the world, the verdict also seemed clear-cut.  She was running in the wrong race.” (McAsey 2009) The scandal is less the assorted perceptions eliciting such superficial, even unwarranted, judgments.  The scandal is not even merely in the public disclosure of (unofficial) results of Semenya’s gender verification testing carried out under the authority of the IAAF which, prior to the Berlin event, already had in place a policy on gender verification prepared by the IAAF Medical and Anti-Doping Commission (2006).  McAsey’s entry in The Australian made it clear: Consequent to this interrogation, Caster Semenya is “lost in the grey areas of gender,” though long before in her settled comfort of life in South Africa she was hardly lost and quite at home as the woman all at home accept her to be in fact.

According to public reports, the IAAF panel investigating Semenya’s “gender” included a gynecologist, psychologist, and internal medicine specialist.  The decision to compose a panel in this way discloses a governing prejudice—gender verification is the province of medicine, and medicine qua domain of knowledge is accordingly appropriated by the relevant international governing authority to disclose the truth of the matter under dispute.  The IAAF commission writes, “Whilst this issue is far from completely resolved there is sufficient consensus of opinion amongst experts in the field as well as sports medicine specialists to be able to introduce a formal policy and mechanism, at least ad interim, so that proper guidelines can be given to event organizers, national associations, athletes and officials as to how to approach this problem and to come up with a satisfactory solution when faced with such a case.” (IAAF Policy, 2006)  Despite the policy’s explicit claim that there is to be no “compulsory” gender verification during IAAF sanctioned championships, Semenya was subjected to testing mandated by the IAAF in the face of media uproar.  Where there is an official challenge, the athlete may be requested “to attend a medical evaluation before a panel comprising gynecologist, endocrinologist, psychologist, internal medicine specialist, expert on gender/transgender issues.”  It is unclear whether, or to what extent, Semenya herself provided prior and explicit informed consent to gender verification testing, consistent with operative standards of biomedical ethics.  Nonetheless, responding to media reports on the results of Semenya’s testing, the IAAF issued a statement, saying, media reports “should not be considered as official statements by the IAAF” and, further, that “gender verification test results will be examined by a group of medical experts.”


The Failure of Prejudice

IAAF may not be faulted for a premature official decision in the Semenya case.  Notwithstanding, having installed a conceptual framework with an assortment of unexamined or unwarranted prejudices, IAAF manifests a failure of governance from the outset.  This failure can be disclosed and contested with reference to the relevant medical standards in place as well as with regard to assessment grounded in contemporary biomedical ethics.  But, the analysis demanded by the Semenya case is much more fundamental, and thereby at once an explicit challenge to the IAAF’s governing framework and a call for reform of its policy of gender verification.  The work of the French poststructuralist Michel Foucault provides the requisite analytical tools, to which we now turn.

Foucault locates his thought in what he calls “the critical tradition of [Immanuel] Kant.” (Foucault 1984) His project, he makes clear in a retrospective commentary to the first volume of his The History of Sexuality, is not “an analysis of errors that might be gauged after the fact.”  He is, as he says, concerned to understand a process in which subjectivation and objectivation are formed in relation to knowledge (connaissance): “This objectivation and this subjectivation are not independent of each other.  From their mutual development and their interconnection, what could be called the ‘games of truth’ come into being—that is, not the discovery of true things but the rules according to which what a subject can say about certain things depends on the question of true and false.”  Games of truth do not discover what is true about a thing, about a person. Rather, they form a subject as object of knowledge, this knowledge itself normative in the formation of that subject such that a person then “observes,” “analyzes,” “interprets,” “recognizes,” and understands himself or herself as “a domain of possible knowledge.”  “In short, this concerns the history of ‘subjectivity’, if what is meant by the term is the way in which the subject experiences himself in a game of truth where he relates to himself.”

In The History of Sexuality Foucault identifies in Western discourse on sexuality what he calls scientia sexualis: Sexuality, in short, is what it is consistent with the scientific knowledge, thus the scientific “truth,” one has of it.  So identified, human sexuality is immediately located in a context of power relations, in which the private and public become intermingled, often to the violent disposition of the private in the public domain of discourse.  This violent disposition occurs in the “medicalization” of sex, thus a discourse about sexuality in which medicine determines the normal and the aberrant, what is normal and what is anomaly relative to the categories of the healthy and the pathological.  Medicine, it is said, provides “the” truth about sexuality as a typology of human anatomy and physiology, as in the typology described by Stephen F. Kemp, who identifies five aspects of sexual differentiation: “genetic (or genotypic) sex [“the collection of chromosomes that an individual possesses,” thus males identified as “46XY” and females identified as “46XX”], gonadal sex [testes for males, ovaries for females], hormonal sex [androgen stimulation (testosterone) in the male, estrogen in the female)], phenotypic sex [“development of external genitalia”], and psychological sex [an individual’s emotive and behavioral expression of sexuality].  In most individuals each of these aspects develops along the same lines, so that they are all male or all female.”  When this is not the case in a given individual, this interpretive approach then speaks of “discordance of sexual differentiation.” (Kemp 2006)


But, in postulating this typology, medicine installs “a” truth disclosed in such typology and nonetheless installs what Foucault calls “systematic blindnesses.”  That is, medicine conceals what may otherwise emerge as “a” truth that challenges its inductively derived norm-ing/taxonomical practices.  These practices are given in clinical codification, this code then serving a dual function—descriptive and normative—in the service of accepted (dominating) social constructions, what in the Semenya case are social constructions about human sexuality generally but now specifically in those constructions that identify intersexuality. To “medicalize” intersexuality is to manifest a hermeneutic comportment and a methodological commitment—neither of which has the status of invincible universal.  Thus genetics, urology, endocrinology, and psychology/psychiatry become the dominant medical specializations determining method and outcome of investigations of intersexuality.  Through the impositions, individual and collective, of this scientia sexualis (as Foucault would say) medicine insists on manifest sexual confession—and this is clearly evident in Semenya’s case.  Either Semenya will confess her intersexuality, or, the medical panel will confess it through its official disclosure of the gender verification results.  Semenya is then expected to understand herself, to situate herself, in this game of truth—to observe, analyze, interpret, recognize, thus experience, herself as intersexual, given the domain of knowledge that identifies her so, that would thereby “govern” her self-identification and the authorized practices that issue from this game of truth.

What Semenya cannot and does not know is that she (and we) need not play this game.  Foucault’s analysis apprises us of “a systematic skepticism toward all anthropological universals”—thus, e.g., skepticism about the reigning anthropological universal that is given in sexual dimorphism—the “truth” that humans are (thus, should be decidedly, normally) only male or female, anything else an anomaly, an aberration, a “syndrome” subject to medicine’s authoritative disposition.  This is a modality of self-conception that is also a modality calling for self-interrogation in the sense that one can contest the application of the rules and so the application of the identities imposed through the descriptive and normative employment of those rules.  These, Foucault asserts, are historical constructs, despite their presentation as anthropological universals. “The discourses of mental illness, delinquency, or sexuality say what the subject is only in a certain, quite particular game of truth; but these games are not imposed on the subject from the outside according to a necessary causality or structural determination.  They open up a field of experience in which the subject and the object are both constituted only under certain simultaneous conditions, but in which they are constantly modified in relation to each other, and so they modify this field of experience itself.”

One is moved, thereby, to interrogate the extant practice of clinical codification as it applies in the case of Semenya, to ask whether one achieves through the installed codification thereby the truth about human sexuality or, more telling, whether through this codification there is installed merely a regulatory fiction, “useful” in societal relations but already masking a will to power (as Foucault, echoing Nietzsche, would say)—useful, that is, for medicine itself as a domain of practices already appropriated by governance structures seeking social assurances in the identification and protection of the “normal” against the “anomalous” in human sexuality, even in the setting of a sport event wherein one such as Semenya immerses herself as competitor.

Introducing the volume on Ethics and Intersex, Sharon E. Sytsma speaks of “the challenges intersexuality raises for both traditional medical practices and traditional cultural and religious views on human sexuality in general.” She writes of the need for “not only the improvement of our medical practices, but also an increasing social awareness and understanding of intersexuality and its implications.” (Sytsma 2006)  Sytsma defines ‘intersexuality’ as “the biological condition of being ‘in between’ male and female.” Significant for ethical analysis is the claim that “The awareness of human intersexuality has emerged largely as a result of the trauma and harm some intersexuals attribute to its medicalization—that is—to the fact that it has been treated as a kind of pathology in need of medical intervention.” (Sytsma 2006)  Sytsma adds, “In fairness, these medical practices were grounded in larger unexamined historical and cultural presuppositions.”  Further, given the practice of gender/sex-reassignment surgery, Sytsma observes, “it has been stipulated that parents should be informed that traditional surgical practices have not been based on evidence—that follow-up studies have not been conducted to ensure that medical protocols were really working to increase the quality of life of intersexuals, or that those practices would be better than simply providing psychological counseling to help parents and children deal with the ignorance and prejudices of people under the influence of the ‘sexual dimorphic’ assumption.”  The “medicalization” of intersexuality has entailed the dominance of urology in the management of such patients, “with input from endocrinology.”  But, writes Sytsma, “those focuses need to be informed by other disciplines as well—both medical and non-medical.  Only fairly recently has the idea that psychology and psychiatry could have an important role in the clinical management of intersexuality been gaining recognition, yet we are far from the point where psychologists are routinely incorporated into the clinical management team.” (Sytsma 2006)

Sytsma considers the argument: “Let us take as our starting point that intersexuality is natural.  If intersexuality is natural, then the assumption that all human beings are either wholly male or female, the theory of sexual dimorphism, is false, or at least it is not the whole truth.  Because there are so many causes of intersexuality, and because all these causes admit of degrees, the idea of a continuum between male and female emerges as a substitute for the ‘either/or’ model of human sexuality.” (Sytsma 2006)  Further, “Another implication of the facts and etiologies of intersexuality is that neither chromosomes, nor gene sequences, nor gonads, nor hormones, nor rearing, nor genital appearance alone determine sexuality.  Talk about being able to determine the ‘true sex’ of a person by attending to just one of these physical elements is not only arbitrary, but greatly misleading, and even harmful.  The truth is: some people are intersexed.”  Distinguishing intersexuality and gender identity, Sytsma writes: “Yet another continuum characterizes gender identity.  While most of us, intersexed or not, think of ourselves as having either a masculine or feminine gender identity, some of us feel in between these largely socially-constructed gender categories, or capable of identifying with either in varying degrees.  Further, gender identity is even more complicated, as is evidenced by the fact that in some individuals it changes throughout the course of their lives.” (Sytsma 2006)

Arguments issuing from child psychology and psychiatry distinguish sexual identity and gender identity. (Diamond 2002) Yet, in the Semenya case these concepts and their factuality are readily confused.  The IAAF itself is concerned with “gender” verification, yet the determination is decidedly medical, concerned primarily with anatomy and physiology as Kemp’s typology of clinical codification makes clear.  The literature manifests the primacy of medical analysis, “abnormal physical sex differentiation”—even as the latter is related to a given individual’s “psychosexual differentiation”—compared to “normal sexuality.” (Zucker 2002) The medical model remains dominant, such that ‘intersexuality’ “has become the preferred umbrella term used to encompass the diverse class of syndromes characterized by some abnormality or anomaly in physical sex differentiation.” (Zucker 2002; italics added) Intersexuality, thus, becomes in an individual subject-ed to medical scrutiny, a subject (in Foucault’s sense of a possible domain of knowledge with its scientific disclosure) denominated a “disorder of physical sex differentiation,” thus a subject of “clinical” management.

The fact is, nonetheless, that games of truth are in play—proponents of the “medical model” versus proponents of the “social constructionist” model. (Dreger 1998b; Fausto-Sterling 2000; Kessler 1998) According to the medical model, “Efforts to devise accurate taxonomic systems are, of course, dependent on our knowledge of multiple parameters that constitute biological sex”—parameters that include “diagnostic techniques,” including clinical miscroscopy, laparotomy, biopsy, histological analysis.  Despite such diagnostic methods, Zucker (2002) concedes, “the notion of a ‘true sex’ in intersexuality is problematic.  Given that a person’s physical sex is multidimensional in nature, there is no reason to insist that one parameter should necessarily hold precedence over another.”  The biological parameters are, of course, hardly determinative, since psychosexual differentiation also contributes to personal identity.  That is: “gender identity…refers to a young child’s developing a fundamental sense of belonging to one sex and not another;” “gender role…refer[s] to behaviors, attitudes, and personality traits that a society, in a given cultural and historical period, designates as masculine or feminine, that is, more ‘appropriate’ to or typical of the male or female social role;” “sexual orientation is defined by a person’s relative responsiveness to sexual stimuli;” and “sexual identity,” concerns how an individual self-identifies (man, woman, heterosexual, homosexual, bisexual, transsexual, etc.). (Zucker 2002)

Thus, any appropriate “gender” verification in the case of Semenya cannot be limited to biological parameters.  It may be argued, indeed, that Semenya’s gender socialization in the setting of South Africa—her gender identity, gender role, sexual orientation, and sexual identity—discloses more of who she is than does the sum of diagnostic results provided by medical analysis (the urological or gynecological disclosure of reproductive morphology, the endocrinological assessment of virilizing or feminizing hormones, genetic assessment of chromosomes, 46XY, 46XX, or other genotype).  Whatever the model, approach, and methods introduced, the fact is, as Preves concludes from her own empirical study in the North American context, “medicalization is experienced as alienating and shaming…” (Preves 2000) Despite IAAF’s presumed effort to implement its gender verification policy in this case, basic biomedical ethics principles have been ignored—non-maleficence, doing no harm to Semenya, despite beneficence interests, seeking to do good with reference to international championship participant protocol, in the collective sense.  The medical subjectivation of Semenya itself unavoidably and irrevocably introduces her to a prospect of sustained gender dysphoria, when otherwise Semenya would be quite “herself” as before the ruckus elicited from Berlin.

It is, therefore, no surprise to find a bioethicist such as Alice Dreger write a decade ago on ethical issues in the treatment of intersexuality and juxtapose the expression “ambivalent medicine” and “ambiguous sex.” (Dreger 1998a) The medicalization of sexuality and the subjectivation of individuals declared to be intersexual disclose the ambivalence of medicine in the face of a phenomenon identified as a syndrome, but which, external to this game of truth, would have a different disclosure.  The mis-management of the Semenya case highlights the presence of medical paternalism in conflict with normally expected deference to the (seemingly lacking) prior explicit and informed consent to gender verification testing in a teenager (or at least the proxy consent otherwise accorded the parents).


Conclusion: Achieving Justice in Sport Competition

            The Semenya scandal brings to the fore the occasion and motivations that put the gender verification process in motion and calls this process into question.  J.C. Reeser writes that the goal of regulations adopted by international sports federations “is to keep the ‘playing field level’ so that athletes may compete fairly and honestly.” (Reeser 2005) Prima facie, the goal is honorable and uncontroversial when the referential context is one seeking to assure fair and honest competition, thus to ward off and prevent cheating and assure “the integrity of the sport.”  ‘Cheating’ connotes deception, intent to deceive that materializes in a fraudulent practice.  In the case of Caster Semenya, neither she nor her sponsoring team structure of South African sports officials entered Semenya in the Berlin games with intent to deceive. Granted, as Reeser opines, “It seems intuitively obvious, given the physiological differences that exist between men and women, that athletes should compete against others of the same sex, unless otherwise specified by rule—for example, in coeducational contests—or in disciplines for which the physiological differences between men and women offer no competitive advantage or disadvantage.” (Reeser 2005)

Thus, “in keeping with the ethic of fair play,” Reeser adds, “most international sports federations…organize their major competitions along sex restricted lines.”  So it is with the IAAF Berlin competition in which Semenya participated.  Justice is achieved through such sex-restricted competition—the ethics of fair play assures neither competitive advantage nor disadvantage among competitors, and each is thereby given his or her due.  Giving what is due to her (absent evidentiary disclosures of any occult gender verification testing conducted by South African officials prior to Semenya’s entry into the Berlin games), all can readily agree Semenya is not “a man masquerading as a woman.”  From the focus on Semenya’s “manly” phenotype, one can identify an assumption, stated by Reeser more generally thus: “most people exposed to testosterone from puberty onward will develop physical and/or physiological attributes that contribute to a distinct performance advantage over most women.” (Reeser 2005) Semenya’s physical features suggest to many that her prowess in the 800-meter race derives from such hormonal (pre-pubertal, pubertal, post-pubertal residual) influence, and thus that she “upset the level playing field of female competition.”  But, at best one can say Semenya is nothing other than what Virginia Wolf found desirable, viz., to be a woman manly, rather than a woman pure and simple.  There is no injustice done when nature itself makes Semenya a woman manly, though nurture makes her a woman pure and simple.  Whether on the world stage in Berlin or in the remote environs of South Africa, Caster Semenya presents herself as the woman she is rightfully.

Accordingly, the IAAF’s policy of gender verification is in need of reform, to be broadened to include on such panels of experts the input of bioethicists and philosophers competent in intercultural philosophy, so as to overcome the structured prejudices of the medicalization of sexuality and the insults to intersexuals seeking their rightful place in international competitions.







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Dreger, A. 1998b. Hermaphrodites and the Medical Invention of Sex. Cambridge: Harvard University Press

Fausto-Sterling, A.  2000. Sexing the Body: Gender Politics and the Construction of Sexuality. New York: Basic Books

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