Portal de Periódicos da CAPES

Personal Account: A woman tried and tested

2005; Elsevier BV; Volume: 366; Linguagem: Inglês

10.1016/s0140-6736(05)67841-5

1474-547X

Maria José Martínez‐Patiño,

Genetics and Physical Performance

From 1968 to 2000 women athletes had to undergo genetic testing to prove their sex before they could compete. From its inception, medical experts questioned the ethics and efficacy of this policy. As an athlete, I believe it added an obstacle to the already demanding course that women had to take to participate in sport. I was born and raised in northern Spain. I had the life of a normal girl, except that I had an affinity for running and jumping. I excelled in athletics and competed at the national level, but only because of concentrated effort and training. I was overjoyed to be able to participate in the 1983 World Track and Field Championships in Helsinki, Finland, when I was 22 years old. There I passed my first sex test, and was given a Certificate of Femininity. In 1985, I went to the World University Games in Kobe, Japan. Unfortunately I forgot my certificate, and my buccal smear test for two X chromosomes had to be repeated. Later that day, our team doctor told me—in front of the team mates I sat with on the night before my race—that there was a problem with my result. At the hospital the next day, I learned that a sophisticated karyotype analysis would be undertaken, and that the results would take months to reach my sports federation in Spain. I would be unable to compete in that day's race. Our team doctor advised me to consult with a specialist when I got home, and urged me in the meantime to fake an injury, so that no-one would suspect anything untoward. I was shocked, but did as I was told. I sat in the stands that day watching my team mates, wondering how my body differed from theirs. I spent the rest of that week in my room, feeling a sadness that I could not share. My mind spun: did I have AIDS? Or leukaemia, the disease that had killed my brother? Back in Spain, I began trying to come to terms with what was happening. Growing up, neither my family nor I had any idea that I was anything other than normal. I went to the best doctors. I attended all appointments alone, however, because I hadn't the heart to tell my parents something was wrong (they were still grieving for my brother) and because my federation was at a loss about what to do until the karyotype result came through. 2 months on, the letter arrived: "All of the 50 counted cells by Giemsa staining had 46 chromosomes. Karyotype analysis by Q-banding method revealed her sex chromosome constitution is XY. Karyotype is decided 46, XY". I have androgen insensitivity, and don't respond to testosterone. When I was conceived, my tissues never heard the hormonal messages to become male. As I was about to enter the January, 1986, national championships, I was told to feign an injury and to withdraw from racing quietly, graciously, and permanently. I refused. When I crossed the line first in the 60 m hurdles, my story was leaked to the press. I was expelled from our athletes' residence, my sports scholarship was revoked, and my running times were erased from my country's athletics records. I felt ashamed and embarrassed. I lost friends, my fiancé, hope, and energy. But I knew that I was a woman, and that my genetic difference gave me no unfair physical advantage. I could hardly pretend to be a man; I have breasts and a vagina. I never cheated. I fought my disqualification. Over the next 2 years, I received letters of support from Albert de la Chapelle, a Finnish geneticist who was an early, vocal opponent of blanket chromosome testing, and from Alison Carlson (see Essay page S39), an American coach and journalist who educated athletes about the ethical difficulties of gender verification. She helped me to tell my story in the press. A sympathetic Spanish professor gathered my medical evidence and presented the scientific reasons why my case should be reviewed during the Olympic Medical Commission meetings at the Games in Seoul, 1988. They all encouraged me in my endeavour to change the regulations and the mindset of sports administrators about perceived advantage in women with congenital differences. Coverage of my case helped to trigger the end of chromosome-based testing. In 1988, the medical chairman of the International Federation for Athletics, Arne Ljungqvist, gave me licence to run again. I paid a high price for my licence—my story was told, dissected, and discussed in a very public way—and my victory was bittersweet. After 3 years away from sports, my momentum was lost. I trained, hoping to qualify for the 1992 Olympics in Barcelona, Spain, but missed the mark at the trials by ten hundredths of a second. I have helped other sportswomen with genetic variance participate without fear, however, and my experience has made me stronger; having had my womanliness tested—literally and figuratively—I suspect I have a surer sense of my femininity than many women. María José Martínez-Patiño was a national champion hurdler in Spain. She retired from sport in 1992, and studied political science and sports science. Her doctoral thesis analyses the changing role of women in sport and the difficulties they face. She teaches at the University of Vigo, Spain, and lectures worldwide. María José Martínez-Patiño was a national champion hurdler in Spain. She retired from sport in 1992, and studied political science and sports science. Her doctoral thesis analyses the changing role of women in sport and the difficulties they face. She teaches at the University of Vigo, Spain, and lectures worldwide.