The Robert MacNeil Report; Transexuality and Sports

ROBERT MacNEIL: Good evening. Jim Lehrer is off tonight. Dr. Renee Richards, the 42 year old, transexual tennis player moves into the second round of the Tennis Week Tournament at South Orange, New Jersey tomorrow, but she is no nearer to gaining admission to the U.S. Tennis Open at Forest Hills which begins next week. Forest Hills officials have demanded that she take a chromosome test like those required of women athletes in the Olympics to prove their femininity. Dr. Richards has refused to take the test and argues that her rights are being trampled on. At the same time she is not unhappy that the so-called "sex change tennis case" has focused more public attention on transexuals than-anything since the notoriety of Christine Jorgensen in the 1950`s. Dr. Richards lived as a man until last year. He was a successful ophthalmologist in New York and a ranked amateur tennis player. Since the sex reassignment operation a year ago, Dr. Richards has been living in California and playing tennis as a woman. That was fine until she decided to enter Forest Hills, the major tennis tournament in this country.

Tonight, the problems of being a transexual athlete and more widely the growing recognition of transexualism and the problems of acceptance in American society.

Dr. Richards, you want to play at Forest Hills. Why are you unwilling to accept a chromosome test?

DR. RENEE RICHARDS: I`m unwilling to accept it because I don`t think it is a good test for sexuality. Sexuality is many more things than what your sex chromosome pattern is. Socially and legally your sex chromosome pattern has nothing to do with it. I am a woman. My gynecologist will attest to that; my documents all say that I am a woman; and I live as a woman. To be asked to take the test that Forest Hills wants me to take seems unfair. They are only going to pass those women who have a specific type of chromosome pattern. That would eliminate most likely me, and it might eliminate some other women with abnormal chromosome patterns too.

MacNEIL: You, being a doctor yourself, if you already have not had a chromosome test as a result of your recent experience, you might suppose that your chromosomes might turn out to have the patterns of a man might they not?

RICHARDS: They might, and I think the probabilities are that they would show the male XY pattern. But I don`t think that it is a fair test for sex regardless of what the chromosome pattern might show.

MacNEIL: Wouldn`t you in fact, and I guess this is what is at the heart of this controversy, unless it`s just pure prejudice which we could come to in a minute. But wouldn`t you in fact, having been born with the body of a man and having played tennis as a man, and having the muscular structure of a man, have an unfair advantage when playing against women?

RICHARDS: I think that what you said just a moment ago is at the heart of it. At the heart of my being excluded is that people are afraid that I do have an unfair advantage having been a man. I don`t think that this is So. There are many women athletes, tennis players, golfers, track stars who have height, weight and muscle mass that is much stronger, bigger or in whatever dimension you would want to measure it, than I. Betty Stow from the Netherlands is 6`1" and 160 pounds; she`s taller and heavier than I am.

MacNEIL: With the same proportion of muscle?

RICHARDS: With the same proportion of muscle. I think that you could do muscle, mass testing which can be done putting somebody in a certain kind of a chamber which allows you to determine what their fat, muscle ratio and so on.

MacNEIL: So you are saying there are other tests than the chromosome test which might reveal whether you would have an unfair advantage.

RICHARDS: Yes. I think that one of the most amusing things was what I read in the newspaper this afternoon. They asked Elia Nastassi who is one of the best men players in the world what he thought of all this, and he said, "I don`t know what all the fuss is. She`s a woman. She can`t play both ways. She can`t play in the men`s, and besides she is old enough to be their mother. What are they afraid of?"

MacNEIL: Do you feel that you are being discriminated against, and if so, how?

RICHARDS: I`m being discriminated against by being deprived of my right to pursue my avocation, not my profession because that is medicine, but my avocation which is tennis. And I feel that I have the right to play tennis the same way that I have a right to alimony if I marry and divorce, and the same way that I have the right to reduce life insurance premiums as a woman. I have all the rights of women, and I have enjoyed them so far in my life, except from being excluded from playing in the U.S. Open which is the pinnacle of every tennis player`s aspiration.

MacNEIL: If you were the officials running the Forest Hills Tournament, how would you get around this?

RICHARDS: I think that some screening test is appropriate. I`m not sure, and perhaps Dr. Harris or one of the other doctors could elaborate on that. I think some screening test would be appropriate, and then in a questionable case, have a gynecologist examine the person, any certified gynecologist, and then you`ll have your answer, "Is this person a man or a woman?"

MacNEIL: Right. Dr. Dorothy Harris has a Ph.D. in physical education and sports psychology. She is a professor at Pennsylvania State University where she directs the research center for the study of women in sports. Dr. Harris, just to pick up on what Dr. Richards was saying, is the chromosome test a fair way of determining gender in so far as it is relevant to sports?

DR. DOROTHY HARRIS: I think it has been, but as we become more sophisticated medically then I think we have to develop other ways and devise other ways, and perhaps another test to make a fair analysis, because the chromosome test only determines whether one is a genetic male or genetic female. That in essence only provides the blueprint for the differentiation of the gonads, so that if one is a genetic male, a normal male will develop testicles and the female will then develop ovaries. All the differentiation thereafter is left to the secretion of those gonads. So I would say in the case of Dr. Richards, the influence on skeletal development, on muscle mass, which are very obvious changes in adolescence in males, and there are also changes in females, more fat percentage and some of the things that we test in terms of efficiency in sport, and I think it has only implication for sport.

MacNEIL: Could you tell us briefly why this kind of testing has become necessary in sports, particularly international sports?

HARRIS: I think at what cost winning, and the fact that there have been violations. It was only beginning in 1968 in the Olympics that they started doing this.

MacNEIL: You mean people were actually sneaking men into competition.

HARRIS: Yes, and a World Record holder of the high jump who was a German who was forced as a male to masquerade as a female and take that medal. It has created a problem. There was a Polish sprinter who unfortunately the gold medals that she won in 1968 were reclaimed after it was discovered that she had masqueraded. So I think there are problems. I think the implications are greater because there are countries in this world where Gold Medals are pretty important. And if there is an advantage to be gained I think many nations would resort to that advantage in countries where males may not have a choice.

MacNEIL: How do you view Forest Hills asking Dr. Richards to take a chromosome test? Is it just hypocrisy because they don`t want her in competition because they are prejudiced do you think; or are they trying to be fair in their way?

HARRIS: I think they are trying to be fair to other women, and I would say in all fairness that there aren`t many 41, 42 year old, female, professional tennis players who can play as well.

You don`t see them playing in Forest Hills anymore. And I think the fact that 25 year old, female professionals do not do as well against Dr. Richards is significant. I think that`s just one example. You don`t see very many 42 year old males still playing professional tennis either.

MacNEIL: No. So you think Dr. Richards does have an advantage in terms of her tennis capability.

HARRIS: Yes, I do.

MacNEIL: Are there any other tests which could equally determine the extent of her advantage?

HARRIS: We do this now for both males and females in international competition. We`re going to add steroids to see if males and females as I said are gaining an unfair advantage by artificially inducing androgens which improve muscle mass, therefore strength, therefore the ability to generate power. Interestingly enough in Montreal, one. female athlete was disqualified for evidence of taking antibiotic steroids. So we even have to monitor male athletes that they don`t try to enhance their own maleness or predisposition to muscle mass by artificial or synthetic rays.

MacNEIL: Could I just ask Dr. Richards? Would you like to reply? Dr. Harris evidently thinks that you do have some advantage because you play better than 25 year old, that is much younger professional women tennis players.

RICHARDS: The answer to that is that I did beat one 25 year old professional tennis player. That`s not the same thing as beating Chris Everett, and this one professional that I did beat was making her first tournament debut as a pro. From the people that I have spoken to who have played Chris Everett and have played me, they are almost uniform in their agreement that she would be an overwhelming favorite if she were to play me. I would also like to correct one thing that Dr. Harris said. It is true that the German athletes that were mentioned were masquerading as women, but the Polish Gold Medal winner that she referred to, Olga, was not such a person. This was a woman in every sense of the word except for the fact that she had testicular feminization which Dr. Granato can elaborate on. She had an XY pattern chormosome, but she was reared from infancy as a girl and became a woman and was a woman, and it was a horrible shame that they took her Gold Medals away from her when she was found to have an XY chromosome pattern.

HARRIS: I would agree with one exception. This problem, this pathology was discovered prior to adolescence, and therefore the influence of androgen did not influence her structure. Post adolescence I think then you have the benefit of all the influence of increasing levels of androgen through adolescence, and so you get all the masculinization.

MacNEIL: Okay. Let`s go on to discuss transexualism itself a bit more. There are more than 10,000 transexuals in the United States, 3,000 of whom have been operated on in this country. Although the first publicly disclosed sex reassignment operation was performed at John Hopkins University Hospital ten years ago, transexualism is known to have existed since ancient times. Roman, Greek and other mythologies mention people who have "the body of one sex and the mind of the other.,` Historians and anthropologists have documented cases of cross-dressing and gender confusion in all cultures. Until the late 1920`s psychiatric treatment had been used to treat transexuals but was unsuccessful. In the 1940`s Dr. Alfred Kinsey referred one of his patients to Dr. Harry Benjamin, a doctor researching the endocrine system. Dr. Benjamin was among the first to define transexualism as different from homosexuality and transvestism. He later became Director of the Harry Benjamin Research Project which treated hundreds of transexuals. The Problems of transexuals and the possibility of sex reassignment was brought to public light by Christine Jorgensen in 1952. In the last 24 years thousands of sex reassignment operations have been performed in the U.S. and abroad. One of these was done on the noted journalist James Morris who wrote a book about it entitled Conundrum, From James to Jan. In it Jan Morris outlines her problems with traasexualiaid" saying "I was three, perhaps four years-old when I realized I had been born into the wrong body and should really be a girl." Dr. Charles Ihlenfeld is a physician who worked with Dr. Harry Benjamin for more than six years in the treatment of transexuals. Dr. Ihlenfeld, what exactly is a transexual?

DR. CHARLES IHLENFELD: Exactly is a very hard question to answer. The simplest definition, the one that people generally assume, is that a transexual is a person whose body is of one sex and whose mind is of another. I think that it is easy to think of it in these terms when you speak with people who do have gender confusion or gender problems because they have a very, very real sense that their mind, their spirit, their psyche is at opposite poles from their body. We know certainly that the body of a transexual male who wants to become a woman has no demonstrable physical endocrine or chromosomal abnormality. Nothing that would differentiate this person from someone else who is a male with a male gender identity. Likewise, in genetic females who feel that they should be males, there is no demonstrable difference.

MacNEIL: Is it more common one way than another? I mean are there more . . .

IHLENFELD: It appears to be more common in the genetic males who want to become women.

MacNEIL: I see. And how does transexualism differ from homosexuality or transvestism?

IHLENFELD: We think of transsexualism and transvestism; transvestism is a condition in which in the genetic male, there is a desire for episodic, cross-dressing as a woman. This is generally done for erotic purposes. This is a syndrome that is unknown in the genetic female I might add. Homosexuality: we have some one who identifies as a male or as a female and simply prefers sexual partners of the same sex.

MacNEIL: Do you know anything about the causes of transexualism?

IHLENFELD: One can speculate. I would defy anyone at all to tell exactly what is the cause of transexualism. My own feeling is that it probably has at least a two-fold origin. We know from work on laboratory animals and also work done in intersex conditions in human beings that there most likely is some prenatal effect of androgen on the developing, central nervous system. Whether or not this alone is enough to cause the gender dysphasia to the degree found in transexualism I can`t say. I certainly don`t think this is enough. The psychoanalysts have been able to trace the origins of cross-gender identity back to some of the earliest phases during which the infant individualizes himself or herself as an entity separate from the mother and then develops his own sense of identification. My own feeling is that we are probably dealing with a phenomenon that is based predominantly in rearing but most likely has in most cases, some sort of underlying neuro-endocrine basis, foundation.

MacNEIL: I see. So people have, they are born with some sort of predisposition toward this, and then their rearing can intensify that.

IHLENFELD: I think that when we are born we all have multiple potentials for development, and I think that the people who develop a gender dysphasia in adults probably have some disposition that other people don`t have.

MacNEIL: How do you decide when people who are transexuals present themselves to you for treatment, how do you decide which ones it is appropriate to treat with the operation and which ones not?

IHLENFELD: The University Clinics find that between 11 and 18 or 19% of the people who come applying for sex reassignment turn out to be what they consider good, class A candidates for sex reassignment. The answer lies in an enormously detailed investigation into the background of the individual, and an extended period of psychiatric interviewing, psychological tests sometimes help but they generally don`t show anything that we don`t know; as well as physical and laboratory examinations into the individual. Following all of these things, it is essential that the person who appears to have a gender disphoria which can be helped by sex reassignment, and certainly this is not the case for all; but those who appear to be good candidates should then undergo a period of at least two years of living in their desired gender role so that they can prove first of all to themselves and then to their doctors to their families and to the society at large that come willy-nilly they can make it in their new role, and that indeed they prefer life in that role to life in the old role.

MacNEIL: Thank you. Dr. Roberto Granato is a urologist who` is a professor at Columbia Presbyterian Medical School in New York. In the last seven years he has performed some 200, male to female, sex change operations including the one for Renee Richards. Dr. Granato, how complicated an operation is this?

DR. ROBERTO GRANATO: I apologize for this deviation from your question, but I must not be unfair to Renee Richards and to many other transexuals who are probably listening to us now. If I don`t make a statement about my feelings about the chromosome test and about the previous conversation that we had. To begin .with, chromosome tests will tell us that an individual has an XX or an XY pattern. Besides in many, many other cases it will tell us whether an individual has an XXXXY, four X`s and a Y, or three X`s and a Y, or three X`s, and some patterns will be so mixed up that some of the cells of the individual will be XX and the others XY. We call this mosaic. So if that individual was raised as a girl although has male genitalia, and that individual spiritually, sexually, socially is a girl, has an operation then, the part of the glands which are secreting the androgens -- I try to make it as lay as possible my nomenclature. . .

MacNEIL: You are almost succeeding.

GRANATO: The part of the endocrine system which secretes the male hormone is removed by the castration, naturally. That individual, as far as I am concerned, has the feminine attitude of a girl, has the feminine attitude when it comes to sex, has a feminine sex, has the breast development, has a vagina which can have normal sex and enjoy it, have a normal orgasm. As far as I am concerned that is a woman, and she should be allowed to play in any woman`s competition. To do otherwise is hypocrisy. Number two: I want to answer to Dr. Harris. When they were talking about the syndrome of feminizing testicles, that girl Olga. I will define it in a lay way for you. Syndrome of feminizing testicles is one in which the individual was born with testicles; testicles which secrete a normal amount and sometimes higher than normal, male hormones. However, and that`s a great point, the individual developed into a female. Female in shape, female in appearance, female in spirit and so on and so forth. Why? Because the hormones secreted by those testicles are not integrated and elaborated by the cells of body. It`s as though I were talking to you in Chinese, and you don`t understand. I talk; I can talk like a machine, but you don`t understand me. The same thing happens with the syndrome of the feminizing testicle. So although in those patients titer of testosterone which is the male hormone in the bloodstream will be high, they are female.

MacNEIL: Okay. That was a very special case that you were discussing with the Polish athlete, Olga.

GRANATO: And the XXY, and so on and so forth; they have two or three X`s. So are they called male or female?

MacNEIL: I`m afraid you have made those points now, and now we don`t have time to ask you in detail about the operation. I just wanted to come back - - we have a minute left -- I wanted to come back to Dr. Richardson. Is tennis the only area in which you have had problems in re-adjusting, and is it confined to your sports performance or what about the other parts of your life?

RICHARDSON: I think that I have been very fortunate that I have had no difficulty socially or professionally in adjusting following my surgery. I have been welcomed into the medical community; I have been welcomed into the wonderful community of Newport Beach, California which is my new home. I don`t even think of it as a new home anymore. And I`ve even been welcomed tennis wise in Southern California. The only place that I have been unwelcome is Forest Hills which happens to be my birthplace and where my father still has his home. However, for some other people this adjustment hasn`t been as easy as it has been for me. It`s been easy for me because I have a profession that I can still practice; I have friends that still love me; and I have a family that didn`t throw me out and still loves me no matter what shape or form I`m in.

MacNEIL: Okay. Thank you very much indeed. I`m sorry we didn`t have more time to discuss all this, but thank you all for coming. I`m Robert MacNeil. I`ll be back tomorrow evening. Good night.