Editor’s Note: Building on yesterday’s post, guest blogger Ross Aikins goes deeper into the strange world of performance enhancement.
Just last week, both NASCAR driver AJ Allmendinger and Cleveland Browns cornerback Joe Haden tested positive for using Adderall without a prescription. But with the world caught in a pandemic of Olympic fever, our collective doping suspicions were too transfixed on Chinese swimming sensation Ye Shiwen to notice . Yesterday’s post began to ask why—with so many substances, technologies, and rituals that purport to enhance performance in various occupations all over the world—are we so concerned about athletics?
For example, would anybody really care if Malcolm Gladwell wrote The Tipping Point while taking Concerta illicitly, or if we found out that the rhetorical clout of Noam Chomsky was aided by decades of beta-blocker use during public debates? To cite a few actual historical examples, the accomplishments of Jack Kerouac, Watson and Crick, and half of the Rock and Roll Hall of Fame aren’t invalidated despite the assistance of illicit substances.
This is another strange facet of sports: fairness is paramount, testing is objective, cheating is unfair, but the exemptions that allow athletes to take certain performance enhancing substances are both subjective and subject to change. There are also different planes of competition in sport, and we historically change how they’re defined. For example, men and women compete separately, while weightlifting and Greco Roman wrestling have different weight classes. We establish competition classes for the disadvantaged in the Paralympics but have arbitrary ceilings and floors—or usually neither—elsewhere in sport.
Kids are stratified by age in most youth sports leagues because age, development, and maturity are generally advantageous. (Except, interestingly, in women’s gymnastics. Remember the controversy surrounding the 2008 Chinese team in Beijing?). Being a relatively gigantic adolescent, Shaquille O’Neal was heckled regularly by opposing parents who wanted to see his birth certificate. Shaq checked out, but Bronx 2001 Little League World Series pitching ace Danny Almonte didn’t, and was disqualified.
By this logic of fairness, why aren’t there any 6-foot-and-under crew or basketball leagues? And why, since 1992, has 23 years-old been the cutoff for men’s Olympic soccer  but not women’s? Clearly women are different than men, but as reported in a recent ESPN piece, official definitions of exactly how different, as well as the criteria used to differentiate sex in athletic competition, have also changed over time.
When suspiciously masculine women began emerging from communist bloc countries to dominate competition in 1966, the International Association of Athletics Federation (IAAF) required all female athletes to submit to a “gender test” (i.e., a gynecological exam). Amid objections to these humiliating ordeals, chromosome tests were substituted during the 1968 Mexico Olympics.
Though chromosome testing was cutting-edge at the time it was still hardly sufficient, as approximately 1 in every 1,000 individuals has a chromosomal anomaly or intersex condition (e.g. Turner Syndrome, or Androgen Insensitivity Syndrome, etc.). This was the case with 1932 gold medal-winning Polish sprinter Stella Walsh, who in an autopsy after her death in 1980, was revealed to have ambiguous genetalia and an extra pair of sex chromosomes. More current examples include Brazilian judoka Edinanci Silva, who was born with dual genetalia but genetically female and thus eligible to compete in 4 Olympiads. And in 2009, after some well-publicized controversy and unpublicized results, South African runner Caster Semenya was also deemed eligible for London, earning a silver medal in the 800M. Experts also debated the conclusiveness of DNA testing, which was employed briefly by the IOC. But still, until 1999, mere “suspicion” could prompt a female athlete to submit to the old-fashioned gender test. For the 2012 London games however, hormone levels became the new determinant of what makes a female athlete.
Harkening back to the popular (and clandestine) use of ADHD medications in major league baseball, could such testing precedents be used to determine which players are allowed to use Adderall? We typically define the presence of ADHD by the skillful (or coerced) determination of a doctor (even “shopped” doctors) probably referring to his or her yet-to-be-released DSM-5. But as I’ve noted, sports can sometimes be strict and arbitrary. What if MLB Commissioner Bud Selig determined that levels of dopamine, or the presence of genes associated with ADHD heritability had to be present beyond a certain threshold in order to be granted a medical exemption to use a banned substance? Is that any more or less fair than the recent IOC resolution on gender?
The problem with the IOC’s latest solution to quantifying gender is that hormone levels in men and women can fluctuate as byproducts of either the normal training regimen and development of elite athletes, or genes. People are born with physiological (including hormonal) traits that they have no control over, some of which can be quite advantageous in sport. Are our rules of fairness in competition meant to exclude naturally gifted individuals? And where do the rules separate predisposed advantage from hard work? Are Dizzy Gillespie’s performance enhancing cheeks God-given or the result of a lifetime of jazz trumpeting? Who is to say whether Lance Armstrong’s lung-capacity and endurance aren’t simply due to hard work? (Not so fast, France).
People who study the science of sports reason that Usain Bolt, like Ye Shinwen, simply leverage their considerable genetic and physiological gifts to maximize athletic advantage. At 6’ 5”, Bolt only has to take 41 strides to run the 100M compared to 44-46 strides for the typical sprinter. In London, Ye dropped her personal best 400 IM time by a staggering 2 seconds since the 2010 Asian Games in-part because she had grown 12 centimeters (perfectly normal for a teenager); according to reports, she has giant, paddle-like hands and feet that may impart a hydrodynamic edge.
There is nothing in the rules against playing to one’s strong suits, and China is famous for combing its population of 1.4 billion specifically for sports strengths, not unlike a typical parent. If you have a child in the 99th height percentile, would you be doing a disservice to steer them toward an athletic career as a jockey or coxswain? But even those generalizations may not apply to the gifted few, which is a great thing about sports: the surprises, from Spud Webb to Oscar Pistorius. The point here is that genes are not fair, which brings us to the uncomfortable future of enhancement technology.
In 2000, an unidentified boy in Germany was born with a genetic mutation that naturally gives him the musculature of a Belgian blue cow (go ahead, click the link, I’ll wait) without ever having to step foot in a gym. The mutation limits the body’s natural production of myostatin, a protein that constrains muscle growth. Liam Hoekstra, now 6 years old, of Grand Rapids Michigan is the second reported case of this condition in humans. It may seem invasive to speculate about children who may very well develop complications from something that they have no control over. But what if there are no downsides to this condition and they grow up even healthier, with the natural strength and physique of the hulking engineer race from Prometheus? Would they—or other future babies with rare or extreme genetic advantages—be disallowed from competing in weightlifting or water polo for reasons of fairness in competition?
Or even crazier, what if we could turn these conditions on or off? The Pope would probably not approve, but by now it is clear that human genetic manipulation will be possible in future decades. Sci-fi wonks may fantasize that this can already occur on some corporately controlled Jurassic Park-style Islands that may or may not contain Dr. Moreau, and the World Anti-Doping Agency (WADA) is not taking any chances. Provisions against “gene doping” are already in the WADA codebook.
Fact or near-fiction, we already talk about genetic tinkering as more ethically palatable in the context of preventing ailments. Hoekstra and the German myostatin baby are being studied carefully by researchers keen on developing treatments for muscular dystrophy and other illnesses. If When we go there, is it such a far leap to enhancement? The realm of genetic tampering or Gattaca-esque testing and segregation in competition makes many people understandably squeamish, and is decades away from being relevant to sports. As an extension of enhancement technology though, medicine is largely responsible for a familiar sports narrative that we generally prefer: athletes overcoming physiological disadvantage or misfortune.
Oscar Pistorius is also in the news a lot because of something he had no control of. Pistorius, the South African sprinter born without fibulas, uses carbon fiber blades en lieu of feet, ankles, and calves, which were amputated just below his knees at birth. Experts debate whether Pistorius’ blades impart a mechanical advantage or disadvantage, but the bottom line is that—as amazing as it is that he is able to qualify for the Olympics—Pistorius is probably only allowed to compete in London because he is not quite fast enough to displace “able-bodied” athletes off the medal podium. With the unstoppable progression of medical technology, that won’t last long.
 It is again worth noting that there is no evidence to suggest Ye ever used a banned substance, and Olympic athletes are among the most tested humans on the planet.
 Even weirder: with three exempt roster spots per team.