Category: Public Engagement

On the 5^th of September 2016, news broke of a study which showed that taking Vitamin D supplements in addition to asthma medication cuts the risk of severe asthma attacks and the number of people needing steroid treatment. BBC World News contacted the Society for Endocrinology for expert comment on the story – here Honorary Associate Professor at the University of Warwick Rosemary Bland describes what she learned from the experience and leaves her top tips for dealing with the media.

 

My Tuesday started off pretty normally. It was around 10.30 in the morning and I had just returned from B&Q with a car full of compost and wood when my mobile rang. It was the press office at the Society for Endocrinology, wanting to know if I could do an interview for the BBC.

“Phone or radio?” I asked.

“Live TV,” they responded.

My instant reaction was to try and get out of it, thinking about my appearance as I was decorating the house. I gave some names for other experts in the field but I‘d barely had time to consider my lucky escape when a BBC producer rang. I guess they couldn’t contact my scapegoat!

It was exactly 10.41AM and I was asked if I could make it down to the London studio for 12.15PM. This is where the speedy nature of journalism and my first lesson really sunk in – what would be a stressful, logistical nightmare for most is just a regular request from the BBC.

London was out of the question. Luckily, Coventry has a BBC studio and a taxi was booked to pick me up at 11.45. The producer asked me a few questions to give the interviewer some background on the subject and she asked who I was and what I did so they could introduce me. Easy enough? Actually I found it difficult to decide.

I know a lot about vitamin D, but what did I know about this asthma study? Not much more than I’d seen on breakfast TV that morning. After a quick Google, I found all 71 pages of it. Here was the second lesson: you will not have time to do any homework in detail.

After absorbing what I could, I began to think about how the only thing I had to sort out now was myself (no hair and makeup in regional studios). However, remember the quote from Alien “in space, no one can hear you scream” well when on BBC World News ‘no one in the UK can see you’, so that was strangely comforting.

The third lesson was on how to dress. The microphone clips on, but the wires go inside your clothes. A blouse was easy; a dress would have been more difficult. In regional studios the camera only grabs your head and shoulders, so shoes don’t matter, but the white blouse was too pale (I’m wearing a coloured top next time). The cameraman kept in touch with London, but it’s weird not being able to see the interviewer. Try not to glance at yourself on the adjacent TV – it doesn’t help.

The next thing I knew, Philippa Thomas in London was introducing me to the hundreds of millions of viewers watching BBC World News around the world.

Like a politician might do, I had thought of three main points I wanted to get across, so I found myself answering her questions that way. Is that a good idea? I don’t know, but it gave me something to focus on and I found that helpful. Here is one of the most important lessons – think about what you want to say, don’t rely on the interviewer’s questions. This is especially important for public health messages where caution needs to be urged. Just try and remember that you are the expert. As it was World News, I also had to remember not to be UK specific – so not ‘the NHS’, but ‘health services’.

Whether it was the producer (get a phone number for your BBC contact just in case and text them afterwards to ask for the clip), Coventry staff, or the VERY calm man in London who talked into my ear, everyone at the BBC was efficient and helpful. Remember that they do this every day, and so if they have forgotten the little things that might be worrying you; just ask.

When I rang the press office to tell them I was doing it they asked if I was excited. At the time it didn’t feel like it, but after it was all over I think I was. Would I do it again? Probably, but I hope I get the call when I’m not decorating.

Following the recent media coverage of Caster Semenya competing at the Rio Olympics 2016, we have republished an abridged version of Harriet Nerva’s essay on disorders of sexual development, which won the Society for Endocrinology Undergraduate Essay Prize in 2010. You can read the full version here.

Gender verification and sport are two terms which when put together provide a bang louder than any starting pistol. In August 2009, Caster Semenya an 18 year old South African female athlete won the 800m sprint in the World Championship in Athletics in a world-record time. Her muscular build and fast time fuelled rumours of hermaphroditism and levels of testosterone three times that of ‘normal’. She was ordered to take a gender verification test. The worldwide controversy that followed has forced athletic organisations to create new guidelines for intersexed athletes, also known as those with a disorder of sexual differentiation (DSD). These are still being decided as this essay is written.

So are you female or male? The answer may seem simple enough – except that is for the 1.7% of the population who are born intersexed, and, for any young budding intersexed athlete out there, the consequences may be far reaching.

Introduced in 1936, and used to catch male imposters in female sporting events, compulsory gender testing of female athletes was abolished in 1992, with organisations retaining the right to test anyone thought of as ‘suspicious’. Males and females have traditionally been separated in elite sport because of the competitive advantage that men are argued to possess. The advantage stems from biologically determined sex differences in physical characteristics such as height, body composition, muscle mass, endurance and cardiovascular capacity.

However gender testing was never meant to address the issue of intersexed athletes. There is no evidence that female athletes with DSDs have displayed any sport-relevant physical attributes which have not been seen in biologically normal female athletes. Why is Semenya being tested? The grounds for her testing and the test itself have not been clarified.

DSD or ‘intersex’ refers to the atypical appearance of the external genitalia at birth where they differ from the usual development of either sex and create difficulty in sex assignment. The DSDs can broadly be split into 3 groups. Firstly, disorders of chromosomal sex occur when there is nondisjunction of sex chromosomes during meiosis. Secondly in disorders of gonadal sex, chromosomal sex is normal but the differentiation of the gonads is abnormal.

Thirdly there are the disorders of phenotypic sex. Here the phenotypic sex is ambiguous or is completely in disagreement with chromosomal and gonadal sex. Female pseudohermaphrodites (virilised females) have a 46, XX karyotype and female gonads, but ambiguous or male external genetalia. Male pseuodohermaphrodites (undervirlised males) have a 46 XY karyotype and male gonads, but ambiguous or female external genetalia. A true hermaphrodite has both ovarian and testicular tissue, irrespective of karyotype. Internal genetalia may also be mixed and external genetalia may be male, female or ambiguous.

Methods of defining gender in sport have been notoriously controversial. In essence what gender verification tries to do is find a cut-off point between females and males. This is harder than it sounds – sex is not defined by one parameter, it is a complicated combination of many, but athletics bodies have broadly used chromosomal sex for differentiation. Do DSDs always result in competitive advantage and do they always affect chromosomal sex test results? What about all this testosterone rumoured to be flying around?

Whereas in men a testosterone dose-response relationship has been shown to exist in sport, in women this relationship has only been found in relation to ‘explosive performance’. This measurement of height and power output involves performing the lowering portion of a lift at normal speed while the lifting portion is performed as rapidly and forcefully as possible. The dose-response relationship found was weaker in women than in men. It has been argued that this is because of gender differences in skeletal muscle sensitivity to testosterone, but this has not been substantiated. Whether women show a dose response relationship across all sporting attributes (for example endurance) is unknown, possibly because there is a lack of data on the relationship between resting testosterone levels in elite competitors and neuromuscular performance. In 2006 Cardinal and Stone found that testosterone levels varied significantly in different athletic groups, with sprinters having the highest values for both men and women.

And what of Caster Semenya? If judged ineligible to compete as a woman, she would also be ineligible to compete as a man, and if she refuses to consent to treatment (and is not taking anabolic steroids), must she be allowed to compete as an intersexed athlete based in moral obligation of athletic organisations? Finally as these organisations move to open “centres of excellence” around the world that would be equipped to treat intersexed athletes with anything from hormone therapy to surgery (Handley, 2010), what is the role of endocrinologists? Torn between controlling athletic prowess and the best interest of the client, we have to ask how level the playing field can, and should, ever be.