(This is a cautionary tale. All persons and organizations in this short story are fictitious.)
From birth, Bory had had a warrior’s heart. Actually, even prior to being born, she had had to fight to survive. At 35 weeks, mom’s “water broke,” suffering from preterm premature rupture of membranes (PPROM). Bory experienced respiratory distress, as well as neonatal sepsis, forcing the doctor’s hand to deliver her preterm in order to avoid the alternative at all cost—fetal death syndrome. To add to her list of complications in the womb, Bory also suffered from a privation of oxygen and nutrients due to a complete separation of the placenta from the uterus, known as placental abruption. Lastly, upon delivery, the umbilical cord was strangling the future fighter. Thankfully, the OBGYN uncoiled the snake from around her throat like a skillful zoologist. The premature baby was born alive, Boryenka Polina Ivanov, weighing 4 pounds, 9 ounces.
Growing up, Bory knew unconditional love and support from her parents. Her “friends” from primary school—not so much. She was repeatedly and tirelessly bullied for exhibiting masculine mannerisms, especially on the playground. Bory was always the fastest runner, being the first in line to everything, including the lunch line. And the fact that she ate three times as much as everyone else in class made her the butt of a litany of jokes. She quickly became the target of cyberbullying in middle school once she told her fellow students that she wanted to be Class President. And not just Class President but President of Russia.
The kids howled at her. “You’ve gotta be liked to be popular. And you gotta be popular to be president. You’re no leader! You’re no hero! You couldn’t even get a khokhol[1] to evacuate to ‘Fire-in-the-hole!’” After school they pelted her with snowballs until she fell to the floor in the fetal position like she did when she was in the womb, defenseless but not destroyed. Sadly, the level of cruelty of adolescent children knows no social-emotional bounds.
There was always one student who teased her most, Christina Anna Petrov, her arch nemesis. She was relentless. If she weren’t so obsessed with humiliating Bory, one would think she were her best friend, given the inordinate amount of time she spent thinking of ways to be involved in her life–although for nefarious reasons. In class, Bory and Christina argued about everything, from religion to science, from politics to morality.
Then one day, the teasing suddenly stopped. There was an uncomfortable void where mocking once militantly pecked at the pecking order. As Bory reached puberty, her body morphed so drastically that she started to actually look like a boy. No one would dare mess with her now. Her testosterone levels surpassed that of all the girls in her class, put together. And it showed. Bigger and denser and stronger muscles and bones, as well as a bigger larynx which deepened her soft, delicate feminine voice. It seemed like overnight facial hair sprouted on a chiseled landscape of peach fuzz with an occasional pimple, until one pimple reproduced into a face full of zits. This frightened poor Bory. But not as much as it terrified her classmates. True, she always wanted to be strongest and most feared person in school. But she wasn’t ready for this type of developmental change. She was scared but she wasn’t about to let her classmates know. The thing that disturbed her the most was what she found in her nether regions—a “micro-penis”[2] where folds of skin used to be.
Alone. In her bathroom. She screamed. Her parents ran in. They tried to console her. She was having a panic attack.
“I’m a freak!” she cried. “Hideous… I can’t even look at myself anymore.” She removed her wet hands from her soaked face to finish, “Koschei must’ve put a spell over me. We have to find his egg.”[3]
“No, Love. You’re our perfect and beautiful daughter. We couldn’t be prouder of you.” Tata paused to raise her chin with his hand to have their eyes meet. “We’re going to get to the bottom of this. All this will be figured out. Don’t you worry. We’re right here with you.”
Bory was taken to an endocrinologist who ran a battery of tests to diagnose the issue and rule out any physiopathological conditions. Imaging tests showed conclusive yet rare results. An ultrasound was used to take an image of bilateral undescended testes and a laparoscopy confirmed there was no uterus. Ultimately, it was the outcome of Bory’s blood tests that influenced the doctor. She was diagnosed with DSD (differences in sex development). Her testosterone level was a few deciliters shy of 1,000 ng/dL. The normal range for men is between 300-1,000. And for women it’s 15-70. So she has almost 1.6 times the amount of testosterone of an average man. And almost 24 times the amount of testosterone of an average woman. Along with checking hormonal levels, her DNA and karyotypes were tested: 46 XY. Biologically speaking, Bory was born a male although anatomically she looked female at birth.
The world-leading endocrinologist explains his observations, tests, and findings to the family. Bory sat sandwiched between Mama and Tata as she self-stimulated by rocking back-and-forth on the stiff, abusive-vinyl sofa.
“Everything points to Bory being born with a difference in sex development. Her gonads developed testicles during late gestation. But no penis. That’s why the delivery doctor called her a ‘girl’ when in fact she was born a boy with a protein deficiency called 5-alpha reductase deficiency or 5-ARD, which means that the enzyme ‘cannot carry out its task of converting testosterone into dihydrotestosterone (DHT), which is necessary for complete masculinization of a male fetus.’”[4]
Bory stopped rocking and looked almost relieved to hear the doctor’s diagnosis, confirming suspicions she’s had about her sex since she was a little girl.
“So what’s happening to her now?” asked her Mama and Tata in unison.
“Bory’s body is responding to hormone signaling. In this case, testosterone is being synthesized, secreted and transported to targeted cells at a rapid rate—to the degree of which I’ve never seen in all my 37-years of testing, diagnosing and treating patients.” Her parents looked troubled. The doctor decided to take a moral-metaphorical approach, “This is a good thing. Think of it this way, she’s drinking from her own personal testosterone-fueled fire-hydrant.”
A nagging thought crept into her father’s mind, irritating his brain like an infected splinter refusing to go away until it had been dealt with. What will happen to Bory’s future as a female fighter? She just won Nationals for her age division and weight class. And in two years, she can represent Russia at the International Federation of World Athletics (IFWA) and take home the gold. In the body she grew up with. The body she’s known all her life. The girl we’ve named Boryenka, which means “fighter.”
The 15-year-old was processing everything the doctor had said. She was feeling exponentially more comfortable with her maleness. But her parents showed their emotional cards too early. Their “tells” too strong and too soon. They demanded a second opinion, storming out, leaving their daughter feeling embarrassed and even more confused.
Understandably, they thought they were protecting her, acting on her best interest. But they failed to comprehend the complexity of emotions she was feeling. And, as it happens all too often in situations where parents insert themselves into their child’s life, they influenced their daughter to reject her own biology and seek professional assistance elsewhere. Their protest was her poison.
Bory waited a moment before she followed her parents. Moving in what felt like slow motion, she stood.
The doctor felt compelled to share his own story with her. “I’m a transgendered male. And I couldn’t be happier. Embrace who you’ve always been. And who you’re becoming.”
He handed her a brochure, squeezed her hand and walked away.
But what the doctor failed to understand was the damage he was doing by playing “pastor,” using his own life story to influence her decision. It’s one thing to share the data-based evidence for her biological sex as a male with DSD. It’s another to seek to persuade her as a medical professional, regardless of his good intentions and personal anecdotes.
On the ride home, Bory was doing the best she could to continue weighing her options. Male or female? Acceptance or rejection? Biology or gender identity?
Although she was sitting in the back seat, only a couple feet away from her parents, she felt like she was isolated on a far-away speck of a rock on an island not found on any map.
Two years later, Bory found herself at Worlds, fighting for the gold medal as a female mixed martial artist (MMA). Her opponent—Christina Anna Petrov. Her middle school and high school rival. And now World Athletics’ rival although Christina defected to Ukraine soon after graduating from secondary education to train with legendary MMA fighter and coach Aleksander Borysko.
The IFWA criteria for both female athletes to fight in mixed martial arts consisted of a declaration that her gender identity is female and the maintenance of testosterone levels is below 8 nmol/L [230 ng/dL] for at least 24 months prior to competing and during competition.
They met the respective criteria.
Upon the opening round of the match, Christina attacked her with a superman punch, forgetting her training to initially evade. Wanting to end the bout with one death blow, Christina, a southpaw, overextended her left hand and lost balance. Bory side-stepped to the right and caught her left temple flush with her right glove. Christina immediately collapsed. Bory erupted. The referee began to count over the motionless body. When he reached “10” she was still unconscious. Bory’s dream to become a gold medalist at Worlds was finally realized. She ran to her corner where her trainer and Tata held her up as she extended both gloves into the air.
After 90 seconds of cheer, she realized that Christina was still not responding to the medical examiner. She became worried, practically throwing herself onto the floor next to her opponent. (If she were completely honest, she not only wanted to bite into her gold hardware and taste victory, she also wanted to knock out her childhood bully. But she never intended to permanently debilitate her.)
CPR was started. It ended with the sport’s doctor closing her pupil-blown eyes with his hand. Christina was dead. Bory ran out of the ring.
The next day, there was a press conference asking Bory questions about the match, once news leaked out that she was in fact a male with 5-ARD. She tried answering but couldn’t form the words to express her deep sympathy for the loss of her opponent. Of course, the rapid-firing questions of the media and the popping flashes of the reporters’ cameras didn’t help. Matter of fact, they made her feel nauseous. Again, she fled.
Rumors that the Petrov family was suing the Ivanovs and the IFWA for safety concerns, unfairness, performance advantage, and emotional distress turned out to be true.
Back at the hotel room, Bory was not taking any visitors. She wouldn’t even talk to her own parents. She crawled into the bathtub and cried herself to sleep. When she awoke, she opened every alcohol container she could find and fell to the floor with the gold medal still slung around her neck. Her back was against the wall adjacent to the bathroom. She opened her mouth and ingested the alcohol without swallowing. Her wide mouth and narrow throat acted as a funnel. This was no skill. Bory had never imbibed a day in her life. But she knew exactly what she was doing.
Her parents met with the leaders of the IFWA.
“We’re being charged with second degree murder!” exploded her father at the well-dressed, well-groomed men sipping on Svalbardi Iceberg Water. “They’re saying that Bory has a ‘performance advantage’ since she experienced testosterone-related muscle mass and strength due to male pubescence. They’re saying that once we knew she was a biological male, we should’ve changed categories from female to male.”
“Litigation is part of the game. Losers who can’t handle the outcome. So they retaliate with tenuous threats… ‘Lawyer up and shut up’ is my advice to you and your family,” spoke the round-faced man with thin lips and thin empathy.
“This isn’t a game! This is my daughter’s life. Her future.”
“And she’s got a bright future. If you stick with the script. She identifies as a female, correct?”
“Yes. That’s how we raised her.”
“It’s what it says on her passport, correct?”
“Yes.”
“Then we stay with the same narrative. All of us. You deviate. You die. Understand?”
“But what if they’re right? What if Bory’s biological advantage is only minimally reduced when testosterone is suppressed?”
“Let us handle that.”
“But the damage is already done! Maybe you should’ve changed the criteria to make it more safe by … by, I don’t know, by lowering the free circulating testosterone. Or by having stricter guidelines for full contact sports where the goal for both competitors is to cause brain damage in the form of a knockout. Or by—”
He’s interrupted. “You don’t get it. It doesn’t matter what we lower it to,” said the portly figure. “But you’re right. ‘The damage is already done!’ Once your daughter went through puberty, ‘male pubescence’, as you called it, her/his power would never be the same as an average female. So who’s really to blame?”
Like Bory, her father’s proclivity to “flight” over “fight”—only in circumstances of high emotional stress—took over. As he reached the room, he could hear crying coming from inside. He fumbled with the cardkey. The door swung open.
On the floor laid his daughter with her head on her mother’s lap. Her fingertips and lips turned blue from lack of oxygen.
“You were the best of both of us,” her mother whispered softly down at her child’s cyanotic corpse.
Just as Bory had entered this world fighting for her life, she left it fighting to escape for fairness. A fairness she never found in this world. A fairness that perhaps exists in the world to come. Where the Christinas of the world are given a fair fight. And where the Boryenkas of the world don’t have to fight.
[1] A pejorative term for a Ukrainian.
[2] This disorder of sexual development (DSD) typically happens after 12 weeks of gestation.
[3] Koschei is a Slavic-Russian mythological male antagonist who has the power to shape shift and torment people with magic. Inside an egg, his soul is hidden. He remains immortal as long as the egg is kept safe. If the egg is destroyed, so does his soul cease to exist.
[4] Children’s Hospital of Philadelphia (CHOP), “Ambiguous Genitalia,” https://www.chop.edu/conditions-diseases/ambiguous-genitalia (accessed August 24, 2024).