Two-time Olympic gold medallist Caster Semenya was born a female, is legally female, has been raised as female and identifies as such. But because her body naturally produces high levels of testosterone, she is being forced to either have surgery or take testosterone-reducing medication in order to defend her 800-metre title at the Tokyo Olympics next year.
Semenya is hyperandrogenous, an endocrine condition that affects five to 10 per cent of women of reproductive age. In addition to high testosterone production, other signs of the condition includes high blood pressure, acne, a hoarse voice, and excess body hair.
In female athletes with “46, XY DSD,” the Y chromosome causes the development of testes which do not descend from the abdomen, but produce testosterone. And since the receptors for testosterone are abnormal, they have a vagina, but no ovaries or uterus. It’s a condition known as “intersex” — a general term used to describe someone born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male.
Because Semenya’s body produces more testosterone, in 2018, the International Association of Athletics Federations (IAAF) — the world governing body for the sport of track and field athletics — ruled she would have to take hormone-lowering drugs to continue to compete fairly. The runner appealed to the Court of Arbitration in Sport (CAS) citing discrimination, but the CAS upheld a rule requiring athletes with certain forms of what they called “intersex” conditions to lower their testosterone levels to maintain fairness in women’s track.
This, despite claims from sports scientists stating the court’s decision is based on weak evidence and sparks bioethical concerns. Higher levels of naturally occurring testosterone has not been proven to increase athleticism and the data the IAAF has used has been criticized and found to be flawed.
The World Medical Association (WMA) also spoke out, issuing a press release reminding doctors around the world to “take no part” in administering testosterone-lowering interventions to female athletes, saying the regulations are “contrary to international medical ethics and human rights standards.”
“We have strong reservations about the ethical validity of these regulations,” WMA president Dr. Leonid Eidelman said. “They are based on weak evidence from a single study, which is currently being widely debated by the scientific community. They are also contrary to a number of key WMA ethical statements and declarations, and as such we are calling for their immediate withdrawal.”
The WMA’s chair, Dr. Frank Montgomery, also advised physicians to “avoid” and “not take part in” hormonal interventions that “are not medically indicated, which have negative health effects and which are not based on an athlete’s free consent. “We regard it as unethical to do so,” he told CBS News.
She says no
Semenya has refused — as she has maintained for more than a decade — to take hormone blockers, which pose significant health risks such as blood clots. She has also criticized the unfairness and violation of human rights that the CAS’ decision symbolizes.
When was the last time a guy had to justify his testosterone?
Testosterone levels in women range from 1.12 to 1.79 nmol/L while in men, it can vary considerably — from 7.7 to 29.4 nmol/L. But men are generally only ever tested in cases of suspected synthetic hormone use because there is no upper limit to the levels of natural testosterone men are allowed to have in their bodies, reports the New Republic.
In fact, male athletes are rarely asked to reduce their biological advantages. Often called the “greatest of all time,” U.S. swimmer Michael Phelps has flexible ankles and size 14 feet that “turn his feet into virtual flippers.” His arm span of 208 centimetres is longer than his 193-centimetre height, giving him an advantage in the pool. Two-time gold medalist Finnish skier Eero Mäntyranta had a genetic mutation that increased his red blood cell count by 25 to 50 per cent, enhancing his oxygen carrying capacity. Both are celebrated, not criticized, for their natural gifts.
The CAS has acknowledged that the policy is discriminatory to athletes with DSD, but necessary. “Such discrimination is a necessary, reasonable and proportionate means of achieving the IAAF’s aim of preserving the integrity of female athletics in the Restricted Events.”
Still, Semenya continues to train for Tokyo. Except this time, it’ll be the 200 metre.
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