Print T his week track and field athletes from all over the world are gathering to compete in the World Championships, an event second only to the Olympics in its level of prestige.
Two of the competitors, South African Caster Semenya and Indian Dutee Chand, will represent their countries while on a quest for gold and glory that started last summer in Rio. The limit dates back to , when the International Association of Athletics Federation IAAF , which oversees track and field events, first created the rule.
Naturally produced high testosterone, the group ruled, provided female athletes with an unfair advantage akin to doping — and so, to compete, a woman over the limit would have to lower her testosterone, through medication or surgery, or prove that she was not sensitive to its effects. That rule was put on pause after a challenge was brought in The arbitrators gave the IAAF a two-year window to provide evidence as to why the rule should persist, or else it would be permanently struck down.
Now, just as the races begin in London, the track authorities have taken their starting positions for a renewed legal fight, filing new evidence with the court that they say supports a testosterone limit — and setting up a complicated battle about sex, physiology, and ethics destined to play out on the largest stage in sports. A running controversy The case in consideration by the Court of Arbitration for Sport centers on Chand.
It quantified that gap as a percent difference. On July 27, , citing a lack of evidence for that magnitude of performance boost, the court temporarily suspended the policy. However, the arbitrators gave the IAAF two years to submit more evidence to support their claim. In recent months the IAAF has done just that, according to a recent press release and an expert witness who testified in Now, both sides will have an opportunity to respond to evidence in a back-and-forth that could drag on for months, and will culminate in the court deciding whether or not to strike down the policy once and for all.
Ever since women have been able to participate, athletic organizations such as the IAAF and the International Olympic Committee have struggled with how to define the female category, and how to decide who is eligible to compete in it.
Over the years, these organizations have deployed policies requiring female athletes to undergo everything from genital examinations to chromosome testing to prove their eligibility to compete as women, and even mandated that women who failed the tests undergo medical or surgical treatments to regain their eligibility, raising serious ethical questions in the process. The reason for a testosterone policy in the first place centers on the relationship between testosterone and biological sex.
Testosterone is a key hormone for the development of male reproductive organs, and also promotes increased muscle and bone mass and the growth of body hair, among other things. But women have testosterone too, typically in the 0. Another kind of superbug: David Cohen, an endocrinologist at Beth Israel Deaconess Medical Center not involved in the case, not all hyperandrogenism is created equal.
One such anomaly, for instance, is 5 alpha reductase deficiency, a rare genetic condition in which a woman can have XY chromosomes and internal male gonads that produce excess testosterone. Disorders of sexual differentiation, previously known as intersex conditions, highlight the inherent messiness of trying to strictly define biological male and female: Scientifically speaking, not everyone fits neatly into one sex category or the other.
Under the testosterone policy, female athletes over the limit had to lower their testosterone levels to compete, which can generally be accomplished with medication or surgery, depending on the source of the hormone.
Semenya continued competing, though the details of if and how she lowered her testosterone are not known. Neither she nor Chand has publicly discussed the cause of her hyperandrogenism. Testosterone and sport One of the strongest new pieces of evidence that the IAAF has in its arsenal is a study published just last month.
The researchers, funded by the IAAF and the World Anti-Doping Agency, divided male and female athletes into low, medium, and high testosterone groups based on results from routine pre-meet blood tests, and compared their athletic performance.
Their main conclusion, touted in an IAAF press release, was that women in the high testosterone group had a significant competitive advantage over women in the low group in a smattering of events, namely the meter, meter hurdles, meter, hammer throw, and pole vault. The advantage ranged from 1. Demand surges for clinicians serving transgender youth — and for earlier treatment That, the IAAF says, is evidence in support of its assertion that women with high testosterone see a boost in performance.
Cohen, however, sees some problems with the methodology of the study. And the paper also double-counted Her paper , published in late June and also submitted as evidence for the hearing, looked at the precursors of testosterone in Swedish women Olympic athletes. However, like the IAAF paper, that study can only establish an association between hormone levels and athletic performance, and it cannot determine whether increased hormone levels directly caused this improved performance.
These papers are certainly not the only evidence IAAF has gathered Hirschberg said other submissions will include individual cases of athletes with testosterone levels over the cutoff , but for Cohen, they are not convincing. Much of the IAAF argument hinges on the idea that a policy is needed to make competitions fair for other female athletes, and without it, female sports will decline. She goes into the World Championships ranked rd in the world in the meter.
Which brings up another question of fairness: She pointed out that elite athletes have many kinds of extreme physiologies that contribute to their success, and, moreover, athletes in countries like the U. Then there is the question of whether it is fair for the policy to only target women. The IAAF argues that there is a scientific basis, namely scientific evidence that indicates women, but not men, with high testosterone levels have a significant performance advantage over their peers.
Others, however, believe a policy that targets only female athletes is inherently sexist. Adrian Dobs, an endocrinologist at Mayo Clinic not involved in the case, can see both sides. And finally, perhaps the most fundamental question of all: Even if female athletes with hyperandrogenism do have a unique and significant performance advantage, is it automatically unfair?
At the end of the day, Karkazis believes that question is a social and cultural one. But for this year at least, as athletes take to the track, women will compete as women, men will compete as men, and testosterone will be left on the sidelines.