South Africa Runner Barred from Competing for High Testosterone Levels

Caster Semenya earned a silver medal in the London 2012 Olympics for the women’s 800 meters.

Caster Semenya earned a silver medal in the London 2012 Olympics for the women’s 800 meters.

South African runner Caster Semenya lost an appeal on September 8 challenging a World Athletics regulation requiring female athletes with sexual development disorders to alter their hormones through medication in order to compete in middle-distance olympic track races.

The initial ruling, which came into effect on May 8, says that athletes with a disorder of sexual development (DSD) would have to reduce their blood testosterone levels to below five nanomoles per liter through medication and maintain this level for six months in order to compete in the 400, 800, and 1500 meter races in international competitions. 

The National Health Service defines DSD as a “group of rare conditions involving genes, hormones and reproductive organs, including genitals. It means a person’s sex development is different to most other people’s.” The term applies to a number of conditions, including hermaphroditism and other cases of non-binary birth. Semenya’s condition falls under this category. 

The regulations initially came about because of key aspects of DSD, such as having testes or possessing both an X and Y chromosome, which “may convey a competitive advantage,” according to a study published regarding hormonal behavior. The study indicates further that endogenous androgens, also known as male sex hormones, stimulate muscle mass and reduce body fat. Androgens “likely also act on specific substrates in the brain to increase aggression and motivation for competition.”

World Athletics' first ruling on Semenya’s case in 2018 declared that DSD athletes “would have to lower their testosterone levels to those of ‘a healthy woman with ovaries’ by taking the contraceptive pill, having a monthly injection or undergoing surgery to remove their testes.” Semenya immediately challenged the rules at the Court of Arbitration (CAS), arguing that she had already taken the medication in 2011, but the pills made her feel sick and negatively impacted her performance. The court ruled sided with World Athletics.

In a similar case, another elite female athlete, Indian-born Dutee Chand, endured numerous rounds of tests in 2014 by the Sports Authority of India, which ultimately ruled that she had male hormone levels above the permissible level. Consequently, Chand received news that the only way she could participate in her race, the 100 meter, would require her to undergo “surgery or pharmaceutical intervention.” 

The CAS, however, questioned the athletic advantage of women naturally possessing higher levels of testosterone. In 2015, they suspended World Athletics’ practice of the hyperandrogenism regulation and gave the organization two years to demonstrate that higher testosterone levels actually enhanced the athletic performance of women. As a result, Semenya could compete without the use of contraceptives during the 2016 Olympics and 2017 World Championships, winning the 800 meter race in the latter.

Nonetheless, the CAS ruled in 2018 that the hyperandrogenism regulation restrictions would re-enter into force after a study by the British Journal of Sports Medicine asserted a causal link between higher testosterone levels and improved athletic performance in women. 

“Excluding female athletes or endangering our health solely because of our natural abilities puts World Athletics on the wrong side of history,” Semeneya said in response to the ruling. She also argued that the regulations unfairly discriminate because they target only female athletes with specific physiological traits. 

World Athletics responded to accusations of discrimination  by stating that “biology has to trump gender identity to ensure fairness” in sport. The Swiss Court backed CAS’ decision, writing that “they represent a fair, necessary and proportionate means of ensuring the rights of all female athletes to participate on fair and equal terms.”

After the appeal’s rejection, Semenya announced that she would continue to refuse to take testosterone-suppressing drugs. She has also commitmented to competing in the 200 meter race, which does not have restrictions on female athletes’ testosterone levels. 

The CAS’s determination remains within the scope of the original Olympic Charter. The Charter lays out the Fundamental Principles of Olympism and states that the right to participate in the games does not take into account “race, color, sex, sexual orientation, language, religion, political or other opinion, national or social origin, property, birth, or other status,” but does not include gender identity as a protected category.