Female Athlete Caster Semenya Loses Landmark Case Over Testosterone Levels

By Caroline L.

May 20, 2019

On April 2018, the IAAF (International Association of Athletics Federations) introduced regulations requiring female athletes born with differences in sexual development (DSDs) to lower their testosterone levels in order to compete internationally in events between 400m and a mile. The IAAF argued that these new rules were to protect female sports, as DSD athletes supposedly have an advantage over the rest of the field.

At the center of this new ruling is Caster Semenya, a South African middle-distance runner with several World Championship 800m titles under her belt. The South African has served as the face of this debate for fellow DSD athletes for almost ten years. In 2009, she was required to undergo a gender verification process, which, as previously stated, concluded that her gender was female. Semenya challenged the new regulations, arguing that her advantages are no different from any other genetic variations celebrated in sports.

One of the terms of the new rules the IAAF has put in place is that any DSD athlete must now take hormone therapy to suppress their natural hormone levels. In Semenya’s case, this means returning to hormone therapy to suppress her naturally-occurring testosterone, which she did 2010-15. If Semenya chooses not to do the hormone therapy, her only other option is to compete in events outside of the 400m to mile range, as there are far fewer DSD athletes that compete in those events. For an intense athlete like Semenya, adapting her training to another event after focusing on and excelling at the 800m for years would disadvantage her.

Semenya has no plans to begin a regimen that would change her biology, but on May 1, after months of legal battle, Semenya and her team lost their appeal against the IAAF in the Court of Arbitration for Sport (CAS). The CAS sided with track and field’s governing body, pushing out one of the greatest female 800m runners of all time.

Semenya’s legal team has called the ruling “discriminatory,” a statement that the CAS surprisingly did not deny. Instead, they released a statement saying, “The Panel found that the DSD regulations are discriminatory, but the majority of the Panel found that, on the basis of the evidence submitted by the parties, such discrimination is necessary, reasonable and proportionate means of achieving the IAAF’s aim of preserving the integrity of female athletics in the Restricted Events.”

Semenya’s case has prompted ethical debates over gender and medical enhancement in sports. The ethics board of the IAAF is made up of ten members, three of whom are women, one of whom is Black, and the CAS ruling team has 19 members, nine of whom are women, and one of whom is Black. Before the actual process of the appeal had even started, the makeup of the higher powers ruling on Semenya’s case was in and of itself cause for concern for Semenya and her legal team.

In Semenya’s case, the main issue is the difference between sex and gender and how the IAAF views Semenya in terms of both. Sex refers to biology, and gender to social roles or self-identification. In sports, the definition of male and female used to be based solely on sex. However, in the 1990s, it was switched to gender. This led to a gray area in terms of whether athletes could identify as a certain gender and thus compete as that gender or if their naturally occurring hormones would affect that. Semenya has aspects of intersex biology, but she was nonetheless raised female, is legally female, and identifies as female.

The CAS determined that Semenya has an “unfair advantage” because of the levels of testosterone in her body. Testosterone levels in men are 295 to 1,150 nanograms per deciliter of blood, while the levels in the women are 12 to 61 nanograms per deciliter of blood. The IAAF finds an issue with this because testosterone builds skeletal and cardiac muscle while also increasing the number of red blood cells in one’s body. Most scientists agree that testosterone is a key reason why professional male athletes are typically around 10-12% faster and stronger than women. These biological traits that can enhance one’s performance are what the IAAF claims are “unfair advantages.” However, Semenya’s team argues that DSD women with high testosterone may not get the same performance benefits from the hormone because their bodies do not convert the testosterone into a fully active form.

At issue is the athletic community’s definition of female-ness. Who or what decides the technically normal amount of testosterone a woman should have in her body? Dr. Helen Webberley, a doctor who specializes in gender issues, says that the verdict the CAS has reached assumes that there is a normal amount of testosterone that should be present in a woman. However, statistics on testosterone in women suggest that there is no norm for the amount that a woman should have. In fact, about 1 in 5 women in the UK have naturally high levels of testosterone.

Another concern has been raised about what amounts to an unnecessary administering of drugs. All professional athletes are regularly tested for drugs, and Semenya, who has never failed a drug test, would now be forced to take drugs administered by the IAAF in order to regulate her hormone levels, which goes against the general anti-doping missions of every major sports association.

A glimmer of hope for Semenya, her team, and other DSD athletes during this ordeal has been the highly criticized scientific reasoning behind the IAAF’s rules on DSD athletes. Although the CAS ruled against the appeal, they highlighted three potentially problematic areas to the rules put in place in April by the IAAF.

The first is the issue that there is difficulty in maintaining testosterone below the prescribed limit. The second is the fact that there is a lack of evidence that DSD athletes in the 1500m and mile have a significant advantage over their fellow non-DSD competitors. The third is that the side effects of hormone therapy could possibly negatively affect the performance of DSD athletes aside from their supposed pre-existing differences in performance.

The debates over Semenya and her case have yet to settle, but when Semenya lost her case on May 1, fellow athletes and mobs of Twitter users took to social media to state their support for her. Numerous professional athletes and even the South African government have backed Semenya.

Female athletes are no strangers to controversy and contention. Historically, women have had to fight for the right to participate, let alone compete, in sports. Alysia Montaño, an Olympic runner and three-time U.S. national champion, recently penned an op-ed in The New York Times, in which she revealed how pregnancy threatens sponsorships. In many cases, athletes are accommodated by their sponsors for injuries. However, those same sponsors also withdraw paychecks if women take time off due to pregnancy.

Semenya and Montaño’s stories illustrate the way women, especially women of color, can be scrutinized when they fall outside of gender norms. One thing is for sure; when the World Championships take place again in five months, if Semenya is not competing by then, her absence will be felt by all members of the track world, for better or for worse.