Hyperandrogenism in Athletics
Today, on May 1st, 2019, the Court of Arbitration for Sport (CAS) announces their verdict on Caster Semenya’s appeal against the IAAF’s rule placing an upper limit on the Testosterone level in female athletes to compete in certain events. It is a very complicated issue, and a tough decision to make, but it is imperative that the CAS rules in favour of Semenya, and here’s why.
Testosterone is a hormone found in the human body. The levels of testosterone in the blood are significantly higher for males than for females, with females generally having extremely low levels of testosterone. Some females, however, have higher testosterone levels than average. In particular, there is a condition called hyperandrogenism wherein females have higher levels of ‘androgens,’ such as testosterone. So, hyperandrogenic individuals, such as South African Caster Semenya, tend to have higher testosterone levels than the average range for females.
Testosterone has many functions, one of which is to contribute to the body’s muscle building processes. Given this, many believe that higher testosterone levels aid athletic performance. So, females with higher testosterone levels may have greater muscle mass and strength than the average female, possibly enhancing their athletic abilities. There has been quite some controversy around this as some believe that this gives hyperandrogenic athletes like Semenya an ‘unfair’ advantage in athletic competition.
The IAAF implemented a rule to eliminate this advantage, putting an upper limit on female athlete's testosterone levels. Athletes with testosterone levels higher than this would not be eligible to participate, unless they took medication to bring their testosterone levels under the allowed limit. So, Semenya, and other athletes with the same condition, used to compete under medication until 2015. In 2015, the hyperandrogenic sprinter, Dutee Chand, of India, appealed to the CAS, who ruled in her favour. The testosterone rule was suspended, enabling the likes of Chand, Semenya, and Burundi's Francine Niyonsaba to compete naturally. Last April, however, the IAAF reintroduced the rule based on new scientific evidence, reintroducing a lower testosterone limit, but only for events between 400 meters and 1500 meters. This includes 3 World Championship and Olympic events: 400m, 800m and 1500m, the latter 2 being Semenya's specialties. IAAF's justification was that they found that higher testosterone levels provided a very significant advantage in these events, but this effect is not as pronounced in others. The limit was put in place so as to try and ensure that all participants have an equal chance of winning these events. Athletes above this limit can either take medication or compete in the men's category, should they choose to. Later last year, Semenya appealed to the CAS, saying the rule was 'discriminatory,' and the court's verdict on the appeal will be released today.
On the face of it, it is easy to support either side of the argument. At first glance, the simple question crops up: these athletes are women, so why shouldn’t they be allowed to participate with women? A higher level of testosterone doesn’t change the fact that they are females, so logically, they should compete with other females. And the rule does single out a particular group, who are in a minority, so it’s can be considered discriminatory. At the same time, the all participants should have a fair chance, right? The rule seems only to attempt to give everyone an equal shot at the gold. As one delves deeper, the issue only gets more intricate and complex, and one’s opinion on it may change many times. But it is an issue which will have important ramifications in the future, so I want to try and deconstruct it a little further.
First, there are some key points that should be clarified. In the past, testosterone has been associated with doping incidents, so it is important to note that we can differentiate between naturally occurring testosterone and artificial testosterone. Artificially added testosterone comes under doping, but here, we are only concerned with natural levels of testosterone in the blood. There are some claims that discrimination has a role to play in the IAAF’s actions, and given the fact that there is no such regulation for men, and how the events affected happen to coincide with Semenya’s events, one can see where these claims come from. However, I’d like to keep faith in the IAAF, and I’m sure the Association has the health of the sport in mind as top priority. Moreover, there have been disputes over whether testosterone has a significant impact on performance or not, and if so, how much of an advantage does it give. Different experiments have yielded contradicting results, and the reliability of some of these studies has come under scrutiny. However, I want to focus on the more ideological arguments. I shall not go into the scientific basis of the issue, rather for argument’s sake, I will proceed with the assumption that higher testosterone levels do aid performance to a certain extent. Moreover, it is also essential to establish that nothing is more important to a sport than its competitors, so the only valid arguments are those which concern the athletes and the health of the sport.
Looking at it first from the IAAF’s point of view, one of their main arguments is that the prevalence of hyperandrogenic females in elite competition in these events is greater than in the general population, implying they may have an advantage. The IAAF are not wrong in their claim that hyperandrogenic athletes have had success in these events. Caster Semenya has been prolific in the last few years, winning 2 Olympic and 3 World Championship golds in 800m, clocking some of the fastest women’s 800 m times ever. The other two medallists in the event from Rio 2016, Niyonsaba and Kenya’s Margaret Wambui may also potentially influenced by the new laws. At least a small part of their successes may be attributed to their higher testosterone levels.
This puts the sport’s governing body in a difficult position as there’s a small percentage of the competitors that seem to be taking home a large share of the spoils. So, for many athletes who have worked hard their entire lives to get to that point, it becomes difficult to then stand at the start of the race knowing that you have a slim chance of winning, because some athletes may have a genetic advantage. So, the IAAF thought it necessary to eliminate this ‘unfair’ advantage and level the playing field. One could also argue that the IAAF isn’t being unreasonable. They are not barring these athletes from competing altogether. They still can compete, so long as they take medication to regulate their testosterone levels.
The IAAF is also concerned about the future health of the sport. They are worried that, with this perceived advantage that a small percentage of athletes may have, other athletes may be dissuaded from pursuing athletics, reducing participation in the sport. They argue that many athletes may not want to compete without an equal chance if winning, so athletics may have a future where only women with some sort of biological advantage would compete.
Given all these factors, one can understand where Sebastian Coe and the IAAF are coming from in wanting to level the playing field, but is what they’re doing really making the sport ‘fair’? It will have significant repercussions for the future of sport and these athletes’ lives, and this rule would be a step backwards in the social message it sends out.
First of all, this entire controversy is not fair on the affected athletes. The life of an athlete is tough enough without such setbacks. These athletes are being considered and treated as though they have cheated: they’re singled out as a group, have to take extra tests, their achievements are questioned, and rules are being made against them. But they are most definitely not cheating, they just run as they are and do the best they can. They are exceptional athletes who have dedicated their entire lives to the sport, just like all other elite athletes. To attribute their success to biological factors takes away from all their hard work and determination. It undermines their achievements and all they have contributed to the sport. The only case in which this rule might be justified is if people somehow used this condition as a loophole for cheating or doping. But there is presently no danger of that.
The implementation of this rule would be discriminatory, not through anybody’s motive or prejudice, but simply because of the impact of the rule. It takes a certain group of individuals, and deprives them of the right to compete, even though they have done absolutely nothing wrong. Moreover, these individuals may be perceived as ‘abnormal,’ and it would significantly damage their careers. Even the United Nations Human Rights Council has condemned the rule. Consider this, if say 80% of the population were hyperandrogenic, the IAAF would not put this rule in place, as it would no longer be considered an irregular condition, but would rather be the norm. So, the regulation is biased towards the majority, which is why it must not be passed. Discrimination, even if not intentional, cannot be allowed to proliferate into sports.
"All sports for all people" - Pierre de Coubertin
One may argue that it is also unfair if not everyone is given an equal chance of winning. But consider what Baron Pierre de Coubertin himself, the founder of the Modern Olympic movement, said: “The important thing in life is not to triumph but to compete.” Looking at this issue from that perspective, on one side, the new rule prevents some athletes from winning, while on the other side, the presence of these athletes means others need to push a little harder in order to win. “All sports for all people,” Coubertin said, and so the new regulation would go against what the Olympic movement stands for.
One may argue that, even under the new rule, hyperandrogenic athletes can still compete, but in reality, the options for them to do so aren’t fair. Asking them to take medication is not right ethically, firstly because of the message it sends out and secondly because, you can’t make athletes change who they are to be allowed to participate. It’s like reverse-doping, asking them to undo years of hard work. It doesn’t make sense. The other option, that they compete with men, is a little ridiculous. This is because firstly, it doesn’t make any logical sense. The athletes are women, so why should they be in the men’s category? Secondly, it sends out a bad social message. And lastly, it creates the same problem because, with the current position of these events, hyperandrogenic athletes then wouldn’t have a fair chance. To take Semenya’s example again: yes, she has been exceptional in women’s 800m, but in the last 4 months alone, over 1100 male athletes have run 800m faster than her personal best. So, the alternatives aren’t good options for the athletes.
Now, one may say that these kinds of differences in performance are what the regulations tries to prevent. However, it is important to remember that testosterone levels are not an overwhelming factor. Yes, they might boost athletic performance, but it isn’t as though hyperandrogenism suddenly makes people superhumans. Athletes like Semenya and Niyonsaba have been very successful but this success, like any remarkable athlete’s, is down to their personal efforts and commitment. Just because an athlete is hyperandrogenic, it doesn’t mean they have guaranteed success and something like testosterone levels is only one of several factors that contribute to an athlete’s success. This is further corroborated by the fact that no such regulation exists for men, implying that testosterone differences are not the most important determinant in performance. However, perhaps the IAAF does believe that testosterone levels are the overwhelming determinant of athletic performance. If that’s the case, however, this regulation is not the solution. The only way to ensure ‘fair and meaningful’ competition for all would be to change the categories for competition. Radical as it may seem, if testosterone levels are so important, it would be better to abolish the gender categorisation altogether and instead classify athletes by blood testosterone levels, creating maybe 4-5 different categories based on testosterone level ranges. However, it does not seem to be that significant a factor, nor does the prevalence of this condition seem to be so high so as to endanger other participants competitiveness, to demand such a reform in eligibility criteria. But the current rule is wrong.
Even if females with higher testosterone levels do have a slight advantage, this advantage is not ‘unfair.’ They have not done anything wrong (or anything at all, really) to gain an advantage, and it is all naturally occurring testosterone. The counter-argument is that a competition is only fair if everyone has an equal chance of winning. In reality, however, this is almost never the case. I’m sure there are plenty of athletes who have lined up against the likes of Usain Bolt, knowing that their odds of medalling are small. At the beginning of any event, the odds of each person winning are not equal, there are always some favourites and underdogs, so we cannot use that as our definition of ‘fairness.’ Attempting to level the playing field, therefore, by trying to give everyone an equal chance isn’t the same as making it a fair competition. In a sport like Basketball, being tall provides a huge advantage. Does that mean we disallow players who are extremely tall? Of course not. Look at how certain countries, regions, and athletes have dominated certain sporting events. It is apparent that all of these individuals and groups would have had some kind of advantage, be it in talent, anatomy, genetics, resources, experience, or any other factor. This did not make the competition ‘unfair’ and we did not stop these athletes from competing for it. Rather, many of them are celebrated for their abilities and success, as they should be. But the competition wasn’t ‘unfair.’ Instead, consider how the President of the IAAF, Sebastian Coe, defined fair competition as that where ‘success is determined by talent, dedication, and hard work.’ This is a good definition of ‘fairness’ but what the IAAF has failed to realise is that the case hyperandrogenism does not violate this definition. ‘Talent’ is nothing but natural ability. These higher levels of natural testosterone may give hyperandrogenic athletes an advantage, but only by boosting their natural ability. It is still only natural ability. Just because we can identify (or at least we think we can) a biological basis for part of this natural ability doesn’t mean it isn’t natural ability. It remains natural ability, and so it is talent. And we cannot stop people from competing because they have too much ‘talent.’ Because that would be very unfair.
Citius, Altius, Fortius. The Olympic motto: “Faster, higher, stronger.” With this new regulation, the IAAF may be missing the essence of sports. Sport is about pushing the boundaries of human capabilities. It is about will, resolve, and determination. It is a celebration of the human spirit. Its power lies in the stories it tells. But this new regulation would go against all of that, because it would discriminate against people who are going ‘faster, higher, and stronger.’ Athletes like Caster Semenya should be celebrated, respected, revered. They are redefining the limits of human abilities not only with their achievements on the track, but also outside of competition, by fighting discrimination and challenging stereotypes. Moreover, their success on the track will only serve to motivate their competitors to work harder than ever to overcome them. It is essential to the development of the sport. As humans, we cannot go against them just because they are a small group.
The CAS needs to think about the consequences of the regulation. Right now, hyperandrogenism would only be one condition that has been addressed, but there would be several different biological factors that contribute to athletes’ exceptional abilities. And since we have done so for hyperandrogenism, if these factors fall outside the norm, and give some athletes an advantage over others, shouldn’t we regulate those factors as well? The culmination of this would be a field of competitors who only fit the biological criteria of what is ‘normal.’ This would not only stifle the athletic performances of the exceptional, but would also go against the great example for diversity and progress that sport has the power to demonstrate. This is a danger that we must keep in mind.
Lastly, but perhaps most importantly, we need to consider the message that would be sent out by this rule. Firstly, there is a danger of this decision being made solely based on the number of people on either side. We have two outcomes, A (no testosterone regulation) and B (the testosterone limit passes). Outcome A would affect a larger number of people than outcome B, and for this, one may choose outcome B. This is because the human mind always has a tendency to favour the majority, but in reality, this predisposition of ours has been the root cause for plenty of prejudice, discrimination, and conflict throughout human history. Especially in the sporting world, this needs to be looked past, and we need to recognise that B has huge repercussion on the lives and careers of those it affects, whereas outcome A, while affecting a larger number of people, has a far less significant impact on their lives, and would be beneficial to sport in the long run. Secondly, the sporting world (which has so often been a benchmark against discrimination) would be missing a great opportunity to break past conventional norms of femininity and take a huge step against discrimination of any kind. Furthermore, it would be sending the message that it’s not okay ‘not to be normal,’ which is a terrible image for sport (which is supposed to celebrate the exceptional) to portray. It almost punishes them for being different. And asking them to take medication to become normal is asking them to change who they are. It’s like saying that hyperandrogenic women are too strong to be women. Any feminist, egalitarian, or compassionate human being should understand that these are not the messages that sports should communicate.
Overall, while it’s a very difficult decision to make, and both sides have very valid, understandable arguments, the correct course of action, all things considered, would be to suspend the IAAF’s testosterone eligibility regulation. Females with above average testosterone levels are women, so they should compete with women. The CAS will announce their verdict from Lausanne at 10 AM GMT, and let us hope they rule in favour of Semenya.