World Athletics president Sebastian Coe announced on 23 March that his organisation was amending regulations governing women’s sport. Alongside a wholesale ban on trans women’s participation in women’s sporting events, Coe also targeted athletes classified as DSD, i.e. having ‘differences of sexual development’.
It’s easy, as a spectator, to read things like ‘tightening restrictions’ without considering their real meaning, impact, or implications – but let’s examine a little.
Case in point
Caster Semenya of South Africa is the most high-profile DSD athlete. She’s a double Olympic champion and triple world champion in the 800m. However, instead of her extraordinary achievements, the sporting world has chosen in recent years to focus on questions about her hyperandrogenism. This is a condition which causes an elevated level of testosterone.
Two years after Semenya’s win at the 2009 world championships when she was 18, the IAAF (International Amateur Athletic Federation, as World Athletics was previously known) introduced new rules for the first time. They stated that hyperandrogenic athletes could compete on the condition that they display androgen levels below those recorded for cis men.
Then in 2018, the IAAF made it mandatory for athletes to lower their testosterone levels via drug treatments to under 5nmol/l. Competitors would have to do this for six months in order to compete in international events from 400m to the mile. Notably, these are Semenya’s main distances.
World Athletics: new regulations
It is these mandatory drug treatments, using anti-androgen medication, which World Athletics is now ramping up. Under the new regulations, DSD athletes will have to reduce their blood testosterone to an even lower level, less than 2.5nmol/l, in order to compete in the female category.
Competitors must also remain below this threshold for two years, rather than just one, as was the case before. The average level of testosterone in cis women is between 0.5 and 2.4 nmol/l.
World Athletics also removed the principle of restricted events for DSD athletes, i.e., 400m to one mile. This means the regulations now cover all events, rather than just the previously monitored ones.
Two years is a long time in terms of any sporting event. Athletes in sports which are based on power and speed are in their prime in their mid-20s. This is obviously a very small window. Mandatory waits to demonstrate ‘acceptable’ hormone levels eat into this precious time.
More importantly, we should bear in mind that this is medication we’re talking about. And more than that, it is completely unnecessary medication. It’s not being prescribed to DSD athletes like Semenya because they are ill. Far from it – Semenya is fit, powerful, and, above all, healthy. Drugs are being prescribed to these athletes because they’re performing ‘too well’ for the women’s event, based on a difference in their bodies’ makeup.
Anti-androgens are the class of drug used to lower testosterone, an androgenic hormone. There are several types of anti-androgens, and all carry risks and side effects:
- Spironolactone is usually used to treat fluid build-up due to organ failure. Because it affects the body’s fluid balance, it often has strong diuretic effects (increased urination). This in turn can cause electrolyte imbalances, which are undesirable for athletes.
- Cyproterone acetate lowers testosterone, but also lowers progestins. These are part of a cis woman’s baseline hormonal makeup – lacking them can cause infertility. Cyproterone also carries risks of blood clots and kidney failure.
- Finasteride is used to treat enlarged prostates and hair loss in cis men. It’s safety for cis women is untested.
- Gonadotropin-releasing hormone agonists (GnRH agonists) stop all natural hormone production. This would require the use of supplemental estrogen to make up the body’s deficit.
Again, all of these side effects are completely avoidable – by not taking the medication. There is no good, medical reason for DSD athletes to have to take these drugs unless their doctors say so. World Athletics is not a doctor, it’s a sports council.
This is what the issue boils down to. It is yet another example of the coercive policing of the borders of womanhood. Height, weight, muscle mass, lung capacity – the men’s competition allows any natural advantage you care to name. However, DSD women are required to take drugs they don’t need in order to lower their performance to an arbitrary baseline.
World Athletics is in charge of amazing, inspiring, extraordinary levels of sport, but sport nonetheless. It is not the sheriff of the border of the category of woman. It would do well to remember that.
Additional reporting via Agence France-Presse
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