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The testosterone rule targets global south athletes like Caster Semenya

Caster Semenya of South Africa, silver medalist Margaret Nyairera Wambui of Kenya and Natoya Goule of Jamaica at the 2018 Commonwealth Games
Caster Semenya of South Africa, silver medalist Margaret Nyairera Wambui of Kenya and Natoya Goule of Jamaica at the 2018 Commonwealth Games Photograph: Athit Perawongmetha/Reuters

“I am unable to understand why I am asked to fix my body in a certain way simply for participation as a woman.” This was the reaction of Dutee Chand, an Indian sprinter, to being banned from competition in 2014 under a regulation from the International Association of Athletics Federations (IAAF), the governing body for track and field, that limited women’s natural testosterone levels. She courageously and successfully challenged it, arguing that the regulation, which would require her to undergo medically unnecessary interventions, was both unfair and coercive, adding that she was born, brought up, and identifies as a woman.

On Thursday morning, the IAAF unveiled a reworked version of its suspended regulation. Still drawing from the idea that women with high testosterone have a performance advantage over women with lower levels, this time they’ve lowered the testosterone threshold by half, and only track events from 400m to 1500m are under scrutiny. The IAAF vehemently defended the 2011 regulation as science, not sex testing, but this was never about science. This regulation is about targeting and impeding a few exceptional women of colour from the global south, especially Caster Semenya. It was a particularly cruel jab to release it on the heels of her 800m and 1500m wins at the Commonwealth Games.

The court of arbitration for sport – the world’s highest adjudication body – sided with Chand, saying the evidence that high testosterone creates performance advantage was too weak to warrant discriminating against women with high levels of the hormone. The court suspended the rule and gave the IAAF two years to present it with sufficient evidence to prove its case.

Instead, the IAAF changed the regulation, a pivot that revealed its true aim. As the window closed, a press release claimed its recent study looking at the relationship between testosterone and performance in 21 women’s track and field events could provide “new support” for the regulation. Critics immediately revealed flaws in the methods of the study the IAAF was trumpeting, undermining its findings.

Illogically, even taken at face value, the study’s findings don’t support the new regulation. Here’s why: testosterone was said to make a significant difference in five events. Women athletes were separated into three groups based on testosterone level, and the performances of the highest and lowest tertiles were compared. The biggest differences were in hammer throw (4.53%) and pole vault (2.94%). Smaller differences were shown for three running events—400m, 400m hurdles, and 800m (2.73%, 2.78% and 1.78%, respectively) Which events are included in the regulation? Not those with the greatest relation to testosterone, but the ones with the weakest. The 1500m, for which there was no effect, was also lumped in.

And in this calculated selection, the contours of IAAF politics are revealed. This is a regulation to exclude women from middle distance running events, the events in which women from the global south have excelled for decades. An IAAF official’s 2012 remarks revealed the geographic focus of his concerns:“[A]thletics is a whole world sport, it’s not purely the Caucasian sports. We have a lot of people coming from Africa, Asia and we have a lot of these [intersex] cases coming from these countries.”

What is hyperandrogenism?

Hyperandrogenism is a medical condition that causes a person to produce high levels of hormones. It has various forms but the IAAF introduced regulations on hyperandrogenism in intersex women that leads to them having testosterone levels that are higher than average for females. Intersex is a term used to describe variations in sex characteristics in someone who does not fit typical binary notions of male or female bodies. It is a sensitive and complicated issue but some claim that a woman who has an intersex condition has an unfair advantage.

When will the court of arbitration for sport decide on the new rules?

The IAAF ruled in 2009 that any athlete competing in a women's event must have a testosterone level lower than 10 nanomoles per litre. In 2015, the Indian sprinter Dutee Chand took the IAAF to the court of arbitration for sport claiming those rules discriminated against her because of her high testosterone levels. Experts for Chand showed the dividing line between men and women when it came to testosterone wasn't as clear as the IAAF suggested. Some elite male athletes had testosterone levels in the female range. Because of this, the court ordered the rules to be shelved until the IAAF could provide evidence to show there was a clear difference between male and female testosterone levels. On 28 July this year, Cas further suspended the IAAF regulation on hyperandrogenism until the end of September 2017.

Why was Semenya banned and then allowed to run again?

IAAF tests taken before Semenya won the 800m world title in Berlin in August 2009 led to her being declared ineligible to compete. The IAAF has not commented publicly on the medical details of those tests but they are believed to have been used to determine Semenya's sex and her testosterone levels. In July 2010, she was cleared to compete again by the IAAF after she was believed to have taken a course of testosterone-suppressing medication. She came second in the 800m at London 2012 then, after the IAAF was forced to drop rules regulating testosterone following the Chand case in 2015, she ran a personal best in Monaco in 2016 before claiming Olympic gold in Rio.

Today’s announcement highlights the science-y sideshow the IAAF uses in order to dazzle and distract from this bias. The court of arbitration for sport required the IAAF to show a performance difference between women with high testosterone and their fellow competitors that approximates the difference between women and men, roughly 10% to 12%.

In an laborious feat of reverse engineering, the IAAF pointed to three athletes whose performance suffered after their testosterone was suppressed. In these instances though, higher testosterone, specifically and by itself, cannot be said to cause the performance difference.

In another black box construction, the IAAF estimated that having testosterone in the “normal male range” increases muscle mass, strength and haemoglobin so much that it yields an overall advantage “greater than 9%” – close to the 10% minimum set by the court – without saying how they came up with this estimate. And it’s moving the target: its new regulation sets prohibited testosterone levels well below the normal male range.

A recent review by two Harvard endocrinologists concluded that it is “unclear” whether naturally high testosterone in women, including intersex women, “confers any competitive advantage”. By crafting an event-specific regulation that does not reach to Dutee Chand’s events, the IAAF circumvents the court’s review of its evidence and effectively closes Chand’s case. Meanwhile, the onus for bringing official scrutiny to this new regulation is once again placed on athletes in the regulated events, one of whom would have to bring a new case to the court.

The new regulation is peppered with the claim that this regulation will “ensure fair and meaningful competition.” But for whom?

Women with intersex traits, whom this regulation targets, aren’t banned outright. But the options available thrust them into impossible decisions.

Theoretically, they can compete in a category they don’t identify with: men, or some new intersex category. They can lower their testosterone using medically unnecessary interventions. They can compete only at the national level, or change to an event that doesn’t (yet) fall under the regulation – both of which prevent them from being at the pinnacle of their sport. All of these “choices” would curtail or end their careers.

Perhaps, most disturbingly, the regulation also continues the practices of sex testing and surveillance that have haunted women’s sports for too long.

What’s at stake here is far more than the right to participate in a sport. Women’s bodies, their wellbeing, their ability to earn a livelihood, their very identity, their privacy and sense of safety and belonging in the world, are on the line. This makes the IAAF’s pious commitment to “respect and preserve the dignity and privacy of athletes” all the more stunning.

• Katrina Karkazis is a senior research visiting fellow in the Global Health Justice Partnership at Yale University; Rebecca Jordan-Young is an associate professor at Barnard College, Columbia University