Report calls for an end to ‘harmful’ rules limiting female athletes’ testosterone levels

Renewed calls have been made to scrap ‘harmful’ and ‘discriminatory’ regulations forcing female athletes to regulate naturally-higher testosterone levels in order to compete.

It comes as a report by Human Rights Watch found that women from developing countries had been disproportionately affected by the ‘sex testing’ rules, leading to discrimination, physical and psychological injury and economic hardship.

The 127-page report, ‘They’re Chasing Us Away from Sport’: Human Rights Violations in Sex Testing of Elite Women Athletes, was published just over two weeks after it was announced that Caster Semenya, one of a number of female athletes with differences in sexual development (DSDs), would take her fight against World Athletics’ regulations to the European Court of Human Rights.

Under current rules, female athletes with testosterone levels above 5 nmol/L must suppress it below that, either through medication or surgery, in order to compete in events between 400 metres and a mile. The regulations have survived challenges by Semenya, the Olympic champion over 800m, at the Court of Arbitration for Sport and Swiss Federal Tribunal.

The Human Rights Watch report, however, argued there was no scientific consensus that women with naturally higher testosterone had performance advantage in athletics and questioned why male competitors were not subject to similar scrutiny.

The report called for the scrapping of the current rules as part of a wave of recommendations to World Athletics, the International Olympic Committee, Governments and the World Anti-Doping Agency.

“These regulations demean women, make them feel inadequate, and coerce them into medical interventions for participation in sports,” said Payoshni Mitra, the athlete-rights advocate who co-authored the report. “Modern sport should adapt itself to support inclusion and non-discrimination rather than perpetuate exclusion and discrimination.”

Athlete testimonies in the report included one individual describing their life as being over after being ruled ineligible: “No coach is interested in training me; no job. I couldn’t even eat.”  

Another read: “The doctor asked me about my life and did a physical exam where she checked my chest, my genitals, even inside, and she asked did I menstruate, did I have a girlfriend or boyfriend.”

Human Rights Watch partnered with Mitra and Katrina Karkazis, visiting professor of women’s, gender and sexuality studies at Emory University, and fellow at Yale Global Health Justice Initiative, to conduct research, interviewing affected athletes, coaches, and other officials and experts, as well as reviewing court and medical documents.

The report found that the process of identifying those covered by the regulations saw women athletes’ bodies subjected to public scrutiny, as well as degrading and often invasive medical examinations. It concluded that this amounted to policing women’s bodies based on arbitrary definitions of femininity and racial stereotypes.

“Animated by erroneous beliefs about testosterone, biology, and gender, and steeped in paternalistic language around ‘protecting’ women athletes, these regulations do untold harm to women,” said Karkazis. “These regulations are damaging because the underlying assumptions are inherently sexist – that women athletes are always inferior to men athletes, so we must police women’s sports in order to protect women. This policing does nothing to protect women; it only serves to harm them.”

Women interviewed in the report described intense self-questioning, shame, withdrawal from sport – even when it was their livelihood – and suicide attempts. A runner who had been sex tested and subsequently disqualified said: “I wanted to know the results…. I wanted to know who am I? Why are they testing me? They’re not testing other girls…. I wanted to know why they have taken me to the hospital, removing the clothes.”

It is not the first time Human Rights Watch has called for the scrapping of the current rules, which the World Medical Association has also urged physicians not to implement. Meanwhile, the United Nations High Commissioner for Human Rights decreed earlier this year that countries should outlaw sporting regulations that pressurise athletes with Differences in Sex Development (DSD) to undergo “unnecessary medical interventions” in order to compete.

Responding to the latest report, a spokesman for World Athletics said: “This report was not written by independent and impartial experts, but rather by advocates for one side of the argument. World Athletics was not asked to provide a response to these allegations as part of the report, which would have provided much-needed balance on this very complex issue.

“We remain committed to fairness for women in sport and reject the allegation that biological limits are based on race or gender stereotypes. On the contrary, they provide an objective and scientific measure to define the category, and are a necessary, reasonable and proportionate means of attaining what both the Court of Arbitration for Sport and the Swiss Federation Tribunal agreed was a legitimate objective, namely preserving fair and meaningful competition in the female category.

“In terms of Human Rights Watch’s other recommendations, published today, World Athletics president Sebastian Coe committed to the establishment of a Human Rights Working Group at the World Athletics 2019 Congress. This Working Group, made up of members from all regions, is tasked with developing a human rights framework for the organisation to be presented to the World Athletics Congress in 2021.”

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