Intersex in sporting competition: The current state of debate

Since October 2017, there has been a debate in Germany about a third positive sex marker in the birth register, and a new law has now been in place in Germany for a few days. Nevertheless, the discussion about sex categories that has been going on for decades in international sporting competition seems to have remained untouched by this. As in 1966, it is limited to the question of whether and on what basis it is possible to exclude track and field athletes from international competitions if they have a variation in physical sex characteristics.

The International Association of Athletics Federations (IAAF) and the International Olympic Committee (IOC) believe that “hyperandrogenic” women – i.e. women with a body testosterone production of >= 10 nmol/L, which is in the “male” range – have an unfair performance advantage over women who showed a testosterone level in the “female” range, which is the equivalent to 1 to 3 nmol/L (cf. Karkazis, Jordan-Young, Davis & Camporesi (2012) and the New York Times of 28 June 2016). According to the IAAF and IOC, it is precisely the difference in testosterone levels that is the basis for almost all sports to be practised under sex separation.

According to an article in the German newspaper “Die Zeit” dated 23 October 2018, the IAAF had introduced a regulation in 2011 that excluded “hyperandrogenic” track and field athletes from international competitions. The impetus for this came from the case of Caster Semenya from South Africa, who won the World Athletics Championships in 2009 and who has regularly had her gender questioned ever since. A complaint by Dutee Chand (a sprinter from India) to the Court of Arbitration for Sport (CAS) in 2015 resulted in a two-year suspension of this regulation in order to verify its scientific soundness.

In 2017, the head of the IAAF’s Health and Science Department and another IAAF member published a study that found that women with higher testosterone levels had a performance advantage of 1.78% to 2.78% in 400- and 800-metre races and 400-metre hurdles. The study is expected to form the basis for the IAAF to introduce a new regulation on the testosterone limit. This was, in fact, supposed to happen in November 2018, but was postponed to March 2019 due to the lack of CAS approval. In the currently proposed IAAF regulation, the permissible testosterone limit will be restricted to 5 nmol/L and will apply to all women’s races between 400 and 1500 metres. Excluded from this regulation are “hyperandrogenic” women who have a sufficiently low response to free testosterone. All other “hyperandrogenic” track and field athletes who wish to participate in the relevant competitions must constantly suppress their “hormone level” for at least 6 months, which can be achieved, for example, by medication or surgery.

The fact that the 2017 IAAF study found a difference in performance between women with extremely low and extremely high testosterone levels in only three of 21 disciplines seems to have been overlooked with the new regulation. After all, why should it equally apply to athletes in the 1500-metre race, for whom no difference in performance was found at all? Furthermore, a review of the study by independent researchers revealed that up to approximately one third of the study data was erroneous, casting the accuracy of the results into doubt. It remains to be seen whether the study will be replicated again and how the IAAF will act in response to this.

If a study conducted according to scientific standards could indeed prove that “hyperandrogenic” women had an advantage through their testosterone levels “lying outside the norm”, it might in fact be time to think about a new categorisation in sport instead of dividing people into two sexes and excluding particular individuals. Anyone who, like Chand, is able run 100 metres in 11.8 seconds at the age of 16 already probably has several physical characteristics that “lie outside the norm”. Should they perhaps also exclude runners with leg lengths that fall into the “male range”? Or as the New York Times article (28 June 2016) puts it: “Relying on science to arbitrate the male–female divide in sports is fruitless, [many geneticists and endocrinologists] said, because science could not draw a line that nature itself refused to draw.”

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