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Two main issues that are affecting women and sports, the first, high natural testosterone levels in women, and the second, trans athletes in sports. While these two issues may appear related, the International Olympic Committee (IOC) and the International Association of Athletics Federations (IAAF now the World Athletics Championship) treat them separately.
High Natural Testosterone Levels in Women
The discovery that some women have naturally high testosterone levels came after decades of testing to verify that men were not competing as women, and has a revealed bias towards women athletes, and the idea of a woman. The IOC and the IAAF believe that increased testosterone gives an unfair advantage to female athletes. If female athletes have too much testosterone in their blood, they may be told to drug themselves to acceptable testosterone levels, restricted to certain sports or distances (for track runners), or banned from the sport.
Whenever a woman athlete did not fit predetermined ideals, standards, or stereotypes in her look or performance, doubts were cast on her femininity. For “…only a man could run as quickly, jump as high or throw as far as these Olympians” or other world competitors (Pieper, L.P., 2016). Due to sporting prowess contradicting womanhood, the International Association of Athletics Federation (IAAF) and the International Olympic Committee (IOC) required sex testing from the 1920s through the 1990s (Pieper, L.P, 2016).
The first known gender testing at the Olympics began with Helen Stephens (USA) at the 1936 Berlin Olympics. Helen who was 6-foot tall was said to have long male-like strides and after she beat the Polish American track legend Stella Walsh underwent a gender verification test (Carlson, A. 2005). However, through the 1940s and 50s, many female athletes were accused of being men, especially if they did not embody Western ideas of femininity or pushed the believable limits of female athleticism (Pieper, L.P., 2016).
In the 1960s the gender verification test became official, as in previous years there were rumours of men pretending to be women, women who later became men through surgery, and the Soviet Union dominated the medal platform in the previous Olympics. The gender verification tests in previous decades did reveal many -often unknown to themselves - intersex (now called differences of sex development or DSD) athletes who quietly dropped out of sports. In the 1950s, Hermann (also known as Dora Ratjen) revealed he had been persuaded by Nazi Officials to pose as a female in the 1930s (Carlson, A. 2005). Dora Ratjen finished fourth at the Berlin Olympics in the women’s high jump and set a world record in 1938. Between 1934 and the late 1960s four world-class athletes who competed as women, became men through surgery.
Gender verification tests initially began as physical examinations, where a doctor would verify that the athlete had female genitals. In 1966, there was even a "nude parade" where female athletes had to walk past doctors partially undressed. In 1967 a new test was added to the gender verification tests -a chromosome test (Carlson, A., 2005). This test would allow doctors to take a sample and it would reveal if an athlete had an XX chromosome (female) or an XY chromosome (male).
Many doctors and scientists disagreed with the chromosome and encouraged compassion as the tests "discriminated against those whose anomalies provided little or no competitive edge and traumatized women who had spent their whole lives certain they were female, only to be told they were not female enough to participate" (Padawer, R. 2016). Later, doctors and scientists disagreed with the science behind the chromosome test and believed research around it was flawed.
In the 1970s and 80s, the focus was on testing for drugs and testing for testosterone in women. The IOC published and circulated reports of doping breaches as a tool to deter others from following suit, on the other hand, in cases of sex control abnormalities more care is taken for the results to be kept secret as the woman is not at fault (Pieper, L.P., 2016). However, doping and sex tests that resulted in elimination from competition appeared the same to athletes, reporters, and medical authorities.
In 1976, there was an increase in protest from women athletes over sex-testing. Many declared that men should also be tested if the goal is fairness. However, as Downhill skier Nicole Spiess commented, “If a girl is a boy, it makes a lot of difference . . . but if a boy is a girl it doesn’t matter (Pieper, L.P. 2016).
“The conspicuous adjustment from sex to femininity to gender underscored the medical commission’s changing anxieties. Rather than to catch men disguised as women, the test evolved into a measure to prohibit female Olympians with biological advantages. In other words, the commission eventually viewed gender verification as a tool to eliminate competitors whom it deemed too strong, too fast, too successful, or too unfeminine for women’s competition.” (Pieper, L.P. ,2016).
While only three stories are highlighted below, from as early as 1928 a minimum of 25 women were scrutinized and gender tested based on their appearance and their performance (Pieper, L.P., 2016). Much more probably dropped out quietly before or after testing and the IAAF keeps the records confidential. At least seven female competitors discovered they were intersex through gender testing and transitioned to men, some even came back and competed in men sports years later (Pieper, L.P., 2016).
Maria José Martínez Patiño
Maria José Martínez Patiño was a Spanish hurdler who was determined to have XY chromosomes and internal testes before the World University Games in Japan. While she had elevated levels of testosterone, her body was not able to absorb or use any of her additional testosterone. Her coaches advised her to feign an injury and withdraw from the games (Carlson, A., 2005), but she refused. Maria competed and won the 60-meter hurdles before someone leaked her test results to the press. Her medals and record were revoked but she decided to fight the test. She was the first athlete to formally protest the chromosome test and to argue that disqualification was unjustified. After three years, the IAAF agreed that her body was not able to use testosterone, so he had no advantage and reinstated Patiño however her hopes for making the Olympics were dashed (Pieler, L.P., 2016). The most unfortunate part, Maria received a femininity certificate from a previous world competition (where she passed the sex test) two years earlier but had forgotten it when traveling to Japan and had to undergo the sex test again at the World University Games (Ospina-Betancurt, J., Vilain, E., & Martinez-Patiño, M.J., 2021).
Dutee Chand
Dutee Chand is an Indian Sprinter who became a national champion at 16 and broke national records. Only a few years later, in 2014 she won gold again at the Asian Championships. Shortly after, she was sex tested, although the tests were not explained to her (Padawar, R., 2016). She was offered a chance to return to the national team after a year of reducing her testosterone levels. The media learned that she had failed a gender test, which humiliated her. Supporters of Dutee suggested she fight back and request her disqualification be reversed (Padawar, R. 2016). “Dutee challenged the sexist ruling that stopped her from competing as a woman because of hyperandrogenism but at the same time, celebrated swimmer Michael Phelps’ genetic advantages gave him an edge over his competitors” (Chintamani, G, 2021). Dutee took her case to the International Court of Arbitration for Sport over the IAAF’s discriminatory testosterone policy. During court, the IAAF was forced to admit that not only did they have no evidence that men with high testosterone have a competitive advantage, but “..the I.A.A.F. also conceded that no research had actually proved that unusually high levels of natural testosterone lead to unusually impressive sports performance in women either” (Padawar, R. 2016). The court determined that requiring women like Dutee to change their bodies to compete was unjustifiably discriminatory (Padawar, R. 2016) leading to the policy being suspended for some time to give the IAAF time to prove the need for the policy. “After winning the case, Dutee went on to win two silver medals in the 2018 Asian Games and, in 2019, became the first openly gay athlete in India” (Chintamani, G., 2021).
Caster Semenya
Caster Semenya is an East African sprinter whose best distance is 800m. In 2009, at the World Championships in Athletics in Berlin, Caster won gold in the 800 meters, and on the same day, gender verification tests were requested by the IAAF (Cooky, C. & Dworkin, S.L., 2013). Her results remain confidential and were not released, and she was given permission to continue competing. She won a silver medal in the 2012 Olympic Games for the 800m. However, new World Athlete (formerly IAAF) regulations require her "to lower their testosterone levels with birth control pills, hormone shots or surgery" to compete in her best events (Bock, M., 2021). Caster refused and took her case to the Court of Arbitration for Sports which ruled against her in 2019, as "necessary, reasonable and proportionate" to "[preserve] the integrity of female athletics" (Block, M., 2021). She appealed to the Swiss Federal Tribunal which also failed and has launched a new appeal to the European Court of Human Rights which has not ruled on the case. Caster failed to qualify for the Tokyo Games, in 2021, as she attempted the 5,000 meters which is an event exempt from the testosterone rules (Block, M., 2021).
The World Athletes Championship (formerly the IAAF) has created new rules on female eligibility regulations which focus on athletes with differences of sex development (DSD). “Under the rules, Semenya and other female athletes who refuse to lower their naturally high testosterone levels are barred from competing in races from 400 meters to 1 mile” (Block, M., 2021). Notably, the other female athletes affected by the rules are African. These include Margaret Wambul and Francine Niyonsaba who also won medals in the 800-meters at the Rio de Janeiro Olympics in 2016, and Christine Mboma and Beatrice Masilingi who qualified for the 400-meters in Tokyo Olympics (Imray, G., 2021).
"Our female eligibility regulations do not target any single athlete or race. ... There is copious evidence that black women are thriving and being celebrated in our sport, that it is in fact the most accessible sport for black women"" (World Athletes as cited in Block, M., 2021).
The way the test results are worded leads the press and thus the public to believe that the rules caught a couple of cheaters especially when athletes are barred from an event and drop down to a lower limit, like Mboma and Masilingi dropping from the 400-meters to the 200-meters to qualify for the Tokyo Olympics without drugs or surgery (Campbell, M., 2021). While World Athletics denies the rule targets Semenya, the testosterone rule only applies to races in which Semenya excels, although research shows "the strongest correlation between natural testosterone and performance in women's pole vault and hammer throw" (Campbell, M.., 2021).
Athletes must lower their "blood testosterone level to below five (5) nmol/L for a continuous period of at least six months" and maintain it continuously for as long as they wish to be eligible (IAAF, 2018). However, anti-androgen medicines can have side effects (Osborn, C. O., 2018) and many athletes view natural testosterone as no more of a benefit than how some athletes are short or tall or have different body types.
