The Decadelong Humiliation of Caster Semenya

If she wants to keep competing, she is now required to take hormonal therapy to reduce natural testosterone.

Semenya walking on the track.
South African Olympic 800-meter champion Caster Semenya looks on after running the 1,500-meter women’s final at the ASA Senior Championships in Germiston, South Africa, on April 26.
Stringer/AFP/Getty Images

After an exhibition women’s 800-meter race in the Amsterdam 1928 Olympic Games, the International Olympic Committee and the organizing body for track and field now known as the International Association of Athletics Federations decided to scrap the event. It wouldn’t return to international competition and the Olympic program for 32 years. Their stated reasons: scientific concerns that the event was too hard for women. Newspaper accounts of the race contributed to the decision and stood as historical record: “Below us on the cinder path were 11 wretched women, 5 of whom dropped out before the finish, while 5 collapsed after reaching the tape,” wrote John Tunis of the New York Evening Post. Even Notre Dame football coach Knute Rockne contributed, declaring: “It was not a very edifying spectacle to see a group of fine girls running themselves into a state of exhaustion.”

In 2012, Roger Robinson, former senior writer for Running Times magazine and world-class runner for England and New Zealand, decided to reconstruct the race narrative by patching together piecemeal footage. In doing so, he successfully debunked media (mis)representations of the spectacle of women collapsing all over the track. Robinson determined nine—not 11—women started the race. Of those nine, all finished, and only one runner fell to the track, and she did this in the way elite athletes are trained to do, leaning at the finish. Five women finished under the time of the former world record. Women were excelling in the 800-meter.

I thought about that on Wednesday, when South African runner Caster Semenya lost an appeal to the Court of Arbitration for Sport. If she wants to compete in her best events—the 400-, 800-, or 1,500-meters—at the 2019 World Championships or any future international competition, she must take hormonal therapy to reduce natural testosterone. The saga of the Amsterdam 1928 women’s 800, placed alongside apocalyptic rhetoric casting Semenya as a threat, offers a lesson about how institutions rely on bad science to “protect” women in sport.

The ruling marks the end of a lengthy and troubling battle. After Semenya won the 2009 World Championships 800-meter, her medical records were leaked and the IAAF began work to develop a new regulation for women with elevated testosterone. It was just the start of the extraordinary scrutiny that she has been subject to over the past decade—scrutiny that has likely already required her to reduce her testosterone levels. In 2011, the IAAF introduced hyperandrogenism regulations that required all women with “excessive production of androgens (testosterone)” within the male range and without androgen insensitivity to undergo medical treatment to bring testosterone levels to within the regular female range. In 2015, those regulations were suspended when Indian sprinter Dutee Chand appealed to the Court of Arbitration for Sport.

The IAAF then scrapped the hyperandrogenism rules and in April 2018 announced new guidelines for women with “differences of sex development,” or DSD. The DSD regulations apply to female athletes—athletes like Semenya who “are born as women, reared and socialized as women, who have been legally recognized as women for their entire lives,” her lawyers note—with 46,XY DSD who experience a “material androgenizing effect.” Many different conditions fall within the 46,XY DSD umbrella, depending on the interaction of multiple genes, hormones, and hormone receptors. These conditions share the presence of one X chromosome and one Y chromosome in each cell, but the presentation of genitalia and sex organs differs, as well as production of and receptivity to testosterone.

Semenya challenged these regulations, which apply to five middle-distance events—the 400, 400 hurdles, 800, 1500, and mile—and require hormone suppressants to artificially reduce the body’s naturally occurring testosterone to a level below 5 nanomoles per liter of blood, for a minimum of six months before eligibility to compete. (When CAS delayed its decision by a month, perhaps because of an intervention by the United Nations Human Rights Council, the IAAF reduced the time requirement so athletes may compete in the upcoming championships in Qatar.)

Although Semenya is not the first athlete to have her identity as a woman challenged, she has endured this obsession over her eligibility in the women’s category longer than any athlete in history. All along, she has continued to compete and excel, earning five global 800-meter championships even as she was likely reducing her testosterone levels under the former hyperandrogenism rules.

On Wednesday, the three-person CAS panel voted to uphold the IAAF regulations, finding that “the DSD Regulations are discriminatory but … such discrimination is a necessary, reasonable, and proportionate means of achieving the IAAF’s aim of preserving the integrity of female athletics in the Restricted Events.”

CAS has decided that discrimination against a minority is required for the protection of the majority. The idea is that if women with DSD are allowed to compete as they are in the women’s category, women’s sport will die. The head of the IAAF, Lord Sebastian Coe, recently stated, “The reason we have gender classification is because if you didn’t then no woman would ever win another title or another medal or break another record in our sport.” Others, like women’s marathon world record holder and British athlete Paula Radcliffe, helped raise the hysteria stakes by conflating women with DSD with transgender women.

The core of the (admittedly, potentially unresolvable) issue is that elite international sport forces us to place bodies that exist along multiple spectrums into one of two sports competition categories: men’s or women’s. The two primary spectrums are biological sex (hormones, genetics, anatomical variations) and gender identity (internal), but gender presentation (external) and sexuality (whom you love) also inform the public’s and sports officials’ ideas about bodies.

Because men’s bodies and sports competition are the standard, men don’t have to prove they’re men. But in international competition since the 1940s, as Lindsay Parks Pieper presents in Sex Testing: Gender Policing in Women’s Sports, women have had to prove they’re women in order to be cleared for competition. These “scientific” policies have ranged from gender parades (show your lady parts) to gender verification cards issued by medical doctors to chromosomal cheek swabs.

In the 21st century, testosterone has been the determiner de jure. The IAAF and those who do not want to see Semenya race unaltered believe she and women with DSD have an unfair advantage and that the best way to measure the advantage is testosterone, so they created a policy to keep her out of competition or make her artificially reduce the testosterone in her body if she still wants to compete. Then they commissioned a study, published in the British Journal of Sports Medicine, to get the science to back it up.

But the science hasn’t held up to scrutiny. Three independent researchers—Erik Boye of Norway, Roger Pielke Jr. of the United States, and Ross Tucker of South Africa—attempted to replicate the IAAF-funded study, found serious flaws, and called for its retraction. A leading expert on testosterone, Katrina Karkazis, has written extensively about why testosterone is not the male sex hormone, how high testosterone—in any body—does not correlate with improved athletic performance, and why it is impossible to determine “a single biological criterion by which to exclude some women from the female category.”

The IAAF seemed to bank on the cultural power of protectionist, “even playing field” rhetoric, confident that even if the science was bad, CAS would still rule in its favor. CAS did just that, but not without expressing “some serious concerns” about the practical application of the regulations and the fairness of how they are implemented. The panel suggested that the IAAF consider postponing implementation of the regulations for the 1,500 and mile, signaling that the science put forth by the IAAF was shaky, and also noted concerns about consequences of “unintentional non-compliance.” Most importantly, CAS warned that the side effects of hormonal treatment could demonstrate “the practical impossibility of compliance.” Has the IAAF considered whether the required performance-de-enhancing drugs might cause harm to an athlete forced to undergo an unnecessary medical intervention?

46, XY DSD is found in populations all around the world. But white, Western standards of femininity are being applied to all female athletes, and it’s no coincidence that the only high-profile, elite female athletes exposed publicly so far as having DSD are women of color from the global south. This isn’t just a gender story; it’s an intersectional story of gender and race, with a hefty sprinkling of imperial legacy. When Western athletes transform their bodies by using antigravity treadmills and platelet-rich plasma injections to speed up recovery, that’s considered to be on the “fair” side of the competitive advantage line. It’s hard to reconcile this with a black South African gay female athlete who is trying to compete as she is, without chemically altering her body, and who has been deemed on the “unfair” side.

There is a long history of questionable science—or, more accurately, scientifically unfounded ideas presented by scientists and medical doctors—used to police and “protect” female athletes. The result has been circular reinforcement: Culturally informed bad science about women creates sports policies toward women, which influence cultural ideas about women, which inform bad science … and so on and so forth.

The Little League lawsuits of the 1970s provide an outrageous example. In Stolen Bases: Why American Girls Don’t Play Baseball, Jennifer Ring shares an excerpt from a 1974 Newsweek article covering the New Jersey hearing: “One doctor asserted that ‘cancerous lesions may be produced by traumatic impact upon female breast tissue.’ He added that many baseball injuries were dental and therefore cosmetic, and girls had to be specially protected from facial injuries because of their social roles.”

The judge in New Jersey in 1974 dismissed the medical expert’s claims that girls could suffer from breast cancer and cosmetic disfigurement if they played the game. But the mere fact that they were stated in court under oath suggests their cultural power. In this case and in the 1928 Olympics exhibition, the harmful idea was that girls needed protection from playing a sport that was perceived to harm them. In the Semenya case, the IAAF has argued women’s sport needs protection from the perceived threat of women with elevated testosterone. In response to Coe’s claims, Semenya and her legal team released a statement: “Mr Coe is wrong to think Ms Semenya is a threat to women’s sport. Ms Semenya is a heroine and inspirational role model for young girls around the world who dream of achieving excellence in sport. Ms Semenya hopes and dreams that one day she can run free of judgement, free of discrimination and in a world where she is accepted for who she is.”

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