May 10, 2018
Limit on Testosterone Levels

The International Association of Athletics Federations (IAAF) recently made a controversial ruling regarding high testosterone levels in female athletes. According to a release from the IAAF, women who compete in sprinting distances from the 400-meter to the mile, along with hurdles and combined events over the same distances, will be affected.

The new regulations are aimed at female athletes whose blood testosterone levels are above five nano-mols per liter (nm-L), a range that is far above the normal level of 0.12 to 1.79 nm-L. An article from Wired explains that women with testosterone levels in this range have hyperandrogenism, a condition that is referred to as a difference of sexual development (DSD). The belief is that these high levels of testosterone can enhance athletes’ explosive muscle power.

“Our evidence and data show that testosterone, either naturally produced or artificially inserted into the body, provides significant performance advantages in female athletes,” Sebastian Coe, IAAF President, said.

The IAAF cited a study that examined the performance of female and male competitors at the 2011 and 2013 World Track Championships. Although a performance difference was seen when comparing females who had normal testosterone levels to those with the highest levels, the most drastic difference was seen among female athletes competing in the pole vault and hammer throw events. Neither of those events’ competitors will be affected by the new regulations.

With the new rule going into effect on November 1, any athlete with a DSD will be required to meet three criteria to compete. This includes being recognized as female or intersex; reducing the blood testosterone level to less than five nm-L continuously for at least six months; and maintaining that level throughout her eligibility.

“The latest research we have undertaken, and data we have compiled, show that there is a performance advantage in female athletes with DSD over the track distances covered by this rule,” Stéphane Bermon, MD, PhD, Sport Physician and Exercise Physiologist at the Monaco Institute of Sports Medicine, and member of the IAAF Medical and Antidoping Commission, said. “We have seen in a decade and more of research that 7.1 in every 1000 elite female athletes in our sport have elevated testosterone levels, the majority are in the restricted events covered by these regulations. This is around 140 times what you will find in the general female population which demonstrates to us in statistical terms a recruitment bias. The treatment to reduce testosterone levels is a hormone supplement similar to the contraceptive pill taken by millions of women around the world. No athlete will be forced to undergo surgery. It is the athlete’s responsibility, in close consultation with her medical team, to decide on her treatment.”

One high-profile athlete who will be affected by the new ruling is South African Olympic gold medalist Caster Semenya, whose testosterone levels exceed the new limits. Following her 2016 Olympic gold medal win in the 800-meter event, Semenya’s performance was criticized by competitors who said she wasn’t a “real” woman and had an unfair advantage. Semenya’s gold was won by 1.18 seconds — a difference of one percent when compared with the runner-up. Under the new ruling, Semenya would have to do one of three things to continue competing: take medication to lower her testosterone levels, move to a longer distance event, or compete in the male classification.

Some say the IAAF’s new rules are misguided. According to Reuters, Athletics Canada said they had “serious concerns” with the announcement.

“In Canada, we encourage the full access for all Canadians to participate and compete in athletics, at every level of our sport free of discrimination,” Reuters reported the federation said in a statement. “Athletics Canada believes in the principles of inclusion, respect and health and safety.”

Others questioned the ethics of restrictions centered on an athlete’s natural characteristics.

“It’s not that there’s no effect of testosterone on athletic performance, but it doesn’t provide the kind they complain about,” Katrina Karkasiz, PhD, a bioethicist and visiting fellow at the Yale University Global Health Justice Partnership, told Wired. “This isn’t doping. Everyone agrees that doping is cheating. I don’t think we have got to the point where natural physiological traits are cheating.”

Image by Filip Bossuyt.

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