The ruling by the Court of Arbitration for Sport on Wednesday that Caster Semenya and other female athlete like her, will have to take testosterone-suppressing medication if she wants to continue running, is sending shockwaves through the sporting world.
Despite an appeal by Semenya, the court decision means new rules by the International Association of Athletics Federation will come into play next week that target women with high levels of testosterone.
Who is Caster Semenya?
The two-time Olympic gold medalist was born female in South Africa and has three sisters and a brother.
The 28 year-old’s gender has been under scrutiny ever since she won gold in the 800 metres at the 2009 IAAF World Championships when she was 18 years-old. She crossed the finish line at 1.55.45 in the final setting - the fastest time that year.
The IAAF responded by saying they were obliged to investigate after her timings at the championships had improved at dramatic levels and had requested a "gender verification test".
The IAAF was accused of racism, and the official result was never released, but media reports suggested that leaked information revealed Semenya was intersex. However, the IAAF cleared her to continue competing and retain her previous medals.
In an interview in a South African magazine, Semenya stated, “God made me the way I am and I accept myself.”
In 2015, she married her wife, Violet Raseboya, who initially mistook her for a man when they met in a women's lavatory.
'Normal' female testosterone levels
Last year, the IAAF introduced new restrictions for female athletes with testosterone levels of five nanomoles per litre of blood or more. These athletes with a "difference of sexual development" would have to use medication to reduce their blood testosterone in order to compete.
The normal range of testosterone levels in the average female is considered to be between 0.1-1.8nmol/L.
Women with hyperandrogenism - an excess of male sex hormones - affects up to 10 per cent of females of reproductive age and can have an impact on women with polycystic ovary syndrome.
South Africa's Caster Semenya is beloved in her own country. Source: AAP
Some medical studies suggest PCOS is overrepresented among Olympic sportswomen
Difference of sexual development
A person with DSD may have a mix of both male and female sexual characteristics. For example, they may be genetically female, but with reproductive organs that are of the opposite sex.
If a female is born with testes, their testosterone level will be high, often reaching male levels.
Despite widely circulated speculation, Semenya's own situation remains private.
Benefits of testosterone
The Court of Arbitration for Sports argues that athletes with high levels of testosterone have an unfair advantage. Testosterone can improve an athlete’s performance, including increasing muscle size and strength, and increasing the ability for the blood to deliver oxygen to those working muscles.
Elite male athletes are generally faster and stronger than females.
Other cases of hyperandrogenism
Indian runner Santhi Soundarajan attempted suicide in 2007 after failing gender tests and being stripped of the silver medal she won in the 800m at the 2006 Asian Games. She now runs her own athletics academy.
Another Indian athlete, Dutee Chand, was banned by the Athletic Federation from competing, including at the 2014 Commonwealth Games, after failing a gender test. She appealed to the Court of Arbitration for Sport and the suspension was removed because of a lack of evidence that testosterone increased female athletic performance.
Dutee Chand competing in the 2018 Asian Games in Indonesia. Source: Getty Images
Stephane Bermon, head of the IAAF’s health and science department, said in a statement that many other female athletes have the condition.
“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,” Bermon said.
“This is around 140 times what you will find in the general female population which demonstrates to us in statistical terms a recruitment bias.”
Opinions polarised
Semanya's lawyers have indicated they may appeal the Court's decision. In an official statement, Semanya says she believes she is being targeted,
"The decision of the CAS. will not hold me back. I will once again rise above and continue to inspire young women and athletes in South Africa and around the world.”
Her response on twitter has been defiant. "Monate mpolaye" she wrote, translated as "Goodness kill me," in the urban dictionary.
Her fans have rallied to her defence calling the decision "disgusting" and urging her "not to give up".
The South African Sports Confederation and Olympic Committee has condemned the decision. The African National Congress also released a statement on Twitter, claiming the IAAF is intentionally targeting Semenya,
“We call on government to challenge this grossly unfair, unjust and blatant racist attempt by the IAAF to the Court of Arbitration for Sport (CAS) and have these regulations set aside. The ANC will stand with Caster Semenya in yet another attempt by international sport bodies to exclude and discriminate against her.”
On the other hand, British Olympic champion Sharron Davies, called the decision "a good day for female sport".
