Credit: By Tab59 from Düsseldorf, Allemagne. CC BY-SA 2.0 via Wikimedia Commons.

When Caster Semenya eased to victory in the women's Olympic 800 metres final in Rio de Janeiro on August 20 2016, the debate on hyperandrogenism was reopened. Semenya burst onto the world scene as an 18-year-old phenomenon at the World Athletics Championships in 2009, comfortably winning the 800 metres.

Incredibly muscular, suspicions about her gender were immediately raised. With the gossip mill in full force, it was leaked to the media that the International Association of Athletics Federations (IAAF) had requested that Semenya undergo sex tests, and she was suspended from competing until a decision had been made. The results remain confidential, but she was cleared to begin competing in women's competitions again in mid-2010.

However, as a direct result of the Semenya case, the IAAF began developing new rules that set out acceptable natural levels of masculinizing hormones in female athletes. The IAAF's working group decided that female competitors could not have levels of testosterone above 10 nanomoles per litre of blood, which is supposedly at the bottom of the male range of testosterone levels. The IAAF’s ruling, however, along with the ‘effective therapeutic strategies’ offered to athletes deemed too masculine to compete in female competition, was highly controversial, and was eventually challenged in the Court of Arbitration for Sport (CAS).

The case against the new rules was brought by Indian sprinter Dutee Chand, who was banned from competing in women's events prior to the Commonwealth Games in Glasgow in 2014 because of her naturally-occurring (but supposedly male levels) of testosterone. Refusing hormone therapy and ‘corrective’ surgery, Chand won, and the court suspended the IAAF's limits on testosterone, giving the governing body two years to produce more conclusive evidence that females with androgen hormones within the “male range” have an overriding competitive advantage over other females. This ruling paved the way for Chand and other athletes with hyperandrogenism, including, perhaps, Caster Semenya, to compete without hormone therapy. 

After the Olympic final, Britain's Lynsey Sharp, who finished 6th, was interviewed by Phil Jones on the BBC. Sharp spoke of the emotional connection between herself and fellow athletes Melissa Bishop and Joanna Jóźwik, who finished fourth and fifth respectively. All three are slender athletes with what might be described as feminine features. Jóźwik, Jones and Bishop hugged at the end of the race, with Jones adding, “we know how each-other feels.”

Insiders and outsiders.  

It’s very common for human beings to group together and bond over similar interests and characteristics, thereby forging a sense of right, acceptable, or normal limits and identities. One of the consequences of this tendency is for individuals in one group to be disconcerted by those in another. This is what is happening in athletics, where even competitors who have nothing to do with the 800 metres are weighing in with their opinions.

The British athlete Paula Radcliffe, for example, has noted that some female athletes may have testosterone levels that are three or more times “the normal level” for females, stating that “’99 per cent of women will be less than three” nanomoles of testosterone per litre of blood. Nevertheless, because the IAAF's ruling only excluded females with testosterone levels in the supposedly male range of ten or greater nanomoles per litre, Radcliffe seems willing to tolerate what she might define as ‘abnormal’ females with readings up to this level. But those over ten are too abnormal for Radcliffe to tolerate as competitors.

In her criticisms of the CAS ruling, Radcliffe overlooks a key point, namely that the court was not ruling on whether elevated levels of testosterone give a performance improvement, but on whether any performance improvement constitutes “such a significant performance advantage” that it lifts hyperandrogenic female athletes out of the competitive range of other females. The court concluded that there wasn’t enough evidence to demonstrate that any performance improvement gained through naturally high levels of testosterone is significantly greater than improvements gained through other factors, such as other natural physical or physiological features and/or access to elite training programmes and coaching.

So even if we could say with confidence that a natural testosterone level of around ten nanomoles per litre of blood gives a performance advantage of up to three per cent as Radcliffe suggests, we would still need to quantify the advantage gained through a whole host of other performance factors to make a judgment on whether relatively high testosterone levels provide an overriding competitive advantage. How would we quantify, for example, the advantage Radcliffe herself gained through highly supportive parents and access to elite Western coaching from a young age? Might this have given her, say, a six per cent performance advantage over athletes who didn't have such highly supportive parents or were from countries with fewer resources?

Comments Radcliffe made in the BBC discussion and elsewhere suggest that she fears women’s athletics will be overrun by hyperandrogenic athletes. Here she seems to display a fear reminiscent of the fear stoked up by the likes of Donald Trump—the fear that foreign ‘others’ with threatening differences will swamp the established group. What Radcliffe and other ‘normal’ female athletes must face up to is that, however ‘abnormal’ such athletes appear to be, they are still in some basic sense female, and therefore have a right to compete. Their exceptional qualities may be reminiscent of the features associated with the group excluded from female competition—men—but hyperandrogenic competitors are not men, and exceptional females cannot be excluded on the grounds that ‘normal’ females feel threatened by their masculine traits. 

What is a female?   

How, then, are we to decide what constitutes a level of masculinity beyond the realms of the female if we want to maintain the existence of separate female competition? A divide based solely on physiological characteristics will never be adequate. What we do know, however, is that there is a quantifiable performance gap between elite male and elite female athletes.

So is it possible to demonstrate that a female athlete with a series of ‘male’ traits is performing ‘beyond the scope of female performance?’ Well, yes, it probably is. A fascinating study by Israeli physicist Ira Hammerman suggests that over the last 50 years, a performance gap of around ten per cent has existed between elite male and elite female competitors in a range of speed sports and events. Despite small fluctuations, there is remarkable consistency to this gap, with little evidence that it is narrowing. In fact according to David Epstein the gap in running events now stands at around 11 per cent. 

What we can say, then, is that in the modern sporting epoch, elite male runners tend to outperform elite female runners by around 10-11per cent whatever the combination of social and biological factors involved. An elite hyperandrogenic athlete who can close that gap may well be beyond the scope of female performance.

The question then becomes, is Caster Semenya the exception?  It seems not, since Semenya is ‘only’ the 11th fastest woman in history. Even if Eastern-bloc athletes are excluded because of doping allegations, there are still four athletes with faster times than her. In any case, even if Semenya's time was the fastest time, it would still not meet the criteria for being ‘beyond the scope of female performance.’ In fact her personal best is more than ten per cent slower than the best men's time in the 800 metres. A fascinating fact here is that Paula Radcliffe proves to be an even more exceptional athlete than Semenya: while Semenya’s best time is around 14 per cent slower than the best male athlete in her event, Radcliffe's world record time in the women's marathon is about only ten per cent slower than the world record time in the men's event.

Semenya, of course, is still in her prime and may go faster, but she will have to improve very significantly to move beyond the scope of female performance. She is, without doubt, an exceptional performer—a once-in-a-generation athlete perhaps—but at the moment she is not an athlete whose level of performance is unprecedented in female competition.

Caster Semenya has exceptional natural capacities. We should celebrate the fact that—while she may have faced discrimination or ostracisation in other walks of life because of her inability to fit into the standard range of normality—she has a chance to shine as a superstar in the athletic arena. We should not, as some groups of athletes and the IAAF seem intent on doing, attempt to medicalise and control the hyperandrogenic ‘condition’, which is not really a condition at all.

Hyperandrogenic females are not suffering from an affliction, because they don’t have ‘excessive’ or ‘unnatural’ testosterone levels. Their testosterone levels do them no harm, and are unnatural only for the tastes of the majority. Those with potentially advantageous natural capacities will always be looked on with suspicion by their rivals, who will group together from a sense of vulnerability, bemoaning, despite all their hard work and endeavour, their natural misfortune, or their lack of natural fortune.

But hopefully, now or in the future, they will also look on in admiration, and think to themselves ‘just imagine what I could achieve if I was endowed with what they have.’