Proposed testosterone testing of some female olympians challenged by Stanford scientists

Posted by Dr. Michael White, Updated on January 5th, 2018
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Public release date: 13-Jun-2012 [ | E-mail | Share ]

Contact: Tracie White traciew@stanford.edu 650-723-7628 Stanford University Medical Center

STANFORD, Calif. Proposed Olympic policies for testing the testosterone levels of select female athletes could discriminate against women who may not meet traditional notions of femininity and distort the scientific evidence on the relationship between testosterone, sex and athletic performance, says a Stanford University School of Medicine bioethicist and her colleagues.

They also warn that the proposed policies would not only be unfair, but also could lead to female athletes being coerced into unnecessary and potentially harmful medical treatment in order to continue competing. The critique was published online today in The American Journal of Bioethics.

The testing policies, adopted a year ago by the International Association of Athletics Federations and now under consideration by the International Olympic Committee, call for using testosterone levels to decide whether an athlete is "feminine" enough to compete as a woman. The problem, the authors explain, is that there is insufficient evidence to set a benchmark for a normal testosterone levels in elite female athletes, let alone persuasive research showing that testosterone levels are a good predictor of athletic performance.

"What makes sex testing so complicated is that there is no one marker in the body we can use to say, 'This is a man,' or, 'This is a woman,'" said first author of the paper Katrina Karkazis, PhD, a medical anthropologist and senior research scholar at Stanford's Center for Biomedical Ethics. "These new policies try to get around that complexity by singling out testosterone levels as the most important aspect of athletic advantage. But what causes athletic advantage is equally complex and cannot be reduced to testosterone levels."

Although it is widely believed that chromosomal testing or genital exams can indicate definitively a person's sex, such methods are flawed. Contrary to the general understanding that women have two X chromosomes and men have an X and a Y, there are actually too many variations on chromosomal markers to use the test accurately in all cases. While it is uncommon for women to have a Y chromosome, it does occur in a small number of women.

What's more, regardless of chromosomes, female anatomy and physiology vary in ways that may make it difficult to quickly classify a person as male or female. There are individuals with intersex traits who are born with reproductive or sexual anatomy that doesn't fit the typical definitions of female or male.

The new polices for testosterone testing arose from the controversy surrounding South African runner Caster Semenya, who won a gold medal in the women's 800 meters at the 2009 World Championships. After complaints from competitors that she was "too masculine" including the comment that, "These kinds of people should not run with us... For me, she is not a woman. She is a man" she was forced to undergo tests that turned a private question of personal identity into a humiliating and distressful public spectacle. The IAAF ultimately ruled that Semenya is eligible to compete as a woman, but the experience led the organization to issue new rules when the sex of an athlete is questioned. The IOC is considering adopting these rules, or some variation of them, in time for the London Games this summer.

The IAAF policies state that female athletes with unusually high testosterone levels, a condition known as hyperandrogenism, will be banned from competition unless they undergo surgery or take drugs to lower their levels. "The new regulations rest on the assumption that androgenic hormones (such as testosterone and dihydrotestosterone) are the primary components of biologic athletic advantage," the authors write. In practice, the policies focus specifically on testosterone, they added.

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Proposed testosterone testing of some female olympians challenged by Stanford scientists

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