• Caster Semenya at the IAAF World Championships in 2015 (Getty) (Getty Images)Source: Getty Images
On the last day of the Rio Olympics, a very important race will be run: the women’s 800 metres final. The odds-on favourite to win is South African woman, Caster Semenya, and her journey to this race has been mired in unfair controversy.
Erin Stewart

17 Aug 2016 - 3:29 PM  UPDATED 17 Aug 2016 - 3:31 PM

In 2009, Semenya won her event at the Berlin World Championships. It was a remarkable victory, her time of 1:55.45 was strides ahead of all her opponents in her first major race since moving up from junior competitions.

But her extraordinary success was not celebrated for long. In the 24 hours after winning the race Semenya was closely scrutinised. She was subjected to “gender tests”, as per International Association of Athletics Federations protocol. The battery involves blood tests, chromosome analysis, ultrasounds, gynaecological examinations, and MRIs. The clitoris, vagina and labia are measured and palpated, The New York Times reports. Breast size and pubic hair are evaluated and scored in reference to diagrams.

Semenya was sidelined from competition for eleven months as these invasive tests went on. Some of the cruellest public remarks labelled her a “man” and a “hermaphrodite”. She was dismissed as too fast and too muscular to be a female athlete. Some of her opponents publicly decried her, “These kind of people should not run with us,” said Elisa Cusma of Italy. Mariya Saviona of Russia told journalists that she doubted that Semenya would pass a gender test. “Just look at her,” she said.

In 2010, Semenya was cleared to compete but she was ruled to also have “hyperandrogenism”, or elevated testosterone levels. Although we only know this because Semenya’s purported results were leaked to the media. Morgan Carpenter, co-chair of intersex advocacy organisation, OII Australia, told SBS “that seems no different to some straight journalist posting the stats of closeted gay athletes in a news article at The Daily Beast.”

She made a media statement at the time, saying:

“I have been subjected to unwarranted and invasive scrutiny of the most intimate and private details of my being. Some of the occurrences…have infringed on not only my rights as an athlete but also my fundamental and human rights including my rights to dignity and privacy.”

Later, in 2011, the IAAF and the IOC decided that in order to compete in women’s events, the testosterone levels of athletes had to be below 10 nanomoles per litre (typical levels for women are between 1.0 to 3.3nmol/L). Those with conditions such as hyperandrogenism were required to suppress their testosterone levels. Semenya’s actual testosterone levels are not public domain information, nor should they be.

However, the public and various media outlets, including The New Yorker’s Malcolm Gladwell, have assumed based on the leaks that Semenya is intersex, meaning that she has one of over 40 conditions which give individuals biological traits which don’t clearly fit either “male” or “female” categories. They’ve also speculated that one of the reasons Semenya only got a silver medal in the 800 metres at the 2012 London Olympics because her testosterone levels were artificially lowered in accordance with IOC rules. Yet, this commentary exists on the assumption that she did receive hormone therapy – we don’t (and shouldn’t) know this to be the case.

As Carpenter points out, “It’s important to recognise that we don’t know which Olympic athletes have intersex traits or not.”

Last year, Indian sprinter Dutee Chand, who openly said that her hyperandrogenism excluded her from running without hormone therapy, brought the matter to the Court of Arbitration for Sport, saying that the cut-off testosterone level for women athletes was unscientific. The matter was ruled in her favour and now greater evidence is required before the IAAF can use testosterone levels as a valid test of sex. Last week, Chand became the first Indian woman to compete in an Olympic 100m sprint since 1980.

“The policy was suspended because there wasn’t the scientific evidence to support it,” Carpenter says.

“Testosterone is not a useful guide to sex assignment in sport.” He points to research from 2014, published in the Journal of Clinical Endocrinology, which not only found that there was little basis for a testosterone level cut-off, and no definitive research linking hyperandrogenism with better sports performance. In fact, in different research published in the same journal that year, it was shown that there’s considerable overlap in the testosterone levels of elite male and female athletes. 16.5% of men had low testosterone levels while 13.7% of women had high levels which, they concluded, shows “the IOC definition of a woman as one who has a ‘normal’ testosterone level is untenable.”

The side effects of artificially lowering testosterone levels may in themselves account for reduced performance while also endangering some athletes. According to a 2014 analysis in the British Medical Journal, therapies can disrupt an individual’s metabolism; cause headaches, fatigue, and nausea; and can even lead to liver toxicity. The previous IOC policy further led to the sterilisation and “partial clitoridectomy” of four women athletes with intersex traits so that they could compete. Carpenter says, “The UN Special Rapporteur has recently described those as cases of female genital mutilation, with no health-based justification. The four athletes come from areas in low to middle income countries where they may not have access to the lifelong hormone treatment they need after sterilisation.”

Carpenter further says, “I think that it’s important to recognise that most elite athletes have genetic advantages of some sort or another. No athletes should be forced to change their natural bodies or natural characteristics in order to compete.” Indeed, athletic performance is associated with over 200 different genetic variations affecting body structure, muscle fibres, metabolism, endurance, and many other traits relevant to physical performance.

There is reason though to separate male and female events. David Epstein, author of The Sports Gene, found that the running times of top male athletes are 11 per cent faster than the times achieved by elite women. But making divisions is fraught. Since the 1950s the IOC have used a range of invasive methods to police gender, initially physical tests, now an entire battery of technologies, all of which are doomed to failure. 1 in 100 people are born intersex and so sharply dividing the population into categories of male and female using any set of biological markers is not a natural reflection of reality. Carpenter argues, “the suspended IAAF and IOC policies on women with ‘hyperandrogenism’ affected women who have lived their whole lives as women, and it’s completely fair for them to compete as women.”

Madeline Pape, an athlete who ran against Semenya in the 2009 Championships in Berlin, wrote for Zela that she initially felt anger towards her.

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“We treated Semenya as a freak of nature, a hybrid creature to be feared, someone who might well have been considered a woman elsewhere but was not a legitimate female athlete in our circles.” But Pape has changed her attitude, and in fact testified against testosterone policing. “This is not really a story about scientific experts sparring over the disputed role of testosterone in producing sex and performance differences. In fact I don’t think it’s about science at all.”

Instead, what’s being tested is our collective perceptions of what women look like, what degree of muscularity is normal, what speeds are acceptable. Women athletes are capable of the extraordinary, and all should be given the opportunity to run as fast as they’re naturally able.

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