Tag Archives: hyperandrogenism

New paper out for Journal of Medical Ethics: “When does an advantage become unfair? Empirical and normative concerns in Semenya’s case”

I published a new paper for the Journal of Medical Ethics titled “When does an advantage become unfair? Empirical and normative concerns in Semenya’s case”.

jmeHere’s the abstract:

There is a fundamental tension in many sports: human sex is not binary, but there are only two categories in which people can compete: male and female. Over the past 10 years, the International Association of Athletics Federations (IAAF) regulations have been at the centre of two notable legal disputes. The Court of Arbitration for Sport (CAS) reached two contradictory rulings: in the first case (Dutee Chand vs Athletics Federation India and IAAF), the IAAF regulations for the eligibility of athletes to compete in the female category were suspended (24 July 2015) on grounds of “discrimination against the female category”; in the latter (Caster Semenya and Athletics South Africa vs IAAF), the regulations were reaffirmed (1 May 2019) on grounds that although discriminatory, they are necessary to maintain a “level playing field” and to “protect” the female category. Although Semenya’s case has paved the way for questioning existing gender norms in sport, a new stable norm has yet to emerge from her case. The pharmacological solution put forward by IAAF to the tension between fairness and inclusivity of bodies non-conforming to two sexes is not, however, the only possible solution/resolution to the case, as I aim to show in this paper. Here I present some reflections on this topic and suggest how CAS should approach the case if it hopes to resolve it.

The full text can be accessed here:

https://jme.bmj.com/content/early/2019/09/15/medethics-2019-105532.full

Drop me a line if you don’t have access and would like to get a copy of the paper.

My commentary on Dutee Chand’s case: When is it fair to be a woman in athletic competition?

The hearing of Dutee Chand is currently underway at the Court for Arbitration for Sport in Lausanne.

Dutee Chand

Dutee Chand

Dutee Chand (19 yo) was disqualified just days before the beginning of the Commonwealth Games in Glasgow in July 2014 after a medical test determined that her androgen level was above the “normal” limit set by IAAF and IOC policies of 10 nmol/lit. According to the IAAF Regulations (May 2011, link) if Chand is able to reduce her androgen levels to fall within the normal testing range, she will be allowed to resume international competition. She refused to do so and appeal.

The assumption of the IAAF regulations is that hyperandrogenism/testosterone confers an unfair advantage and disrupts the level playing field.

I provided some commentary on Dutee Chand’s appeal for BBC World News Hour on Monday, March 23rd. You can listen to the clip here.

I also participated in a debate on BBC World Service Have Your Say last night. The podcast is available here.

Here’s in brief what I think about the case:

Even if it were case proven (and it is not) that higher levels of androgens provided an advantage, that would not imply that it were unfair. In other words, we do not care whether testosterone provides an advantage or not, we care whether that advantage is unfair. And to demonstrate that it is not we reflect on bigger questions, such as the meaning of athletic excellence, and gender and performing feminity in sport.

We think that exceptional biological and genetic variations are considered part of what the elite athlete is, and of what makes sports completion valuable and admirable: achieving excellence through the combination of talent – the natural endowment of the athlete- and dedication – the efforts in training and preparation that the athlete put forth to maximize what her talent offers. That is we, together with the governing bodies of athletics, do not consider unfair many other genetic variation many other biological and genetic variations which confer an advantage in sport. For example, endurance athletes have mitochondrial vairations that increase aerobic capacity and endurance. More genetic variations and polymorphisms in the genetic basis of sport performance are unravelled as we speak. Why aren’t such genetic and biological variations consider unfair? Because it is part of what we think elite athletes are. The level playing field in competition, which is one of the arguments that is going to be used to upheld the IAAF regulations in the courtoom, does not exist. It is a myth.

 Why is hyperandrogenism singled out? It is only one of these variations. I argue that it is singled out as it challenges deeply entrenched social beliefs of women in sport in a way that other variations do not.

I argue that the IAAF/IOC are now faced with a disruptive dilemma: Either ban from competition all athletes who derive an advantage from biological variations, or let everybody who is “out of the ordinary,” compete, athletes with hyperandrogenism included.

If they do not do so and uphold their regulations, they will stand to create many levels of unfairness while upholding the very opposite fairness ideal.

Hyperandrogenism, unfair advantage and the myth of the level playing field in competition

In this paper, published on the American Journal of Bioethics and co-authored with Katrina Karkazis (Department of Biomedical Ethics, Stanford), Rebecca Jordan-Young (Barnard College, NYC), and Georgiann Davis (Southern Illinois University), I analyse and question the 2011 IAAF  policies on the eligibility of female athletes with hyperandrogenism to compete in the female category.

Caster Semenya

Caster Semenya

We argue that the policies are  flawed on at least three grounds: 1) the underlying scientific assumptions; 2) the policy-making process; and 3) the concept of fairness for female athletes, and that they should be withdrawn.

The new IAAF policies aim at  isolating the presumed positive effect of increased androgen levels on athletic performance from a myriad of other factors. However, as we show in the paper, such a move is logically flawed, and consequently, the new regulations themselves are logically flawed—it is impossible to reduce the complexity of athletic excellence to a univocal relationship between androgen levels and performance.

Read more: my post for Somatosphere.

Karkazis K, Jordan-Young R, Davis G, Camporesi S. (2012) Out of bounds? A critique of the new policies on hyperandrogenism in elite female athletes,  Am Journal Bioethics; 12(7):3-16