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Caster Semenya, who lives with a condition named Differences in Sexual Development (DSD) is waiting for the European Court of Human Rights (ECHR) to rule on her eligibility as an athlete. The ruling pertains to her ability to compete in the women’s category in athletics. The decision may take another two months, the fight has been going on for years. The retired South African middle-distance runner is now fighting for other athletes. World Athletics is fighting to protect women’s sports.

The issue

Semenya’s career is essentially over now. When she was competing, she medalled at the 2012 and 2016 Olympic Games in the 800-metre event. When it was discovered that she naturally produces more testosterone than other women — nearly as much as some men do — World Athletics ruled that she must take medication to limit the production of the hormone.

She naturally produces a volume of testosterone that women would need to take performance-enhancing drugs to compete against. In other words, they would need to be in conflict with the World Anti-Doping Code and could be banned.

In 2018 World Athletics created the rule that forced her to take medication to lower her testosterone levels. That was when Semenya began to fight back.

In July 2023, the Lausanne-based Court of Arbitration for Sport (CAS) ruled that she had been the victim of discrimination. “I hope that World Athletics, and indeed all sporting organizations, will take into account the decision of the ECHR and ensure that the dignity and human rights of athletes are respected,” said Semenya.

The overarching perspective from World Athletics is to protect women’s sports. While Semenya lives with DSD, the issue is not connected to the current problem of trans men competing in women’s events. Semenya has a vagina, but also testes. She is unable to bear children and does not have ovaries or a uterus. Semenya underwent a sex verification test in 2009, the results of which were not
officially released. However, some information was leaked. As it turns out, Semenya endogenously produces at least three times the testosterone (T) in comparison to the average woman, 99 times out of 100. While the issue is natural, it renders women who do not live with DSD uncompetitive against those who do. For example, during the 2016 Rio Olympic final, the top three women live with DSD, the fourth woman was Canadian Melissa Bishop-Nraigu, who does not live with DSD.

Limiting testosterone

The idea is to limit the T-levels to less than 5 nmol/L, more than double the normal female range below 2 nmol/L. Most females have T-levels ranging from 1.12 to 1.79 nmol/L while the normal adult male range is 7.7 — 29.4 nmol/L.

After the initial CAS ruling, Semenya stormed back in 2009. In just one year, she dropped her personal bests from 2:04.23 to 1:55.45 as a teenager. This is an unheard-of performance improvement, which prompted World Athletics to put her through a sex verification test.

The current world record set in 1983 is 1:53.28 by Czechoslovakian Jarmila Kratochvílová, long suspected of benefitting from the state-sponsored doping program within the former communist country.

It revealed Semenya’s unfair advantage. She was subsequently ordered to take testosterone-limiting medication.

During the time that she was receiving the testosterone-controlling protocol, her performances plummeted. From 2009 to 2016 she ran annual seasonal bests at well under 2:00. Except during 2014, when she could manage just 2:02.66; a big drop in performance.

Once again, it was proven that high T-levels significantly influence performance, but it varies per person and during various conditions and, therefore are difficult to measure fairly. Apparently, after winning and experiencing the joys of victory, testosterone levels can be higher, than when that same person loses. 

In 2023 World Athletics adjusted its rules back to limiting T-levels to reduce testosterone levels to less than 2.5 nmol/L.

The world awaits the fateful decision, as it will be binding. While Semenya acknowledges that her career is over, people living with DSD will continue to exist as will World Athletics’ attempt to create an even playing field for women.

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