The International Olympic Committee has lifted its blood testosterone level cap for female athletes, two years back. Commending the suspension of these hyperandrogenism policies in a viewpoint published recently in JAMA, Dr Myron Genel states that the ostracized athletes often had to face bashing from the media and the general public. In fact, an Indian athlete, Dutee Chand, got 7th place in round one recently but could not qualify for the semifinals in the 100m women’s race in Rio Olympics. She was also affected by these policies a while back.

The viewpoint authored by the three medical doctors — Myron Genel, Joe Leigh Simpson and Albert de la Chapelle — went on to describe the history of crude and often draconian methods previously practiced to determine if a female participant was eligible for a women’s competition. The writers implied that there are several other factors that are responsible for an athlete’s competitiveness like, genetics, height and economic opportunities. The authors argued that testosterone levels should not be treated any different from other congenital factors like mutations for high hemoglobin. Hence, suggesting that androgens like testosterones are not meant as a yardstick to determine eligibility.

Debate about the testosterone levels as the appropriate eligibility criteria for a female competitor have recently amplified. The surge is a result of an Indian athlete Dutee Chand’s ban due to elevated levels of testosterone in 2014 and later her victory at the International Court of Arbitration for Sport which made her eligible again by retraction of the criteria. But that’s not all, the removal of the testosterone level criteria means that Caster Semenya (an intersex) will be able to compete in the Olympics. Her recent phenomenal performance in 800m races has alarmed several people, questioning whether removing the cap is fair to other women athletes with a lower testosterone level. She will now participate at Olympics this year, in the women’s 800m race set to be held on 17 August.

The viewpoint issued in JAMA concluded with the proposition: “One of the fundamental recommendations published almost 25 years ago that states that athletes born with a disorder of sex development and raised as females be allowed to compete as women remains appropriate.” The argument is supported by those who understand the complications women have historically faced at the hands of a sports committee that’s trying to demarcate a line between the two genders, especially the intersexual community itself.

Controversy Surrounding Intersex Athletes In Olympics

Intersex is a socially polite term for the previously used term ‘hermaphrodite’, meaning that a person is physically neither a typical male nor female, rather possesses characteristics that fall somewhere in between. There are up to 46 different types of intersexes. Unlike transsexuals who are born distinctively with either male or female bodies, intersexes usually don’t undergo any operations to change their sexual characteristics (like transsexuals do) and identify themselves as the initial gender that was associated to them. Several intersexuals live their entire lives without ever actually finding out that they are intersexual as their irregular characteristics are so subtle or well concealed.

However, in intersexes that are identified as females, it is believed their male streak often grants them a slight athletic advantage over their ordinary competition in sports. Therefore, policies of International Association of Athletic Federation and the International Olympic Committee have long kept their reservations against intersex athletes in all women competitions.

One of the reasons why intersex females are speculated to be more athletic than typical women is due to their hyperandrogenism, a condition whereby intersex females have elevated levels of testosterone. Testosterone is a male hormone which increases one’s bone and muscle mass. Hence, the most convenient way to check the male-ness of a person, referees found, was to check the testosterone level. An average female has a 1-3.3 nano-molar concentration in their blood while men have concentrations usually higher than 10 nano-molar.

In order to compete in Olympics, intersexual were bound to comply with the hyperandrogenism regulations of the International Association of Athletics Federations introduced in 2011. They generally imply that females with testosterone level of 10 nano-molars or more should undergo hormonal therapy to lower their testosterone levels unless they are medically proved to be androgen resistant (meaning the hormone has no effect on their body). However, the therapy almost always declined their athletic ability, it virtually meant to forfeit the competition.

But now that the restriction has been removed, concerns regarding fairness of the competition are being raise by the other side. In fact, Maria José Martínez-Patiño, an ex-athlete herself, whose dreams got torn apart once she learned that she was an intersex and failed one such gender test, is an advocate of the International Association of Athletic Federation’s regulations. “I tried to get across how difficult and complicated the situation is and how finding a solution where nobody gets hurt is pretty much impossible,” she said in an interview to USA Today.

The reason Dutee Chand was able to win her case in 2015 and remove the regulatory test was because there was no clear research showing exactly how much of a competitive advantage does testosterones award to females in sports. A lack of statistical data compelled the Court of Arbitration for Sport to rule in Dutee’s favor. The court has asked for the International Association of Athletic Federation to do the research on the edge testosterone provides players and come up with the results after two years.

During the times she was banned, Dutee missed out on two competitions, the Asian Games and the Commonwealth Games. Her ban and subsequent case surely took a toll on the athlete’s training schedule and overall motivation as she lost in the very first round at the Olympics women’s 100M.

Meanwhile, the world will have its own little simulation to watch as this year’s Olympics fall within those two years the regulations are down. The performance of intersexuals that have a free pass this year, like Semenya’s, will surely go on to decide the fate of regulations to follow which, in turn, decides how the world will ultimately perceive their gender identity and liberty to express it.