With the rescheduled Tokyo Olympics approaching in July, Human Rights Watch on Friday demanded that track and field officials halt sex testing of female athletes, describing the practice of measuring and restricting their natural testosterone levels as abusive and harmful.
Sex testing has been a deeply contentious issue in sports for decades, but the dispute has been heightened since 2018, when track and field’s world governing body instituted its latest rules regarding intersex athletes like Caster Semenya of South Africa, a two-time Olympic champion runner at 800 meters. The sport’s regulations have inflamed debates about biological sex, gender identity and fair play.
Semenya and others who have what are called differences of sexual development, or D.S.D.s, are required to suppress naturally elevated testosterone levels — through hormonal therapy or surgery — before competing internationally in women’s running races at distances from the quarter mile to the mile.
World Athletics, track and field’s governing body, acknowledges that the restrictions are discriminatory, but says they are necessary to ensure a level playing field.
Semenya, who identifies as a woman and has declined to undergo testosterone suppression, has lost appeals before the Court of Arbitration for Sport, which is based in Switzerland, and the Swiss Supreme Court. Last month, her lawyers said she would take her case to the European Court of Human Rights, though it is unclear if any decision can be reached before the Tokyo Games, scheduled to start on July 23. Otherwise, Semenya, 29, has suggested she will try to run the 200, an event free of the recently introduced testosterone restrictions, at the Olympics.
In a 120-page report, the New York-based Human Rights Watch amplified with athletes’ voices what critics of the current testosterone regulations have long argued: that they are medically unnecessary and humiliating; encourage coerced medical intervention; can result in physical and psychological injury and the loss of careers; violate fundamental rights to privacy, dignity, health, nondiscrimination and employment; and adhere to standards of femininity that are racially biased, disproportionately affecting women of color from Africa, Asia, Latin America and Oceania.
“Whether it is hormone therapy or surgery, why should a perfectly healthy woman agree to do so to compete in sports?” Francine Niyonsaba of Burundi in East Africa said in an email to The New York Times. She finished second to Semenya in the 800 at the 2016 Olympics and is also affected by the testosterone regulations.
Like Semenya, Niyonsaba has refused to undergo hormone suppression and is now training to run the 5,000 meters, a distance at which the biological restrictions do not apply.
“They treat us as if we are cheats,” Niyonsaba said. “We deserve to be respected as athletes, as champions.”
The report was based on interviews last year with 13 female athletes from African and Asian countries, as well as input from lawyers, doctors, academics and medical ethicists. Annet Negesa, an intersex middle-distance runner from Uganda, told researchers that an operation to remove her internal testes was performed in 2012 without her consent. The operation, she said, left her battling headaches and achy joints and ruined her career.
Another athlete, identified by her initials as J.G., said in the report that once she was declared ineligible because of testosterone regulations, she lost her career, could not get a job and struggled to eat. “My life is over,” she said.
Payoshni Mitra, an Indian scholar and athletes’ rights advocate who was a co-author of the report, said in a telephone interview from London that “regulating fair play is understandable. Committing human rights violations in the process is not acceptable. And that is what World Athletics is doing.”
Human Rights Watch called on World Athletics to immediately rescind its testosterone regulations. And it implored the International Olympic Committee to uphold the Olympic Charter, which prohibits discrimination of any kind, and to develop guidelines that meet the standards of international human rights and medical ethics.
In a statement, World Athletics rejected the accusation that biological limits set on athletes competing in certain women’s events were based on race or gender stereotypes. Rather, the governing body said, the testosterone regulations provide “an objective and scientific measure” to preserve equitable competition.
The International Olympic Committee said it was working on inclusivity guidelines to “ensure fairness, safety and non-discrimination of athletes on the basis of gender identity and sex characteristics.”
A 2017 study, commissioned by World Athletics and later challenged by independent researchers, said that women with D.S.D.s tended to have distinct advantages in races from a quarter mile to a mile, distances that require a combination of speed and endurance.
In 2018, track’s governing body instituted regulations governing female athletes who have a disorder of sexual development and both X and Y chromosomes, the standard male pattern. Intersex athletes with testosterone in the male range, the governing body argued, possess an unfair advantage in lean muscle mass, strength and oxygen-carrying capacity in certain events. The lowest level of testosterone in the typical male range is four times greater than the highest level in the typical female range, according to World Athletics.
But critics of the regulations have contested the science underpinning the World Athletics rules and noted that there was no scientific consensus on the precise impact of testosterone on athletic performance.
In June, the Office of the United Nations High Commissioner for Human Rights said that sports officials should revoke regulations regarding intersex athletes. And the World Medical Association last year urged doctors not to implement the regulations, saying they were based “on weak evidence.”
It is a mistake to view this issue in scientific terms alone, said Katrina Karkazis, a co-author of the Human Rights Watch report and a visiting professor of women’s, gender and sexuality studies at Emory University.
“In doing that, you obfuscate or ignore the very real harms done to women,” Karkazis said. “That is the importance of the report.”
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