What's at stake in Semenya vs. IAAF -- Amby Burfoot breaks down the monumental looming CAS decision

Semenya has not raced 1500m so frequently and while her PB is not that impressive it was rather impressive how she destroyed runners with superior PB (like Muir and Hassan) in the 2017 WC final. So I'd be wary in claiming that the higher T level does not help her in that event.

But I agree that the apparent concentration of athletes with probable DSD in the 800m (and maybe 400m) is not yet explained very well. One would expect also quite a few of them in the field events and sprints (or maybe almost everywhere in sports).

Dr Taboo wrote:

Does testosterone help her in the 1500 and up? Not even a little bit. Semenya's best 1500 ranks #326 all-time and the science certainly does not support what the IAAF is attempting to do. Does testosterone help her in the 800? Probably, but not nearly as much as people believe.

We know it helps her! Look at how slow she got when she was on treatment to reduce her T levels... even though she was allowed to have FAR HIGHER T than her competitors.

If it helps her in the 800, then shouldn't she be required, either chemically or by testes removal, to reduce T levels to the norm (~0.67) for women in order to compete as a woman? Internal testes are a health hazard so this would be improving her health not hazarding it.

And yes, we can infer that she has internal testes because she refused chemical or surgical intervention initially. The only reason for surgery would be internal testes.

The fact that others are faster in the 1500 could mean that she doesn't have the 1500m specific training or the other genetics to run the 1500 at world class level. Not every 400/800m runner can move up to the 1500. Not every 800m runner can drop down to the 400.

No, you - and we - are not getting anywhere. You are just continuing to disappear down your own little endocrinological rabbit-hole.

The issue is not whether Semenya has internal testes or not, whether she is XX or XY in the strict sense, or whether she is even female or not - her sex or gender isn't being disputed - but, solely, that she has levels of testosterone that give an advantage denied other biological women without her highly-specific physiological characteristics. Those characteristics are not gender-neutral variations within a talent spectrum - like speed, strength or height - but differentiate her in a fundamental way from the gender-restricted category within which she competes. By analogy, the competitive advantage she has would be similar to a middle-weight boxer being able to compete as a lightweight, by virtue of defining out of existence what is meant by "weight". There is also little doubt about the extent of the advantage she gains by virtue of her higher than normal levels of testosterone; her own reduced performances showed it when she was required to take drugs to bring those levels back to the normal female range.

If the issue of using suppressant drugs is also one that concerns her health - which, incidentally, I have not heard that she has argued - then it is still the case that an entire category of competition is not revised for the sake of a single individual. Bad luck, to that individual. As it stands, the IAAF is still striving to find a way to allow her to compete as a woman, and without prejudicing her fellow-competitors.

There is no "solution". No doctor with any sense of ethics would prescribe hormone therapy as a way to suppress the performance of any athlete - especially when the unknown side effects of this therapy are potentially powerful and harmful in the long run. We are left with two categories of sport: Men's sports, and Other sports. It's unfair to XX women, but the greater unfairness would be this grotesque attempt to medicate people so as to create a level playing field in the Other category. That's just not possible.

Dr Taboo wrote:

I apologize for the thumbnail above. I did not know that is what the thumbnail would be for the article.

No worries. We fixed it so the image didn't show up.

Dr. Taboo has made some interesting points. I think it might make a difference for some people whether she is XX or XY. Before I saw his post saying she might be XX I had started to reply this:

Star wrote:

It’s crazy to instruct someone to have hormone therapy to compete.

The more I think about it the more I agree.

Then the question becoomes in what category do intersex (and transgender) athletes get to compete.

But I think a lot of people don't want to say, "transgender females and intersex athletes then have to compete in the male category".

So the testosterone reduction is a compromise.

Maybe we just define the women's category as for biological females. The open category is for everyone else.

That seems like a fair and reasonable distinction. Then the question would be become do you want to let athletes who are willing to suppress their testosterone compete in the female division.

I hadn't really thought must about an intersex athlete being XX like she apparently could be. But the logic would apply.

alanson wrote:

There is no "solution". We are left with two categories of sport: Men's sports, and Other sports. It's unfair to XX women, but the greater unfairness would be this grotesque attempt to medicate people so as to create a level playing field in the Other category. That's just not possible.

Your solution is Men's and Others but it just was easily be argued, the solution is "Open sports (which is men's and intersex)" and "Female Sports". That seems logical to me, the protected class "female sports" is more restrictive than the open category.

Just a very complex issue. Unless they open the door for transgender athletes to pick their sex without hormone therapy this really just seems to primarily affect the 800 on a world class level at least the last couple of decades. I've yet to see a good explanation for that. But if the impact is limited I guess that is better but if you're an affected athlete it's obviously a huge deal.

It's impossible to know the extent of Semenya's advantage based on her performance while on hormone suppressants. This is something that's been mentioned a few times (on here and by people like Ross Tucker). Her slower times MAY be due to lower testosterone levels, but it could also be due to the side effects of the hormone treatment. The side effects may have affected her both physically and mentally (which would have an effect on her ability to train at the volume she would have without the hormone treatment).

Now there may be no side effects at all, in which case any decreased performance is likely due to lower testosterone. But that is impossible to tell with the information we have.

wejo wrote:

[quote]Vancomycin wrote:

When a 10 sigma genetic outlier in some other way that is also correlated with sex shows up - will we have to go through the same song and dance?

Now you're going into hypotheticals.

The more I have time to think about this it's pretty simple. We have 2 categories of sex and sports and not everyone fits into them. Semenya is intersex. Pretty sure that actually means she's XY.

David S wrote:

.........

Interesting to see how this is ruled upon and what's next for transgender athletes. From talking to Amby it sounds like this was narrowly tailored to a few events for legal reasons, not to just go after Semenya but the optics look bad.

And herein lies the issue. If intersex athletes are determined to have an advantage due to elevated levels of T for events between the 400m and the mile, then it is clear that the same advantage would be gained for all events where power and speed are evident (see all field events, 100m, 200m, etc.). It's more than just bad optics, it is not a logical argument and should be rejected based on that fact alone. Come back when they are ready to proffer T-level restrictions across all events. Remove the gray area entirely.

alanson wrote:

There is no "solution". No doctor with any sense of ethics would prescribe hormone therapy as a way to suppress the performance of any athlete - especially when the unknown side effects of this therapy are potentially powerful and harmful in the long run. We are left with two categories of sport: Men's sports, and Other sports. It's unfair to XX women, but the greater unfairness would be this grotesque attempt to medicate people so as to create a level playing field in the Other category. That's just not possible.

If the IAAF proposal was in breach of medical ethics or best medical practice it wouldn't have got off the ground, and most certainly would have resulted in it being thrown out in the CAS hearing once the medical issue was raised by Semenya's lawyers. It hasn't been.

Furthermore, Semenya and others were required to take hormone suppressant drugs previously and yet no objection was made to this on medical grounds.

Hormone therapy is prescribed for a variety of medical conditions. Where is the medically-accredited evidence that reducing testosterone is a risk to health?

If reducing her levels of testosterone was not the crucial factor in the decline in Semenya's previous performances she would not be making the case that she has against the IAAF proposal. No argument has been made about side-effects from taking suppressant drugs. Her argument has essentially been that it is unfair in principle to have to change her natural condition in order to compete as a female. For its part, the IAAF takes the view that it is unfair to other competitors that she should compete without changing that condition. The argument is one of principle, not medical practice. The only area of science debated was over the extent to which testosterone contributed to superior female performances.

Amby's article is very, very good. It's disappointing that he doesn't note that Radcliffe's statement was ridiculous and transphobic.

dunes runner wrote:

I totally agree that Semenya and other non XX and/or DSD people

should simply not be allowed to compete with XX / non DSD women people.

Vancomycin wrote:

Great! so how do test for that... with testosterone tests! Not genetic tests

Actually, I'm pretty sure chromosome analysis is done with genetic testing - not testosterone tests.

However, provided a reasonable testosterone range is determined for typical XX women people,

anyone who does not meet that standard should NOT be allowed to artificially change their natural levels,

i.e. people who don't meet the standard of being XX / non DSD should not be allowed to use drugs to change

their test results. Anyone doing so should be banned immediately, and not allowed to compete in either division.

dunes runner wrote:

Actually, I'm pretty sure chromosome analysis is done with genetic testing - not testosterone tests.

However, provided a reasonable testosterone range is determined for typical XX women people,

anyone who does not meet that standard should NOT be allowed to artificially change their natural levels,

i.e. people who don't meet the standard of being XX / non DSD should not be allowed to use drugs to change

their test results. Anyone doing so should be banned immediately, and not allowed to compete in either division.

I won't continue to discus how chromosomal testing is not a robust solution to this problem, you haven't responding to any of my previous comments regarding the issues. Testosterone is likely the best proxy we have sorting men and women.

The IAAF is trying to 1) figure out what the range for phenotypic females is - for the 1000th time "typical" doesn't apply here. No elite athletes are "typical." 2) Show the testosterone is the primary driver for sex performance differences. Their studies have FAILED to show correlation so far. This is surprising to me and most people, but we cannot arbitrarily ban people for metrics we cannot show drive performance. This issue is on the IAAF, they've done a shoddy job collecting data.

Right now it doesn't matter what you or I want/think/wish the situation is, the IAAF must be able to prove their claims about testosterone effects and the benefits of limits. We will see if they can.

The IAAF has made a good case, backed by research, that differences in testosterone are a primary driver in the differences between male and female sporting levels. Of course, this does not exclude differences of a cardiovascular, muscular and skeletal nature, that also contribute to those differences of performance. But testosterone has long been known to be key in the physical development of males, from the onset of puberty, that gives them the athletic strength they possess. Reduced testosterone is also a cause of decline in older males. From that perspective the research is not controversial. Indeed, if testosterone was not the factor that it is we would not see the reduction in performance that typically occurs with transgender who have "transitioned" using testosterone suppressant drugs.

However, the research relied upon is not exhaustive and is questioned by some, who think the effects of testosterone on performance can be exaggerated. That case can be made - and has been - but it has not successfully refuted the IAAF argument or its research used. The balance of the argument is still overwhelming in the IAAF's favour. At this stage it would only be for political reasons that CAS would rule against the IAAF.