Women barred from Olympics for being ‘manly’

Hers is a case of unfinished business, a dream that was cut short in June 2012 when she received a call from a doctor from track and field’s world governing body telling her, according to the New York Times newspaper - that “she would no longer be competing in the London Olympics because her testosterone levels were too high for competition,” thereby giving her an unfair advantage over other female athletes.

Negesa, 20 then, was one of Uganda’s top athletes. On the back of her London preparations, she set a national record for 800 metres earlier that year at a meet in Netherlands. She was a three-time national champion and brought home a gold medal at the 2011 All-Africa Games.

She identifies as female and was born with external female genitalia but also with internal male genitalia that produce levels of testosterone that men do. Most women, including elite female athletes, have natural testosterone levels of 0.12 to 1.79 nanomoles per litre, according to World Athletics. The typical male range after puberty is reportedly much higher, at 7.7 to 29.4 nanomoles per litre.

After years of litigation, the Court of Arbitration for Sport (CAS) in 2019 upheld World Athletics’ testosterone restrictions for female athletes in races with distances from 400 meters to the mile after renowned athlete Caster Semenya (we shall get to her later in the article), filed an appeal.

The court ruled by a 2-to-1 vote that the restrictions were indeed discriminatory but also a “necessary, reasonable and proportionate” means of achieving the World Athletics goal of preserving a level playing field in women’s track events.

Therefore intersex athletes (these are said to be roughly one in every 2,000 births), who want to participate in middle-distance women’s track events must take hormone-suppressing drugs and reduce testosterone levels to below five nanomoles per litre (5 nmol/L) for six months before competing, then maintain those lowered levels.

Unfortunately, the intervention seems to have come seven years late for Negesa, who claims World Athletics physician Dr Stéphane Bermon gave her surgery as her first option to reduce testosterone levels in 2012. 

But Negesa has since battled persistent headaches and achy joints that have not allowed her to pursue her career. Her postoperative care, which according to documents seen at the Kampala Hospital by the New York Times should have been recommended in further discussions with Dr Bermon, did not include the kind of hormone treatment that might have helped her body adjust to the change.

After Negesa appeared in a ‘break the silence’ documentary on German television’s ARD network in October 2019, World Athletics issued a statement denying that it participated in or recommended a specific treatment to Negesa.

Third category

Nine years after Negesa’s predicament, another recommendation to World Athletics; to introduce a third category of events in order to allow competitors with high testosterone levels to compete in their preferred disciplines, seems to be gathering steam after Kenyan 800m runner Margaret Wambui was ruled out of the Tokyo 2020 Olympics.
The Kenyan was an 800m bronze medallist at the 2016 Olympics. 

“It would be good if a third category for athletes with high testosterone was introduced; because it is wrong to stop people from using their talents,” Wambui told BBC Sport Africa.

The sport’s governing body, World Athletics, says it has no plans to introduce such a category and will stick to its current classifications of men’s and women’s events.

The idea of a third category in athletics has been floated before, but Wambui is the first athlete to express outright support for the suggestion.

“We would be the first people to compete in that category - so we can motivate others who are hiding their condition,” she said.

“We could show them that it is not their fault, that this is how they were created, and that they have done nothing wrong,” the 25-year-old, who has not raced competitively since July 2019 and will not be competing at the Tokyo Olympics, having struggled to choose between competing in either sprints or long distances .

Since World Athletics introduced its latest rules governing DSD (disorders of sex development) athletes in 2018, not one of the three athletes who stood on the 800m podium in Rio has contested the distance at a global international championship.
At the 2016 Games, Wambui was beaten to gold by Semenya and silver by Burundi’s Francine Niyonsaba.

“It is sad to see that the whole podium won’t be there.”  “They cut short our careers, because that wasn’t our plan. I feel bad that I won’t be in the Olympics because of World Athletics rules,” says Wambui.

Semenya’s winding run in court
Semenya, on her part, has had a more publicised rollercoaster ride with the authorities from the get go.
Following her victory at the World Championships in 2009, questions were raised about her sex.

Having beaten her previous 800m best by four seconds at the African Junior Championships just a month earlier, her quick improvements came under scrutiny. The combination of her rapid athletic progression and her appearance culminated in World Athletics (then IAAF) asking her to take a sex verification test to ascertain whether she was female.

The IAAF says it was “obliged to investigate” after she made improvements of 25 seconds at 1,500m and eight seconds at 800m – “the sort of dramatic breakthroughs that usually arouse suspicion of drug use”.

The sex test results were never published officially, but some results were leaked in the press and were widely discussed, resulting in, at the time, unverified claims about Semenya having an intersex trait.

In November 2009, South Africa’s sports ministry issued a statement that Semenya had reached an agreement with the IAAF to keep her medal and award. Eight months later, in July 2010, she was cleared again to compete in women’s competitions.

Her fortunes grew even stronger when the IAAF policy on hyperandrogenism, or high natural levels of testosterone in women, that had been in place since 2011 was suspended following the case of Dutee Chand v. Athletics Federation of India (AFI) & The International Association of Athletics Federations, in CAS.

The ruling found that there was a lack of evidence provided that testosterone increased female athletic performance and notified the IAAF that it had two years to provide the evidence.

Semenya went on to dominate from home to the international stage. She became the first person to win all three of the 400m, 800m, and 1500m titles at the South African National Championships, setting world leading marks of 50.74 and 1:58.45 in the first two events, and a 4:10.93 in the 1,500m, all within a nearly four-hour span of each other.

On July 16, she set a new national record for 800 metres of 1:55:33. On August 20, she won the gold medal in the women’s 800m at the Rio Olympics with a time of 1:55.28.

But the win only reignited controversy over the rules on permissible testosterone levels. Immediately after the race, Lynsey Sharp, who finished sixth, broke into tears, having previously said that “everyone can see it’s two separate races,” while fifth-placed Joanna Jóźwik reportedly claimed that she was the “first European” and “second white” to finish the race.

Semenya, undeterred by what seemed to be discriminatory comments, went on to win bronze and gold in the 1,500m and 800m events respectively at the 2017 World Championships held in London. 

However, in April 2018, the IAAF announced new rules that required athletes who have certain DSDs that cause testosterone levels above 5 nmol/L and androgen sensitivity to take medication to lower their testosterone levels in order to compete in the female classification, effective May 8, 2019.

Due to the narrow scope of the changes, which also apply to only those athletes competing in the 400m, 800m, and 1500m, many people thought the rule change was designed  to target Semenya.

In June 2018, Semenya announced that she would legally challenge the IAAF rules. She claimed that such hormonal medication, which she had taken from 2010 to 2015, had made her feel “constantly sick” and caused her abdominal pain. More like Negesa’s surgery.

In May 2019, CAS - as mentioned above - rejected her challenge, paving the way for the new rules to come into effect.
During the challenge, the IAAF amended the regulations to exclude hyperandrogenism associated with the 46,XX karyotype.

In July 2019, Semenya said that the ongoing issue had “destroyed” her “mentally and physically” and sought distraction by joining the South Africa Women’s League football club JVW, which is owned by the legendary female footballer Janine van Wyk.

Semenya appealed the CAS ruling at the Federal Supreme Court of Switzerland, which ultimately rejected the appeal in September 2020.

The court had provisionally suspended the rules while deciding whether to issue an interlocutory injunction in June 2019, but reversed this decision a month later, leaving Semenya unable to compete in the 2019 World Athletics Championships in Doha while her appeal continued.

In 2020, Semenya announced that she had decided to switch to the 200 metres for the 2021 Tokyo Olympics, in order to avoid the 400m to one mile ban. In order to qualify for the 200 metres, Semenya had to achieve the qualifying time of 22.80. She had previously won the 5000m at the South African championship in 2019 but like Wambui, she has been caught in two minds on which way to go; sprint or long distance?

But on April 15 this year, two months after filing a challenge against the Switzerland Supreme Court decision at the European Court of Human Rights, Semenya confirmed she would not try to make the Tokyo 2020 200m qualifying standard.

On May 28, 2021, Semenya ran a personal best of 15:32.15 in the 5,000m but it was 22 seconds outside the Tokyo 2020 standard.

While she won’t be in Tokyo, it’s clear Semenya will continue challenging the decision to bar her from competing. Where that will end is as unclear as her decision to either become a sprinter or long-distance runner.
For Niyonsaba, according to her Wikipedia profile, her problems started in 2019 when it was revealed that she was born with the 46,XY karyotype and an intersex condition.

The numbers
Most women, including elite female athletes, have natural testosterone levels of 0.12 to 1.79 nanomoles per litre, according to World Athletics. The typical male range after puberty is reportedly much higher, at 7.7 to 29.4 nanomoles per litre.
1:2000. Roughly one intersex baby is born in every 2,000 births
2:1. CAS upheld in a 2-to-1 vote the IAAF decision to force intersex athletes who intend to partake in women’s track events to take hormone-suppressing drugs and reduce testosterone levels below five nanomoles per liter (5 nmol/L). CAS labelled the restrictions discriminatory but also a “necessary, reasonable and proportionate” means of achieving the World Athletics goal of preserving a level playing field in women’s track events.
3. About Shs3.4m, currently, is what Negesa paid for a gonadectomy to alter her body by removing her internal testes, at the Women’s Hospital International and Fertility Centre in Kampala.

Chronology of events
2009. Questions raised over Semenya’s sex after her World Championship win
2010. Semenya cleared to participate in women’s middle-distance events but starts to take testosterone reducing medicines in 2011
2012. Uganda’s Negesa ruled out of the London Olympics for having high testosterone levels and desperately goes through a career-threatening surgery to alter her body.
2015. IAAF policy on hyperandrogenism, or high natural levels of testosterone in women, that had been in place since 2011 suspended following the case of Dutee Chand v. Athletics Federation of India (AFI) & The International Association of Athletics Federations, in CAS.
2016. Lynsey Sharp, who finished sixth, and fifth-placed Joanna Jóźwik criticize Semenya’s Rio Olympics gold in the 800m race but the South African continues to compete.
April 2018: the IAAF announced new rules that required athletes who have certain DSDs that cause testosterone levels above 5 nmol/L and androgen sensitivity to take medication to lower their testosterone levels in order to compete in the female classification, effective May 8, 2019.

Decision means Rio women’s 800m podium finishers Semenya, Niyonsaba and Wambuyi are ruled out of the race and other mid-distance races for years to come.

June 2018. Semenya announces she will challenge the decision in CAS.

May 2019. CAS rules against Semenya and upholds IAAF decision. Semenya turns to 200m event to save her Tokyo 2020 plan despite winning the national women’s 5000m event in SA.

September 2020. Federal Supreme Court of Switzerland sides with CAS and IAAF and rules against Semenya appeal.

February 2021: Semenya challenges Switzerland Supreme Court decision at the European Court of Human Rights

April 2021: Semenya confirms she would not try to make the Tokyo 2020 200m qualifying standard.

May 2021: Semenya runs a PB of 15:32.15 in the 5000m but it is 22 seconds outside the Tokyo 2020 standard.

July 2021: Namibia’s Christine Mboona and Beatrice Masilingi ruled out of Tokyo 2020 for having high natural levels of testosterone.

Decision reopens debate on whether there is discrimination against African female mid-distance runners given that 43-year old biological male Laurel Hubbard, who identifies as a woman since 2012, will compete in the women’s weightlifting events at the Olympics.

Discrimination 
Discrimination against African Olympic athletes?
Meanwhile, Namibia’s Christine Mboona and Beatrice Masilingi who have both been summarily disqualified from the 400m race by the Olympics committee, join the fray prompting a debate on whether these regulations are just a case of discrimination against African female  athletes.

From an African perspective it does not help matters that a white biological-male athlete, who identifies as a woman, from New Zealand, Laurel Hubbard, has been designated eligible for female classification and will compete in the women’s weightlifters contest in the 2020 Olympics. 

Hubbard, 43, will compete in the women’s 87-kg weightlifting category following her gender transitioning in 2012. Hubbard became eligible to compete at the Olympics when the International Olympic Committee (IOC) in 2015 changed its rules allowing transgender athletes to compete as women if their testosterone levels are below the allowed threshold.

Critics of her eligibility have pointed to the biological advantages of those who have gone through puberty as males, such as increased bone and muscle density.

In May, the BBC reported that Belgian weightlifter Anna Vanbellinghen, who is competing in the same category, said that «if Hubbard were to compete in Tokyo it would be unfair for women.»

It can only get messy from here.