Rules for female athletes regarding gender eligibility are complex and legally difficult

PARIS (AP) — The women’s boxing at the Paris Olympics has underscored the complexity of establishing and enforcing gender-based rules for women’s sports, and how vulnerable athletes like Algeria’s Imane Khelif and Taiwan’s Lin Yu-ting are to the consequences.

When eligibility for women’s events was at stake, it was often a legally fraught process for sports organizations, risking exposing athletes to humiliation and abuse. In the 1960s, the Olympics used humiliating visual tests to verify athletes’ gender.

The modern era of eligibility rules famously began in 2009, when South African 800-meter runner Caster Semenya became a track star at the age of 18 when she won gold at the world championships.

Semenya, the 2012 and 2016 Olympic 800m champion, will not compete in Paris because she is effectively barred from doing so unless she medically lowers her testosterone. However, she is still embroiled in a legal battle against track and field rules, now in its seventh year.

Below is a look at sex testing in sports and the complexities they bring at a time when attitudes toward gender identity are changing:

What are the criteria for female participation?

Testosterone levels, not the XY chromosome pattern typically found in males, are the primary criteria for participation in Olympic events, with rules set and approved by the sport’s governing body.

That’s because some women, who were assigned female at birth and identify as female, have conditions called differences in sex development, or DSD, which involve an XY chromosome pattern or natural testosterone that’s higher than the typical female range. Some sports officials say this gives them an unfair advantage over other women in sports, but the science isn’t conclusive.

Semenya, whose medical information was impossible to keep private during her legal proceedings, has a DSD condition. She was legally identified as female at birth and has identified as female her entire life.

Testosterone is a natural hormone that increases the mass and strength of bones and muscles after puberty. The normal range in adult males is many times higher than in females, up to about 30 nanomoles per liter of blood, compared to less than 2 nmol/L in females.

In 2019, at a hearing of the Court of Arbitration for Sport, the umbrella organisation for athletics argued that athletes with DSD conditions were “biologically male”. Semenya said this was “deeply hurtful”.

Semenya’s case played out very publicly before 2021, when gender identity was a big story at the Tokyo Olympics and in society and sport at large. She took oral contraceptives from 2010 to 2015 to lower her testosterone levels and said they caused a host of unwanted side effects: weight gain, fever, constant nausea and abdominal pain, all of which she experienced while running at the 2011 world championships and the 2012 Olympics.

Female athletes of color have historically faced disproportionate scrutiny and discrimination when it comes to gender testing, and have been wrongly accused of being masculine or transgender.

Why does the gender verification test differ per sport?

Each governing body of an Olympic sport is responsible for creating its own rules, from the playing field to who can compete.

Women’s boxing came to the Paris Games with essentially the same eligibility criteria — an athlete is a woman in her passport — as it did at the 2016 Rio Olympics, after the International Boxing Association was permanently banned from the Games following decades of problematic governance and long-standing allegations of a profound lack of normal transparency. Much has happened in the science and debate in those eight years.

Since the 2021 Tokyo Games, World Athletics has tightened eligibility rules for female athletes with DSD conditions. From March 2023, they will have had to keep their testosterone levels below 2.5 nmol/L for six months, usually through hormone suppression treatment, to be eligible to compete.

That was half the standard of 5 nmol/L proposed in 2015 for athletes racing distances from 400 meters to 1 mile.

World Athletics followed another major sport — World Aquatics — in banning transgender women from competing in women’s races if they had gone through male puberty. The International Cycling Union also took the same step last year.

The swimming federation’s leading rules also require transgender females who have not benefited from male puberty to keep their testosterone levels below 2.5 nmol/L.

World Aquatics does not actively test junior athletes. The first step for athletes is for national swimming federations to “certify their chromosomal sex.”

The international football association FIFA also leaves the control and registration of the gender of players to the national associations that are members of it.

There will be no mandatory or routine gender determinations in FIFA competitions, the organization said in a 2011 advisory that is still in force and has been the subject of lengthy research.

Why do governing bodies find it important who identifies as a woman?

Many sports organizations are trying to strike a balance between inclusion for all athletes and fairness for everyone on the playing field. They also argue that physical safety is an important consideration in contact and combat sports, such as boxing.

In the Semenya case, the judges of the Court of Arbitration for Sport, in a 2-1 ruling against her, recognised that discrimination against some women was “a necessary, reasonable and proportionate means” of maintaining fairness.

Male athletes do not need to regulate their natural testosterone levels, but female athletes who do not have DSD may also benefit.

The idea that a testosterone test is some kind of miracle cure is wrong, International Olympic Committee spokesman Mark Adams said in Paris as the debate over women’s boxing heats up.

What does the IOC demand?

The IOC is sometimes very powerful, but sometimes not at all.

The Switzerland-based organization manages the rulebook of the “Olympic Charter,” owns the Olympic brand, chooses the hosts and helps finance them through the billions of dollars it makes from selling broadcast and sponsorship rights.

However, Olympic sporting events are run by individual governing bodies, such as FIFA and World Athletics, which codify and enforce their own athlete eligibility and field of play rules, as well as disciplinary codes.

When Olympic sports reviewed and updated the way they addressed issues surrounding sexual suitability, including those relating to transgender athletes, the IOC in 2021 issued advice, not binding rules.

That was the organisation’s framework for gender and sex inclusion, which recognised the need for a “safe, harassment-free environment” that respects athletes’ identities while ensuring that competitions are fair.

Boxing, however, was different and the consequences in Paris were severe.

The IOC has been involved in an increasingly fierce conflict with the International Boxing Federation, now under Russian leadership, for years. This conflict led to a permanent ban from the Olympic Games last year.

For the second year in a row, the Olympic boxing tournaments are being organised by an IOC-appointed governing committee rather than a functioning umbrella body.

Due to this dysfunction, the rules for participation in boxing matches have not been adapted to those of other sports. Furthermore, the problems were not addressed prior to the Olympic Games in Paris.

At the 2023 world championships, Khelif and Lin were disqualified and stripped of medals by the IBA, which said they had failed the women’s competition eligibility tests but provided little information about it. The governing body has repeatedly contradicted itself over whether the tests measured testosterone.

At a chaotic news conference in Paris on Monday, IBA officials said they had only conducted blood tests on four of the hundreds of fighters competing in the 2022 world championships, and that they tested Khelif and Lin following complaints from other teams, an apparent acknowledgement of an uneven standard of profiling that is considered unacceptable in the sport.

Who challenges the established rules in some sports?

Before Semenya, there was Indian sprinter Dutee Chand who went to the Court of Arbitration for Sport, challenging the first testosterone rules for athletics, which were passed in 2011 in response to Semenya.

An initial CAS ruling for Chand in 2015 froze the rules, leading to an update in 2018 that was subsequently contested by Semenya. Her 800 career was halted after she refused to take medication to artificially suppress her testosterone levels and was banned from elite events.

Semenya lost at CAS in 2019, but went to the European Court of Human Rights via the Swiss Supreme Court, where she won a historic, but not complete, victory last year.

In May, the ECtHR held another hearing in Semenya’s case. The verdict is likely to follow next year.

The case could be sent back to Switzerland, perhaps even back to CAS in the Olympic home city of Lausanne, Switzerland. Other sports watch and wait.