Caster Semenya and Differences in Sexual Development

One month ago, The Court of Arbitration for Sport (CAS) ruled in favor of new regulations proposed by the International Association of Athletics Federations (IAAF). These rules would prevent athletes with differences in sexual development (DSD) from competing as females if their testosterone levels do not fall within a certain range. The ruling will likely affect the eligibility of South African runner Caster Semenya, the reigning women’s 800-meter Olympic gold medalist. Here’s the story of Semenya’s decade-long fight to race as a woman.

Breaking Out

Caster Semenya burst onto the track stage in 2009 at the age of eighteen by winning the 800-meter World Championship. Her winning time was the fastest by any woman that year and markedly faster than her previous bests. Her rapid improvement and physical appearance aroused the suspicions of her fellow competitors and the sport’s governing body, the IAAF. Following the race, the IAAF asked Semenya to take a sex verification test. This multiweek examination includes a physical evaluation and reports from a gynecologist, endocrinologist, psychologist, internal medicine specialist and expert on gender.

Caster Semenya, an athlete with presumed differences in sexual development, at the 2012 Olympics
Caster Semenya at the 2012 Olympics (Flickr: Citizen59)

In the face of accusations about Semenya’s sex and eligibility to race, her family, community and country rallied behind her.

“She is my little girl,” said her father Jacob. “I raised her and I have never doubted her gender. She is a woman and I can repeat that a million times.”

Her grandmother, Maphuthi Sekgala, echoed, “I know she’s a woman—I raised her myself… What can I do when they call her a man, when she’s really not a man? It is God who made her look that way.”

South Africa’s governing party, the African National Congress, released a statement saying, “We condemn the motives of those who have made it their business to question [Semenya’s] gender due to her physique and running style. Such comments can only serve to portray women as being weak.”

Differences in Sexual Development

The IAAF never officially published the results of Caster Semenya’s sex verification test. However, reports leaked to the press suggested Semenya has an intersex trait. Unlike transgender individuals, who identify with a gender that differs from the sex they were born with, intersex refers to physical differences in sexual development. The term can apply to both men and women. Intersex traits can manifest themselves externally, for example, with varied external genitalia or other characteristics, or internally, as with differences in chromosomes and testosterone. But many individuals can live their entire lives without knowing they have any differences in sexual development.

In 2010, after a year of closed-door negotiations, the IAAF cleared Semenya to race. She was chosen to carry the South African flag at the 2012 Olympics, where she won the 800-meter silver medal. Gold medalist Mariya Savinova of Russia was later stripped of her medal for a doping violation, giving the title to Semenya.

An Unfair Victory?

But the IAAF had not yet accepted Semenya and other DSD athletes as female competitors. In 2015, the CAS ruled against the IAAF in the latter’s attempt to bar Indian sprinter Dutee Chand from competing as a woman based on her higher-than-average testosterone levels. The CAS questioned the IAAF’s claim that naturally higher levels of testosterone gave some women an athletic advantage. However, they granted the IAAF two years to furnish more convincing scientific evidence for the role of elevated testosterone. In the interim, Semenya won 800-meter gold at the 2016 Olympics. Yet a few of her competitors voiced their displeasure at what they perceived as an unfair victory.

“These colleagues have a very high testosterone level, similar to a male’s, which is why they look how they look and run like they run,” said fifth-place finisher Joanna Jozwik about Semenya and the other two medalists, Francine Niyonsaba of Burundi and Margaret Wambui of Kenya. “I’m glad I’m the first European, the second white,” Jozwik added.

Sixth-place finisher Lynsey Sharp had also questioned the fairness of Semenya’s participation. “I have tried to avoid the issue all year,” she said after the race. “You can see how emotional it all was. We know how each other feels.”

“Such discrimination is a necessary, reasonable and proportionate means of achieving the IAAF’s aim of preserving the integrity of female athletics.”

Necessary Discrimination?

Then in 2018, the IAAF announced new requirements for female track events ranging from 400 meters to one mile. These regulations are specific to athletes with 46 XY DSD, that is, athletes who compete in the female category but have an X chromosome and a Y chromosome and differences in sexual development. Because these regulations apply to Semenya, the logical conclusion is that she is 46 XY DSD.

These new rules required athletes with 46 XY DSD who have elevated testosterone to reduce their blood testosterone levels to below five nmol/L for six months prior to an event and thereafter maintain those levels for as long as they wish to remain eligible. Semenya appealed the IAAF ruling to the CAS, but lost.

In explaining its 2-1 decision, the CAS wrote, “The Panel found that the DSD Regulations are discriminatory. But the majority of the Panel found that, on the basis of the evidence submitted by the parties, such discrimination is a necessary, reasonable and proportionate means of achieving the IAAF’s aim of preserving the integrity of female athletics in the Restricted Events.”

Other prominent athletes have come down on both sides of the issue.

“I understand how hard a decision this was for CAS and respect them for ruling that women’s sport needs rules to protect it,” said women’s marathon world record holder Paula Radcliffe.

Eighteen-time tennis Grand Slam champion Martina Navratilova disagreed: “The verdict against Semenya is dreadfully unfair to her and wrong in principle. She has done nothing wrong and it is awful that she will now have to take drugs to be able to compete.”

Unfinished Business

At this point, the case against Caster Semenya remains up in the air. At the end of April, Semenya won gold at the South African Athletics Championships in the 5,000-meter race, a new distance for her and one not covered by the IAAF’s testosterone rules. And she recently appealed the CAS decision to the Swiss Federal Tribunal, the country’s supreme court.

“I am a woman and I am a world-class athlete,” Semenya said of her appeal. “The IAAF will not drug me or stop me from being who I am.”