New study on the effects of testosterone on female athletes raises more questions than it answers

Female athletes with hyperandrogenism (elevated levels of testosterone) could have performance advantages according to a new study, forcing international sport governing bodies like the IOC to reconsider the participation of such women in their competitions.

The International Association of Athletics Federations commissioned a study on how testosterone affects female athletes, and the study’s results put the future competition of women like Olympic champion Caster Semenya in doubt.

Semenya and others like her, who have developed hyperandrogenism, were part of the study along with other female athletes whose levels of testosterone were diminished in comparison. According to Martha Kellner and James Rudd of The Guardian, the study concluded that female athletes with elevated levels of testosterone showed small but still quantifiable advantages over their competitors with levels of testosterone closer to what is currently considered a normal range.

"Those with the highest levels of testosterone demonstrated significant advantages over those with the lowest levels – notably in the 400m (2.7% faster), the 400m hurdles (2.8% faster), the 800m (1.8% faster), the hammer throw (4.5% longer) and in the pole vault (2.9% higher)….Testosterone has several potential performance-enhancing effects on the body, including boosting the oxygen-carrying capacity of the blood, building lean muscle mass and increasing mental drive and aggressiveness. The new study also found that female competitors with high levels of androgens benefit from improved visuospatial abilities."

The quantification of advantages such as these raise several questions for governing bodies like the International Olympic Committee. The first and perhaps most important of which is how does the IOC balance protecting a level playing field for all of its competitors against not penalizing women like Semenya for a condition that they had no part in initiating.

Semenya’s advantage could not only be considered quantifiable by data, but demonstrable via “the eye test” as well.

It would be shortsighted of the IOC to ignore this situation, especially when there is refined data supporting the contention that athletes with hyperandrogenism have a tangible advantage. According to the National Center for Biotechnology Information, about 5 to 10 percent of women of reproductive age exhibit some symptoms. That’s prevalent enough that simply ignoring the issue is out of the question.

At the same time, simply disqualifying any woman who exhibits any symptoms could be too restrictive, even punitive. The women who display these symptoms aren’t doping; it’s a natural occurrence for them. Additionally, the IOC would have to decide what the threshold for the elevated testosterone level that evokes disqualification is. Determining that threshold could also eliminate the participation of women who otherwise would be worthy Olympians even without the elevated testosterone levels.

One of the treatments for this condition for the women who wish to undertake it is hormone therapy. The medication prescribed in these circumstances lowers the testosterone levels to a more typical range for the female population at large. The IOC could set a testosterone threshold for all of its female competitors and require that all those women who qualify for the games to undergo hormone therapy for a determined period of time prior to competition if they fall above that threshold. While that would seem to be a solution for the problem, there are potential issues even with that.

There are other naturally-occurring and artificially-created factors that can give Olympic athletes an advantage, like anatomical structure, mental processing abilities, and access to injury recovery techniques. If the IOC enacts strict constraints on hormone levels because it could result in an unfair advantage, shouldn’t the IOC also try its best to level the playing field in every other way as well?

That’s where the conversation treads into the arena of the intent of the Olympics. Isn’t the idea of the competitions to determine who the best in the world at a particular event is? If artificial constraints are being placed on the abilities of some competitors but not on others, doesn’t that defeat the purpose?

Another potential solution that might be considered controversial but not out of the question is: could women with testosterone levels within a normal range for males of the general population compete against men instead of other women? On the other hand, do we really want to make hormone levels, not the presence of genitalia or other secondary sex characteristics or gender identification the prevalent determining factor for athletic competition separated by gender?

The problem is, as represented by the presence of athletes like Semenya, human beings don’t fall into clean, neat categories on a wide variety of factors. Hormone levels are just one such example. This is problematic because our understanding of sport demands those clean, neat categories. This issue is a matter of sport trying to catch up to the evolution of athletes.

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These are all questions that bodies like the IOC have to answer in the face of increased research on the subject of how hormone levels affect athletic performance. The answers are uncertain right now, but what seems more certain is that no matter what the consensus ends up being, criticisms of the policy will exist, and some of those criticisms will be valid.