06 August, 2017

The hyperandrogenism plague

Back in 2015 I wrote about gender issues and the fact that, following the appeal of D. Chand (an indian sprinter) against the decision of the Athletics Federation of India (sustained by the IAAF) to ban her from participation at women’s events at the Court of Arbitration of Sport, the initial decision was suspended. That decision opened the floodgate, allowing hyperandrogenic female athletes to participate in women's competitions.

This allowed, among others, C. Semenya to return to the limelight winning the 800 m in the Rio, 2016, Olympics (after having been unable to reach the final in the World's one year before). She is now poised to win the same distance at the 2017 World Championships. But enough on Semenya. I am going to write a longer article on her after the London World's.


The Rio 800 m podium: Niyonsaba, Semenya, Wambui
You can judge for yoursleves

(By the way. J.-P. Vazel had published in his blog a very interesting article on hyperandrogenism, an article to which I was linking in my post. For unfathomable reasons Vazel's article has disappeared and the link leads to an error page. Fortunately I had made a copy of the article as soon as I saw it. In fact the blog of J.-P. Vazel seems dead, not having been updated in almost a year. On the other hand Vazel is quite active in Twitter).

But let us start at the beginning. What is hyperandrogenism? This is a term used to describe the excessive production of androgenic hormones, essentially testosterone, in females. The IAAF regulations stipulated that no hyperandrogenic female would be eligible to compete in a women’s competition if she had functional androgen levels (testosterone) that are in the male range. In fact, it is this rule that replaced the existing Gender Verification policy. If a female athlete had androgen levels inside of the male range (in the case of testosterone larger than 10 nmol/L) she could not compete in women's events (unless she could establish that she derived no advantage from such levels of androgen). What that meant in practice was that a hyperandrogenic athlete had to undergo a hormone treatment in order to bring her testosterone levels down to ones deemed "normal" for females. 

These are, in a nutshell, the rules suspended by the Court of Arbitration of Sport. A two year period was set by the Court at the end of which the IAAF would have to provide convincing scientific evidence of significantly enhanced performance in hyperandrogenic athletes, lest the hyperandrogenism regulations be thrown out as void. The IAAF found themselves with their back to the wall. They had to allow hyperandrogenic athletes to participate in major championships. D. Chand, who was at the origin of the affair, improved her 100 m record to 11.24 s and obtained a bronze medal at the 2017 Asian Championships.

The two-year period is now practically over and the IAAF is gearing up for the hearing at the Court of Arbitration of Sport. Two research articles will provide the main argument in support of the IAAF regulation. The first is an article (Bermon S, Garnier P-Y. Br J Sports Med 2017;0:1–7. doi:10.1136/bjsports-2017-097792) by S. Bermon and P.-Y. Garnier published in the British Journal of Sports Medicine under the title "Serum androgen levels and their relation to performance in track and field: mass spectrometry results from 2127 observations in male and female elite athletes". The second is an article by the team of the Karolinska Institute of Stockholm (Eklund E, et al. Br J Sports Med 2017;0:1–9. doi:10.1136/bjsports-2017-097582) with title "Serum androgen profie and physical performance in women olympic athletes". An article more "accessible" to non-specialists is a review by S. Bermon in the journal Current Opinion in Endocrinology (volume 24, June 2017, pages 246-251) under the title "Androgens and athletic performance of elite female athletes". Bermon's conclusion is clear: "Female athletes with high androgen levels benefit from a 2–5 % competitive advantage over other female competitors with normal androgen levels".


The same trio again. At least they are ruining only the 800 m

What does this mean in practice? Let's assume that Semenya has a 5 % advantage due to her high testosterone levels. Taking out this advantage her 800 m record would be over 2 min, relegating her to the "also run" class. There you have it. Allowing hyperandrogenic females to participate in women's events is tilting the field in a way that is blatantly unfair to "real" women. Yes, I wrote the word real on purpose. Because I am convinced that gender is not a "yes or no" issue, the two sexes being separated by an unbridgeable gap. There is a continuity between male and female and hyperandrogenic females are a class of their own, being neither (anatomically female but endocrinologically male). When unscrupulous countries are scouting for such cases and push to allow them to participate in women's competition in the name of human rights I perceive this as a blatant injustice. Let us be fair to women and not force them to play with loaded dice.

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