Female Testosterone: Contested Terrain

in Kinesiology Review
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  • 1 School of Human Movement, Sport, & Leisure Studies, Bowling Green State University, Bowling Green, OH, USA
  • | 2 American Culture Studies, Bowling Green State University, Bowling Green, OH, USA
  • | 3 Ochsner Medical Center, New Orleans, LA, USA
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World Athletics policy narrowly defines female athletes, creating contested bodies in elite sport. Framed by feminist cultural studies and transfeminism, we discuss the eligibility rules and their real-life impact. Women with naturally elevated endogenous testosterone (hyperandrogenism) are being treated as if they are cheating. That high testosterone in female bodies has been deemed an unfair competitive advantage is consistent with dominant cultural narratives rather than the research about testosterone and sport performance. Applying an intersectional lens, it becomes clear that race, region, class, and nation intersect so that women athletes from the Global South are disproportionately affected by the eligibility regulations. This creation of contested bodies has led to critical mental and physical health outcomes. Cherry-picking one biological component of a body as the cause of exceptional performance in elite sport is irresponsible. Instead, we need education, compassion, and to follow sound science grounded in moral and ethical research.

Krane (vkrane@bgsu.edu) is corresponding author, https://orcid.org/0000-0002-8722-4140.

  • Abdul, G. (2020, November 19). This intersex runner had surgery to compete. It has not gone well. New York Times. https://www.nytimes.com/2019/12/16/sports/intersex-runner-surgery-track-and-field.html

    • Search Google Scholar
    • Export Citation
  • Ahmetov, I.I., Stepanova, A.A., Biktagirova, E.M., Semenova, E.A., Shchuplova, I.S., Bets, L.V., Andryushchenko, L.B., Borisov, O.V., Andryushchenko, O.N., Generozov, E.V., & Roos, T.R. (2020). Is testosterone responsible for athletic success in female athletes? The Journal of Sports Medicine and Physical Fitness, 60(10), 13771382. https://doi.org/10.23736/S0022-4707.20.10171-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Alexander, S.E., Abbott, G., Aisbett, B., Wadley G.D., Hnatiuk, J.A., & Lamon, S. (2021). Total testosterone is not associated with lean mass or handgrip strength in pre-menopausal females. Scientific Report, 11, 10226. https://doi.org/10.1038/s41598-021-89232-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Amsan, A., (2021, June 30). Seema Antil demands hyperandrogenism test on competitor. Indian Express. https://indianexpress.com/article/sports/sport-others/seema-antil-demands-hyperandrogenism-test-on-competitor-7382091/

    • Search Google Scholar
    • Export Citation
  • Bavington, L.D. (2019). Sex control in women’s sport: a history of the present regulations on hyperandrogenism in female athletes. In V. Krane (Ed.), Sex, gender, and sexuality in sport: Queer inquiries (pp. 181201). Routledge.

    • Search Google Scholar
    • Export Citation
  • Bermon, S., & Garnier, P.Y. (2017). Serum androgen levels and their relation to performance in track and field: Mass spectrometry results from 2127 observations in male and female elite athletes. British Journal of Sports Medicine, 51(17), 13091314. https://doi.org/10.1136/bjsports-2017-097792

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bhasin, S., Brito, J.P., Cunningham, G.R., Hayes, F.J., Hodis, H.N., Matsumoto, A.M., Snyder, P.J., Swerdloff, R.S., Wu, F.C., & Yialamas, M.A. (2018). Testosterone therapy in men with hypogonadism: An endocrine society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 103(5), 17151744. https://doi.org/10.1210/jc.2018-00229

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bhowmick, N., & Thottam, J. (2009, September 1). Gender and athletics: India’s own Caster Semenya. Time. http://content.time.com/time/world/article/0,8599,1919562,00.html

    • Search Google Scholar
    • Export Citation
  • Block, M. (2021, July 28). Olympic runner Caster Semenya wants to compete, not defend her womanhood. NPR. https://www.npr.org/sections/tokyo-olympics-live-updates/2021/07/28/1021503989/women-runners-testosterone-olympics

    • Search Google Scholar
    • Export Citation
  • Brenner, S. (2021, April 23). Caster Semenya: ‘They’re killing sport. People want extraordinary performances.’ The Guardian. https://www.theguardian.com/sport/2021/apr/23/caster-semenya-theyre-killing-sport-people-want-extraordinary-performances

    • Search Google Scholar
    • Export Citation
  • Brömdal, A., Olive, R., & Walker, B. (2020). Questioning representations of athletes with elevated testosterone levels in elite women’s sports: A critical policy analysis. International Journal of Sport Policy and Politics, 12(4), 699715. https://doi.org/10.1080/19406940.2020.1834432

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cardinale, M., & Stone, M.H. (2006). Is testosterone influencing explosive performance? Journal of Strength and Conditioning Research, 20, 103107.

    • Search Google Scholar
    • Export Citation
  • Cater-Francique, A., & Flowers, C.L. (2013). Intersections of race, ethnicity and gender in sport. In E.A. Roper (Ed.), Gender relations in sport (pp. 7393). Sense Publishers.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Collins, P.H., & Bilge, S. (2020). Intersectionality. John Wiley & Sons.

  • Committee on Gynecologic Practice. (2017). Committee Opinion No. 698: Hormone therapy in primary ovarian insufficiency. Obstetrics & Gynecology, 129(5), e134e141. https://doi.org/10.1097/aog.0000000000002044

    • Search Google Scholar
    • Export Citation
  • Cook, C.J., Fourie, P., & Crewther, B.T. (2020). Menstrual variation in the acute testosterone and cortisol response to laboratory stressors correlate with baseline testosterone fluctuations at a within- and between-person level. Stress: The International Journal on the Biology of Stress, 24(4), 458467. https://doi.org/10.1080/10253890.2020.1860937

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cooky, C., & Dworkin, S. (2013). Policing the boundaries of sex: A critical examination of gender verification and the Caster Semenya controversy. Journal of Sex Research, 50(2), 103111. https://doi.org/10.1080/00224499.2012.725488

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Court of Arbitration for Sport [CAS]. (2019). CAS 2018/0/5794 Mokgadi Caster Semenya v. International Association of Athletics & Federations CAS 2018/0/5798 Athletics South Africa v. International Association of Athletics Federations. Arbitral Award. https://www.tas-cas.org/fileadmin/user_upload/CAS_Award_-_redacted_-_Semenya_ASA_IAAF.pdf

    • Search Google Scholar
    • Export Citation
  • Crenshaw, K. (1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43(6), 12411299. https://doi.org/10.2307/1229039

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Crewther, B.T., Cook, C., Orysiak, J., Zmijewski, P., & Obminski, Z. (2019). Individual variation in the cortisol response to a simulated Olympic weightlifting competition is related to changes in future competitive performance. Biology of Sport, 36(2), 133139. https://doi.org/10.5114/biolsport.2019.81115

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Enke, A. (2012). Introduction: Transfeminist approach. In A. Enke (Ed.), Transfeminist perspectives: In and beyond transgender and gender studies (pp. 115). Temple University Press.

    • Search Google Scholar
    • Export Citation
  • Erikainen, S.. (2020). Gender verification and the making of the female body in sport: A history of the present. Routledge.

  • Fénichel, P., Paris, F., Philibert, P., Hiéronimus, S., Gaspari, L., Kurzenne, J.Y., Chevallier, P., Bermon, S., Chevalier, N., & Sultan, C. (2013). Molecular diagnosis of 5α-reductase deficiency in 4 elite young female athletes through hormonal screening for hyperandrogenism. Journal of Clinical Endocrinology & Metabolism, 98(6), E1055E1059. https://doi.org/10.1210/jc.2012-3893

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Goh, Z.K., Watta, E., & Knowles, E. (2019, September 25). DSD athletes: What does it mean to be DSD and how gender and sex are the big issues in athletics? https://olympics.com/en/news/semenya-niyonsaba-wambui-what-is-dsd-iaaf-regulations

    • Search Google Scholar
    • Export Citation
  • Goodman, N.F., Bledsoe, M.B., Cobin, R.H., Futterweit, W., Goldzieher, J.W., Petak, S.M., Smith, K.D., Steinberger, E., Anderson, R.J., Bergman, D.A., Bloomgarden, Z.T., Dickey, R.A., Palumbo, P.J., Peters, A.L., Rettinger, H.I., Rodbard, H.W., & Rubenstein, H.A. (2001). American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of hyperandrogenic disorders. Endocrine Practice, 7(2), 120134. https://doi.org/10.4158/EP.7.2.120

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Handelsman, D.J., Hirschberg, A.L., & Bermon, S. (2018). Circulating testosterone as the hormonal basis of sex differences in athletic performance. Endocrine Reviews, 39(5), 803829. https://doi.org/10.1210/er.2018-00020

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Henne, K., & Pape, M. (2018). Dilemmas of gender and global sports governance: An invitation to southern theory. Sociology of Sport Journal, 35(3), 216225. https://doi.org/10.1123/ssj.2017-0150

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hilton, E.N., & Lundberg, T.R. (2021). Transgender women in the female category of sport: Perspectives on testosterone suppression and performance advantage. Sports Medicine, 51(2), 199214. https://doi.org/10.1007/s40279-020-01389-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Human Rights Watch [HRW]. (2020, December 4). “They’re chasing us away from sport.Human rights violations in sex testing of elite women athletes. https://www.hrw.org/report/2020/12/04/theyre-chasing-us-away-sport/human-rights-violations-sex-testing-elite-women#

    • Search Google Scholar
    • Export Citation
  • International Association of Athletics Federations [IAAF]. (2011). IAAF regulations governing eligibility of females with hyperandrogenism to compete in women’s competitions. www.iaaf.org/mm/Document/AboutIAAF/Publications/05/98/78/20110430054216httppostedfileHARegulations(Final)-Appendices-AMG-30.04.201124299.pdf

    • Search Google Scholar
    • Export Citation
  • International Association of Athletics Federations [IAAF]. (2017, July 3). Levelling the playing field in female sport: New research published in the British Journal. IAAF Press Release. https://www.worldathletics.org/news/press-release/hyperandrogenism-research

    • Search Google Scholar
    • Export Citation
  • International Association of Athletics Federations [IAAF]. (2018). IAAF introduces new eligibility regulations for female classification. www.iaaf.org/news/press-release/eligibility-regulations-for-female-classifica

    • Search Google Scholar
    • Export Citation
  • International Association of Athletics Federations [IAAF]. (2019). Eligibility regulations for the female classification (Athletes with differences of sex development). https://www.worldathletics.org/download/download?filename=656101dc-7716-488a-ab96-59d37941e9ac.pdf&urlslug=C3.6%20-%20Eligibility%20Regulations%20for%20the%20Female%20Classification

    • Search Google Scholar
    • Export Citation
  • International Olympic Committee [IOC]. (2012). IOC Regulations on female hyperandrogenism Games of the XXX Olympiad in London. www.olympic.org/results?q=hyperandrogenism

    • Search Google Scholar
    • Export Citation
  • International Olympic Committee [IOC]. (2015). IOC Consensus meeting on sex reassignment and hyperandrogenism November 2015. https://stillmed.olympic.org/Documents/Commissions_PDFfiles/Medical_commission/2015-11_ioc_consensus_meeting_on_sex_reassignment_and_hyperandrogenism-en.pdf

    • Search Google Scholar
    • Export Citation
  • Jordan-Young, R.M., & Karkazis, K. (2019). Testosterone. Harvard University Press.

  • Jordan-Young, R.M., Sönksen, P.H., & Karkazis, K. (2014). Sex, health, and athletes. British Medical Journal, 348, g2926. https://doi.org/10.1136/bmj.g2926

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Karkazis, K., & Carpenter, M. (2018). Impossible “choices”: The inherent harms of regulating women’s testosterone in sport. Journal of Bioethical Inquiry, 15(4), 579587. https://doi.org/10.1007/s11673-018-9876-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Karkazis, K., & Jordan-Young, R. (2015, May 22). Debating a testosterone “sex gap.” Science, 348(6237), 858860. https://doi.org/10.1126/science.aab1057

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Karkazis, K., & Jordan-Young, R.M. (2018). The powers of testosterone: Obscuring race and regional bias in the regulation of women athletes. Feminist Formations, 30(2), 139. https://doi.org/10.1353/ff.2018.0017

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Karkazis, K., Jordan-Young, R., Davis, G., & Camporesi, S. (2012). Out of bounds? A critique of the new policies on hyperandrogenism in elite female athletes. American Journal of Bioethics, 12(7), 316. https://doi.org/10.1080/15265161.2012.680533

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kauer, K.J., & Krane, V. (2012). Heteronormative landscapes: Exploring sexuality through tales of elite women athletes. Psychology of Women Section Review, 14(2), 1019.

    • Search Google Scholar
    • Export Citation
  • Kidd, B. (2018). Towards responsible policy-making in international sport: Reforming the medical-scientific commissions. Sport in Society, 21(5), 773787. https://doi.org/10.1080/17430437.2018.1401357

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Krane, V. (2015). Gender nonconformity, sex variation, and sport. In R. Schinke & K. McGannon (Eds.), The psychology of sub-culture in sport and physical activity: A critical approach (pp. 4863). Routledge.

    • Search Google Scholar
    • Export Citation
  • Krane, V. (Ed.). (2019). Sex, gender, and sexuality in sport: Queer inquiries. Routledge.

  • Krane, V., & Panunti, B. (2019). Fair play: Athletes with intersex conditions. In V. Krane (Ed.), Sex, gender, and sexuality in sport: Queer inquiries (pp. 202220). Routledge.

    • Search Google Scholar
    • Export Citation
  • Magubane, Z. (2014). Spectacles and scholarship: Caster Semenya, intersex studies, and the problem of race in feminist theory. Signs: Journal of Women in Culture & Society, 39(3), 761785. https://doi.org/10.1086/674301

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mahomed, S., & Dhai, A. (2019). Global injustice in sport: The Caster Semenya ordeal—prejudice, discrimination and racial bias. South African Medical Journal, 109(8), 548551. https://doi.org/10.7196/SAMJ.2019.v109i8.14152

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McQuoid-Mason, D.J. (2019). Would it be ethical or legal for doctors in South Africa to administer testosterone-reducing drugs to Caster Semenya? South African Medical Journal, 109(8), 552554. https://doi.org/10.7196/SAMJ.2019.v109i8.14146

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • Mitra, P. (2014). The untold stories of female athletes with intersex variations in India. In E. Anderson & J. Hargreaves (Eds.), Handbook of sport, gender and sexuality (pp. 384394). Routledge.

    • Search Google Scholar
    • Export Citation
  • Mohapatra, S. (2021). ‘We are equal but different’: Challenging compulsory heterosexuality by intersexual female athletes in the world of sport. Sociological Bulletin, 70(3), 291313. https://doi.org/10.1177/00380229211011855

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mulot, R. (2019, June 25). Athletism: “If you want to compete in the feminine category, then you must not oppose a treatment.” Sciences et Avenir, https://www.sciencesetavenir.fr/sante/athetism-if-you-want-to-compete-in-the-feminine-category-then-you-must-not-oppose-a-treatment_134846

    • Search Google Scholar
    • Export Citation
  • Munro, B. (2010). Caster Semenya: Gods and monsters. Safundi: The Journal of South African and American Studies, 11(4), 383396.

  • Nyong’o, T. (2010). The unforgivable transgression of being Caster Semenya. Women & Performance: A Journal of Feminist Theory, 20(1), 95100.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pavitt, P. (2020, March 3). IOC confirms existing guidelines on transgender athlete eligibility to remain for Tokyo 2020. Inside the Games. https://www.insidethegames.biz/articles/1091417/ioc-guidelines-transgender-tokyo-2020

    • Search Google Scholar
    • Export Citation
  • Pielke, R. (2017). Sugar, spice and everything nice: How to end ‘sex testing’ in international athletics. International Journal of Sport Policy, 9(4), 649665.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pielke, R., Tucker, R., & Boye, E. (2019). Scientific integrity and the IAAF testosterone regulations. International Sports Law Journal, 19(1–2), 1826. https://doi.org/10.1007/s40318-019-00143-w

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pieper, L.P. (2016). Sex testing: Gender policing in women’s sports. University of Illinois Press.

  • Prabhudesai, S. (2001, October 11). Mystery of Pratima’s suicide. Goa News. https://www.goanews.com/news_disp.php?newsid=7&catid=220

  • Query, C., & Krane, V. (2016). “Well everyone has something”: A case study of a collegiate athlete with congenital adrenal hyperplasia. Qualitative Research in Sport, Exercise & Health, 9(1), 8798. https://doi.org/10.1080/2159676X.2016.1210206

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schultz, J. (2021). Good enough? The ‘wicked’ use of testosterone for defining femaleness in women’s sport. Sport in Society, 24(4), 607627. https://doi.org/10.1080/17430437.2019.1703684

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Shapiro, S. (2012, July 23). Caught in the middle. ESPN. https://www.espn.com/olympics/story/_/id/8192977/failed-gender-test-forces-olympian-redefine-athletic-career-espn-magazine

    • Search Google Scholar
    • Export Citation
  • Sönksen, P.H., Bavington, L.D., Boehning, T., Cowan, D., Guha, N., Holt, R., Karkazis, K., Ferguson-Smith, M.A., Mircetic, J., & Böhning, D. (2018). Hyperandrogenism controversy in elite women’s sport: An examination and critique of recent evidence. British Journal of Sports Medicine, 52(23), 14811482. https://doi.org/10.1136/bjsports-2017-098446

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sudai, M. (2017). The testosterone rule--constructing fairness in professional sport. Journal of Law & the Biosciences, 4(1), 181193. https://doi.org/10.1093/jlb/lsx004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Support Annet Negesa. (n.d.). https://support-annet.org/

  • Tannenbaum, C., & Bekker, S. (2019). Sex, gender, and sports: New regulations challenge the evidence based, benevolent ethos that underlies medical practice. British Medical Journal, 364, 1120. https://doi.org/10.1136/bmj.l1120

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thomas, J.D., & Cardinal, B.J. (2018). Gibberish in communicating written physical activity information: Making strides at derailing a perpetual problem. Sociology of Sport Journal, 35(2), 108118. https://doi.org/10.1123/ssj.2017-0181

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vanny, P.J., & Moon, J. (2015). Physiological and psychological effects of testosterone on sport performance: A critical review of literature. Sport Journal, 19. http://thesportjournal.org/article/physiological-and-psychological-effects-of-testosterone-on-sport-performance-a-critical-review-of-literature/

    • Search Google Scholar
    • Export Citation
  • Waldron, J.J. (2019). Four perspectives for understanding LGBTIQ people in sport. In V. Krane (Ed.), Sex, gender, and sexuality in sport: Queer inquiries (pp.1532). Routledge.

    • Search Google Scholar
    • Export Citation
  • Wells, T. (2019). Intersex, hyperandrogenism, female athletes: A legal perspective on the IAAF doping regulations and where hyperandrogenic female athletes fit in. Santa Clara Journal of International Law, 17(2), Article 1. https://digitalcommons.law.scu.edu/scujil/vol17/iss2/1

    • Search Google Scholar
    • Export Citation
  • WMA. (2019, April 25). WMA urges physicians not to implement IAAF rules on classifying women athletes. https://www.wma.net/news-post/wma-urges-physicians-not-to-implement-iaaf-rules-on-classifying-women-athletes/

    • Search Google Scholar
    • Export Citation
  • Worden, M. (2020, December 8). No equality in sport until we stop policing women’s bodies. https://www.hrw.org/news/2020/12/08/no-equality-sport-until-we-stop-policing-womens-bodies

    • Search Google Scholar
    • Export Citation
  • World Athletics. (2019). Eligibility regulations for the female classification (athletes with differences of sex development). https://www.worldathletics.org/download/download?filename=656101dc-7716-488a-ab96-59d37941e9ac.pdf&urlslug=C3.6%20-%20Eligibility%20Regulations%20for%20the%20Female%20Classification

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