black and white running race track

Bioethics Forum Essay

We Should Be Concerned About Athletes Having to ‘Dope Down’

Last week, the Court of Arbitration for Sport rejected an appeal by South African runner Caster Semenya that challenged the International Association of Athletic Federation’s proposed regulations that women like her with atypically high levels of testosterone must take medication to reduce testosterone levels in order to compete in certain events.  

I am sympathetic to the Court’s desire to “protect the integrity of female athletics.” In an ideal world, female athletes who have the dedication and drive to perfect their natural talents should be able to be competitive in their sport and not be overshadowed by women with significant natural advantages. The purpose of gender segregation in competition, after all, is to give female athletes a fair shot at winning and setting records; the typical male body has the capacity to be stronger and faster in part due to its naturally higher testosterone levels. (There are ways in which typical women’s bodies possess categorically competitive advantages over typical male bodies, such as in some contests of endurance or flexibility.) The Court’s ruling was based in part on a 2017 study that concluded that women with hyperandrogenism – unusually high testosterone — have an advantage over other women in certain track events. The study, which was funded by the IAAF, makes a strong case for leveling the playing field by mandating that athletes like Semenya reduce their testosterone to make it comparable to that of their competitors.

 But I am troubled by the precedent this sets. I’m not concerned about the suggestion that Caster and similar athletes have to change their bodies to remain competitive; changing one’s body is often a natural result of the dedicated training athletes do to perfect their sport. I’m concerned that the ruling signals that it is necessary for some athletes to diminish factors of their physical makeup that positively contribute to their athletic performance; that Semenya and similar athletes will have to lower their natural levels of steroid production in order to remain eligible for competition within the bracket of their gender.

Tom Murray, president emeritus of The Hastings Center and author of Good Sport: Why Our Games Matter – And How Doping Undermines Them makes it clear: that sport should celebrate the “virtuous perfection of natural talents.” Semenya’s testosterone levels confer an athletic advantage, but so do Simone Biles’ muscular build, Katie Ledecky’s long wingspan, and Michael Phelps’s natural low levels of lactic acid production. When these competitors enter the gym or the pool, many sportscasters acknowledge that the rest of the field is competing for second place. Like everything in sport, the dominance of these athletes is not just dedication; their natural bodies do contribute to their overall excellence. Why should Semenya have to lower what naturally gives her body an advantage, but Michael Phelps doesn’t have to take extra lactic acid, or Ledecky and Biles have to alter their natural builds?

I am reminded of Kurt Vonnegut’s dystopic short story, Harrison Bergeron. “THE YEAR WAS 2081, and everybody was finally equal,” it begins. In order to maintain equality, each person must wear handicapping devices that lower their natural abilities to match the slowest, or the dumbest, or the least talented individual in society. Ballerinas are burdened with weights and their faces are masked to not make them prettier or more talented than anyone else. This story isn’t our reality, but it points out what equality in competition should not be about: diminishing the natural talents of some to ensure fair play for all.

Since the ruling, Semenya has since said she will not take the medication to comply with these rules, which could jeopardize her athletic career.  “They laugh at me Because I am Different. I Laugh at them because they’re all The same,” she tweeted. I hope no one is actually laughing at Semenya, but I believe her difference should be permitted in competition, not diminished.

Marnie Klein is The Hastings Center’s communications assistant.

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  1. I think Marnie Klein nails it when she asks, “Why should Semenya have to lower what naturally gives her body an advantage, but Michael Phelps doesn’t have to take extra lactic acid, or Ledecky and Biles have to alter their natural builds?” Combine that with Agnes Klein’s post about health risks to Semenya (which hadn’t occurred to me), I think it’s clear she shouldn’t be required to reduce her natural testosterone levels to compete. Yes, there’s an unfairness to other women competing, but it isn’t in principle different from the other sources of unfairness Klein identifies.

    1. Thanks, Bonnie and Agnes (no relation to the latter). Since writing this article, I’ve engaged with athlete friends and read the perspectives of others (Nick Symmonds, Robert Johnson) who support the CAS ruling against Caster Semenya. The essential point of disagreement between my and their points of view is whether or not we should treat testosterone differently than other genetic attributes, because testosterone is closely linked to sex, and athletic competitors are separated by sex. In their view, high testosterone (in the male range) is a distinct genetic advantage from the physical advantages of athletes like Ledecky and Biles; Semenya is therefore unfit to compete as a woman without lowering her testosterone.

      Leaving the safety issues and the recognition that binary sex categorizations do not accurately represent the full spectrum of human diversity aside, I think this argument is flawed because testosterone alone does not distinguish men and women. Yes, it dramatically enhances performance, but I would need to see more evidence to be convinced it is the categorically crucial (and only?) difference in distinguishing men vs women.

      Sports are unfair. Nevertheless, we should try to reward natural talent and disciplined training. It seems to me that Caster has both. And going forward, we’re going to need more clarification of what distinguishes male and female brackets of competition, and more globally, greater respect towards athletes (particularly genderqueer, gender nonconforming, intersex, nonbinary and trans athletes) whose intimate worlds will be exposed in the quest to seek greater fairness in sports.

  2. We segregate certain sports at the elite (and typically lower) levels because if they were sexually integrated women would never win. No women would ever even qualify for any track and field event in the Olympics. Men naturally have such an advantage that its considered unfair for them to compete against women. So, should people with rare (I’ll call it abnormal) genetic condition(s) grouped as DSD (Differential Sexual Development, vernacularly termed “intersex”) be allowed to compete as women? These people form a very small part of the population, less than 0.2%. How fair is it to the vast majority of women for these people to compete as men when physiologically they have certain characteristics typical of males and those characteristics give them the same sort of advantage that men have when competing against women? Its suspected that all of the medal winners (top three finishers) in the women’s 800 meters in the 2016 Olympics are intersex. Run the statistics on that happening if the abnormal condition doesn’t confer an advantage!
    Of course, this whole discussion gets even more complex and muddled if men who identify as female compete as females, something that is starting to happen. How fair is that? Don’t confuse gender identity with sex. Yes, all people deserve respect. But even a so-so runner like I was in high school could run every female in the school into the ground at any distance without even trying hard. That’s simply reality. So, if I had identified as female should I have been allowed to compete as a female? If that’s fair, who to?

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