https://theconversation.com/amp/ten...-semenya-decision-on-intersex-in-sport-116448
Ten ethical flaws in the Caster Semenya decision on intersex in sport
Julian Savulescu, University of Oxford
Published: May 10, 2019 6.07am AEST
This essay is part of our occasional series Zoom Out, where authors explore key ideas in science and technology in the broader context of society and humanity.
Middle-distance runner Caster Semenya will need to take hormone-lowering agents, or have surgery, if she wishes to continue her career in her chosen athletic events.
The Court of Arbitration in Sport (CAS) decided last week to uphold a rule requiring athletes with certain forms of what they call “disorders of sex development” (DSD) – more commonly called “intersex” conditions – to lower their testosterone levels in order to still be eligible to compete as women in certain elite races.
The case was brought to CAS by Semenya, as she argued discrimination linked to a 2018 decision preventing some women, including herself, from competing in some female events.
This ruling is flawed. On the basis of science and ethical reasoning, there are ten reasons CAS’s decision does not stand up.
But first let’s take a quick look at the biology involved.
Semenya underwent medical testing in 2009: at the time she was told it was a doping test. The results are confidential, but it has been widely reported that she does have an intersex condition. It seems reasonable to assume she has XY chromosomes, as she is covered by the CAS ruling. Her testosterone levels have not been disclosed, but since the ruling applies to her, they must almost certainly be in what they classify as the “male range”.
According to CAS, the DSD regulations require athletes who want to compete in some female events, who have XY chromosomes and in whom testosterone has a biological effect to reduce their natural testosterone levels to an agreed concentration (below 5 nmol/L).
In women referred to as “46 XY DSD” – the most common intersex condition among female athletes – the presence of a Y chromosome causes the development of testes. These do not descend from the abdomen but do produce testosterone. However the receptors for testosterone are abnormal, with the result that the individual develops as female with a vagina, but no ovaries or uterus. Circulating testosterone may have no biological effect in the case of complete androgen insensitivity syndrome (AIS), or some effect in partial AIS.
Now let’s consider what’s wrong with the ruling.