Caster Semenya's 800-meter gold medal in Rio is stirring debate over
what it means to be a female athlete
K. Aleisha Fetters
When Caster Semenya took to the 800-meter start line on Saturday, she did
it in a uniform that was clearly different from those of her fellow Olympic
competitors. She didn't wear cheeky briefs or a sleeveless top. Her
green-and-yellow one piece extended from halfway to her knees to halfway
to her elbows. Unlike those of the women lined up next to her, her abs
were not exposed to the hot Rio air—or to the millions of spectators
watching from around the world.
Her body was under enough scrutiny already, with the world questioning
if she wasreally a woman.
It's a question that has chased the 25-year-old South African runner
for nearly a decade. Long ago, Semenya got used to competitors accompanying
her to the restroom at track meets so that they can verify her femininity,
according to a
New Yorker article from 2009. That year, she first dominated the World Championships
in Berlin with a time that others could only explain by calling her a
man. Russia's Mariya Savinova
said, "Just look at her." Pierre Weiss, the general secretary of
the International Association of Athletics Federations, responded by saying,
"She is a woman, but maybe not 100 percent."
The IAAF subjected her to invasive gender verification tests and suspended
her from competition for 11 months. Then, in 2011, the IAAF put limits
on the amount of testosterone that could naturally circulate within a
woman's veins for her to still compete as a woman. Women, like Semenya,
who were deemed to be "too mannish" due to high naturally occurring
testosterone levels, were given the option: subject yourself to humiliating
and potentially fatal measures or don't compete.
These measures included hormone-suppressing drugs or, if testing determined
that the woman was intersex, having both an X and Y chromosome and traces
of testicular tissue in her abdomen, surgery to remove that tissue.
Since testicular cells in intersexed women are prone to malignancies, it's
generally recommended that they be removed anyway, and there aren't
currently any FDA-approved medications for the suppression of testosterone
levels in women, says board-certified endocrinologist
Andrea Dunaif, M.D., director of the Northwestern University Specialized Center of Research
on Sex Differences in Chicago. Options exist abroad, but their safety
is controversial. Some women take medications intended for men with prostate
cancer, she says. Lowered testosterone levels are a side effect. However,
so is liver damage.
It's not known for sure what, if any, procedures Semenya underwent,
but she was allowed to compete in 2010 and went on to win a silver medal
at the 2012 Olympics—behind Savinova, who is currently at risk of
losing her Olympic title due to Russia's current doping scandal. (Still,
many people were quick to point out that Semenya's times were slowing,
a sign that she
must have been lowering her testosterone levels.)
In 2015, however, a fellow athlete with "too-high" levels of
testosterone, Indian sprinter Dutee Chand, challenged the IAAF's body-altering
rules, with the Court of Arbitration for Sport subsequently suspending
the regulations. Female athletes with higher-than-average levels of testosterone
would be able to compete against other women in Rio without first submitting
to medical intervention.
In case you're wondering, Semenya took gold in the 800-meter run on
Saturday. With her time of 1:55.28, she earned a personal best, set a
new South African national record, and the fifth-fastest time in Olympic
history. Hours before the race, the IAAF's president,
Sebastian Coe, said that the group will soon try to overturn the Court of Arbitration
for Sport's decision and again prevent women from competing with high
levels of testosterone.
press conference after the race, Semenya responded to questions about her influence on
the 800-meter event. "I think it is all about loving one another.
It's not about discriminating against people. It is not about looking
at how people look, how they speak, how they run, it is not about being
muscular. It is all about sport. When you walk out of your apartment you
think about performing, you do not think about how your opponent looks.
So I think the advice from me to everybody is just to go out there and
have fun," she said.
Semenya's fans from around the world have responded with the hashtag
#HandsoffCaster, which was a top trending topic on Twitter this weekend, in response to
those who have questioned whether she should be competing.
So what does the science say?
High Levels of Testosterone Aren't All That Uncommon in Women
Testosterone is known as the male sex hormone, but women still produce
the hormone. The typical adult female has blood serum levels ranging from
roughly 30 to 95 nanograms/dl. The typical adult male's levels are
around 300 to 1200 ng/dl, explains
Janis Fee, M.D., chair of obstetrics and gynecology at St. Joseph's Hospital
in Orange County, California.
However, levels in both men and women vary widely—and often.
For instance, on the road to the 2012 Olympics, four female athletes were
flagged for high levels of natural testosterone, according to one
New York Times report. (It also noted that they had received major treatments including
surgeries to reduce the size of their clitorises.)
And a 2014
study from the IAAF Medical and Anti-Doping Department and Commission concluded that seven out of every 1,000 elite female athletes may have
above-average testosterone levels. Study authors noted that these rates
of hyperandrogenism—medical speak for having higher-than-average
levels of androgenic hormones such as testosterone—are far greater
than what they would expect in the general population.
Still, the general population is more familiar with hyperandrogenism than
it realizes, and perhaps even more so than the IAAF researchers concluded.
After all, it's the primary cause of polycystic ovary syndrome (PCOS), of which
15 to 20 percent of womensuffer, explains Dunaif. One
UCLA study of 716 women with PCOS found that 75 percent were hyperandrogenic.
Hyperandrogenism can occur simply due to genetic differences, but can also
be a result of tumors or of being intersexed. But most women with hyperandrogenism
don't know they have it, Dunaif says. Think about it: have you ever
had your testosterone levels tested?
So Does Testosterone Really Give Female Athletes an Edge?
Most of us know testosterone as something that makes men strong and prevents
women from getting "bulky" when they lift weights. And that's
true, to an extent.
After all, testosterone is an anabolic hormone, meaning it helps to build
cells, like muscle cells, in the body. In men, it's associated with
increased muscle size, strength, and bone mass, and with decreased levels
of body fat, Dunaif says. And in one
Journal of Strength & Conditioning Research study of elite athletes, testosterone levels were correlated with vertical
jump performance—a measure of explosive power—in both men
So, while it makes things no less painful for women whose gender identity
is publically questioned, it is understandable why it would trouble the
competition, Dunlaif says. "I was a competitive athlete. I understand
how no one wants anyone else getting an unfair advantage. But these women
are not doping or trying to cheat. This is how they were born," she
says. "And still, there's no conclusive evidence that naturally
high levels of testosterone would enhance exercise performance in women."
What's more, while some experts estimate that excess levels of natural
testosterone would give women's performance a boost that would minimize the
gap between male and female race times, Dunlaif notes that in women with hyperandrogenism-related
PCOS, that doesn't always seem to be the case.
For instance, in one
The Journal of Clinical Endocrinology & Metabolism study that matched women with PCOS with women with similar ages and weights,
those with PCOS had significantly lower aerobic capacities, anaerobic
thresholds, and maximal workload capacity compared to those without the
endocrine disorder. A similar
study from the University of South Australia found that although women with PCOS had higher levels of testosterone,
they displayed no significant differences in aerobic capacity or muscle
strength. Fee also notes that PCOS typically is associated with weight
gain, not loss.
In the end, researchers just don't have any conclusive evidence to
prove whether or not higher-than-average testosterone levels give women
an athletic edge. And if so, in what sports.
But does it really matter if they do? "There are so many other kinds
of biological variants that can lead to enhanced athletic performance,"
says Dunlaif, referring to what many experts call "the sports gene."
For instance, Kenyan distance runners have an on-the-track advantage due
to the architecture of their Achilles tendons, according to research published in the
Scandinavian Journal of Medicine & Science in Sports. Sprinters may have been born with more fast-twitch muscle fibers than
were endurance runners, according to exercise physiologists. And elite
basketball and volleyball players are a good foot or two taller than gold-medal-winning gymnasts.
Maybe that's just part of sports. We all bring something different
to the playing field: ourselves.