Olympic gender confusion: Woman with too much testosterone required to take estrogen to compete while drug that blocks estrogen is banned

Sports Olympic Doping Alan Li JPG

Erik Lief and Chuck Dinerstein have each weighed in with companion pieces about a highly controversial rule by the International Association of Athletics Federations (I.A.A.F.), which governs international track and field competition.

[Editor’s note: This is the third in a three-part series on the complicated and fluid issue of gender and sexual identity in elite sports. Read part one and part two.]

South African Caster Semenya, a two-time Olympic champion in the 800 meters has unusually high levels of testosterone for a woman. While this no doubt plays some part in her success Semenya is not accused of doping; her body just makes more testosterone, which I.A.A.F. claims gives her an unfair advantage. So much so that they have established another classification female athletes called “differences of sexual development” (DSDs). The I.A.A.F established a maximum concentration of 5 nanomoles (a little more than a milligram) per liter (nM/L) of testosterone in blood for women who compete in the 400 m, 800 m, and 1,500 m events. The normal range in women is 0.12 to 1.79 nM/L.

At least they’re not being too unreasonable.

Athletes will not be required to undergo surgery to lower their hormone levels


That leaves Semenya with three choices; not compete, compete against men, or take medication to lower her testosterone levels. It is the last of these that strikes me as rather strange. Should we be forcing athletes to take powerful medications to “correct” whatever advantage they were born with? And if so, there are certainly plenty of genetic advantages that determine size, strength, and endurance. Lung capacity is determined by both genetic and environmental factors and athletes with greater lung capacity will excel in sports like running and swimming. Michael Phelps has a lung capacity that is twice that of a normal man. Clearly, this gives him a competitive advantage, but is it unfair? Is the Phelps case all that different from the Semenya case? Is Semenya being required to take medicine because it is feasible while cutting out one of Phelps’ lungs is not? Where do we draw the line?

Related article:  Research integrity and why bad science has become such a problem

The powerful medicine that Semenya would need to take is hormone replacement therapy (HRT), which is used most commonly by women who are going through menopause and are experiencing unpleasant symptoms, such as hot flashes and also to fight osteoporosis.

There are two types of HRT–estrogen-only and estrogen plus progesterone. Estrogen plus progesterone is used in women who still have a uterus (have not undergone a hysterectomy) Semenya would be presumably taking estrogens to make herself “more female.”

Will HRT therapy for some period of time before a competition be harmful? Probably not. Young women with certain conditions are treated with the drugs. But this would be the first time an athlete would be required to take a drug to decrease performance.

And there is a bit of irony here. Cheating is an Olympic sport in the Olympics. This lead the International Olympic Committee to form the World Anti-Doping Agency (WADA) in 1999. WADA’s mission is to ensure that performance-enhancing drugs stay out of sports. The agency is rather strict about what to ban or limit, for example, asthma medications, diuretics, growth hormones, decongestants, and anti-inflammatory steroids (prednisone), to name a few.

And Tamoxifen, which blocks the action of estrogen. So, in track and field, a woman with too much testosterone is required to take estrogen to compete while in the Olympics it’s illegal to take another drug that blocks estrogen.

Pretty crazy, no?

Josh Bloom is the Senior Director of Chemical and Pharmaceutical Sciences at the American Council on Science and Health. Follow him on Twitter @JoshBloomACSH  

This article was originally published by the American Council on Science and Health as Women Athletes & Elevated Testosterone: A Pharmacological View, and has been reproduced here with permission.

Outbreak Daily Digest
Biotech Facts & Fallacies
Talking Biotech
Genetics Unzipped
Video: Test everyone – Slovakia goes its own way to control COVID

Video: Test everyone – Slovakia goes its own way to control COVID

As Europe sees record coronavirus cases and deaths, Slovakia is testing its entire adult population. WSJ's Drew Hinshaw explains how ...
mag insects image superjumbo v

Disaster interrupted: Which farming system better preserves insect populations: Organic or conventional?

A three-year run of fragmentary Armageddon-like studies had primed the journalism pumps and settled the media framing about the future ...
dead bee desolate city

Are we facing an ‘Insect Apocalypse’ caused by ‘intensive, industrial’ farming and agricultural chemicals? The media say yes; Science says ‘no’

The media call it the “Insect Apocalypse”. In the past three years, the phrase has become an accepted truth of ...
globalmethanebudget globalcarbonproject cropped x

Infographic: Cows cause climate change? Agriculture scientist says ‘belching bovines’ get too much blame

A recent interview by Caroline Stocks, a UK journalist who writes about food, agriculture and the environment, of air quality ...
organic hillside sweet corn x

Organic v conventional using GMOs: Which is the more sustainable farming?

Many consumers spend more for organic food to avoid genetically modified products in part because they believe that “industrial agriculture” ...
benjamin franklin x

Are most GMO safety studies funded by industry?

The assertion that biotech companies do the research and the government just signs off on it is false ...

Environmental Working Group: EWG challenges safety of GMOs, food pesticide residues

Known by some as the "Environmental Worrying Group," EWG lobbies for tighter GMO legislation and famously puts out annual "dirty dozen" list of fruits and ...
m hansen

Michael Hansen: Architect of Consumers Union ongoing anti-GMO campaign

Michael K. Hansen (born 1956) is thought by critics to be the prime mover behind the ongoing campaign against agricultural biotechnology at Consumer Reports. He is an ...
News on human & agricultural genetics and biotechnology delivered to your inbox.
Optional. Mail on special occasions.
Send this to a friend