27 September 2017

CAS deadline day for IAAF’s Hyperandrogenism Regulations

Today is the deadline given to the International Association of Athletics Federations (IAAF) to produce additional evidence in support of its Hyperandrogenism Regulations, which seek to limit the amount of natural  testosterone females are allowed to produce to under 10nmol/L of serum. The Court of Arbitration for Sport (CAS) initially suspended the Regulations on 24 July 2015, after the IAAF failed to produce scientific evidence that females with natural (endogenous) testosterone above this level enjoyed a significant performance advantage.

The initial CAS ruling gave the IAAF two years to come up with scientific evidence to support the Regulations. After the IAAF failed to produce it, the CAS gave it an additional two months to come up with such evidence on 28 July this year. This deadline expires tomorrow. ‘Should the IAAF not file any scientific evidence within the additional two-month period granted by the CAS Panel (i.e. end of September 2017), the Hyperandrogenism Regulations will be declared void’, read a statement.

The IAAF Hyperandrogenism Regulations were promulgated due to concerns that female athletes with hyperandrogegism enjoyed a significant advantage due to elevated natural testosterone levels. As the CAS rulings referred to above suggest, this was not backed by any scientific evidence.

For example, the Regulations did not consider that athletes suffering from Androgen Insensitivity Syndrome (AIS) were successfully competing in sport, despite their bodies not responding to endogenous testosterone. Similarly, women with polycystic ovary syndrome will have elevated testosterone levels, but that doesn’t make them elite athletes.

Dr. María José Martínez-Patiño successfully challenged her exclusion from the Spanish Olympic team in 1985 on the grounds that she had AIS. If testosterone is such an important arbiter of performance, as the IAAF argues, then how did Dr. Martínez-Patiño manage to compete at elite level when her body cannot respond to testosterone?

In addition to the apparent lack of scientific evidence backing the IAAF’s Regulations, the manner in which they are triggered is also a cause for concern. A female athlete who knows that they have hyperandrogegism to self notify, however the IAAF can also initiative investigations into athletes. ‘The IAAF Medical Manager may initiate a confidential investigation of any female athlete if he has reasonable grounds for believing that a case of hyperandrogegism may exist’, read the Regulations (PDF below).

Such ‘reasonable grounds’ include an athlete making an approach to the IAAF or national federation; the results of a medical examination conducted by a national federation; a report from a doping control officer (DCO); analytical results from anti-doping procedures; or information received by an IAAF medical delegate or ‘other responsible medical official’ at a competition.

The International Olympic Committee (IOC) suspended gender tests ahead of the Sydney 2000 Olympics. However, difficult questions about whether the Hypderandrogenism Regulations reintroduce a form of gender testing – based on whether a female athlete appears to have hyperandrogegism and how a fellow athlete would spot that – have yet to be asked.

It is understood that the IAAF has submitted additional evidence to the CAS in support of its Hyperandrogenism Regulations. Whether that will be enough to satisfy it that females with hyperandrogegism enjoy a significant advantage, comparable to that of a male athlete over a female athlete, remains to be seen. For a more detailed analysis of the issues involved, click here.

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