Lawyers acting for Dutee Chand will formally ask the International Association of Athletics Federations (IAAF) to reform its Medical Commission, heard delegates attending the final day of Play The Game 2015 in Aarhus, Denmark, yesterday. In its efforts to split sport into male and female categories, the IAAF was subjecting women to its Hyperandrogenism Regulations – until they were suspended on July 14 this year for two years after Indian athlete, Dutee Chand, challenged them at the Court of Arbitration for Sport (CAS).

Such policies led the surgical castration, the removal of internal testes and ‘feminine’ remodelling of the genital area of four young athletes (18, two that were 20 and one that was 21 at the time) ahead of the London 2012 Olympics, who were told that although the surgery would reduce their performance level, it would allow them to continue to compete in elite female sport. The process is documented in the Journal of Clinical Endocrinology.

However, the policy does not appear to be based on science. Katrina Karkazis of Stanford University – interviewed below – highlighted how higher androgen levels do not necessarily mean better performance. The 161-page decision details that the degree of advantage enjoyed by a women with androgen levels above the range outlined in the HA regulations is between 1% and 3%, much less than the 10% to 12% male advantage. “It is a very generous decision”, she said. “The CAS has given the IAAF two years to come up with evidence which it said it had four years ago”. It was also pointed out that men are not tested for levels of naturally produced (endogenous) androgens.

Also highlighted at Play The Game was the arbitrary nature of how the HA Regulations come into force in the first place. It appears that they are based on suspicion amongst sport’s administrators or other athletes that a competitor may have what are stereotypical ‘male’ characteristics, such as bigger muscles, deeper voice, etc. The Explanatory Notes to the regulations stipulated that any athlete with a history of hyperandrogenism must notify the IAAF so that their case can be evaluated, however controversially stipulated: ‘The IAAF Medical Manager may also initiate a confidential investigation into an athlete’s case if he has reasonable grounds for believing that a case of HA may exist’.

The HA Regulations were first introduced in 2011, after the suspension of South African middle-distance runner Caster Semenya in 2009. The regulations were purported to be a fairer way of splitting athletes into male and female competition than the gender test used to suspend Semenya, when she was 19.  “She is a woman, but maybe not 100%”, IAAF General Secretary Pierre Weiss told media at the time.

The policy was introduced by the IAAF Medical & Anti-Doping Commission, which includes ten members from developed countries, despite the issues highlighted above primarily applying to athletes from developing countries. Despite the HA Regulations being suspended, a 2014 letter from the Sports Authority of India (SAI) asked the Athletics Federation of India (AFI) to perform a gender test on Chand – despite the IAAF’s contention that the HA Regulations are not about gender.

“The Regulations introduced a chill on the competing women of the world”, said Dr. Bruce Kidd of the University of Toronto, who also features in our interview. “There is pressure to appear as ‘feminine’ as possible to avoid being targeted by the Regulations…we should initiate a formal requirement to the IAAF to reform the way that the Medical Commission operates.”

Kidd pointed out that the World Anti-Doping Agency (WADA) had initiated a year-long consultation on the contents of its Prohibited List, arguing that the IAAF should at least run such policies past athletes. “It’s completely indefensible”, he said.