Sex in Sport

Discussion in 'Women and Steroids' started by Michael Scally MD, Mar 15, 2018.

  1. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Sex in Sport

    Doriane Lambelet Coleman & Kimberly D. Krawiec, Foreword, 80 Law and Contemporary Problems 1-5 (2017). Available at: "Foreword" by Doriane Lambelet Coleman and Kimberly D. Krawiec

    Historically, debates about what it meant “to be a woman” for purposes of sport were largely confined to elite sports circles. That changed in 2009, when it was announced that South African runner Caster Semenya, the just-crowned world champion in the women’s 800 meters, had been subjected to gender verification testing. Fellow competitors were outspoken: Semenya was not a woman, they said, and it was unfair to allow her to compete in the women’s category. “These kind of people should not run with us,” said Italian runner Elisa Cusma, “For me, she is not a woman. She is a man.”1 “Just look at her,” said Russian runner Mariya Savinova.2

    The controversy set off debates around the world about whether and why sex segregated sports are justified and how eligibility determinations for the women’s category should be made. Suddenly, in social media and the popular press, at coffee shops, and in chats at the local grocery store, people who had rarely paused to question issues of biological sex, gender identity, or affirmative action in sports debated Semenya’s case, and what it meant for conceptions of binary sex categories. It also inspired this volume, in which scholars from gender studies, law, philosophy, and biology bring insights to bear on an issue that is important, not only to sport, but to cultural debates about gender and sex more broadly.

    Taken together, these multidisciplinary approaches to the common question of sex in sport should inform contemporary debates about the relative salience of biology in the different institutional spaces that comprise this world. The issue’s authors provide relevant factual background from their respective areas of expertise and offer arguments from those disciplines about how policymakers within and outside of sport should assess and resolve the debates. Because sport has significant cultural currency and cross-cultural significance, we expect that these contributions and the processes by which they are generated will also have salience as questions about sex and identity are addressed in the non-sporting contexts in which they also arise.

    Sex in Sport. Law and Contemporary Problems. 2017;80(4).
    Law and Contemporary Problems | Journals | Duke Law
  2. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Is testosterone responsible for athletic success in female athletes?

    The aim of this study is to determine the interrelationship between the resting serum testosterone (T) levels (an inherited trait) of female athletes from different types of sporting events and their athletic success. The study involves 599 Russian international-level female athletes (95 highly elite, 190 elite, and 314 sub-elite) and 298 age-matched female controls. All subjects were age 16-35 years old and to the best of our knowledge have always tested negative for performance enhancing substances.

    The athlete cohort was stratified into four groups according to event duration, distance, and type of activity:
    1) endurance athletes,
    2) athletes with mixed activity,
    3) speed/strength athletes, and
    4) sprinters.

    Athletic success was measured by determining the level of achievement of each athlete. The mean (SD) T levels of athletes and controls were 1.65 (0.87) and 1.76 (0.6) nmol/L (P=0.057) with ranges of 0.08-5.80 and 0.38-2.83 nmol/L in athletes and controls, respectively. No significant differences in T levels were found between different groups of athletes.

    T levels were positively correlated (r=0.62, P<0.0001) with athletic success in sprinters (runners, cyclists, kayakers, speed skaters, swimmers). Moreover, none of the sub-elite sprinters had T > 1.9 nmol/L, while 50% of elite and highly elite sprinters had T > 1.9 nmol/L (95% CI: 2.562-862.34; OR=47.0; P<0.0001). We do not observe the benefits of having high T levels for success in other groups of athletes. Conversely, highly elite middle-distance (P=0.235) and mixed activity athletes (P=0.096) tended to have lower T levels than less successful athletes.

    Our data suggest that the measurement of the serum T levels significantly correlates with athletic success in sprinters but not other types of athletes and in the future may be useful in the prediction of sprinting ability.

    Ahmetov II, Roos TR, Stepanova AA, et al. Is testosterone responsible for athletic success in female athletes? bioRxiv 2019:557348. Is testosterone responsible for athletic success in female athletes?
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  3. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Sex, Gender, and Sports

    In 2018, the International Association of Athletics Federations (IAAF) introduced new eligibility regulations for female athletes with differences of sex development, including those with congenital adrenal hyperplasia, androgen insensitivity syndrome, and 5α-reductase deficiency (box 1).1

    The regulations are based on the contention that women with high levels of endogenous testosterone and androgen sensitivity have a performance advantage over their peers. Athletics South Africa and Mokgadi Caster Semenya, the South African runner who won Olympic gold medals in 2012 and 2016, are contesting the legality of the new regulations.

    Box 1

    IAAF eligibility regulations for female athletes with differences of sex development1

    · The regulations apply to athletes in events from 400 m to 1 mile, including 400 m, hurdles races, 800 m, 1500 m, 1 mile races, and combined events over the same distances

    · Any athlete who has a difference of sexual development, defined by a circulating testosterone concentration ≥5 nmol/L, and who is androgen sensitive must meet the following criteria to be eligible to compete in restricted events in an international competition or to set a world record in a competition that is not international:

    · She must be recognised in law as either female or intersex (or equivalent)

    · She must reduce her blood testosterone concentration to below 5 nmol/L for a continuous period of at least six months (for example, by using hormonal contraceptives)

    · Thereafter she must maintain her blood testosterone concentration below 5 nmol/L continuously (whether she is in competition or out of competition) for as long as she wishes to remain eligible

    The basis for their claim is a lack of scientific evidence showing that endogenous testosterone concentrations substantially enhance sports performance. This is in alignment with the 2015 judgment of the Court of Arbitration for Sport on the case of Dutee Chand v Athletics Federation of India and the IAAF.2 The IAAF has delayed the implementation of the 2018 regulations until the outcome of the Court of Arbitration for Sport hearing on their legality is determined; this is expected on 26 March 2019.

    At their core, the 2018 regulations seek to identify athletes whose lifetime sex assignment as female—and gender identity as a girl or woman—does not match an imposed female serum testosterone level ≤5 nmol/L.

    Beyond issues of medical governance by sports federations, the 2019 Court of Arbitration for Sport case is garnering growing media attention around gender and race discrimination, binary stereotypes of men and women according to the presence or absence of testosterone, and implications for trans women in sports.

    These issues highlight the fact that although sports policies exist to serve the organisations that develop them, the effect of these policies on individuals, societies, and even medical science has far reaching implications.

    Sitting at the intersection of biological sex and gender identity, the 2018 IAAF regulations challenge the evidence based, benevolent ethos that underlies medical practice. The medical profession does not define biological sex or physical function by serum testosterone levels alone.

    If more science is needed to develop an objective measure of androgen sensitivity, then call for health research organisations to deliver on this mandate. In the meantime, complacence around the IAAF 2018 testosterone regulation for women with differences of sex development risks setting an unscientific precedent for other cases of genetic advantage.

    History compels us to ensure that decisions about genetic superiority are supported by objective, rigorous, and reproducible data. Although this is purely conjecture, we venture that the Olympian gods smile down on winners like Mokgadi Caster Semenya when they perform extraordinary feats of human endeavour.

    Tannenbaum C, Bekker S. Sex, gender, and sports. BMJ (Clinical research ed) 2019;364:l1120. Sex, gender, and sports
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  4. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Science's Place In Shaping Gender-Based Policies In Athletics

    In 2009, South African runner Caster Semenya, aged 18 years, won the 800 m at the World Championships in Athletics in Berlin, only to be rapidly declared “a woman, but maybe not 100%” by the general secretary of the International Association of Athletic Federations (IAAF), and barred from competing.

    After being reinstated, she won Olympic Gold in 2012 and 2016 and became the 800 m World Champion in London in 2017. However, by the time the World Championships in Athletics take place between Sept 28 and Oct 6, 2019, new eligibility regulations for female classification from the IAAF, based on the interpretation of data from studies of androgen concentrations in elite athletes, might have prevented Semenya from competing again.

    We have been deeply involved in shaping the rules of eligibility for female athletes throughout years of regulatory changes. We have now become unlikely partners: an athlete wronged by misuse of genetic data and a geneticist listening to an athlete's perspective—a rapprochement of sorts that has led to this common critique of the new regulations.

    Vilain E, Martinez-Patiño MJ. Science's place in shaping gender-based policies in athletics. The Lancet.
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  5. Praeceptorem

    Praeceptorem Member

    They should have they’re own category plain and simple. But that’s my opinion.
  6. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    [OA] Statement of FISA Sports Medicine Commission: Biological Effects of testosterone

    After recent public discussions and a request of the CAS to justify the biological effects of testosterone on performance, the FISA Sports Medicine Commission summarizes in this short statement the effects of testosterone on development, sex differentiation, many bodily functions, and performance.

    Steinacker JM, Ackerman KE, Koubaa D, Nielsen HB, Hannafin J, Hiura M, Poli P, Smoljanovic T, Wilkinson M, Zupet P, Lacoste A. Statement of FISA sports medicine commission: biological effects of testosterone. Dtsch Z Sportmed. 2019; 70: 83-84. Statement of FISA Sports Medicine Commission: Biological Effects of Testosterone
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