The IOC suggests that it is unsure about testosterone's effect on performance. Photo: Getty Images
What is the opinion of the sports world about whether transgender women can seriously compete with biological women? The International Olympic Committee moved away from the issue. Its framework for transgender and athlete sexual development differences, published in November 2021, leaves it up to individual sports to decide for themselves. World Athletics and World Aquatics have decided to ban transgender women from competing against biological women on the international stage if they have experienced male puberty. The International Cycling Union (UCI) allowed transgender women to compete with biological women if their testosterone levels were below 5 nmol/l for 12 months. They then changed the requirement in June 2022 to below 2.5 nmol/L for 24 months.
This brief history should demonstrate that there is still no consensus on this issue. At the heart of this is the uncertainty of sports leaders regarding the impact of testosterone on performance. This was highlighted in the IOC's presentation of their new concept when they stated that «there is no scientific consensus on how testosterone affects athletic performance.»
And here I am confused. Because amidst the uncertainty of the governing bodies, there is one global sports organization that remains very clear on the performance-enhancing effects of testosterone: the World Anti-Doping Agency (WADA).
Testosterone is on Wada's banned drug list for both men and women because they recognize its performance-enhancing properties. A substance is added to the banned list if it meets any two of the three criteria:
'There was never any doubt: testosterone increases performance'
In anti-doping discussions, there has never been any doubt that testosterone improves performance. If even trace amounts of testosterone or the diuretic used to disguise it are found in your body, you will be penalized with very few questions. Even if you can prove that it was accidental and unintentional, you will still be punished and deprived of medals and prize money. That's how seriously WADA takes the use of testosterone.
On the contrary, the IOC is not sure about the effect of testosterone on performance.
Why is testosterone important? In healthy adults, the testosterone range is 8.8–30.9 nmol/L for men and 0.4–2.0 nmol/L for women. When boys reach puberty, higher testosterone levels lead to several performance benefits such as larger and stronger muscles, reduced fat mass, higher bone density, and better cardiovascular and respiratory function. In addition to these developmental benefits, governing bodies such as the UCI allow transgender women to maintain testosterone levels higher than most biological women.
So, if a woman is defined by the sports authorities as having 2.5 nmol/L or less testosterone, can biological women artificially increase testosterone levels to 2.5 nmol/L without doping?
Likewise, would WADA allow biological women to take a year or two off from competition, have a few solid blocks of training with elevated testosterone levels, and then return to competition as soon as their levels fall below 2.5 nmol/L again? If transgender women have the advantage of physical development with increased testosterone levels, why should biological women be punished for something like this?
To be clear, I offer this as a thought experiment, not as a suggestion on how to equalize playing field. I don't see how you can avoid these awkward questions when you start to define a woman in terms of testosterone.
'We need clarity and agreement from our sports leaders'
I am not in favor of or against transgender women competing with biological women. I stand for the clarity and agreement of our sports leaders. I understand that their situation is difficult. Leaders try to make political decisions with limited information. What if there is not enough data on the results of transgender athletes to draw a valid scientific conclusion?
I wonder if the Court of Arbitration for Sport answered this question indirectly in July 2021. The backstory is that World Athletics denied German long jumper Markus Rehm's request to compete as a healthy man at the Tokyo 2021 Olympics. Rem has a leg amputated and there was concern that his prosthetic leg gave him a performance advantage. Both the burden of proof and the cost of the study fell on Rem. As a result, the results were mixed. They didn't find that Rem had an advantage, but he couldn't prove that he didn't.
The court upheld World Athletics' decision and dismissed Rem's appeal. Ryomu was banned from the Tokyo Olympics, but he won gold at the Paralympics. His winning jump of 8.18m would have secured him fourth place in the Olympics, but his personal best of 8.62m would have made him an Olympic champion.
The fact is that when there was no confidence in that leg amputees could compete on an equal footing with able-bodied men, the supreme sports court upheld the decision to exclude Rem because they did not want to risk the integrity of the category or the competition.
On the contrary, the uncertainty about transgender women and the female category does not cause the same caution. Instead, the approach was experimental, random, chaotic, and filled with ambiguous messages.
Which one? Is testosterone so powerful and dangerous that Wada has to spend a huge amount of time and money regulating it? Or is it not such a big deal and is it perfectly normal for athletes to artificially adjust their levels to the standard set by their sports governing body? Both cannot be true.
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