'I Am A Woman': Track Star Caster Semenya Continues Her Fight To Compete As Female Male and female athletes compete in separate categories because of advantages that come with testosterone. But what should be the rules for women who have naturally high testosterone levels?

'I Am A Woman': Track Star Caster Semenya Continues Her Fight To Compete As Female

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When a two-time Olympic champion runner, Caster Semenya, was asked if she would agree to take drugs to lower her testosterone, she gave a definite answer - quote, "hell no." This week, she filed an appeal to press that point. She's asking the Swiss Federal Supreme Court to throw out an earlier court ruling that went against her.


At issue are rules that require track and field athletes who are intersex to suppress their naturally elevated testosterone levels with drugs or surgery if they want to compete in certain events. This has generated a whole lot of controversy. And as NPR's Melissa Block reports, it raises difficult questions about fairness, ethics and who gets to be allowed to compete as a woman.

MELISSA BLOCK, BYLINE: In her native South Africa, Caster Semenya is a hero. This video from one of her corporate sponsors asks, how do you stop a determined woman?


UNIDENTIFIED NARRATOR: You can't. You can knock her down, kick her down.

BLOCK: We see Semenya on the track festooned with medals. But then we see a news clipping that says, man or monster?


UNIDENTIFIED NARRATOR: You can even try to drug her to slow her down. When the rights of a woman are threatened, she will never, ever back down.

BLOCK: And indeed, just two days after a court ruled against her this month, Semenya took to the track.


UNIDENTIFIED ANNOUNCER: Look at that silky smooth, serene style from Caster Semenya.

BLOCK: She blistered past the competition in the 800 meters in Doha, Qatar.


UNIDENTIFIED ANNOUNCER: My word. Is there any end to her talent? And she's just running away. Is this, as some people have suggested, something of an act of defiance, given what's been going on?

BLOCK: Afterword, the 28-year-old called it the easiest race she had ever run.


CASTER SEMENYA: For me, negativity's nothing. So as long as it doesn't kill me, it makes me stronger, like I said.

BLOCK: But the racing future of Semenya and other intersex athletes is very much in doubt. Let's back up. We're not talking about transgender athletes here. Intersex refers to people who are born with anatomy that doesn't neatly fit into the binary male or female categories.

ERIC VILAIN: People think that it's simple to define sex. It's not.

BLOCK: Dr. Eric Vilain says the biology of sex classification is anything but straightforward. There can be a wide spectrum of variations. Vilain is a geneticist at Children's National Health System in Washington, D.C. He specializes in the study of sexual development and testified as an expert witness on Caster Semenya's behalf.

VILAIN: It's really difficult to support a rule that seems to be based more on preconceived idea of what a woman should be rather than who a woman is.

BLOCK: Semenya was raised as a female and is legally female. She's fighting rules that target athletes with a difference of sex development or DSD, specifically those who have what are typically male XY chromosomes who were born with internal testes and have testosterone levels higher than the typical female range. Supporters of the rules say higher testosterone gives these athletes an unfair performance advantage since it provides a boost in power, endurance and speed. So they say if you want to create a level playing field, the new restrictions make sense.

Joanna Harper researches gender and sport and testified in the Semenya case on behalf of the governing body for track and field, the IAAF.

JOANNA HARPER: We separate male athletes and female athletes not on the basis of gender identity or legal sex or how people are identified at birth, but rather on biological characteristics that make men so much better at sport than women.

BLOCK: And Duke Law School professor Doriane Coleman says the rules guarantee a protected space for women to compete. She is a former 800-meter runner who studies sex and sport.

DORIANE COLEMAN: If eligibility for women's sports events can't be based on biological sex traits or at least one biological sex trait, then you won't see females on the podium.

BLOCK: But who gets to decide who is female? As Caster Semenya said in a statement when she filed her appeal, I am a woman, and I am a world-class athlete. The IAAF will not drug me or stop me from being who I am. The new rules apply only to certain distance events from 400 meters to one mile where the Federation claims runners get the most benefit from testosterone. If the affected athletes want to race in those events, the Federation says, well, they can compete in the male classification. Geneticist Eric Vilain says that's absurd.

VILAIN: If the same athlete could be a woman in one and a man in another, it makes absolutely no sense.

BLOCK: As for how the DSD athletes can suppress their testosterone, they have three choices. They could have their testes surgically removed. They can get a monthly injection that blocks testosterone, or they can take birth control pills. Dr. Veronica Gomez-Lobo is the founder of the Differences of Sex Development clinic at Children's National. She says all of these options come with risks, even birth control pills.

VERONICA GOMEZ-LOBO: Even though we tend to think of them as being very safe, they can cause blood clots that can travel to your lung and can be very dangerous. Although that's very rare, that can happen. So you're forcing somebody to take a medication she doesn't want to take, and she's incurring the side effects and risks of that medication only to compete.

FRANK MONTGOMERY: There is no medical need and no medical indication for this therapy, and therefore doctors should not prescribe it.

BLOCK: That's Dr. Frank Montgomery, chair of the World Medical Association, which calls the regulations unethical, a violation of human rights. The group has urged doctors around the world to refuse to comply. Requiring athletes to take drugs that will reduce performance, Montgomery calls that inverse doping.

MONTGOMERY: And we are against doping of any sort. Ethically and medically, this fairness argument doesn't carry. It is definitely not a way to tell someone you're a woman only if you take certain medication.

BLOCK: None of this is simple. And Steve Magness, who coaches professional runners, says it's possible to hold what seem like contradictory opinions on this.

STEVE MAGNESS: You can at the same time feel incredible compassion towards Semenya and DSD athletes and say that, hey, what's happening isn't right. But at the same time, you can say we protect the women's division of sport for a reason, and we have to decide somewhere where we want to divide that.

BLOCK: For now, these rules apply only to track and field. It's up to other sports federations to decide whether to follow suit. Melissa Block, NPR News.


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