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Below you will find what I think is a fascinating, exhaustive interview on hyperandrogenism in female athletes with Joanna Harper, who you will meet in the interview, but who describes herself as a “scientist first, an athlete second, and a transgender person third”. Harper is unique in the sense that she speaks on this incredibly complex topic from all three aspects – science/physiology, performance and as a transgender person herself. She has been, and is, part of the various panels and groups that are exploring the issue, and so offers insights with authority and experience on what is likely to be one of Rio’s, if not sport’s, greatest ever controversies.
It’s a long read, this one, but if you’re at all interested, I’d encourage you to do it in shifts, or settle in with a cup of tea and take in her insights!

I wanted to interview her to give you a broader understanding of the concepts. And so below, you can see every word she has kindly written to explain what she believes are the issues facing women’s sport right now.
But first, some context, and my views…

TopHyperandrogenism background

Caster Semenya is about as sure a gold medal bet as there is at this year’s Olympic Games. If I had one bet to make, and my life was at stake, I’d put in on her to win the 800m. This past weekend she just missed out on the Diamond League record, running 1:56.46, at a jog. A month ago, she won the 400m, 800m and 1500m at the SA champs, all on the same day. The 400m and 800m, 50 minutes apart, were run in 50.7s and 1:58, with a second lap faster than 60 seconds, suggesting that she could go much, much faster. I watched them in Stellenbosch and have never seen anything like it. The 400m was jogged until the last 100m, and could have been under 49 seconds, and the 800m could have been run in 1:55 if it was needed.
Caster Semenya could, and should, break the 800m world record. It’s the oldest record on the tracks, held by oneJarmila Kratochvilova, and if you know anything about the sport, you know that whoever it was who broke that record was going to be faced with a few probing questions. Most of them would have been doping-related, but in the case of Semenya, thanks to the public drama that played out in 2009, they’re related to sex/gender.
Specifically, we know that Semenya was identified as having elevated testosterone levels after her gold medal in Berlin (1:55.45, as an 18-year old). We know that some intervention was applied, and we can, through pretty basic deduction, figure out that it involved lowering her testosterone levels. How? Well, at the time Semenya emerged, from nowhere, the IAAF and IOC policies on gender verification (they should call it ‘sex verification’, by the way, because sex is biological, gender is social, but anyway) were vague and unrelated to testosterone.

It was as a result of Semenya, and the absolutely disastrous handling of that situation, that the policy changed, and until last year, the policy in place said that women could compete only if their testosterone levels were below an upper limit. That upper limit, 10 nmol/L, was set up based on a study done on all the women competing in the World Championships in 2011 and 2013. The researchers took the average testosterone levels of women with a condition called Polycystic Ovary Syndrome, which was already elevated at 4.5 nmol/L, and then added 5 SD to it.
The addition of 3 SD (which created a level of 7.5 nmol/L) would have meant that 16 in 1000 athletes would exceed the cutoff. That’s why the extra 2 SD were added, to make sure that the upper limit would apply only to those with hyperandrogenism (or those who are doping).

99% of female athletes, by the way, had testosterone levels below 3.08 nmol/L. So the upper limit of 10 nmol/L was three fold higher than a level that applies to 99 in 100 women participants.
Semenya’s performances, under this policy of reducing testosterone, dropped off in a predictable manner. Having run the 1:55.45 at 18, she never got close again, though did win Olympic silver in London (behind a doper), and a World silver in 2011. Last year, she failed to advance beyond the semi-finals in Beijing, and hadn’t even made the qualification mark for the preceding year’s Commonwealth Games. 2:00 had become a significant barrier, when the world record had been plausible at 18.

Now, she is untouchable. People will (and have said) that it’s down to her focused training, recovery from injury and so forth, but I’m not buying that. The change has happened for an obvious reason – the restoration of testosterone levels, and that is thanks to the courts – CAS, the Court of Arbitration for sport, last year ruled that the IAAF could no longer enforce the upper limit of testosterone, and in so doing, cleared the way for Semenya, and at least a handful of others, to return to the advantages that this hormone clears provides an individual. That CAS ruled this way because they felt that there was insufficient evidence for the performance benefits is one of the stupidest, most bemusing legal/scientific decisions ever made.
In any event, the situation now is this – Semenya, plus a few others, have no restriction. It has utterly transformed Semenya from an athlete who was struggling to run 2:01 to someone who is tactically running 1:56. My impression, having seen her live and now in the Diamond League, is that she could run 1:52, and if she wanted to, would run a low 48s 400m and win that gold in Rio too.

Semenya is of course not the only such athlete. And in the absence of a policy, I fully expect more in future. However, right now, Semenya is the unfortunate face of what is going to be a massive controversy in Rio. That’s because she was so unfairly “outed” in Berlin in 2009, when what should have been handled discreetly became a public drama, thanks to inept/arrogant SA officials. It won’t be any consolation to Semenya, and the media, frankly, have no idea how to deal with this – nobody wants it to be about the athlete, and it certainly is not her fault. However, it is a debate we must have, and I want to try to have it from the biological, sporting perspective, and steer clear of the minority bullying that so often punctuates these matters.
On that, I have written a couple of scientific articles on this issue, back in 2009, inspired by the relevance of the Semenya debate. You can read those at these links:

• For the International Journal of Sports Performance and Physiology
• For the SA Journal of Sports Medicine

Since 2009, that viewpoint has not changed, and let me state it as directly as possible:
TopTaking a position: Divisions must be defended
I do not believe that women with hyperandrogenism should be competing unregulated. I believe that the divide between men and women exists precisely to ensure fairness in competition (as far as this is ever possible), and I think that if you respect that division, then a policy that addresses hyperandrogenism must exist. I think CAS made a ludicrous decision, and I think it is damaging to women’s sport. Saying that men and women are different is a biological reality, and in sport, the difference has obvious performance implications. It does not mean “inferior”, but different, so spare me any “patriarchy” nonsense on this (I’ve heard it said, for instance, that women’s performances are slower because of the “fucking patriarchy”. If you think that, let me save you time and tell you to stop reading now, and save us both the aggravation).
I wish that it did not affect individuals like Semenya, but it does. It also affects many, many other women who frankly, have no chance of competing against the right athlete with an advantage that challenges the male-female division. And let me be very clear – this is not the same as tall people dominating in basketball, or people with fast-twitch fibres dominating sprints. We do not compete in categories of height, because we have decided that there is no need to “protect” short people. We certainly do not compete in categories of muscle biochemistry or neurology.

There are many aspects and arguments in this debate, and I respect most of them, but this particular offering of “whataboutery” is garbage, utterly inadmissible in this complex debate. If you want to play whataboutery in this way, think about weight classes in boxing, contact sports, rowing. Would it be fair if someone said “I can’t help my physiology, and I’m 2kg over the limit for “lightweight”, so let me in?” Or, if you did create a division for height in basketball, should we allow people who can’t help that they’re tall because of genes to come down and play with those under 6 foot? Of course not.
Point is, if you create a division to ensure performance equality based on a known performance advantage, then you absolutely must defend that division, however ‘arbitrary’ the line appears to be. The division between men and women is clear. It is obviously significantly influenced by testosterone, and few physiological variables are as clearly (if imperfectly) separate like testosterone is. If that division is to be respected, as it should, then hyperandrogenic women should have some regulation in place.

For that reason, I believe that the IAAF policy around an upper limit was the best solution, for now. It’s not perfect, and anyone who claims it’s simply about testosterone is wrong. But it’s a better place to be than where the sport is, and that’s my opinion. I cannot acknowledge the women’s 800m as a credible event as a result, but I hope that Semenya (and a few others) go out and run 1:52, and I wish she would run and win the 400m too. Sometimes people need to be struck between the eyes to see the obvious.