IAAF warns against stigmatising athletes after new rules

Officials who stigmatise athletes with hyperandrogenism following new rules restricting competition in track events by female runners with high levels of male hormones face heavy sanctions.

The International Association of Athletics Federations (IAAF) President Seb Coe, while issuing the new rules on Thursday, said the fresh guidelines were meant to ensure fair play in the women’s competitions.

The new eligibility rules apply for events from the 400 metres to the mile, and include the 400m hurdles and 1,500m along with the 4x400m relay.

The world athletics governing body further said the new rules were in no way intended “as any kind of judgment on or questioning of the sex or the gender identity of any athlete.”

“To the contrary, the IAAF regards it as essential to respect and preserve the dignity and privacy of athletes with DSDs, and therefore all cases arising under these regulations must be handled and resolved in a fair, consistent and confidential manner, recognising the sensitive nature of such matters,” the IAAF said.

“Any breach of confidentiality, improper discrimination, and/or stigmatisation on grounds of sex or gender identity will amount to a serious breach of the IAAF Integrity Code of Conduct and will result in appropriate disciplinary action against the offending party.”

In a press statement, the IAAF noted that: “The new regulations require any athlete who has a Difference of Sexual Development (DSD) that means her levels of circulating testosterone (in serum) are five (5) nmol/L or above and who is androgen-sensitive to meet the following criteria to be eligible to compete in Restricted Events in an International Competition (or set a World Record in a Restricted Event at competition that is not an International Competition):

(a) she must be recognised at law either as female or as intersex (or equivalent);

(b) she must reduce her blood testosterone level to below five (5) nmol/L for a continuous period of at least six months (e.g., by use of hormonal contraceptives); and

(c) thereafter she must maintain her blood testosterone level below five (5) nmol/L continuously (ie: whether she is in competition or out of competition) for so long as she wishes to remain eligible.”

REGULATIONS APPROVED

IAAF’s statement said the new regulations, which were approved by the IAAF Council in March, will come into effect from November 1, 2018, and will and replace the previous “Regulations Governing Eligibility of Females with Hyperandrogenism to Compete in Women's Competition” which no longer apply.

“We want athletes to be incentivised to make the huge commitment and sacrifice required to excel in the sport, and to inspire new generations to join the sport and aspire to the same excellence,” said Coe.

“As the International Federation for our sport we have a responsibility to ensure a level playing field for athletes. Like many other sports we choose to have two classifications for our competition – men’s events and women’s events.

“This means we need to be clear about the competition criteria for these two categories. Our evidence and data show that testosterone, either naturally produced or artificially inserted into the body, provides significant performance advantages in female athletes.

“The revised rules are not about cheating, no athlete with a DSD has cheated, they are about levelling the playing field to ensure fair and meaningful competition in the sport of athletics where success is determined by talent, dedication and hard work rather than other contributing factors.”

LOW TESTOSTERONE LEVELS

According to the IAAF statement, most females (including elite female athletes) have low levels of testosterone circulating naturally in their bodies (0.12 to 1.79 nmol/L in blood); while after puberty the normal male range is much higher (7.7 – 29.4 nmol/L). No female would have serum levels of natural testosterone at 5 nmol/L or above unless they have DSD or a tumour.

“Individuals with DSDs can have very high levels of natural testosterone, extending into and even beyond the normal male range,” the statement adds.

“There is a broad medical and scientific consensus, supported by peer-reviewed data and evidence from the field, that the high levels of endogenous testosterone circulating in athletes with certain DSDs can significantly enhance their sporting performance.

“These Regulations accordingly permit such athletes to compete in the female classification in the events that currently appear to be most clearly affected only if they meet the Eligibility Conditions defined by these regulations.”

According to Dr Stephane Bermon from the IAAF Medical and Science Department, the latest research undertaken by the IAAF, and data compiled, show that there is a performance advantage in female athletes with DSD over the track distances covered by this rule.

“We have seen in a decade and more of research that 7.1 in every 1000 elite female athletes in our sport have elevated testosterone levels, the majority are in the restricted events covered by these regulations,” Dr Bermon said.

“This is around 140 times what you will find in the general female population which demonstrates to us in statistical terms a recruitment bias. The treatment to reduce testosterone levels is a hormone supplement similar to the contraceptive pill taken by millions of women around the world. No athlete will be forced to undergo surgery.

“It is the athlete's responsibility, in close consultation with her medical team, to decide on her treatment.”

According to the IAAF, female athletes who do not wish to lower their testosterone levels will still be eligible to compete in “the female classification at competitions that are not International Competitions: in all track, field and combined events, including the restricted events; and at international competitions: in all track, field, and combined events, other than the restricted events; or in the male classification, at all competitions (whether International Competitions or otherwise), in all track, field, and combined events, including the restricted events; or in any applicable intersex or similar classification that may be offered, at all competitions (whether international competitions or otherwise), in all track, field and combined events, including the restricted events.”

“The regulations exist solely to ensure fair and meaningful competition within the female classification, for the benefit of the broad class of female athletes,” the statement added.

IAAF added that any athletes, athlete support personnel and national federation officials with questions about the application of the new regulations or requiring advice or support is able to contact the IAAF Medical Manager.

“All contact will be treated in confidence and if additional support is required the athlete, or her representative, may agree on the appointment of an independent ombudsman to assist the athlete in understanding and addressing the requirements of the regulations,” the statement said.

“The regulations also outline in detail the process by which an Expert Panel (made up of experts in the fields of endocrinology, gynaecology, genetics and paediatrics) will assess cases in anonymised form,” it concluded.