In August 2009, an 18-year-old Caster Semenya ran two laps of a Berlin track so fast that it would alter the course of both her life and her beloved sport. At 1:55.45, her World Championships’ time was the quickest anyone had run the 800m that year. Someone decided it was too good to be true.
Ten years later the fight to secure a spot on the right side of athletics history is only getting dirtier. Not that it was ever particularly clean, but at least the International Association of Athletics Federations (IAAF) purported to base its actions on logic and scientific reasoning.
On Tuesday evening, however, the body’s bravado seemed to rise to new heights. In response to the World Medical Association’s (WMA’s) call for doctors to refuse to comply with new testosterone regulations because of concerns about the side-effects of potential treatment, the IAAF had a simple solution. No one was forcing anyone to do anything, it said, any athlete was more than welcome to run with the men.
Maybe there’s a reason it released the latest “briefing notes and Q&A on female eligibility regulations” late on a Tuesday night. Perhaps the thinking was that everyone was too transfixed by what was happening in Liverpool to care about anything else at the time. Or maybe it just doesn’t care to reveal one of its core motivations: limiting the sport to its conception of the ideal female.
Is there another way to describe the following passage?
“There are some effects of the medication that might be considered as or confused with ‘side effects’ but are in fact the desired effects of treatment to reduce testosterone levels. Those are effects like loss of muscle mass, reduction of haemoglobin concentration and increase in fat mass.
“For many … individuals with one of these DSDs [differences of sexual development] and a female gender identity, such treatment is the recognised standard of care and the medication helps to change their body to better reflect their chosen gender.”
Semenya was too tall and muscular in 2009. Even before she ran the final, the IAAF demanded a gender test — something it initially kept quiet until it was leaked to the press. So began an extremely humiliating period of Semenya’s life.
Today, the IAAF has a regulatory framework to support its eligibility probes. The problem is that, in turning down Semenya’s appeal last week, the Court of Arbitration for Sport (CAS) did nothing to explain how those should be conducted to ensure the protection of all athletes’ safety and dignity.
There is nothing they can do to remove Semenya as the figurehead.
“There certainly is a danger, because what remains unclear is exactly how they will identify athletes who they believe need to be screened or put through this protocol,” Dr Phathokuhle Zondi, the chief executive of the Sports Science Institute of South Africa told the Mail & Guardian.
“They’ve almost put the onus on the medical team, or the doctor or the athletes themselves. Of course it raises the question that if you didn’t necessarily think you had a question or if you were quite comfortable with how you look or how you present, or whatever the case … there is certainly the risk of victimisation. People pointing others out and saying: ‘What about that person? Is that person under treatment?’ and so forth. It really opens a can of worms.”
Zondi, who was part of Athletics SA’s concurrent CAS appeal, joins a growing list of experts and professionals who have expressed concerns about the implementation of the new regulations. The WMA’s call stems from the fact that affected athletes must now either take medication or undergo treatment for non-symptoms. Before a doctor prescribes you medication, they weigh up the potential of the side-effects with the value of its curing effects. Here, the equation is pure risk — there is nothing to cure. This is why the WMA has declared assisting the IAAF to be unethical.
“Regardless of what’s happening at the WMA and IAAF, every individual practitioner who might potentially be faced with this situation, needs to, themselves, make a decision about what they feel is the correct stance, position or action to take in case of this ethical conundrum,” Zondi continued.
“Of course the risk for the practitioner is [that] we are placed in quite a difficult situation. If you do decide to oblige and follow through with IAAF protocol — perhaps you’re thinking about the athlete because refusing to treat them would further disadvantage them — there is a risk that you would be held accountable by your own health professions council if they view this as unethical behaviour. So you’re putting yourself potentially at risk as a practitioner.”
This is an untenable situation. The IAAF will be unable to implement anything cohesively if the authority of the WMA is against it. Yet at the same time medical professionals around the world risk being incapacitated by contradicting demands on them.
The WMA has a choice. Back down or continue to take the fight to the IAAF. The IAAF, for its part, showed on Tuesday night that it was not backing down easily from its ideals. Success in this battle, however, might just determine whether Semenya can shatter expectations at the World Championships once more.
See Caster treated like Saartjie Baartman, Page 41