Let CAS decide (Part II)

'Let Dutee run'

There is an online petition ‘Let Dutee run’  apparently got up mainly through the efforts of Bruce Kidd, a Canadian distance runner who won medals in the Empire and Commonwealth Games and competed in the 1964 Olympics, Dr. Katrina Karkazis, a bioethicist at the Stanford University, USA, and Ms. Payoshni Mitra, an Indian researcher and activist on gender issues in sports. They are the ‘experts’ assisting SAI in fighting the case against the IAAF.

Bruce Kidd has been a campaigner against  gender rules. Dr Karkazis has been the most prolific writer among activists who have campaigned against gender verification in recent times. Her article in the New York Times ‘The trouble with too much T” elicited varied responses from the readers.

One of them wrote “So what solution should we go with - no division between men and women in competition? A three gender system? Gender self-identification as the final arbiter? A 4-tier system with testosterone tiers for both men and women? I don't know the answer but we should figure it out together.”

Testosterone debate

No matter what new studies might have revealed, as claimed, not many are prepared to believe that testosterone is not the most important factor in performance-determination between male and female athletes.

BBC Sport quoted David Epstein, award winning writer for the Sports Illustrated, USA, as saying-

"For lots of good reasons, we have decided to have a class of athletes who aren't men.

"But biological sex is not binary. That means whichever line you draw between men and women it is going to be arbitrary."

Epstein, according to the report, agrees with the IAAF's experts that testosterone is probably "the best line we can draw.” 

The question also arises whether the IAAF regulations are purely a matter of higher levels of testosterone as is being made out and insisted upon.  

The IAAF document talks of three levels of examination and investigations.  First a clinical examination, followed by endocrine (hormone) investigations, winding up with “full examination and diagnosis.”

What decides eligibility?

Does this mean you take a reading of testosterone level, find out it is way above 10nmol/L (288.18ng/dL)…voila you have a ‘positive’ case fit enough to be banned!

It surely  cannot be. Otherwise why should there be a clinical examination, and why should, for example, there be an ultrasound scan done on the athlete?

And why should a panel of doctors go through a full examination in the end before pronouncing a verdict?
There is also no explanation in the IAAF rules about intersex conditions (except for one reference) or  undescended testes producing 'functional' testosterone which could be the reason for elevated levels of the male hormones found in a woman athlete.
There is an opinion developing among critics that men also should be subjected to testosterone-level testing, not to find out doping but to determine whether some of the elite athletes could be having too much testosterone, much above normal limits which will give them an undue advantage over athletes with normal levels of testosterone.

This could be stretching things a little too far. For, no two individuals could be the same. There could be a number of genetic features that could help an athlete more than an adversary. Obviously the authorities are not attempting to lay down rules to determine classifications in normal competitions as there are in Paralympic events for example.

Male and female categories are a different matter though many people in the current debate might not agree with that assumption arguing that there are several categories of sex.

'Cut off long limbs'?

Of course there has been the comparison with long limbs, broad wingspan of swimmers and height of basketballers to point out that God-given natural advantages should not be considered as unfair or needing ‘correction’ to level the playing field. Ms. Payoshni Mitra is one among those who have argued about such advantages for certain athletes. 

SAI Director General Jiji Thomson was also quoted saying the same thing about Usain Bolt that Ms. Mitra has said in the above interview.

The argument of course is nothing new. It has been made in the past too to explain why the authorities needed to ignore the so-called advantage gained by some female athletes because their bodies produced more testosterone than normal.

Mr. Thomson has also been quoted in another report saying that SAI was opting for the second option (of appealing to CAS) since the first (treatment) may take time and there would be no guarantee that she would be back with the same level of performance.

An Olympic medal prospect?

Somehow SAI seems to have accepted this idea that Dutee could be a medal prospect at the Rio Olympics!

As pointed out by intersex activist Hida Viloria below, Dutee Chand does not figure too high in world lists either this season or last. Her 11.63s, her season best this year, ranks only 374^th in the world for the 100 metres. Her junior National mark of 23.57s for the 200m at Taipei ranks 252^nd.

Many among the readers of several articles which have by and large supported the Dutee Chand case and demanded the IAAF scrap its hyperandrogenism regulations have, however, suggested that in case women needed a separate category of competitions then perforce authorities had to draw the line somewhere or else it would be better to have ‘mixed’ competitions.

A few have also suggested that intersex athletes be allowed to compete separately. Hida Viloria, Chairperson of the Organization  Intersex International  (OII), who was in the IOC panel in 2012 to discuss the new ‘gender rules’, has however argued, in an article titled 'Stop freaking out about female intersex athletes' that the number of intersex people being limited and elite athletes among them being still fewer, there would not be much competition if a new category was to be created.

‘Gender verification’ is no longer valid and there is no mention of determining  biological sex in the rules related to hyperandrogenism. This has led to the belief that a mere rise in testosterone levels could be depriving a female athlete of the chance to compete unless she went through potentially dangerous medical treatment or surgery that otherwise would be unnecessary.

The demand that “surgical violence” in the name of levelling the playing field in sports should be stopped may not, however, get much backing from the rules of the IAAF or the IOC.

Neither the IAAF regulations nor the IOC rules mention anything about surgery! They also do not talk of lowering testosterone levels through hormone therapy though that could be expected since otherwise an athlete found to have excess testosterone levels would not be able to come back into sports at all.

IAAF position on treatment

The IAAF rules (explanatory notes) do mention specifically that it would be entirely up to the athlete to undergo "treatment".
This is what is stated in the explanatory notes
"Will the IAAF be involved in carrying out medical diagnosis of an athlete and/or prescribing treatment?
"No. Diagnosis will always be carried out by medical experts at specialist reference centres that are independent of the IAAF and treatment, if any, will be prescribed by the athlete’s supervising physician. The IAAF will not be involved in either process. The IAAF’s role is strictly limited to deciding on the eligibility of such athletes to compete in its women’s competitions."

One is not sure what findings the medical panel reported to SAI about Dutee Chand’s condition. According to SAI's statement that announced the suspension of Dutee Chand  last July, it simply found out that the Odisha sprinter had a testosterone level higher than permitted by regulations.

Dutee's T level

The level of testosterone found out by the SAI in Dutee's sample, well above the IAAF ‘cut-off’, it was learnt, in itself might be of minor significance if Dutee and  her team are able to prove that testosterone was not a major factor in determining performance of a female athlete.

The question of biological sex could then come into the debate though that is something that both the IAAF and the IOC would not want to tread on.

Hopefully the details of her condition that alone had been kept out of the millions of words written over her these past few weeks, would remain within the medical records.

The IOC rules say that only men are eligible to participate in men’s competitions and only women are eligible to compete in women’s competitions.

The IOC rules 2014 also state “Human biology, however, allows for forms of intermediate levels between the conventional categories of male and female, sometimes referred to as intersex.Usually, intersex athletes can be placed in the male or female group on the basis of their legal sex. However, as explained below, intersex female athletes with elevated androgen production give rise to a particular concern in the context of competitive sports, which is referred to as “female hyperandrogenism.”

“In general, the performances of male and female athletes may differ mainly due to the fact that men produce significantly more androgenic hormones than women and, therefore, are under stronger influence of such hormones. Androgenic hormones have performance enhancing effects, particularly on strength, power and speed, which may provide a competitive advantage in sports. This is one of the reasons why the exogenous administration of such hormones and/or the promotion of the endogenous production of these hormones are banned under the World Anti-Doping Code, to which the IOC is a signatory.”

The task before CAS

Should  CAS allow women with any level of testosterone? Or should they uphold the rules and allow a ‘cut-off’ for T? Or should they determine a new level, slightly more than the current one since research seems to suggest that there could be higher levels among elite athletes? How high should it be pegged? Or will they suggest a more detailed investigating process before declaring an athlete ‘ineligible’?

Can the CAS arbiters rule a separate intersex category if that, and not hyperandrogenism alone, is the issue?

Or as someone commented in response to an article  can they“make it gender neutral”.

We will have to wait a few months since the initial CAS procedures do take time before the panel starts hearing the case.

Either way the verdict goes, this will be path-breaking.

(Concluded)

(amended on 31 Oct 2014)
Post-script-CAS has scheduled the Dutee Chand hearing for March 23-26, 2015.