Hassan vs Niyonsaba vs Semenya at Prefontaine Classic

That is incorrect.

In 2015, Semenya got a temporary stay of the rules, which ended up lasting until the summer of 2019 when the court issued their final ruling that said intersex athletes with testes, like Semenya, couldn't run in events from 400-mile without reducing their testosterone to female levels.

But in the 100, 200, and distances from 2,000 - marathon the court didn't make any restrictions on testosterone. Which is why Semenya and Niyonsaba are running 2 miles at Prefontaine.

Could they compete right now in the 400-1 mile if they reduced their testosterone to female levels? Yes, but they won't do it because they aren't any good without male levels of testosterone, so there would be no point.

Would love to know how you're so sure Sifan is more "female" than these athletes? FWIF these are not trans-athletes, choosing their gender, this is the way they were born. So a natural advantage, and how lucky they found their calling!

To be clear: the CAS did not rule, nor do the current IAAF/WA regulations require, that XY athletes with disorders of male sex development like Semenya and Niyonsaba reduce their endogenous testosterone to female levels in order to participate in middle-distance women's events (the 400 through the mile).

The regulations of the IAAF/WA - and IOC - have never ever required XY DSD athletes like Semenya and Niyonsaba to lower their natural testosterone to female levels in order to compete in women's events. The rules that are in place now for middle-distance women's races, and the different rules in place in the past, always only required such athletes to lower their testosterone levels somewhat - either to near the lower end of the normal male range, or to a level that's below the bottom of the normal male range but still much, much higher than the top end of the normal female range.

The IAAF/WA maintains, and the CAS affirmed in its 2019 decision in the Semenya case, that the normal adult male range for endogenous testosterone is 7.7-29.4 nmol/L and the normal adult female range is 0.02-1.68 nmol/L.

The current IAAF/WA rules say that athletes like Semenya and Niyonsaba can compete in women's middle-distance events if they lower their endogenous T to under 5 nmol/L for sixth months beforehand. That's nowhere near female levels.

In women (the biological kind that we all came out of), an endogenous T level of - or near - 5 nmol/L would require urgent medical investigation because it would indicate serious disease such as a testosterone-secreting tumor, CAH, the most extreme PCOS - or it would indicate an unusual and concerning condition of pregnancy (pregnancy being the single most common cause of elevated endogenous T in women). But a female with an endogenous T level of, or near, 5 nmol/L - either chronically due to disease or transiently because of pregnancy - would not be in the sort of shape to enable her to be competing at the top level of elite international sports.

Previously, the IAAF/WA rules said that XY athletes with testes, male levels of T and male-typical ability to utilize T who sought to compete in women's events only had to reduce their T to under 10 nmol/L. The IAAF/WA lowered the limit from 10 to 5 nmol/L in the course of the investigations and litigation it's had to spend an enormous amount of time and money on in the years since Semenya won Semenya's first women's World Championship in 2009 and since both Dutee Chand and Semenya filed lawsuits accusing the IAAF/WA of unfair and unlawful discrimination against them.

However, the IOC continued to use the 10 nmol/L level as the threshold that had to be met by males with XY DSDs as well as transgender identities seeking to compete in women's events through the Olympics held in Tokyo in 2021. Since then, the IOC has dropped the T limits for males seeking eligibility in women's sports altogether. Now the IOC's official position is that neither XY DSD adults nor normally-developed males who now claim to have opposite-sex (or no sex) gender identities should ever be assumed to have any physical advantages over female competitors because believing that adolescent and adult males have natural advantages over females due to biology is some kind of bigotry. At the same time, the IOC has tried to bow out of all responsibility in these matters by saying that the specific criteria for inclusion of males in the female category should be left up to the governing bodies of each sport to decide for themselves.

Regarding Semenya and Niyonsaba, I think it's important to note that researchers have found that XY athletes competing in women's elite track and field who have the particular kinds of disorders of male sex development covered by the current WA DSD rules typically have endogenous T levels in the middle to the high end of the normal male range. Though some people suggest or assume that these athletes have low or lowish T by male standards, this is not the case. They do not even come close to having low T for males of their same age. In fact, some persons with these XY sex development disorders have endogenous T levels that are higher than the top end of the normal male range.

I’m nitpicking here but no, intersex women don’t produce the same testosterone as the average man. It’s in between the levels of women and men. A lot more than ur average XX woman but not at all the average man’s.

This is an issue that should be left up to real women worldwide to decide.

I have no objection to such high testosterone males competing in their own divisions in some special events for themselves, for example in the Special Olympics, but they have no business being entered in women's events.

Because they aren't women, they aren't actually competing except with each other anyway, so they should have their own events to compete in, and perhaps their own governing body, that is apart from and has nothing to do with women nor women's events.

Women have had to fight for the right to vote.
Now we have to fight for the right to be able to compete with each other.

You are totally wrong. The normal male range of testosterone is 7 to 29. Normal for females is less than 2.

All the intersex athletes that were top middle distance runners had testosterone over 10, which is why they had to take medication up until 2015 in order to reduce their testosterone below 10. (10 was the max allowed back then. Now the allowable max is 5.)

They weren't competitive with world class women when they had to go below 10, so that's why none of them have even tried to reduce their testosterone below 5, because then they would be even less competitive.

It's known for sure that Sifan is "more female" than Niyonsaba and Semenya because all athletes in elite international competition in both the women's and men's divisions are subject to anti-doping regulations that require them to get their urine and blood tested for PEDs including testosterone and other androgens.

These tests easily tell which athletes are female with ovaries and which athletes are male with testes because there is no overlap between the natural testosterone levels of those two groups. Using the standards WA goes by, adolescent and adult athletes with testes normally have endogenous T levels ranging from 7.7 to 29.4 nmol/L; and adolescent and adult athletes with ovaries normally have endogenous T levels from 0.02 to 1.68 nmol/L.

When athletes competing in women's events are found to have T levels above the normal female range but below the normal male range, they are immediately made to taken a pregnancy test. If it turns out they are not pregnant, and their T appears to be natural, they will be advised they are in urgent need of further medical investigation for a health condition like PCOS, CAH or a tumor. If their elevated T is above the range typically found in females and there's suspicion it's external in origin, they will be investigated for doping violations.

However, when athletes competing in international women's events are found to have apparently natural T levels either in the normal male range or far higher than the normal range even for females with hyperandrogenism due to female-specific health conditions, they are not given pregnancy tests. Nor are they advised that they urgently need to get checked out for other female health condition like PCOS, CAH or cancer. Instead, such athletes are suspected to be XY DSD athletes with testes - and they are thus given further testing to establish that this is indeed the case.

In 2021, when the newcomers Mboma and Masilingi started running in international women's events regulated by WA and they sought eligibility to compete in women's races at the upcoming Tokyo Olympics, the two teenagers became subject to WA and WADA rules. As a result, they underwent the standard testing for PEDs, and did so under WA oversight. It's because their testosterone levels were found not to be in the normal female range, or anywhere close to the female range, that WA medical officers concluded they were most likely XY with disorders of male sex development and had them undergo further testing to confirm this.

But according to experts in this area such as sports scientist Ross Tucker, in the case of XY DSD athletes like Semenya, Niyonsaba, Mboma and Masilingi, their testosterone levels as revealed by standard WADA and WA testing are only part of the story. There are many other physical signs apart from T levels - and which don't require chromosome testing, abdominal scans, endocrinology/metabolism workups or analysis of genes - that serve as reliable "tells" that these athletes are males with disorders of male sex development, not "females with naturally high testosterone" the way they are inaccurately described in the media.

It might be true that some persons with disorders of male sex development don't produce the same amounts of testosterone as the average man. For example, this might be the case with men with Klinefelter syndrome, who are XXY.

But persons who are XXY or who have low T for men are not the issue here. Semenya, Niyonsaba and all the other athletes with testes competing in women's sports whose inclusion is so hotly contested - and to whom the current WA regulations apply - do not have DMSDs like Klinefelter's. They have a handful of disorders of male development characterized by normal XY chromosomes, normal SRY genes, and functioning testes that cause them to produce normal amounts of testosterone for healthy males.

Also, many persons with male androgen insensitivity (AIS) have been found to have testosterone levels far in excess of the normal male range. Various studies done in different labs in different countries on patients with different ethnicities have found that some persons with AIS produce much higher levels of T than the average man. T levels as high as 55 nmol/L have been found in XY persons with PAIS and CAIS.

When researchers affiliated with the IAAF/WA tested the T of XY athletes with DMSDs then competing in women's international elite athletics in 2011 and 2012, they found that these athletes had T levels in the middle to high end of the normal male range - 15.9 to 29.3 nmol/L. None of them had T levels in between the normal male range of 7.7 to 29.4 nm/L and the normal female range of 0.02 to 1.68 nm/L like you say .

What are the “reliable tells” that indicate these athletes are males with disorders of male sex development?

Do you think Mboma had to undergo an abdominal ultrasound or scan to confirm the presence of internal testes?

Lastly, do males with these disorders tend to have external genitalia that makes it easy for doctors/midwives/parents to assign “female” at birth? Does it become obvious to the individual as she goes through puberty that there is a disorder, from absence of menstruation to appearance of the vulva? Thanks.

Male genitalia isn't a disorder...

These races are an insult to the sport.

The intersex girls/boys should not be allowed run against regular girls.

I think the regular girls should protest by non-participation until the rules are changed.

That would bring about change quickly.

Re intersex athletes, I don't hate the players, just the game.

All that said I still fancy Hassan to whoop ass.

I'll have to answer your questions one at a time.

I didn't mean to suggest that there are "reliable tells" that indicate these athletes are males with DMSDs when when they are viewed amidst a mixed-sex crowd at, say, an airport, a busy city sidewalk, a shopping mall, or in the stands at a sporting event. Or when they are viewed amongst a group of males.

I was speaking specifically of physical signs that make them stand out when these athletes are entered in and competing in women's sports. I specified that these are tells which indicate they are not "females with naturally high testosterone" the way they're commonly described and thus instead tip off observers that they are males with disorders of male sex development - because males with normal male sex development don't typically try to enter women's and girls' sports. (Or at least they didn't used to before it became "a thing" for males to use gender identity claims and the Trojan horse mantra of "diversity and inclusion" to wheedle, manipulate, bully and muscle their way in.)

But I didn't mean to suggest that these athletes have telltale signs that would make it easy for passersby on the street or people who encounter them socially in most other contexts to suss out that they have disorders of male sex development.

If they weren't famous, no one would look twice at, or even take notice of, persons like Semenya, Niyonsaba, Wambui, Chand, Mboma and Masilingi in most ordinary, everyday settings - and no one would think twice about their sex. In most settings, no one would ever wonder about their sex at all.

These athletes only stand out as atypical and prompt others to raise questions about their sex when they are in the specific area of women's sports - and in other contexts where others are expected to see them as women. As when they get prizes and accolades meant for females, they use female facilities, and they hold themselves up as experts on issues like women's rights, sex discrimination against women, and menstruation the way Semenya often has done.

When someone like Semenya gets an award for championing women's rights, women's accomplishments in sports, and is the keynote speaker at a convention about women's rights and the status of women, the average person is bound to take notice that Semenya does not appear or sound like a woman - not even a very butch woman - just as most people do when they watch Semenya trounce the female field when Semenya runs the 800m in women's track. Same goes for when Semenya served as the brand ambassador for, and the public face of, a line of menstrual cups.

But if Semenya wasn't famous, and the average Joe or Jane saw Semenya out and about in the world, either alone or with Semenya's wife and their two kids, no one would look twice at Semenya - and no one could possibly tell Semenya has a DMSD.

Same goes for the others. There's nothing "wrong" with these athletes that would make them stand out amongst a crowd of ordinary people at an airport, movie theater, subway station or shopping mall. They only reason attention is drawn to them - and to their appearance, body shapes, muscle and fat distribution, gaits, pelvic widths, Q angles, explosiveness off the blocks, etc - is that they are competing in the wrong sex category with an unfair advantage. Moreover, they are competing in the wrong sex category with an unfair advantage on the world stage at a level of sport where the bodies and performances of all athletes get very close scrutiny.

Sorry I didn't make my point more clearly the first time.

To add: in one of his podcasts in the past 9 months (sorry, I can't recall which one) Ross Tucker said that when athletes like Mboma and Masilingi come on the scene and start turning in remarkable performances in female competition, sports physiologists and medical experts can tell that chances are good these athletes are males with disorders of male sex development before they see them IRL - before they even watch them run on videotape, in fact. Because their stats and sports development trajectories as shown on paper, or on a screen, will be very different to what is customary for female athletes of the same age.

Although the changes that the bodies of males and females undergo during the most intense phases of puberty of adolescence are most pronounced and obvious to ordinary observers, there are a host of important but more subtle telltale differences in the ways that members of the two sexes continue developing at age 17, 18, 19 and beyond, too. The average person might not be aware of, or attuned to, all these differences, but coaches, trainers, physiotherapists, doctors and sports officials who work with elite and promising athletes of these ages definitely are - and most have learned over the years to spot them.

It's a women's race with more pricks than the average Patriot's crowd. Just what the sport needs.

"their two kids."

If there ever was a major clue, that is it. Everyone knows that he's not a woman.
This travesty against women and women's competitions needs to be stopped right away.

I cannot see Semenya finishing top 6. Hassan over Niyonsaba if she is any type of form. Koko and Beatrice Chebet next two.

So much testosterone going around in this one. Mixed in with Hassans EPO and have a truly volatile situation!

This is to answer the question I've bolded.

The IAAF/WA has published documents in pdf form clearly spelling out its protocols for assessing athletes competing in the female category who turn out to have endogenous testosterone levels of 5 nmol/L or higher. You can see the docs by clicking on the link at the top of this press release:

worldathletics.org

IAAF introduces new eligibility regulations for female classification | PRESS-RELEASE | World Athletics

Open link

As you can see, there are three levels of assessment, though in the cases where they think there is good reason, the WA medical officers can require athletes to undergo third-level assessment from the get-go.

Level 1 involves taking and testing blood and urine samples to get a full endocrine profile of the athletes, and also to see if they have male or female typical androgen sensitivity. In Level 1, WA medical officers also obtain the athletes' previous medical records and talk to (or attempt to) physician(s) who've examined and cared for these athletes in the past, including personal physicians and physicians who work with/for their countries' national sports federation.

If need be, as part of Level 1 assessment, WA will send an athlete under investigation for a physical exam to "an appropriate examining physician," who has to be "a gynecologist,
endocrinologist or pediatrician with extensive experience of DSDs" as well as "other conditions leading to female hyperandrogenism."

"The examining physician will then take a full medical history and conduct a careful clinical examination of the athlete designed to ensure accurate assessment and diagnosis."

Cleverly, the IAAF/WA regulations stress:

"The examining physician will assess the athlete in particular for clinical features associated with pronounced and chronic cases of female hyperandrogenism."

This makes it clear that the examining doctors will check just as carefully for conditions involving female physiology and reproductive organs, including ovaries, as they will for conditions affecting male sex development that involve male physiology and anatomy, including testes. Approaching the testing this way saves WA from accusations of sex discrimination from affected athletes. Moreover, and more importantly, it requires that the examining doctors to do the kind of invasive "full pelvic" internal exams that gynecologists customarily do as a matter of course on female medical patients during and after our reproductive years.

I'd assume these Level 1 exams would involve scanning of internal organs in the customary ways, which in female health care means not just getting images by external means, but by internal means too. In other words, sticking a sonogram/ultrasound wand inside the body, and pretty far in too, rather than just using a sensor or transducer on the outer surface of the abdomen, or taking an Xray or MRI using a machine whose sensors don't directly touch the body of the person being scanned.

In Level 2 , the information gathered in Level 1 is examined by a panel of medical experts in order to determine if the athlete meets the criteria to be considered to have one of the specific DSD conditions named in, and covered by, the IAAF/WA DSD regulations in place since 2019, and therefore warrants Level 3 assessment.

In Level 3, the athlete is sent for a thorough workup at one of the medical centers in various locations around the world that the IAAF/WA have already designated as "specialist reference centres" for DSDs. There, DSD experts "will conduct a full examination on the athlete and will carry out a diagnosis of the athlete in accordance with best medical practice."

"The Level 3 Assessment will normally include the following different types of test: physical, laboratory, (including urine and blood analysis and appropriate genetic testing for mutations in the genes involved in the conditions at issue), imaging, and psychological assessment."

BTW, in doing imaging on athletes under investigation, the point isn't just to confirm the presence of testes - be they wholly internal or external but just not in the usual place as is often the case. The point is also to see what other organs are present and which ones are absent. The physicians will be looking to see if the athletes have male reproductive organs such as a prostate and seminal vesicles along with testes - and to confirm that they do not have the usual suite of female organs, such as ovaries, Fallopian tubes, uterus, cervix, vagina and female urethra.