What's at stake in Semenya vs. IAAF -- Amby Burfoot breaks down the monumental looming CAS decision

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LetsRun.com

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1 year ago 04/22/2019 8:49pm CDT

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Before the end of April, the Court of Arbitration for Sport (CAS) is set to deliver a verdict in Caster Semenya vs. the IAAF. Semenya, as you may know, is appealing against the IAAF's new DSD (differences of sex development) policy that would impose a testosterone limit of 5.0 nmol/L for women in events between 400m and the mile.

Semenya has dominated the 800 for much of the last decade, and the decision in the CAS case won't just have an impact on track & field but potentially all sports as many view CAS as the Supreme Court of international sports and this case could set a precedent.

There's a lot at stake, and it's a very complicated issue.

Thankfully renowned running journalist Amby Burfoot has taken you through the case, its background, and its potential legacy in a special guest article for LetsRun.com. We've read a lot of articles on the subject over the years, but this one may be the most comprehensive yet.

Amby did a ton of research for this story, reading 500+ pages of medical journals and law reviews and calls it "the most difficult issue that sports has ever faced." He treats the situation with the detail and nuance it deserves and we highly recommend you give it a read:

https://www.letsrun.com/news/2019/04/the-whole-world-is-watching-caster-semenya-vs-iaaf/

Amby also reaches the same conclusion that we at LetsRun.com have come to: there needs to be testosterone limits in place to create a level playing field.

We want to know your thoughts. Like the article? Agree or disagree with Amby's conclusion? Other thoughts on Semenya or the IAAF's policy?

This is meant to be a serious discussion, so only registered users will be able to post on this thread.
Vancomycin

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1 year ago 04/22/2019 9:05pm CDT
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It is a good summary of the issues the sport has dealt with over the past (almost) decade. I believe the T limit will be enforced, people want a statement to be made.

I am not sure anything can be 100% fair. Had this been 50 years ago, Caster would've simply been a dominant woman athlete. Were she a tall, strong, blonde American, would these questions have ever been asked?

There are thousands of endogenously occurring compounds that have an effect on performance. T has such an effect and is also highly-correlated with sex. When a 10 sigma genetic outlier in some other way that is also correlated with sex shows up - will we have to go through the same song and dance?
David S

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1 year ago 04/23/2019 12:16am CDT
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Overall I think it was well thought-out. I have a few comments:

1. My primary question is: How are they going to enforce this?

It's not illegal for women to have high testosterone levels. It's only illegal for them to have high testosterone levels if they have DSD. So what is the protocol going to be for the next Caster Semenya? If drug tests show a new runner has >5.0 nmol/L and she has no external male genetalia, then she's obliged to undergo some sort of doctor's exam to look for internal testes? If the doctor's exam is inconclusive then they have to do genetic testing to make sure there's no chromosomal abnormality? IIRC, part of the problem with the Caster Semenya case was that they didn't really inform her of what they were doing.

2. As a secondary comment, while it's clear now that Caster isn't the only athlete who will be affected, it does seem kind of obvious that she was somehow targeted, since they targeted only the 400, 800, and 1500/mile (plus 400 hurdles) -- they made sure to shut her down for her whole range of competitive events and nothing else. If they care so much about this for some sort of abstract reasons of fairness, why *didn't* they go after shorter events?

3. Similarly, something bothers me about the justification of this as a performance-based decision.

First, Amby makes many comments about how her "peers who strive as hard as she does but have no chance of winning". But it's not true. She hasn't destroyed the all-time records. She hasn't beaten Pamela Jelimo's time, even though she ran a decade later. Her PR is less than half a second faster than Ajee Wilson's. Ignoring Niyonsaba, the next fastest runner of the decade after Ajee Wilson is Natoya Goule, who ran half a second slower than Ajee Wilson, and the next fastest runner is Habitam Alemu, who ran over a second slower than Ajee Wilson (according to alltime-athletics.com). So Caster Semenya is just as much of an outlier as Ajee Wilson would be without Semenya and Niyonsaba. Just to put things in perspective here. [Related side comment: What's really remarkable about Semenya isn't her PR, but her consistency. Semenya has 3 of the top 10 performances of all time, which is more than anyone else. Pamela Jelimo has 5 of the top 20, but Caster has 8 of the top 30.]

Second, this is only a concern in the first place because Caster Semenya started winning. You can't know that the fact that she's winning and has a DSD implies that the DSD is what causes her to win. There's a phenomenon/fallacy (in statistical genetics) called "Winner's Curse" that we should watch out for -- the first discovery of something tends to outshine subsequent examples of it. Regarding the increased rate of DSD athletes winning medals, there's also a phenomenon that small sample sizes have large error bars. "DSD medals in the women’s “restricted events” at the World Championships and Olympics during the last 25 years" -- I don't have access to the journal article, but doesn't Semenya herself account for like half of these? And there are like two or three of these athletes in total?

Third, maybe she IS doping. Maybe all of these DSD athletes are doping.

Fourth, this quote: "In Lausanne, the IAAF team presumably submitted additional data linking testosterone and real track times." I don't think anyone doubts that the results of such a study would be huge -- most of us on here know there's a roughly 10% difference between men and women in most of T&F, and many of us wouldn't be too surprised to hear that testosterone works. But it's still not clear to me how someone with androgen insensitivity syndrome is going to be affected by an increase in testosterone levels. Isn't the whole cause of Caster Semenya's unusual development due to the fact that she was unable to make use of the excessive amounts of testosterone in her system? It doesn't sound to me like this establishes that she has an advantage. So what's the point? She might have an advantage, and we're not sure, so we might as well try to limit her testosterone levels?

I'm not saying this isn't a good decision, I'm just saying that there's something about this sort of justification that rubs me the wrong way as a statistician.
David S

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1 year ago 04/23/2019 12:17am CDT
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I see I used the word "illegal" when I meant "against the rules", sorry about that.
wejo

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1 year ago 04/23/2019 7:54am CDT
re: Vancomycin

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Vancomycin wrote:
When a 10 sigma genetic outlier in some other way that is also correlated with sex shows up - will we have to go through the same song and dance?

Now you're going into hypotheticals.

The more I have time to think about this it's pretty simple. We have 2 categories of sex and sports and not everyone fits into them. Semenya is intersex. Pretty sure that actually means she's XY.

David S wrote:

2. As a secondary comment, while it's clear now that Caster isn't the only athlete who will be affected, it does seem kind of obvious that she was somehow targeted, since they targeted only the 400, 800, and 1500/mile (plus 400 hurdles) -- they made sure to shut her down for her whole range of competitive events and nothing else. If they care so much about this for some sort of abstract reasons of fairness, why *didn't* they go after shorter events?

That's one thing I don't understand. Why are intersex women possibly concentrated in the 800? Supposedly the IAAF targeted the mid distances because the science was stronger that the intersex women had an advantage in these events.

But if intersex people really scientifically don't have an advantage at 100m then this won't radically change sport. And I think even some of the claims "women's sport are at risk"(that we've even said at LetsRun) are a bit overblown. There have been intersex women for ages and women's sports have existed. This really affects the top professional tier. Now looking back people wonder about some of the great 800m female runners of the past and if they were intersex.

However, I think the real big issue is if this sets a precedent for transgender athletes and that would on a more broad level affect women's sport. If people just get to choose what sex they are in terms of sport then we'll have the CT high school situation.

And finally I still don't get why we don't just go to genetic testing for pro sports? I know some transgender athletes are against that type of rules (so it might not be good to have different rules for pros than recreational athletes and high school). and I think there are some intersex athletes who don't respond to testosterone but I'm not sure it's any less fair.

The line has to be drawn somewhere. We have males and females for sports yet in real life we have males, females and intersex. So the question is where do intersex athletes get to compete. Letting them compete in the female division with a testosterone limit seems to be a fair compromise. I think the argument could easily be made they should compete in the male division or an intersex division (not practical).

Interesting to see how this is ruled upon and what's next for transgender athletes. From talking to Amby it sounds like this was narrowly tailored to a few events for legal reasons, not to just go after Semenya but the optics look bad.
??????????

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1 year ago 04/23/2019 8:22am CDT
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[quote]David S wrote:

Overall I think it was well thought-out. I have a few comments:

3. Similarly, something bothers me about the justification of this as a performance-based decision.

First, Amby makes many comments about how her "peers who strive as hard as she does but have no chance of winning". But it's not true. She hasn't destroyed the all-time records. She hasn't beaten Pamela Jelimo's time, even though she ran a decade later. Her PR is less than half a second faster than Ajee Wilson's. Ignoring Niyonsaba, the next fastest runner of the decade after Ajee Wilson is Natoya Goule, who ran half a second slower than Ajee Wilson, and the next fastest runner is Habitam Alemu, who ran over a second slower than Ajee Wilson (according to alltime-athletics.com). So Caster Semenya is just as much of an outlier as Ajee Wilson would be without Semenya and Niyonsaba. Just to put things in perspective here. [Related side comment: What's really remarkable about Semenya isn't her PR, but her consistency. Semenya has 3 of the top 10 performances of all time, which is more than anyone else. Pamela Jelimo has 5 of the top 20, but Caster has 8 of the top 30.]

Have you watched Caster's races? Notice the ease with which all this winning is done. I do not believe the Caster has ever shown what Caster's PR capability is. Caster is a smart person and is surrounded by others smart enough to know that Caster needs to keep the numbers being run "reasonable" so as to not add more fuel to the fire. Win convincingly but not too convincingly. As Phoebe Wright stated in the article "I felt I was a Toyota Camry mashing on the gas as a Ferrari zoomed past." Don't think for a minute that Ferrari couldn't have gone faster from the get go.

Racket

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1 year ago 04/23/2019 8:24am CDT
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Read it, still skirts what I believe is the "hard problem" which is : is it a human right to participate in sport?
Raddison

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1 year ago 04/23/2019 8:31am CDT
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Excellent article. It's too bad that in the media today analysis has almost disappeared and instead we are bombarded with opinion, opinion, opinion. It's good to read an article where the basic facts are presented and the reader is left with the task of drawing conclusions. Or as in this case, realizing there is no simple conclusion.

David S wrote:

.... while it's clear now that Caster isn't the only athlete who will be affected, it does seem kind of obvious that she was somehow targeted, since they targeted only the 400, 800, and 1500/mile (plus 400 hurdles) -- they made sure to shut her down for her whole range of competitive events and nothing else.

I can't help but agree. If Caster was not so dominant this would not be an issue. Also, if Caster met the usual ideal of feminine beauty this would probably not be an issue. Unfortunately, the public wants their female track stars to look good as well as perform good, Caster has definitely drawn the short straw in that respect. However, in the field events, such as shot put or discus, feminine beauty has never been a requirement. I can't help wondering what the typical T levels are in those athletes, and whether anyone gives a damn.

In the end I c'ant see any winners in this. Amby was right when he likened this to the trolley car problem.
Armstronglivs

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1 year ago 04/23/2019 8:33am CDT
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Good article and good summary of the issues.

However, what isn't entirely clear to me from this discussion is why higher levels of testosterone in women are deemed only to confer an advantage in certain specified events. It is apparent from male v female performances across the board that testosterone would play a part in superior male performances in every event from the sprints to the marathon, and also including all the field events. After all, as the article points out, it is at the onset of puberty that the advantage of higher levels of testosterone in males becomes apparent in every kind of competition.

I wonder if, for political reasons, the IAAF is embarking presently on what may be only the first and thus more manageable step in a longer-term strategy to ensure the integrity of men's and women's elite competition. It would seem strange and somewhat piecemeal to introduce a radical new measure to the sport if it is based largely on limitations in the research relied upon.
fisky

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1 year ago 04/23/2019 9:00am CDT
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The IAAF ruling is limited, but it probably the best they could come with given the limited amount of data available.

A better ruling would be...

1. An upper limit of 3.0 instead of 5.0.
2. Expand the rule to include all distances.
3. A ban from competition for 1 year AFTER levels have been reduced to 3.0.

(Note that 3.0 is still WAY HIGHER than the 0.67 average of world class women runners.)

Others protest that if T was so great, Castor would have destroyed the Women's WR in the 800. I would counter that she never looks like she's running hard. She mostly sits and kicks with whatever effort is needed to win. Second, even with massively higher T levels, she simply might lack the other genetics to run at WR level. That is, she wouldn't even be winning at the national level without her elevated T levels.

Even the above limits are unfair, because having far higher T levels since puberty may have already conveyed a change in body structure that could create an unfair advantage even after T has been reduced chemically or by surgery. We can see this change in women body builders on T. For this reason, I believe transgenders should not be allowed to compete with XX women.

Getting back to Castor, since she stated that she would not do surgery, we can infer that she has internal testes because there would be no other reason for surgery.
tartarm

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1 year ago 04/23/2019 9:04am CDT
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People who are saying this is a good article have an agenda here including Wejo. I seriously doubt they’d publish anything with a differing viewpoints. So all you jokers who complain about agenda driven opinion piece - the Burfoot piece is exactly that. I lost a ton of respect for Burfoot with this piece. He’s just another senile old white guy. I saw him shuffling a few years back in a Road Race. He’s lost it

To compare what’s going on with Caster to doping in the 70s/80s is wrong. In fact those wanting to “change” Caster are more on the side of state sponsored doping- better living thru chemistry. Using drug to alter her body chemistry.

There are real issues here. But using doping or Wejo’s dumb example of TG teens in CT doesn’t help the point. I know why they do it - teens in Connecticut are easy targets for the Brojos. Dead dopers are too. But we aren’t talking about that here.

A poster above had a great point. If Caster was a blue-eyed blonde from the USA. We wouldn’t have this discussion.
tartarm

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1 year ago 04/23/2019 9:14am CDT
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fisky wrote:

Even the above limits are unfair, because having far higher T levels since puberty may have already conveyed a change in body structure that could create an unfair advantage even after T has been reduced chemically or by surgery. We can see this change in women body builders on T. For this reason, I believe transgenders should not be allowed to compete with XX women.
[/i]

I take it you didn’t read the whole article. 1) it talks about women who have transitioned from men (with appropriate T reductions). Their times were slower. Heck Caster’s times were slower when she was being reduced.
But you might say- well there are other benefits from a higher T that results in a change to body structure. There are also other differences. How to attribute them to T and not some other factor? There are physiological differences between elites and people like me that contribute to their success.

Primo Numero Uno

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1 year ago 04/23/2019 9:46am CDT
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Since Amby has worked for Runners World for as long as I can remember I'm stunned that he took a public stance in this direction. I thought this was very well done and did take as objective and fair as possible look at the issue.

But given Amby wrote this article that takes on the activist position with facts and thoughtful insight Runners World will be firing him in 3, 2, 1.....

It's ok Amby you don't need to work for a magazine that celebrates obese people walk-jogging 5K's.
fisky

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1 year ago 04/23/2019 10:11am CDT
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tartarm wrote:

fisky wrote:

Even the above limits are unfair, because having far higher T levels since puberty may have already conveyed a change in body structure that could create an unfair advantage even after T has been reduced chemically or by surgery. We can see this change in women body builders on T. For this reason, I believe transgenders should not be allowed to compete with XX women.
[/i]

I take it you didn’t read the whole article. 1) it talks about women who have transitioned from men (with appropriate T reductions). Their times were slower. Heck Caster’s times were slower when she was being reduced.
But you might say- well there are other benefits from a higher T that results in a change to body structure. There are also other differences. How to attribute them to T and not some other factor? There are physiological differences between elites and people like me that contribute to their success.

I missed the part about transgendered competing only after 6 months of chemically lowered T levels so your point is correct.

I understand the position, but I don't support it for two reasons. I believe that high T since puberty conveys a growth and muscularity potential that cannot be offset in 6 months. Second, a chemically reduced level of 5.0 is still much higher than XX women without DSD.

If transgenders are allowed to compete at 5.0, then XX women without DSD should be allowed to dope to the 5.0 level. Otherwise, the transgender women still have a huge testosterone advantage.

If transgenders are allowed to compete, then their T levels should be reduced to the normal level of 0.67 not 5.0.
Vancomycin

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1 year ago 04/23/2019 12:17pm CDT
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wejo wrote:

Vancomycin wrote:
When a 10 sigma genetic outlier in some other way that is also correlated with sex shows up - will we have to go through the same song and dance?

Now you're going into hypotheticals.

The more I have time to think about this it's pretty simple. We have 2 categories of sex and sports and not everyone fits into them. Semenya is intersex. Pretty sure that actually means she's XY.

Come on wejo, we are in this place because we didn't consider "hypotheticals" 50 years ago. T is not the ONLY physiological sexual difference.

There's been plenty of talk about genetic testing.

I believe there are too many karotypes and psychological variation to deal with for genetic testing to be sufficient. What if you are XXY but have complete androgen insensitivity. This person would show no signs of androgen promoted masculinity (i.e. would pass the "look test" LRC users love use), however she would fail a T limit test (which could be discarded under IAAF rules with proof androgen insensitivity) and she would fail a genetic test thanks to her Y chromosome.

An additional issue at play here is that you'd have to genetically screen many athletes, which I believe is a privacy concern - worsened that you'd only be targeting women. T is a good proxy for a genetic testing, much less invasive, cheaper, and just as fair.
RunAnnArbor

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1 year ago 04/23/2019 12:59pm CDT
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Great article by Amby.
Whenever this subject comes up, I remember this bit from Nick Symmonds:
https://www.youtube.com/watch?v=vH8DnoVOCkA
The relevant bit in the context of this thread starts at about the 1:17 mark.
I know this is nothing new, but it makes a lot of sense to me:
If you are genetically XX, you compete against other XX athletes.
If you are genetically XY, you compete against other XY athletes.

Obviously, that model suggests a seismic shift in how we silo athletes and structure competitions—away from Men and Women, and to, well . . . XX and XY.

Several posters in this and related threads, have mentioned that a condition called Androgen insensitivity syndrome throws a wrench in the XX and XY competition scenario. Here's one of many bits I found on the subject:
https://ghr.nlm.nih.gov/condition/androgen-insensitivity-syndrome#

I see this bit in Amby's article:
"2–Now, some DSD (Differences of Sexual Development) athletes will also have to pass a testosterone test that sets an upper limit of 5.0 nmol/L for eligibility in female competition. Or they can show that they are androgen-insensitive — that is, that their body doesn’t process testosterone."

Could someone with a good understanding of the issues, weigh in on where/how Androgen insensitivity syndrome . . . figures into the DSD discussion, and within the idea of delineating athletes based on XX or XY. It's all likely laid out between this and other threads, and Amby's article, . . . but I'm still a bit lost. It's tough to follow. A distilled summary, if possible, would be helpful.
David S

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1 year ago 04/23/2019 1:53pm CDT
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RunAnnArbor wrote:
Could someone with a good understanding of the issues, weigh in on where/how Androgen insensitivity syndrome . . . figures into the DSD discussion, and within the idea of delineating athletes based on XX or XY. It's all likely laid out between this and other threads, and Amby's article, . . . but I'm still a bit lost. It's tough to follow. A distilled summary, if possible, would be helpful.

Not sure your question. Ross wrote this blog post from 2009 and it seems not much has changed in ten years: https://sportsscientists.com/2009/09/caster-semenya-leaks-begin/?doing_wp_cron=1556045140.5259809494018554687500

Now, let’s just very quickly look at the claims – the presence of testes, and the absence of a uterus, would suggest that she is genetically male (has a Y chromosome, possibly XY, possibly XXY). In order to develop as a female, she may be insensitive to androgens, or have a deficiency in an enzyme in the androgen pathway. This means that if the reports are accurate, she may have AIS (Androgen Insensitivity Syndrome) or alpha-5-reductase deficiency, or possibly a genetic abnormality that is much rarer than these (which are pretty uncommon themselves) and results in the development of an under-masculinized male (there are three categories of condition – under-masculinized males, masculinized females and hermaphrodites).

What people need to know is that AIS, if complete, as well as alpha-5-reductase deficiency, are both conditions which the IAAF policy says are “allowed”. The problem is with partial AIS, where it becomes a decision around whether she has an advantage or not. And that is exactly the same position as we were in before, though now we have a possible biological piece of the puzzle to add to yesterday’s debate.

Basically, my understanding is that androgens cause your body to develop as a male when you're a fetus (otherwise you develop female characteristics), but those with androgen insensitivity are unable to utilize the testosterone their body produces (and it can happen to varying degrees).
The Scot

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1 year ago 04/23/2019 1:58pm CDT
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Either they run or we force them to take medication? Then they should run.

If Dr. Mengele were here, he would force them to take medication.
Primo Numero Uno

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1 year ago 04/23/2019 1:59pm CDT
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It seems like certain people are so focused on accommodating a few individuals that they lose sight that they are ruining the integrity of the sport for almost everyone else.

Maybe people just have to accept that it is not an exact science but we have to do the best we can to be as fair as possible. The other option is to get rid of gender categories altogether and have 1 open category in which women are completely non-competitive. I don't think anyone will be that excited about that option.
David S

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1 year ago 04/23/2019 2:00pm CDT
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wejo wrote:
Supposedly the IAAF targeted the mid distances because the science was stronger that the intersex women had an advantage in these events.

Allegedly. I'd like it if they showed us how they came to that conclusion. Maybe the science is stronger because Caster and Niyonsaba are the only examples they have at the pro level. That would be targeting. If they didn't do a study of shorter events or longer events then how could they know? I hope she goes after them.

wejo wrote:
Interesting to see how this is ruled upon and what's next for transgender athletes. From talking to Amby it sounds like this was narrowly tailored to a few events for legal reasons, not to just go after Semenya but the optics look bad.

Yeah let's trust the lawyers /s