"We don't even know what typical testosterone levels are for elite female athletes," Karkazis added.
The authors also contend that, even if high testosterone levels were found to be a marker of improved athletic ability, it is not reason enough to bar women with naturally occurring high levels of the hormone from competing.
"There are many biological reasons some athletes are better than others," the authors write, pointing to several runners and cyclists who have rare mitochondrial variations that give them extraordinary aerobic capacity, or basketball players who have acromegaly, a hormonal condition that results in exceptionally large hands and feet. Such biological differences don't cause them to be banned from competition, they write.
"It bears noting that athletes never begin on a fair playing field; if they were not exceptional in one regard or another they would not have made it to a prestigious international athletic stage," the authors note.
Of particular concern with the potential policies is the possible coercion of athletes into undergoing unnecessary and potentially harmful medical treatment if they are found to have hyperandrogenism. "If the athlete does not pass, she is banned from competition until she lowers her testosterone levels," the authors write, noting that the treatment options would entail either pharmaceutical intervention or gonadectomy, both of which carry serious potential side effects.
Instead of adopting such policies, the authors recommend against gender policing by international sporting authorities. Historically, the rationale for sex testing was based on the long-standing concern that men could masquerade as females in elite sports, and must be weeded out. Yet, decades of routine sex testing in international sport have revealed that, at most, there have only been two instances of this. "Men trying to compete in women's competition is not, nor ever has been, a signifi
|Contact: Tracie White|
Stanford University Medical Center