Sama backs Caster against the IAAF on hormone manipulation

Organisation: Position: Deadline Date: Location:

The SA Medical Association (Sama) has thrown its support behind athletics star Caster Semenya, saying that the proposed requirement for hormonal manipulation in athletes is “unethical and invasive”, says a Cape Times report. The Court of Arbitration for Sport (CAS) has announced that it will deliver a decision by 26 March in the controversial case pitting Semenya against the International Association of Athletics Federations (IAAF). Semenya is challenging proposals by the IAAF that aim to restrict female athletes’ testosterone levels.

Sama chairperson Dr Angelique Coetzee said: “The requirement for hormonal manipulation runs in stark contrast to the entrenched principle of athletes competing in their natural state. “Such rules are excessive and would constitute a systematic affront to the dignity of all female athletes.”

Coetzee said in the report that in the interest of medical ethics, the medical profession was compelled to denounce any policies in sport, or any other fields, which were not compatible with the basic human rights principles of individual choice, confidentiality, consent, dignity, non-discrimination, and equity. “We are concerned that the arguments by the IAAF for regulating testosterone levels in such athletes are most likely based on a single, flawed study in which reporters were highly conflicted.

She said the World Medical Association‘s statement on Principles of Health Care for Sports Medicine requires that physicians oppose or refuse to administer any such means or method which were not in accordance with medical ethics, and/or might be harmful to the athlete using it, especially procedures which artificially modify blood constituents or biochemistry, amongst others.

“In addition, doctors prescribing treatment of this nature for a condition that is not recognised as a pathology will be in violation of medical ethics. It is baffling that natural advantages in sport are being critiqued for athletics, but not for other sports. Basketball, high jump and goalkeeping in soccer are examples where acromegaly – condition responsible for excessive tallness – would confer a clear advantage.”

Coetzee said in the report: “We support Semenya in this legal battle and look forward to a successful outcome for her. We urge the IAAF to reconsider their stance on this issue and to rely on better and more extensive research emanating from the world’s greater medical community.”


The issue was a proposed ruling which would see her forced to lower her natural testosterone levels if she wants to keep competing in women’s athletics. The court has described the case as one of its most ‘pivotal’ in its 35-year history. Her lawyers, Norton Rose Fulbright, teamed up with two Canadian lawyers for the landmark hearing.

Sport24 reports that her appeal at the CAS is a groundbreaking moment in the history of sport, and Semenya has received overwhelming support from South Africans throughout the week.

The landmark hearing will see a verdict late next month. Semenya is fighting the athletics body’s new regulations, which some say unfairly targets female middle-distance athletes with naturally high testosterone levels.


Eyewitness News reports that the hearings were done behind closed doors with strict confidentiality guidelines. The court said the hearings were conducted in a cordial and respectful atmosphere.

CAS also added it dealt with a similar testosterone case with Indian sprinter Dutee Chand but said Semenya’s case is different as the IAAF believes it has new evidence.

The three-judge panel will now begin with deliberations in a case the court has described as one of its most “pivotal” in its 35-year history.


Most of the arguments against allowing trans women to compete in female athletic competition rest on a scenario that borders on the fantastical writes Johnathan Liew, chief sports writer in The Independent. He writes: “Are we really suggesting there are hordes of male athletes who will suddenly declare themselves female simply to game the system? Going through the protracted and often traumatic transition process, securing the necessary medical and psychological documentation, living their entire lives under a fraudulent identity, facing the extreme and often violent prejudice that trans people encounter on a daily basis? Most men can’t even remember when to put the bins out.”

Liew writes: “It’s a straw man, a distraction, a pure chimera. In many ways, it falls under the most literal definition of transphobia: an irrational fear of the other, based on ingrained prejudice and occasionally pure ignorance. And yet, perhaps that’s not quite the right tone to strike either. We are, after all, hard-wired to conceive the world as we were taught to conceive it. Realigning that vision, however necessary, is not an easy thing for everyone to do.”

Liew writes that for others, this isn’t so much an issue of identity and freedom as simple sporting fairness. The “level playing field” is an idea you frequently come across in this debate: the idea that whatever the inviolable rights of trans women to live however they choose and call themselves whatever they want, sporting competition demands different standards. “I am happy to address a transgender woman in whatever form she prefers,” the tennis legend Martina Navratilova wrote in a Sunday Times column last weekend, “but I would not be happy to compete against her. It would not be fair.”

Liew writes: “I have a lot of time for Navratilova, a tireless campaigner against social and political injustices far beyond her own sport and her own circumstances. But on this one, she’s sadly misguided. You know what? Sport isn’t fair. Never has been. Genetics isn’t fair. Basketball players are blessed with height. Gymnasts are blessed with compact, flexible bodies. Fulham players are blessed with a preternatural ability to give the ball away on the halfway line. Economics isn’t fair. Geography isn’t fair. Privilege isn’t fair. What we call the level playing field is in fact a cosy myth, a homespun feel-good tale that hoodwinks us into chasing our dreams.”

But, he writes, let’s follow this argument all the way through. Let’s say the floodgates do open. Let’s say transgender athletes pour into women’s sport, and let’s say, despite the flimsy and poorly-understood relationship between testosterone and elite performance, they dominate everything they touch. They sweep up Grand Slam tennis titles and cycling world championships. They monopolise the Olympics. They fill our football and cricket and netball teams. Why would that be bad? Really? Imagine the power of a trans child or teenager seeing a trans athlete on the top step of the Olympic podium. In a way, it would be inspiring.

Liew writes that sometimes we forget that there are bigger things than sport. Yes, the virulent discourse of certain trans activists can be alienating at times. No, it’s probably not that helpful when a prominent advocate of trans athletes compares a feminist pressure group to the Ku Klux Klan. But ultimately, the burden of change here is not on the trans community, but on the rest of us.

He says that it’s going to require some fresh thinking, and a recognition that what we’re brought up to believe isn’t unquestionable truth, he writes. “That trans people aren’t hostile invaders on the shore, but our friends and our colleagues and our families. That giving some of society’s most marginalised groups a chance to express their talent doesn’t harm anyone. Because trans women are women. And sport, I’m afraid, is only sport.”

Cape Times report
Sport24 report
Eyewitness News report
The Independent report

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