Olympics unveil strict rules on DSD and transgender athletes as athletes refuse to take drugs to compete

Over the past few years, the International Olympic Committee has significantly changed its rules regarding the participation of transgender athletes and people with differences in sexual development (DSD).

Rather than a set set of rules applicable to all sports, the IOC has developed ten guidelines on gender mainstreaming and allows each sports governing body to decide independently how to implement them.

This means that each sport can decide for itself what rules apply to transgender or DSD athletes, provided that they respect the principles set out in the ten guidelines because they are “based on respect for internationally recognized human rights.”

The Committee stated that when implementing the principles: “This Framework recognises both the need to ensure that everyone, regardless of gender identity or gender variants, can participate in sport in a safe, harassment-free environment that recognises and respects their needs and identity.”

The general guidelines for transgender women at the Paris 2024 Olympic Games state that they must complete their gender transition before the age of 12 to be able to compete in women’s categories.

The purpose of the ruling is to bypass any possible unfair advantages that may result from undergoing male puberty.

But because the IOC allows each sport to set its own rules, many sports organizations have changed their rulings on transgender women, some more stringent than others.

For example, sports such as athletics, cycling, swimming, rugby, rowing and boxing have restricted the participation of transgender athletes, with each having its own criteria, such as testosterone levels.

However, the situation is a bit more complicated and changes significantly in the case of people with DSD.

People with DSD have differences in their genes, reproductive organs and hormones, which the NHS says means that “their sexual development is different to that of most other people”. This is usually something they have had from birth.

In March 2023, the World Athletics Council issued a new ruling for athletes with DSD, which reduced the allowable amount of testosterone in the blood – and therefore the possibility of competing in women’s categories.

Under the ruling, athletes with DSD must have a blood testosterone level below 2.5 nanomoles per liter. The previous limit was 5.

As for the Olympics, the IOC issued guidelines in 2015 that placed limits on athletes’ testosterone levels and required some to undergo treatment, such as testosterone-lowering drugs, in order to compete.

The IOC later rejected the rulings, calling them “medically unnecessary” and emphasizing that athletes should never feel forced to undergo such treatments to meet eligibility criteria.

Caster Semenya, a two-time Olympic 800-meter champion, has probably been the most high-profile victim of the testosterone rulings to date.

In 2019, new regulations introduced by the World Athletics Council banned female athletes with elevated testosterone levels from participating in races of 400 metres or longer.

When advised to take testosterone-lowering medication before the race, Semenya refused, saying it could be harmful to her health.

She appealed the verdict but was never allowed to compete in the 800-meter race at the Olympic Games again.

The changing regulations regarding transgender athletes and people with DSD have recently been widely commented on following the controversial boxing fight between Italian athlete Angela Carini and Algerian athlete Imane Khalif at the Olympic Games in Paris.

Carini left the fight after 46 seconds, sparking a huge debate about her opponent, who had previously failed a gender qualifying test at the World Boxing Championships in New Delhi.