South African runner Caster Semenya yesterday lost her court challenge against IAAF rules forcing some female athletes to regulate their testosterone levels, but judges voiced concern with the “discriminatory” regulations. 
The decision by the Court of Arbitration for Sport means that women with elevated testosterone will have to take suppressive treatment if they wish to compete as females in certain events.
The verdict triggered emotional reactions following a charged legal battle over increasingly complex questions of gender, which are likely to have far-reaching consequences for the future of women’s sport. 
In a 2-1 decision, CAS judges dismissed Semenya’s appeal against measures imposed by the International Association of Athletics Federations (IAAF) targeting “hyperandrogenic” athletes — or those with “differences of sexual development” (DSD).
The judges said that although the rules are “discriminatory...such discrimination is a necessary, reasonable and proportionate means of achieving the IAAF’s aim of preserving the integrity of female athletics in the Restricted Events.”
In a statement issued by her lawyers, the 28-year-old double Olympic champion Semenya said that “for a decade the IAAF has tried to slow me down.”
“But this has actually made me stronger. The decision of the CAS will not hold me back. I will once again rise above and continue to inspire young women and athletes in South Africa and around the world.”
South Africa, which has accused the IAAF of seeking to violate women’s bodies, said it was “disappointed” with the judgement.
The IAAF said it was “grateful” for the verdict and that the DSD rules — first adopted last year but suspended pending the legal battle — will come into affect on May 8.
The athletics governing body has maintained that the rules are necessary to ensure all female athletes can see “a path to success”.
It has stressed that DSD athletes with male levels of testosterone benefit from increased bone and muscle strength similar to men who have gone through puberty.
While the court said there was insufficient evidence to overturn the regulations, it “expressed some serious concerns as to the future practical application of these DSD Regulations.”
The rules must remain a “living document,” which are revised based on new information, the court added. 
Judges specifically raised the issue of “unintentional non-compliance,” given the difficulty of maintaining artificial testosterone levels, and possible side-effects of mandated hormone treatment. 
And the court suggested the rules should not be applied to longer events like the 1500 metres because there was insufficient evidence to indicate that hyperandrogenic athletes had an advantage. 
The testosterone rules will however apply to the 800 metre race, an event Semenya has dominated over the last decade. 
In order to defend her title at the world championships in September, Semenya will have to take medication, likely including birth control pills. 
Semenya’s testosterone levels are not publicly known, but she is unlikely to be the only athlete affected by rules compelling female runners in certain categories to cap their testosterone levels at five nanomoles per litre (nmol/L) of blood. 
Caster Semenya has 30 days to challenge the decision to dismiss her appeal against restrictions being placed on female athletes with elevated levels of testosterone — but the timescale for choices over her career direction is far shorter.
The 28-year-old South African can appeal the CAS ruling at the Swiss Federal Tribunal within 30 days, and she might well take that option. Some observers suggest she might then contemplate taking the case to the European Court of Justice.
But in the meantime, the IAAF says that if she wants to defend her 800m title at the world championships in Doha in September, Semenya needs to start taking medication immediately to show significant change within seven days and then maintain it below a set level continuously.
The IAAF also quickly dismissed CAS’s advice that the restrictions should not apply yet to the 1,500m, where Semenya won bronze at the last world championships in London two years ago.
In other words, if Semenya wants to race her preferred distances, she needs to start taking the suppressant medication right away.