This Tuesday, a Columbia Science Review event asked questions about testosterone’s role in elite women’s athletics. Who gets to define gender in the context of sports? And is testosterone level an appropriate marker of sex? 

On Tuesday, April 30, Columbia Science Review hosted an 8 pm event in Hamilton’s room 702. Titled, “Testosterone: Defining Gender in Sports,” the talk was led by Professors Rebecca Jordan-Young and Katrina Karkazis. Professor Jordan-Young teaches in Barnard’s Department of Women’s, Gender and Sexuality Studies and is the former Tow Associate Professor for Distinguished Scholars. Professor Karkazis is the Carol Zicklin Endowed Chair in the Honors Academy at Brooklyn College, CUNY and a Senior Research Fellow with the Global Health Justice Partnership at Yale University.

Jordan-Young and Karkazis were awarded a Guggenheim Fellowship in 2016 to work on their book, Testosterone: An Unauthorized Biography. It will be published in October 2019 by Harvard University Press. As both women began speaking about their work, their energy and enthusiasm were palpable. They tended to jump from topic to topic and story to story, giving background information when deemed necessary but otherwise charging forward at full-speed.

Professor Karkazis began by noting the relevance of the talk; at six the following morning, May 1, 2019, a historic decision would be made. The Court of Arbitration for Sport would be determining whether or not South African track and field runner Caster Semenya, a female athlete with naturally high testosterone, would be allowed to compete as a woman. The morning after the Columbia Science Review’s event, judges ruled that restrictions on naturally-occurring testosterone levels are “necessary and reasonable to preserve the integrity of female competition.” Although track and field’s world governing body, the International Association of Athletics Federations, was “grateful” for the ruling, it comes as a major blow to scientists like Jordan-Young and Karkazis who study gender science and testosterone’s effect on athletes.

Jordan-Young made it clear to the audience that “ultimately, the decision about who competes is not something that can be decided by scientific methods and scientific evidence.” Rather, there are connections with ethics and human rights as well as political and cultural issues.

The moderator formally began the talk by asking about “the basics.” In 2011, the International Association of Athletics Federations and the Olympic Committee ruled that women whose bodies naturally produced testosterone in the “male range” would not be able to participate in the women’s category of any Olympic or world-level track and field competitions.

Karkazis and Jordan-Young interviewed some of these policymakers in their defining meetings. Karkazis called testosterone the “Trojan horse” of how sex testing returned to women’s athletics. Ever since women entered into competitive sports, she explained, there needed to be some way to deem them women, and the sex trait that officials looked at varied with the latest scientific methods, ranging from genital exams to assessments of femininity before things like chromosomal testing. The problem that arises here is that there is no one biological feature or criterion that determines a man from a woman, nor is there an objective way to create some sort of algorithm using a range of criteria.

Karkazis told the audience that she suspected the regulations proposed about women’s natural testosterone in track and field were about “ferreting out” intersex women and emphasizing the kind of bodies and appropriate femininity that women should have. She said, “I thought, ‘Let’s look at the testosterone science. Let’s make sure it’s as shallow as I think it is.’” In one footnote of the regulation’s proposal, it is explicitly noted that for any woman who has polycystic ovary syndrome (PCOS), the testosterone regulations don’t apply. When women have high testosterone levels, but no distinguishable intersex characteristics, they oftentimes have and are diagnosed with PCOS. Karkazis read this footnote as clear evidence of discrimination against women with intersex characteristics, like Semenya.

At this time of the talk, Jordan-Young jumped up to the classroom’s computer in order to pull up some photos presented at the medical conference before the 2012 Olympics. The medical director of track and field suggested that all women undergo a clitoral exam, which would be the clearest indicator of one’s testosterone levels. As he continued talking about women athletes, he presented Goya’s romantic nude portrait, La Maja Desnuda, as an example of the supposed “perfect female phenotype.” In this portrait, race and femininity are on display. There is nothing active about the woman’s figure, nor does she have any defined muscles. Jordan-Young posed pressing questions: “What’s the discomfort with elite women athletes? What’s the suspicion, that if you’re too good, there’s something masculine about you?”

Karkazis forayed back into the current case, explaining that the International Associations of Athletics Federation has continuously done its own studies on testosterone in athletics, but a 2017 study was so critiqued (for bad statistical methods and more) that prominent sports scientists even called for the study to be retracted.

Jordan-Young said, “The more specific we get about how testosterone works, the harder it is to accept that these kinds of regulations make sense.” She explained that testosterone is dynamic. For example, if a coach continuously points out their athletes’ positive performances, testosterone can double. If they point out negatives, testosterone levels can decrease. What’s especially interesting is that performance doesn’t necessarily increase when testosterone increases. There is a lack of a predictable relationship between testosterone and performance. In the case of young Olympic weight lifters, there’s even an inverse relationship between testosterone and performance. Jordan-Young emphasized, “There is no tidy set of correlations,” noting that “Sometimes you see high testosterone levels because people’s bodies are bad at using testosterone!”

Karkazis added that there are ways women athletes can surgically or pharmacologically lower their testosterone levels. When this happens, they can be faced with side effects like dehydration, muscle weakness, and depression, which are symptoms of changing one’s steroid/hormone profile that make it difficult to perform. If they slow down as a result, it’s taken as evidence that they’ve slowed because of reduced testosterone, when in reality, the athletes would face the same symptoms whether they had surgically or pharmacologically changed their hormone profile in any way.

Karkazis concluded, “If testosterone was known as ‘jet fuel for athletes’ then I’d say ‘let’s talk about this.’ But the fact of the matter is that the evidence about testosterone just isn’t there, so the regulations just don’t make sense.”

Although the court rulings against Semenya are undoubtedly a blow for gender scientists like Karkazis and Jordan-Young, emerging criticism and loud opposition to the decision proves that the fight for fairness regarding sex testing and elite women athletes is far from over.

Rebecca Jordan-Young and Katrina Karkazis via Bwog.