Physicians group calls on members to reject IAAF regulations

In Summary

• We have strong reservations about the ethical validity of these regulations — WMA President Dr. Leonid Eidelman.

•  Under the rules, female athletes with high natural levels of testosterone wishing to compete in events from 400m to a mile must medically limit that level to under 5 nmol/L.

Caster Semenya of South Africa
Caster Semenya of South Africa
Image: /FILE

The World Medical Association has called on its members not to implement new International Association of Athletics Federations (IAAF) regulations that restrict testosterone levels in female athletes with differences in sexual development.

The Court of Arbitration for Sport (CAS) this week dismissed an appeal by Olympic 800 metres champion Caster Semenya to set aside the regulations, which will come into effect on Wednesday.

However, the WMA, which represents physicians from 114 national member associations, said there was “weak evidence” that the regulations were necessary and that they should be scrapped.

“We have strong reservations about the ethical validity of these regulations,” WMA President Dr. Leonid Eidelman said in a statement on the organisation’s website.

“They are based on weak evidence from a single study, which is currently being widely debated by the scientific community. They are also contrary to a number of key WMA ethical statements and declarations, and as such we are calling for their immediate withdrawal.”

Under the rules, female athletes with high natural levels of testosterone wishing to compete in events from 400m to a mile must medically limit that level to under 5 nmol/L, which is double the normal female range of below 2 nmol/L.

The IAAF has said no athlete would be forced to undergo surgery and that oral contraceptives should suffice in allowing them to reach the required level.

Testosterone increases muscle mass, strength and haemoglobin, which affects endurance. The WMA has previously said the regulations ‘would constrain the athletes concerned to take unjustified medication, not based on medical need, in order for them to be allowed to compete, and accordingly require physicians to prescribe such medication.’

The association added it was unethical for physicians to prescribe treatment to lower testosterone if the condition was not recognised as pathological, and warned of the dangers of ‘artificially modifying blood constituents, biochemistry or endogenous testosterone’.