For decades, sport governing bodies have regulated women’s participation in sport through “sex testing:” practices that violate fundamental rights to privacy and dignity. Through their policies, sport governing bodies have created environments that coerce some women into invasive and unnecessary medical interventions as a condition to compete in certain events, and sports officials have engaged in vitriolic public criticism that has ruined careers and lives. Women from the Global South have been disproportionately affected. There have never been analogous regulations for men.
The body that enforces these practices for athletics—the group of sporting events that involves competitive running, jumping, throwing, and walking—is not a government or multilateral body, but a private one, World Athletics. This entity (known prior to 2019 as the International Association of Athletics Federations, or IAAF) is the body that governs international athletics, and the regulations it has promulgated have resulted in the profiling and targeting of women according to gender stereotypes. Women perceived to be “too masculine” may become targets of suspicion and gossip, and may have their careers ended prematurely. The standards of femininity applied are often deeply racially biased.
Sex testing regulations, including the World Athletics 2019 regulations and its precursors, and the manner in which they are implemented—including their repercussions—discriminate against women on the basis of their sex, their sex characteristics, and their gender expression. Sex testing violates a range of internationally protected fundamental rights including to privacy, dignity, health, non-discrimination, freedom from ill-treatment, and employment rights. These punitive regulations push them into unnecessary medical procedures that are conducted in coercive environments in which humiliated women are forced to choose between their careers and their basic rights.
The policies also put physicians, sporting bodies, and governments in precarious positions of being implicated in violations of privacy, dignity, health, and non-discrimination protections.
This report provides an overview of the nearly century-long history of sex testing of women athletes, details how and where such testing continues today, and identifies the human rights issues at stake. It draws on more than a dozen first-hand accounts from affected athletes to illustrate the deep and lasting negative impact this abuse is having on women’s lives.
This report finds that the human rights violations that such testing involves have taken place under the veneer of purportedly evidence-based policies that sport governing bodies have presented as necessary to ensure fairness in competition, even though the science behind them is contested. Athletics officials identified testosterone as the primary driver of athleticism, selected a scientifically specious threshold for functional endogenous testosterone that they deemed confers a performance advantage, and ascribed an unfair advantage to women with natural testosterone above this level. They deemed this level within the “normal male range,” ignoring the variability of women’s and men’s testosterone levels, and the overlap between normal ranges for women and men.
The World Medical Association; the United Nations Human Rights Council; and health, bioethics, medical, and human rights experts, among others, have sharply criticized World Athletics’ application of arbitrary testing based on stereotypical gender norms and using flawed science to coerce healthy athletes into medically unnecessary interventions in order to compete. They have condemned these practices as unscientific, unethical, and violations of domestic and international human rights laws.