A groundbreaking study recently published in the European Journal of Sport Science sheds new light on the perceptions of elite female athletes regarding the inclusion of athletes with differences in sex development (DSD) in competitive female sports categories. This research, encompassing responses from 147 national, elite, and world-class female athletes spanning diverse sports and nations, delves deeply into the complex and often contentious debates surrounding eligibility criteria for athletes with DSD conditions. By focusing on the athletes’ perspectives, the study provides a crucial yet often overlooked dimension in the ongoing policy deliberations that govern elite sport.
Differences in sex development denote a group of rare congenital conditions characterized by atypical development of chromosomal, gonadal, or anatomical sex. Individuals with DSD may possess a mosaic of reproductive, hormonal, and genetic features that do not conform neatly to traditional male or female classifications. This inherent biological complexity complicates the establishment of fair and inclusive categories in competitive sport, particularly in events emphasizing physical prowess such as sprinting and contact sports like rugby. Public awareness of DSD conditions has increased due in part to high-profile athletes like South African middle-distance runner Caster Semenya, whose career has drawn intense scrutiny and legal battles centered on eligibility and fairness.
The study foregrounds a nuanced, somewhat unexpected stance among female athletes: 43% perceive the participation of athletes with DSD in female categories as fair, compared to 36% who view it as unfair. This contrasts notably with earlier findings from the same research group involving transgender athletes, where 48% of female athletes believed the inclusion was unfair and 38% deemed it fair. Such a divergence underscores the complex and distinct considerations that athletes attribute to DSD and transgender participation, challenging blanket policies that treat these groups identically.
One of the most striking dimensions of the research is the ethical consensus emerging from the surveyed athletes concerning medical interventions. A sizable majority, amounting to 67%, consider it unethical to compel athletes with DSD to undergo hormonal treatment or other forms of medication solely to meet regulatory eligibility requirements. This challenges decades-long practices where governing bodies have mandated reductions in testosterone or other physiological parameters, often at significant personal and health costs to the athletes involved. The findings thus argue for a critical reevaluation of these policies through both ethical and empirical lenses.
Furthermore, the study reveals a pervasive rejection of segregated competition categories based specifically on DSD status, with an overwhelming 70% opposing the creation of separate divisions, particularly in precision-based sports. Athletes’ responses suggest that stratifying competition in this way may be perceived as stigmatizing or impractical given the rarity and variability of DSD conditions. Instead, a clear majority—82%—advocate for enhanced inclusivity efforts within existing competition structures, signaling a push toward more integrative and less divisive approaches in sports governance.
Led by Dr. Shane Heffernan of Swansea University’s Applied Sports Science Technology and Medicine Research Centre, this research builds upon prior work by incorporating direct athlete voices into a policy debate frequently dominated by medical, scientific, and juridical perspectives. The study’s cohort includes 21 world champions, 15 Olympians, among them multiple medalists, and six Paralympians, ensuring that the insights reflect the views of those at the pinnacle of competitive achievement. Their perspectives offer not only empirical value but also a mandate for sporting bodies to consider the lived experiences and ethical outlooks of athletes most impacted by these policies.
Dr. Heffernan emphasizes that while DSD athletes exhibit complex and individualized biological characteristics, there is no empirical evidence conclusively demonstrating that DSD confers an inherent athletic advantage at the elite level. The focus on a few high-profile cases has skewed policy development, often divorced from peer-reviewed scientific data. This research seeks to recalibrate the discourse by prioritizing inclusivity and fairness grounded in robust evidence and the athletes’ authentic experiences, rather than fear or anecdotal assumptions.
Complementing this perspective, Professor Alun Williams of Manchester Metropolitan University, an expert in sports genomics, highlights the significant gap in scientific knowledge regarding the biological impact of DSD. His extensive work on genetics and athletic performance elucidates that while DSD conditions involve rare and heterogeneous genetic anomalies affecting reproductive and hormonal systems, the translation of these biological factors into competitive advantage is neither straightforward nor well quantified. Williams stresses that conflating DSD athletes with transgender athletes in policy-making ignores crucial biological distinctions and presents serious ethical challenges.
The recent decision by World Athletics to merge regulations for transgender and DSD athletes has prompted criticism from many quarters, including the researchers leading this study. The athlete survey data demonstrates that high-level female athletes view these categories as fundamentally different and warranting separate consideration. Applying uniform eligibility standards risks oversimplifying complex biological and ethical realities, potentially undermining fairness and inclusivity goals simultaneously.
Beyond biology and policy, this study opens a critical debate about how the evolving understanding of sex and gender intersects with the centuries-old structure of competitive sport. Traditional binary classifications increasingly face challenges from scientific insight and social change alike. Athletes and organizations are grappling with how to honor competitive integrity while adapting to a more nuanced recognition of sex development diversity. This research contributes meaningfully to that discourse, advocating that athlete voices not be sidelined but placed at the heart of regulatory evolution.
The implications extend beyond sport itself, touching on broader societal questions concerning inclusion, identity, and the limits of medical intervention. The explicit rejection by a majority of athletes of mandated medication for eligibility foregrounds the human rights dimensions of doping-like regulations imposed on DSD athletes. By documenting a clear ethical stance, the study encourages sports governing bodies to reconcile regulatory frameworks with respect, dignity, and scientific integrity.
In conclusion, the findings presented offer a timely and critical contribution to ongoing debates in sports policy and ethics. They call on governing bodies such as World Athletics to rectify the conflation of DSD and transgender athletes in eligibility rules, acknowledging the distinct biological and social complexities involved. The call for more inclusive and scientifically grounded policies resonates strongly with the athletes who remain at the core of competitive sport. As research in this area advances, iterative dialogue incorporating athlete perspectives will be indispensable to forging equitable solutions in elite athletics.
—
Subject of Research: Athlete perceptions on eligibility and inclusion of athletes with Differences in Sex Development (DSD) in female competitive sports
Article Title: Female elite athlete perspectives highlight ethical and policy complexities in DSD athlete inclusion in sport
News Publication Date: 2024
Web References:
European Journal of Sport Science – DOI: 10.1002/ejsc.12300
Swansea University DATES Project: https://www.swansea.ac.uk/sport-exercise-sciences/astem/dates-project/
References:
Heffernan, S., Williams, A., Stebbings, G., & Chollier, M. (2024). Athlete perspectives on eligibility policies for athletes with differences in sex development: A European Journal of Sport Science publication.
Keywords:
Differences in sex development (DSD), elite sport, athlete eligibility, ethics in sport, female athletes, sports genomics, inclusion, hormone regulation, transgender athletes, World Athletics, sport policy, human biology
Tags: athletic performance and genderCaster Semenya impactcompetitive sports categoriescongenital conditions in athleticsdifferences in sex developmentDSD eligibility criteriaelite sports policy debatesfemale athletes perceptionsgender inclusivity in sportshormonal and genetic featurespublic awareness of DSDwomen’s sports fairness