Caster Semenya of South Africa wins the women's 800 meters for Africa at the International Association of Athletics Federations Continental Cup in September in Ostrava, Czech Republic. (Petr David Josek/AP)

Hida Viloria is the author of “Born Both: An Intersex Life,” and is executive director of the Intersex Campaign for Equality.

On Wednesday, the Court of Arbitration for Sport took a startling step backward in the fight for equality in women’s athletics. At issue was the case that Olympic gold medal runner Caster Semenya and Athletics South Africa had brought against regulations of the International Association of Athletics Federations set to take effect this year, which would force Semenya to take hormones to lower her testosterone levels to compete as a woman.

The association asserts that it’s not Semenya’s womanhood that is in question: She and all the women who would be affected by this regulation were assigned female at birth and raised and live as women. The organization says the issue is that she’s different enough from other women that she has a scientifically demonstrable, unfair advantage. The evidence suggests this is untrue. And the association’s new rules are just the latest effort to force intersex people into procedures intended to make other people comfortable.

It’s important to be clear: Naturally occurring testosterone is different from steroids or other methods of doping, which can increase the amount of testosterone in the body relative to what an individual athlete is used to. The research on naturally occurring testosterone and athletic performance is limited, and the study the association commissioned on the subject has been criticized as including flawed data. A recent review by Harvard Medical School endocrinologists concluded that it remains unclear whether naturally high testosterone levels found in some intersex women confer a competitive advantage.

As I told association officials and leading medical and scientific experts on athletic performance during the 2010 International Olympic Committee meeting on this issue, there are women with an intersex variation known as complete androgen insensitivity syndrome whose bodies cannot respond to testosterone. This means they have functional testosterone levels of zero, which, under the association’s reasoning, would put them at a disadvantage to non-intersex women, whose bodies contain some functional testosterone. Yet multiple women who have been diagnosed with CAIS have been able to compete at the Olympic level.

Then, there is the case of Indian sprinter Dutee Chand. In 2014, Chand was found to have testosterone levels above the limit of 10 nanomoles per liter specified in regulations that became effective in 2011, and that were implemented despite the 2010 meeting. She was banned from competition unless she took estrogen, but she fought the ruling in the Court of Arbitration for Sport and won in 2015, overturning the regulations. Despite having very high testosterone levels, Chand has never dominated women’s track and field. She’s ranked 34th in the 100 meters, 23rd in the 200 meters, and 375th in the women’s overall field. Obviously, having naturally high testosterone doesn’t make women unbeatable competitors, as alarmists claim.

Semenya may have broken some world records, but she isn’t running anywhere near as fast as men in similar events. She runs in women’s speed ranges, and she just happens to be really good.

In other words: The relationship between the presence of specific testosterone levels and athletic performance is not as exact as the International Association of Athletics Federations makes it seem. And the fact that its proposed policy applies only to events from the 400 meters to a mile is not only scientifically unsound, given that testosterone has more of an effect in power events such as shot put and javelin but also directly targets Semenya, as these are her events.

So why did the association revive this issue? At the 2016 Olympics, British runner Lynsey Sharp received extensive media coverage for a tearful interview in which she suggested that a number of athletes said it was unfair that they had to compete against Semenya. And the International Association of Athletics Federations went at it again.

Sporting bodies have spent decades imposing regulations on intersex female athletes to appease perceptions that they’re not “real women,” and complaints from non-intersex female athletes, but the regulations keep getting overturned because the science just doesn’t support them.

Sadly, efforts to make women more “feminine” are not unusual. As babies, intersex people have been subjected to cosmetic medical treatments aimed at making our bodies fit gender expectations for decades. In the case of intersex female babies, the treatments aim to make their bodies more feminine.

The association would like you to believe that these regulations are about “fairness for women,” but the contrast between Chand’s and Semenya’s cases demonstrates otherwise. Both Chand and Semenya have naturally high testosterone, yet Chand is allowed to run in her events, which are not covered by the regulations that affect Semenya, without feminizing her body, while Caster is not being extended the same right. What distinguishes them? Chand is short, with a genteel, feminine smile and long hair. Semenya is tall, black, unapologetically butch and married to a woman.

Forcing or coercing people to undergo these procedures has been condemned by human rights organizations, including the United Nations and Human Rights Watch, because it’s harmful. But the regulations say Semenya will have to undergo them if she wants to compete in her events.

The International Association of Athletics Federations can argue that Semenya has a choice about whether to undergo risky treatments, but the other option is potentially losing her brilliant career and her financial means of supporting herself and her family.

I know Semenya will find a way to triumph despite how much these regulations inhumanely aim to derail her. But rules such as these, and the attitudes they represent, will affect many other female runners, particularly those from the global south, many of whom lack the support and profile Semenya can command. And these rules are unethical. Period.

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