IOC's shift may alter DSD, trans rules

Historic moment for the International Olympic Committee. Its upcoming presidential elections, scheduled for 20 March, could redefine the policies the organisation maintains regarding the participation of athletes with differences in sexual development (DSD) and transgender athletes in the Olympics.

Among the seven candidates to succeed Thomas Bach as president, Lord Sebastian Coe, current leader of World Athletics, stands out as the favourite. Known for his strict approach to regulation for DSD and transgender athletes, he could significantly influence the way the IOC addresses these issues. During his tenure at the helm of athletics, with the idea of ensuring fair competition in the women's categories, he implemented some particularly controversial rules.

In 2023, World Athletics required female athletes to maintain testosterone levels below 2.5 nanomoles per litre (nmol/L) for 12 to 24 months. Additionally, this rule, which originally applied only to middle-distance events (400-1,500 metres), was extended to all disciplines. "If you are not willing to make clear decisions, you will lose women's sport, and I am not willing to let that happen," Coe declared at the time.

The presidential candidate wants to revolutionise the women's category if he wins the elections, and maintains that controversies like the one that took place in Paris 2024 around Imane Khelif and Lin Yu-ting, who won gold in women's boxing despite failing gender tests, would not occur under his leadership.

In his candidacy manifesto, Coe does not hesitate to explain his stance on the debate around gender identity and biological sex. The Briton assures that his commitment lies in "protecting and promoting the integrity of women's sport". What sets him apart from his rivals is the experience he has accumulated in this regard as president of World Athletics, a position from which he has ensured that only biological women can compete in the women's category.

"On the female category, for me it was non-negotiable," Coe said. "If you don’t have clear policies, you end up with where you got to in Paris. The comforting thing for me is that this couldn't have happened in athletics. Why? We had a policy, and it was discussed, debated and driven by some of the smartest people in sports science and genetics. I wasn't sitting there in Paris thinking: 'Oh my goodness, there's a chance I’ve got three on a rostrum who are going to fall into that crevice.'"

In Rio 2016, during his initial year leading World Athletics, Coe had to address an issue concerning the participation of athletes with DSD. On that occasion, Caster Semenya and two other DSD competitors reached the podium in the women's 800 metres, sparking widespread debate about fairness in competition. As a result, Coe implemented a policy requiring such athletes to undergo a minimum of two years of testosterone suppression to compete in women’s categories. Additionally, he banned the participation of transgender athletes who have undergone male puberty, arguing that "gender cannot trump biology."

The position adopted by Coe reinforces his image as a leader willing to reshape the current sports structure. While the IOC tends to prioritise ideology over biological considerations, the Briton promotes policies grounded in scientific evidence. In his manifesto, he emphasises the need to collaborate with renowned medical and educational institutions to foster research into women's health, sports performance, and exercise physiology. According to Coe, women's sport is at a critical juncture that demands both sensitivity and decisive action to ensure future generations of women find sport a viable and fair path.

This vision is opposed by his strongest adversaries, Kirsty Coventry and Juan Antonio Samaranch Jr., who were part of the Executive Commission that allowed Imane Khelif and Lin Yu-ting to win the Olympic title in Paris. "The IOC has the fundamental duty to protect women's sport by adopting a policy that maintains unequivocal distinctions between male and female categories, and must take the lead on this issue with clear guidelines," says Samaranch. Coventry, for her part, does not clearly state any position on this controversial issue in her manifesto.

David Lappartient, another candidate, does not address women's categories in sport and only mentions transgender athletes in his proposal to promote inclusion and diversity. "Regarding transgender athletes, it is a complex issue that must be addressed rationally to achieve the right balance between the need to respect human rights and the obligation to ensure fair competition. We cannot ignore what female athletes say, but our decisions must also be based on solid scientific evidence," said Lappartient.

Also in the presidential race is Johan Eliasch, who does not hide his argument. The head of snow sports stated that the organisation must be guided by facts and not by cultural trends. "There can be no grey areas. The integrity of women's sport must be protected regardless of cultural pressures. In the face of these pressures, justice and clarity can be achieved if we return to biological facts," wrote Eliasch.

Eliasch understands that exposure to puberty creates differences that can provide a sporting advantage, and argues that only those who were born women can compete in women's sport. "We owe it to female athletes to protect their competitive future through objective frameworks based on science, not policies shaped by subjective opinions or ideologies," he added.

The rest of the candidates for the IOC throne, Morinari Watanabe and Prince Faisal Bin al-Hussein, do not even mention the gender debate around women's categories.

Who are DSD and transgender athletes and what regulatory framework do they assume?

DSD athletes have natural variations in their sexual characteristics, such as chromosomes, hormones, or gonads, that do not fully fit into typical male or female categories. Elevated testosterone levels in some DSD athletes have led to debates about competitive advantages, particularly in women's sports.

Transgender athletes, on the other hand, identify with a gender different from the one assigned to them at birth. The discussion about their participation, especially in the case of transgender women, focuses on whether they retain physical advantages after transitioning.

The current IOC framework requires them to maintain testosterone levels below 10 nmol/L for 12 months prior to competition. However, other federations, such as the International Cycling Union (UCI) and World Aquatics, have adopted stricter thresholds or additional requirements. Conversely, transgender men face fewer restrictions, as they are not assumed to have a competitive advantage.

The IOC's regulatory framework, revised in 2021, marked a significant change. Instead of imposing a uniform testosterone limit for all sports, it delegated the creation of specific criteria based on fairness, inclusion, and scientific evidence to individual federations. There are no universal rules for DSD athletes, but many federations apply standards similar to those for transgender athletes. This decentralisation has been praised for fostering inclusion but also criticised for creating confusion among athletes and other stakeholders.

World Athletics is not the only organisation that has tightened its regulations. In 2022, World Aquatics introduced one of the strictest policies for transgender women, limiting participation to those who transitioned before puberty. For DSD athletes, specific thresholds were established by event, considering the variable impact of testosterone in each swimming discipline.

World Rugby, for its part, was the first major body to ban transgender women from competing in elite women's rugby in 2020, citing safety and fairness concerns. In 2023, the UCI lowered its testosterone limit to 2.5 nmol/L, aligning with other stricter federations.

This lack of a unified approach reflects the divergences around the role of testosterone as a determining factor in competitive advantage. The election of a new president could bring significant changes in how the IOC addresses these key issues. Possible measures include the implementation of standardised rules for all sports, with unified eligibility criteria that simplify policies for DSD and transgender athletes, reducing current confusion.

Additionally, testosterone limits and their scientific validity could be reviewed, considering a broader range of factors that influence athletic performance. This would include new strategies to balance safety and fairness, especially in contact sports like rugby, where the risks to athletes' well-being are greater.

The search for a balance between inclusion and fairness will be a crucial challenge for the future IOC president. With figures like Lord Sebastian Coe in the running, this issue could become a central focus of the next decade of Olympic sport.