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      Out of Bounds? A Critique of the New Policies on Hyperandrogenism in Elite Female Athletes

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          Abstract

          In May 2011, more than a decade after the International Association of Athletics Federations (IAAF) and the International Olympic Committee (IOC) abandoned sex testing, they devised new policies in response to the IAAF’s treatment of Caster Semenya, the South African runner whose sex was challenged because of her spectacular win and powerful physique that fueled an international frenzy questioning her sex and legitimacy to compete as female. These policies claim that atypically high levels of endogenous testosterone in women (caused by various medical conditions) create an unfair advantage and must be regulated. Against the backdrop of Semenya’s case and the scientific and historical complexity of “gender verification” in elite sports, we question the new policies on three grounds: (1) the underlying scientific assumptions; (2) the policymaking process; and (3) the potential to achieve fairness for female athletes. We find the policies in each of these domains significantly flawed and therefore argue they should be withdrawn.

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          Most cited references41

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          Deliberative Policy Analysis

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            Beyond the Natural Body

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              Impaired skeletal muscle development and function in male, but not female, genomic androgen receptor knockout mice.

              To identify mechanisms of anabolic androgen action in muscle, we generated male and female genomic androgen receptor (AR) knockout (ARKO) mice, and characterized muscle mass, contractile function, and gene expression. Muscle mass is decreased in ARKO males, but normal in ARKO females. The levator ani muscle, which fails to develop in normal females, is also absent in ARKO males. Force production is decreased from fast-twitch ARKO male muscle, and slow-twitch muscle has increased fatigue resistance. Microarray analysis shows up-regulation of genes encoding slow-twitch muscle contractile proteins. Real-time PCR confirms that expression of genes encoding polyamine biosynthetic enzymes, ornithine decarboxylase (Odc1), and S-adenosylmethionine decarboxylase (Amd1), is reduced in ARKO muscle, suggesting androgens act through regulation of polyamine biosynthesis. Altered expression of regulators of myoblast progression from proliferation to terminal differentiation suggests androgens also promote muscle growth by maintaining myoblasts in the proliferate state and delaying differentiation (increased Cdkn1c and Igf2, decreased Itg1bp3). A similar pattern of gene expression is observed in orchidectomized male mice, during androgen withdrawal-dependent muscle atrophy. In conclusion, androgens are not required for peak muscle mass in females. In males, androgens act through the AR to regulate multiple gene pathways that control muscle mass, strength, and fatigue resistance.
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                Author and article information

                Contributors
                Journal
                100898738
                26837
                Am J Bioeth
                Am J Bioeth
                The American journal of bioethics : AJOB
                1526-5161
                1536-0075
                5 December 2016
                2012
                12 December 2016
                : 12
                : 7
                : 3-16
                Affiliations
                Stanford Center for Biomedical Ethics
                Barnard College
                Southern Illinois University at Edwardsville
                King’s College London
                Author notes
                Address correspondence to Katrina Karkazis, Stanford Center for Biomedical Ethics, 1215 Welch Road, Modular A, Palo Alto, CA 94305, USA. karkazis@ 123456stanford.edu
                Article
                PMC5152729 PMC5152729 5152729 ems70625
                10.1080/15265161.2012.680533
                5152729
                22694023
                f60b08ea-95b0-4952-9281-9e2a70f85099
                History
                Categories
                Article

                gender/sexuality,feminist ethics
                gender/sexuality, feminist ethics

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