World Athletics’ Sex Testing Policy Revives a Harmful, Discredited Practice

On March 25, World Athletics president Sebastian Coe announced that the track and field governing body would introduce chromosomal testing of women athletes to “doggedly protect the female category.” Concern around “protecting” women athletes and the women’s category has resurged in recent years as the issue of transgender participation in sport has become politically expedient in the United States culture war, culminating in President Donald Trump’s executive order in January banning athletes from participation on teams that don’t align with the sex assigned to them at birth.

Sex and gender verification has been utilized by sport organizations for over a century. Previous methods included “nude parade” physical examinations requiring genital inspection, chromosomal testing, and testosterone level testing. However, World Athletics (previously known as the International Association of Athletics Federations, or IAAF) stopped mandatory sex testing in 1991, due to scientific inaccuracy, inability to prove unfair advantages, and ethical concerns. Women athletes could continue to be tested if their gender presentation was deemed “suspicious.” Notably, Indian track star Pratima Gaonkar committed suicide in 2001 after failing a sex test. In the 2010s, South African distance runner Caster Semenya and Indian hurdler Dutee Chand endured intense public scrutiny over their sex and gender after they were assumed to have androgen insensitivity syndrome. This is one of many conditions that are broadly classified as differences of sexual development (DSDs), and can occur for many reasons but are usually linked to sex chromosomes or anomalies in how the body produces or responds to hormones such as testosterone.

Unlike the World Athletics’s 2023 policy that banned trans athletes from competing in the women’s category, this policy targets women who were assigned “female” at birth, identify as women, and have always lived as women. They simply don’t have the XX chromosomes that World Athletics now deems necessary.

Chromosomal testing does not determine athletic performance and has been condemned by scientists and human rights organizations as discriminatory and unethical.

The new policy requires mandatory chromosomal testing, including a check swab and dry-blood test. While World Athletics claims to have consulted 70 sporting and advocacy groups, it is unclear who was included. Their cited scientific bibliography is largely authored by individuals affiliated with World Athletics, ignoring significant research questioning the ethics and efficacy of female eligibility policies in sport. Notably absent are two pieces by Roger Pielke and colleagues: one exposing flaws in World Athletics’ original 2011 policy and another reaffirming those issues after the organization admitted its female eligibility research was flawed.

The well-established problem with World Athletics’ chromosomal testing is that it actually has no linkage to performance. Put simply, “failing” a chromosomal, DNA, or sex test tells us nothing about whether an athlete will destroy a world record or even win a race. “Failed” tests, more often than not, indicate a chromosomal anomaly—something that neither enhances an individual’s athletic ability nor impedes their quality of life (if this were the case, it would probably be diagnosed way before an elite sport competition!). The inability of chromosomal testing to determine an “unfair” performance advantage was resoundingly proven by geneticists, bioethicists, medical researchers, physicians, and endocrinologists in the late 1980s and early 1990s, which was what led to the abolition of mandatory sex testing.

Systematically, policies like these disproportionately target women from the Global South and reinforce racial and gender biases. A 2020 Human Rights Watch report detailed discrimination, surveillance, and coerced medical intervention that elite athletes from the Global South experienced when seeking to comply with sex testing practices. The women interviewed detailed how medical practitioners did not fully explain the tests and procedures conducted, and the humiliation and discrimination they experienced in their communities when their medical records were disclosed without informed consent. This may be why earlier, in 2019, the World Medical Association released a notice imploring physicians to “take no part in implementing new eligibility regulations for classifying female athletes.”

These concerns highlight the urgency for educating sport governing bodies, and the general public, about the broader implications for the autonomy and safety of girls and women that can result from “protective” policies in sport. While the new World Athletics policy does not mandate surgical alteration, history shows the risks of such regulations. In 2013, four elite women athletes underwent gonadectomies and partial clitoridectomies—an unnecessary and harmful procedure classified as a form of female genital mutilation/cutting (FGM/C)--to comply with eligibility rules. These policies can serve to legitimize and reinforce cultural practices with serious health risks for girls and women.

Women athletes must already carefully negotiate their athleticism with market-driven expectations of femininity to secure sponsorship deals, which are especially critical for women athletes because of the sport industry’s pervasive pay inequity. Mainstream beauty norms—favoring whiteness, thinness, and hairlessness—inform which bodies will be deemed “suspicious” under World Athletics’ new policy. Black and brown athletes, particularly those with more muscular builds and deeper voices, are more likely to be targeted. Research shows that elite women athletes already feel they are forced to choose between appearing “strong” or “feminine”; the reintroduction of sex testing may add further pressure for women athletes to conform with rigid gender norms to avoid harassment and surveillance. Athletes like Algerian boxer Imane Khelif and Semenya endured an onslaught of online attacks following public scrutiny of their gender. Women in sports generally already face disproportionate abuse, with an NCAA study finding that women basketball players receive three times more abusive messages than their male counterparts.

World Athletics’ claims that chromosomal testing will protect women athletes and the women’s category. However, chromosomal testing does not determine athletic performance and has been condemned by scientists and human rights organizations as discriminatory and unethical. Rather than “protecting” the women’s category, these regulations reinforce harmful gender norms, disproportionately target women from marginalized backgrounds, and risk severe personal and professional consequences for women athletes.