title: Women with hyperandrogenism in elite sports: scientific and ethical rationales for regulating.
abstract: The recent implementation by some major sports-governing bodies of policies governing eligibility of females with hyperandrogenism to compete in women's sports has raised a lot of attention and is still a controversial issue. This short article addresses two main subjects of controversy: the existing scientific basis supporting performance enhancing of high blood T levels in elite female athletes, and the ethical rationale and considerations about these policies. Given the recently published data about both innate and acquired hyperandrogenic conditions and their prevalence in elite female sports, we claim that the high level of androgens are per se performance enhancing. Regulating women with clinical and biological hyperandrogenism is an invitation to criticism because biological parameters of sex are not neatly divided into only two categories in the real world. It is, however, the responsibility of the sports-governing bodies to do their best to guarantee a level playing field to all athletes. In order not cloud the discussions about the policies on hyperandrogenism in sports, issues of sports eligibility and therapeutic options should always be considered and explained separately, even if they may overlap. Finally, some proposals for refining the existing policies are made in the present article.
authors.affiliation: Laboratoire Motricité Humaine, Education, Sport, Santé (S.B.), Nice Sophia Antipolis University, 06107 Nice, France; Monaco Institute of Sports Medicine and Surgery (S.B.), 98000 Monaco; Department of Human Genetics and Unité Centre National de la Recherche Scientifique Unité Mixte Internationale 3663 "Epigenetics, Data, Politics" (E.V.), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-7088; Department of Reproductive Endocrinology (P.F.), and INSERM Unité 1065, Hôpital l'Archet, University Hospital of Nice, 06200 Nice, France; and Department of Women's and Children's Health (M.R.), Karolinska Institutet and University Hospital, SE-141 86 Stockholm, Sweden.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bermon
authors.forename: Eric
authors.initials: E
authors.lastname: Vilain
authors.forename: Patrick
authors.initials: P
authors.lastname: Fénichel
authors.forename: Martin
authors.initials: M
authors.lastname: Ritzén
mesh_terms: D056352:Athletes; D054874:Athletic Performance / Q000941:ethics / Q000331:legislation & jurisprudence / Q000502:physiology; D004300:Doping in Sports / Q000941:ethics* / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications / Q000453:epidemiology*; D013177:Sports