Dr Ross Tucker, aka FitnessDoc, discusses the latest in the Caster Semenya saga after she announced this week her return to running - despite the fact the IAAF has not yet cleared her to do so.
Caster Semenya, South Africa's 800m world champion from Berlin last year, and the athlete who, for all the wrong reasons, dominated the world scene towards the end of 2009. Her story, and the web of lying, corruption, cover-ups, leaks and gender verification tests were perhaps the big story in athletics, if not sport, in 2009.
And for the IAAF, the story seems set to continue, as she has announced her intention to compete again. Reading a statement prepared by her legal team, Semenya declared that she would be working with her coach and agent to select and compete in a limited number of races over the coming season.
This follows only a day after the IAAF requested that she not run in a local meeting in Stellenbosch, South Africa, after it was reported that she would be returning for the first time since her Berlin victory last year.
That was blocked only by a late request, but the ball has still found its way firmly into the IAAF's court, as they must now surely make some kind of decision on her eligibility to compete as a woman.
Policy, performance and proof
It's a difficult subject to discuss, because the boundary between speculation, fact and violation of a person's privacy rights is non-existent. However, I think it's pretty safe to say that the testing conducted on Semenya revealed significant questions over whether she should compete as a woman.
This was all but confirmed when the South African Minister of Sport said publicly that he would support Semenya 'despite her condition'. This was confirmation of the leaks and allegations which had suggested that Semenya had internal testes.
However, physiologically, proving that having an intersex condition confers an advantage is a difficult proposition. And there is no policy, at least that I am aware of, that states when an athlete should be barred from competing.
The only IAAF policy that I have been able to find states that certain conditions are allowable. However, in the frenzy last year, it was revealed that eight athletes had been asked to either seek medical treatment of discontinue running as a result of such conditions. So clearly, there are precedents and some means to determine whether an athlete should not run.
So is this the sticking point? Why has it taken this long to announce a decision, when the test results would have been known many months ago?
We have to be clear - the actual testing produces a pretty obvious answer. A person either has internal testes or they don't. They either have a Y-chromosome or they don't.
Once you get beyond that surface assessment, things become complex, because there are varying degrees or grades of conditions, for example. However, even this would have been resolved by now, and the medical diagnosis and picture of Caster Semenya will be very clear and obvious to all concerned.
The stumbling block
However, the policy regarding performance is the stumbling block. High powered lawyers (they got Pistorius off, after all, despite a massive advantage), lawsuits, media glare and a political backlash last year all factor in, but the bottom line is that the IAAF must now commit to a decision.
This has taken much too long. Is she allowed to participate without medical treatment to remove the internal testes? Or is that to be enforced? Can it be enforced?
And most interestingly, would that medical treatment affect her performance?
No follower of athletics failed to notice that in 2009, Semenya, still a teenager and following a structured programme for only a few months, managed to run 1:55 looking like she was jogging in the Berlin final.
There was little doubt among athletic followers that had she desired, she could have increased her pace even more, and run close to 1:53 in that race. For a first year teenager, that is remarkable, and suggests that with maturity, more training and the right race, she would be capable of 1:51.
Those who know the history of the event are also aware that of the top 20 women in history in the 800m event, at least 16 are known to have doped, and few athletes get down to 1:55 without doping.
So a 1:51? I have stated this before, and believe that a 1:50-something would be a very real possibility. That is a fact many dismiss as irrelevant, but the fact is, if Semenya does compete and does run unaffected by last year (either training or medically), we will see processions, not races.
So would the medical treatment prevent this? Certainly, removal of the testes would have far-reaching consequences, not only for performance, but for her health, since she'd be obliged to seek hormone replacement for the rest of her life. It's thus not a decision to be taken lightly.
There are other options. If not surgical, then there are means to reduce the testosterone levels, which may be a compromise of sorts.
Is that being done?
These options will have been discussed, and Semenya may well be on a course to reduce testosterone levels non-surgically. In fact, I strongly suspect she is, for that would have been part of the "negotiations" and compromises reached last year when the IAAF, ASA, SA government and legal team were discussing Semenya's future.
So I suspect that something is being done, if not surgically, then medically. It's anyone's guess how the IAAF will enforce this, because all the athlete needs to do is miss a week of treatment and they're effectively benefiting from the same effect as doping.
Of course, none of these details should ever be announced, for they infringe on patient rights. However, what does need to be announced is whether Semenya's statement is rhetoric, or whether the IAAF are going to allow her to run.
If she is cleared, will any of the meetings invite her, and if they do, will any of the competitors she races against object, or even withdraw? That will depend on how well she performs - if she runs 1:55 while jogging, the fall-out may be difficult to contain.
That verdict, provoked by Semenya's statement, should come soon.
Semenya herself stated that "these processes have dragged on for far too long with no reasonable certainty as to their end". Let's hope that her statement inspires action, so that the issue can move beyond this big question mark, and onto the next one - performance.
Dr Ross Tucker, is Health24’s FitnessDoc and has a Ph.D. in Exercise Physiology from the University of Cape Town and a Post-Graduate degree in Sports Management from the UCT's Faculty of Commerce. He is currently employed at the University of Cape Town and Sports Science Institute of South Africa, and works as a consultant to various sporting teams, including South African Sevens, Canoeing, Rowing and Triathlon SA. He also blogs on www.sportsscientists.com)