On May 6, 2024, SRHM, in collaboration with the Global Health Justice Partnership (GHJP) of the Yale Law and Public Health Schools, held a webinar on “What Oral Contraceptives Have to Do with Human Rights Violations in Sports ?”
This webinar comes at a critical time, days before the Grand Chamber of the European Court of Human Rights is scheduled to hear double Olympic runner Caster Semenya’s complaint on May 15, 2024, against regulations introduced by World Athletics in 2018, the which require some female athletes to suppress their natural testosterone levels, often by taking oral contraceptive pills. Semenya claims Switzerland breached its human rights obligations by upholding a Court of Arbitration for Sport ruling allowing these gender-testing regulations to stand.
During this rich one-hour discussion, which he moderated Professor Alice M. Miller, JD. (co-director of the Yale Law and Public Health Schools GHJP), the authors of a recently published SRHM paper (What do oral contraceptives have to do with human rights abuses in sport?), Katrina Karkazi, PhD, MPH (Professor, Sexuality, Women and Gender Studies at Amherst College) and Michele Krech, JSD (Bigelow Fellow and Lecturer in Law at the University of Chicago Law School) discussed in detail how the Court of Arbitration for Sport relied on erroneous oral contraceptive cases and used scientific evidence to support the coercive and medically unnecessary use of oral contraceptive pills .
The paper we use here as a springboard today arose in light of the range of equity and fairness concerns raised by the gender test regulations. Katrina was particularly interested in concerns related to the use and misuse of science, and I am particularly interested in concerns related to the violation of human rights law. And we understood that these phenomena occur in parallel. That the way courts and the public talk about the science of gender testing has, in many ways, obscured human rights as well as medical ethics from view.
Michele Krech
Michele Krech also drew attention to how faulty assumptions about the science of oral contraceptive pills were used to make these regulations seem reasonable and proportionate.
So let me put it this way: if the effectiveness of the oral contraceptive pill as a means of complying with the gender test regulations is questionable, and it is, then we cannot say that the regulations are reasonable. And similarly, if the harms of oral contraceptive pills when used for this particular purpose are not properly calculated and taken into account, then the regulations cannot be considered proportionate.
Sex-testing regulations not only violate human rights, but also put doctors at risk, where they are likely to breach their ethical obligations by complying with these regulations.
It is not possible to simply rely on doctors to implement World Sports regulations, because doing so will often conflict with their ethical obligations to patients.
Michele Krech
Michele Krech pointed out that reliance on these data being generated about the effectiveness and safety of oral contraceptive pills has distracted attention from the central harm associated with these regulations: that it is a medically coercive, but not medically beneficial, physical intervention.
The two wrong assumptionsas discussed in the paper and webinar are:
- Oral contraceptive pills are an effective and exclusive method of compliance
- Oral contraceptive pills are not harmful because many women use them for contraception
Katrina Karkazi discusses these cases in detail in the webinar and explains how they were accepted. She emphasizes:
Even if using oral contraceptive pills to comply with the regulations carries exactly the same health risks that one might have using them for contraception, there is absolutely no health benefit that can be balanced against them. the risks when used to comply with regulations. Oral contraceptive pills are not benign, no matter how many millions of women use them. But their use may be considered beneficial to a patient and physician in light of the desired health benefit or goal. But selection is fundamental to these decisions and the weighing of these risks and benefits. When the goal is just a single regulatory compliance like it is for these women. There is no free choice, no medical benefit, only harm, and chief among them is the forced manipulation of his body, which is a significant harm in itself.
Part of what allows this kind of dead end around ethics and human rights is the widespread perception among many, not only in the courts themselves, but a broader cultural perception among journalists among otherwise reasonable people, that the same oral contraceptives are no big deal. and that it is the key to women’s freedom, emancipation, choice and other things.
Our claim here is not, to be very specific, that oral contraceptives are bad. Our contention is how (the courts) instrumentalize this broader cultural view, to a very specific end, designed to infringe rights. And it’s this movement, which, frankly, a lot of people have lost… One of our hopes is that a wider group of people understand the manipulation of certain facts and arguments to the detriment of other women.
Katrina Karkazi
The webinar also includes two important recordings. The first has characteristics Dr. Ottmar Kloiberthe Secretary General of the World Medical Association discussing his stance and concerns regarding these coercive regulations brought about by World Athletics.
Our Declaration of Principles of Health Care in Sports Medicine, which was adopted 40 years ago, contains an explicit statement, and I quote, “The sports physician must be aware that methods, drugs or intervention, which artificially modify blood components, biochemistry , genome sequencing , gene expression or hormone levels and do not benefit patients violate the core principles of the WMA Declaration of Geneva, which states that “the health and well-being of my patient shall be my first consideration.”
Dr. Ottmar Kloiber
In the second recording, Dr Payoshini Mitraan athlete’s rights campaigner actively campaigning to end sex-testing practices in women’s sports talks to former Ugandan running champion Annette Negesawho was forced to undergo an invasive procedure requested by World Athletics to lower her testosterone levels.
I really didn’t have enough information about it. And they squeezed me, as if they didn’t give me a choice. Because I like sports, other kinds of sports. It’s something I really love so much. So it was something that gives me joy. And it makes me happy. And, as I say, they gave me no choice. So they pushed me.
Annette NegesaThis post by Katrina and Michelle talks about the birth control pill, which is often treated, not as seriously, obviously, as life-changing surgery. But there are harmful effects of any form of hormone therapy that your body doesn’t really need. But you only do it because you want to compete in sports.
Dr Payoshni Mitra
Alice Miller sums up the impossible position in which female athletes are often placed.
You are between a rock and a hard place as an athlete trying to protect your rights or challenge World Sport’s practice of regulating sports, that is, you can go to your country and protect your rights. they use their constitution and international human rights treaty rights and protect you and now you can’t compete.
Alice Miller
You can now watch the entire recording of this webinar here at the link below and hear directly from these experts as we approach the hearing date in Caster Semenya’s case.
Through this webinar, we hope to raise awareness and dialogue and encourage reproductive health advocates around the world to share and discuss this issue, to ensure that all athletes can exercise bodily autonomy and protect themselves their human rights without being subjected to coercive medical treatment is based on false assumptions.
