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In historical terms, modern, codified sport was invented in Britain by men, for men and thus in their own interests. Games therefore centred on Victorian notions of athletic manliness and associated ideals of masculinity. This involved physical and biological appearance i. Reflecting the wider constraints of a patriarchal society, women were often disallowed from competing in several sports, or constrained from taking part in particular events within them. Women were, however, extremely important to Olympic national teams; after all, a medal for a female athlete counted the same towards the medal tally as that for a male athlete.
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Circulating Testosterone as the Hormonal Basis of Sex Differences in Athletic Performance

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Women Athletes Subjected to ‘Sex Testing’ are Faced With Impossible Choices – Foreign Policy

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End Abusive Sex Testing for Women Athletes

Since she first won an international track event in at age 18, the South African middle-distance runner Caster Semenya has had every aspect of her body subjected to scrutiny. Semenya is one of many women around the world targeted by regulations that require women with naturally higher-than-typical levels of testosterone to submit to so-called sex testing and undergo unnecessary medical interventions to reduce hormone levels in order to keep competing. Chand won her case, but World Athletics, the international governing body in global track and field, fought back with a similar regulation targeting middle-distance runners like Semenya.
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Prior to puberty, there is no sex difference in circulating testosterone concentrations or athletic performance, but from puberty onward a clear sex difference in athletic performance emerges as circulating testosterone concentrations rise in men because testes produce 30 times more testosterone than before puberty with circulating testosterone exceeding fold that of women at any age. There is a wide sex difference in circulating testosterone concentrations and a reproducible dose-response relationship between circulating testosterone and muscle mass and strength as well as circulating hemoglobin in both men and women. Suppression of elevated circulating testosterone of hyperandrogenic athletes results in negative effects on performance, which are reversed when suppression ceases. This would include all women other than those with untreated hyperandrogenic disorders of sexual development and noncompliant male-to-female transgender as well as testosterone-treated female-to-male transgender or androgen dopers.
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