What scientific evidence challenges the link between testosterone and intersex athletic performance?

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Scientific Evidence Suggests Talent, Not Testosterone, Drives Intersex Athletic Success

Scientists have challenged the direct link between testosterone levels and athletic performance, particularly in intersex athletes, asserting that talent and other factors are more significant drivers of success. This perspective contrasts with regulations that seek to limit testosterone levels in female athletes with intersex variations. The debate centres on fairness in women's sports and the extent to which naturally occurring hormone levels constitute an unfair advantage.
Editorial Disagreement with Testosterone as a Performance "Elixir"

An editorial published in the British Medical Journal (BMJ) argues that the perception of testosterone as the "elixir of performance" is mythical and unsupported by scientific evidence. Cara Tannenbaum, a professor at the University of Montreal, and Sheree Bekker, a researcher at the University of Bath, co-authored this piece, stating there is no direct correlation between testosterone levels and athletic achievement. They suggest that the extraordinary feats of athletes like Caster Semenya are more attributable to divine favour or inherent talent rather than hormonal levels.
Overestimation of Testosterone's Role in Regulations

Experts have voiced concerns that regulatory bodies may be overestimating the impact of endogenous testosterone on athletic capabilities. Peter Sonksen, a retired professor of endocrinology, has stated that the International Association of Athletics Federations' (IAAF) proposed rules, which mandate intersex female athletes to maintain testosterone below a certain level, "greatly overestimates the role of endogenous testosterone." This sentiment suggests that such regulations might be disproportionately targeting athletes based on a limited understanding of hormonal influence.
Conflicting Studies and Expert Opinions

While the BMJ editorial and some experts dispute the central role of testosterone, other scientific findings and expert opinions support the IAAF's stance. A 2017 study of Swedish female Olympians by Angelica Linden Hirschberg indicated a correlation between higher natural testosterone levels and improved athletic performance. Furthermore, Joanna Harper, an expert on transgender sportswomen who provided evidence to the IAAF, suggested that in certain intersex conditions, women may experience "pretty much full male advantage when they go through puberty," implying a significant performance enhancement. These divergent views highlight the complexity and ongoing debate within the scientific community regarding DSD (Differences of Sex Development) and its impact on elite athletics.

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What scientific evidence challenges the link between testosterone and intersex athletic performance?

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