By Laura RivardIntroductionLast month, The New York Times on Dutee Chand, afemale Indian sprinter who was recently barred from international competitiondue to elevated levels of testosterone. Chand, however, is not guilty ofdoping. She has hyperandrogenism, a condition which causes her body to naturally produce levels of testosteronethat are in the range of what is typical for males. Based on 2011 guidelinesenacted by the International Association of Athletics Federations (I.A.A.C.),Chand can return to competition only after lowering her testosterone levelsbelow the male range via hormone-suppressing drugs or surgery. There is noevidence that elevated levels of naturally produced testosterone give athleticadvantage. But, the number of women with hyperandrogenism competing in elitetrack and field events is 140 times greater than the average population, whichsuggests an association. Dutee Chand is challenging her ban by appealing hercase to the Court of Arbitration for Sport in Switzerland.
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Chand’s actions arenoteworthy in that she is the first in her situation to refuse medicalintervention, opting against altering the body she was born with. This caseraises myriad questions. Organizations like the I.A.A.C. Have clear rulesagainst athletes that use drugs to gain a competitive advantage. How thenshould sporting organizations manage athletes whose genetic makeup alters theirphysiology in a way that is consistent with doping but is, instead, completelynatural? Is it fair to allow them to compete against traditional athletes that, in comparison, have a significant disadvantage?Case StudyJameson“Jamie” Weaver is a 21-year-old collegiate track star, specializing in themile. He trains hard and has benefitted from excellent coaching throughout hiscareer.
However, Jamie has long suspected that he was “different” from otherathletes. He decides to undergo a complete medical exam before training for theOlympic Trials in 2016. His blood work reveals abnormally high levels of redblood cells (rbcs). Jamie’s physician, Dr. Chase, initially suspects that Jamieis illegally injecting Erythropoietin (EPO), a synthetic version of a natural hormonethat stimulates bone marrow to increase red blood cell production. EPO has beenprominent in the drug scandals that have plagued professional cycling foryears. Jamie convinces his doctor thathe is not doping.
Chase decides to order more tests to find a cause forJamie’s condition. Genetic screening reveals that Jamie has a mutation in hiserythropoietin receptor. His body lacks the feedback mechanism that signalswhen enough rbcs have been made. In fact, his body behaves as if he ispermanently at high altitude where oxygen is reduced.
As a result, he makes between 25-50% more rbcsthan an average person. Red blood cells carry oxygen, and this increasedcapacity is certainly a factor in Jamie’s success on the track. After learning his results, Jamie wonders ifhe should tell his coach or try to keep his condition a secret. He knows thathe is not guilty of cheating, but at the same time he is not comfortable withthe knowledge that he possesses an advantage that others need to take illegaldrugs to obtain. Jamie knows that he will be under intense scrutiny if he makesthe Olympics, and his genetic anomaly will likely be revealed.
He is unsure howto proceed and who to trust with the information.Please take our poll and leave a comment below. This is a complex problem with no easy answer.Sources:Epstein,David. National Geographic. October 7, 2013.Macur,Juliet. The NewYork Times.
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