A court in Switzerland has dealt a cruel blow to Caster Semenya, the double Olympian who has been fighting to compete like every other cisgender woman athlete in the world.

By a vote of 2-1, the Court for Arbitration for Sport decided Wednesday that for her to race again in the event in which she clearly excels, she and other runners like her must have their testosterone chemically suppressed.

The head-spinning ruling by the CAS called that rule “discrimination” and in the same sentence deemed it “necessary.”

“By majority, the CAS panel has dismissed the requests for arbitration considering that the claimants were unable to establish that the DSD regulations were ‘invalid’.

”The panel found that the DSD regulations are discriminatory, but the majority of the panel found that, on the basis of the evidence submitted by the parties, such discrimination is a necessary, reasonable and proportionate means of achieving the IAAF’s aim of preserving the integrity of female athletics in the restricted events.”

Semenya responded on Twitter with a meme that said “sometimes it’s better to react with no reaction.”

Despite international support for Semenya from athletes, scientists and experts, the court ruled against her, and agreed with the International Association of Athletics Federations’ argument that women athletes with differences of sexual development, often called DSD, including Semenya, have an unfair advantage over other women due to their higher testosterone levels.

The long awaited verdict limited the scope of new rules proposed by IAAF, which wanted to require all female athletes with DSDs to take testosterone blockers.

The IAAF’s new rules will apply to all women runners who are classified as having DSDs, who compete in federation events between 400 and 800 meters. The federation had wanted that restriction to apply up to the mile, but the CAS found that the evidence was not clear that women with elevated testosterone levels have a competitive advantage in the 1,500 meters.

What the IAAF can do now is require that runners in events up to 800m chemically reduce their blood testosterone level to below five nmol/L for at least six months before they will be allowed to compete. Plus, they will had to maintain a reading below that level going forward to continue as an athlete in those events.

What Semenya and athletes like her can do now is begin racing at distances longer than one mile; compete against men; enter competitions for intersex athletes, if such a thing ever exists, or walk away from the world’s most prestigious competitions like the 2020 Olympic Games in Tokyo she’s now preparing for.

She does have 30 days to appeal her case to the Swiss Tribunal Courts, as SB Nation reported, in the hopes that court will overturn the CAS ruling. Or she can agree to take androgen suppression medication in order to fall in line with the policy and compete, following the Diamond League meet scheduled for Friday in Doha. Despite the ruling, Semenya remains eligible to compete in that event. It may very well be her last.

As The New York Times reported, the IAAF considers athletes like Semenya as legally female, but for competitive purposes, “it effectively considers them biologically male.” Unless it took this action, the IAAF has said, it risks “losing the next generation of female athletes,” an argument widely used by opponents of transgender inclusion.

Semenya is not transgender, so this is not a case impacting trans athletes directly. But advocates for trans inclusion fear it will have far-reaching ramifications.

Semenya’s claim, according to her attorneys, was that forced medical intervention amounted to discrimination, and the CAS agreed with that part of her argument. “Her case is about the rights of women such as Ms. Semenya who are born as women, reared and socialized as women, who have been legally recognized as women for their entire lives, who have always competed as women, and who should be permitted to compete in the female category without discrimination,” said her attorneys in a February statement. There have been reports circulating for years that she was born with internalized testicles, but that has never been confirmed or announced publicly for privacy reasons.

Semenya won the 800 metre gold medals at both the 2012 and 2016 Olympics, and also won her third world title in London two years ago.

Semenya, 28, first appealed the proposed rule change last year and waited from February until today for a verdict.