Reports from Switzerland reveal South Africa’s two-time Olympic champion Caster Semenya has lost what is considered her final appeal of restrictions on testosterone levels in female runners. The ruling by Switzerland’s Federal Supreme Court dashes what is likely the out lesbian runner’s last chance to compete in the 800-meter race next summer in Tokyo — or in any organized track competition on earth, for that matter.

Outside court, Semenya told reporters including the BBC she was disappointed but not deterred, and will never agree to medical intervention to lower her naturally-high testosterone levels in order to compete.

“I am very disappointed,” the 29-year-old South African said. “I refuse to let World Athletics drug me or stop me from being who I am.”

World Athletics officially changed its rules in 2019 to bar Semenya and other athletes with natural testosterone levels far above the standard range for women athletes, to compete in events between 400m and a mile, unless they take testosterone-reducing drugs.

South African 800m Olympic champion Caster Semenya competes in the women’s 200m during the Athletics Gauteng North Championships at the LC de Villiers Athletics Stadium in Pretoria on March 13, 2020.

In March, Semenya announced she would attempt to qualify to compete in the 200m Olympic race next July at the postponed Tokyo Summer Games. If she qualifies, there is no restriction in that competition requiring medical intervention.

The Swiss Supreme Court ruling is a victory for track’s governing body, following an extended court battle with Semenya that started in 2018 when World Athletics sought to restrict intersex athletes who have a disorder of sexual development, or DSD. Any female athlete found to have both X and Y chromosomes, the standard male pattern, would have to lower their testosterone levels to keep competing in women’s events like Semenya’s signature event, the 800m. She’s won two gold medals at the Olympics and three World titles.

What’s just so outrageous about all this is that officials admit that these regulations are discriminatory, but claim they are “necessary” to preserve “a level playing field” in women’s events. The governing body argues that intersex athletes with testosterone in the male range have an unfair advantage in lean muscle mass, strength and oxygen-carrying capacity. The lowest level in the male testosterone range is four times greater than the highest level in the women’s range, according to the governing body.

Human Right Watch, however, argues this is unscientifically sound, a violation of women’s rights as well as sexist, misogynist and unnecessarily invasive.

“The regulations compel these women to undergo medical interventions or be forced out of competition,” HRW director of global initiatives Minky Worden writes. “Identifying which athletes are impacted by the regulations will be done through subjecting all women athletes’ bodies to public scrutiny and requiring those that seem ‘suspect’ to undergo a medical examination. Men athletes are subject to no such surveillance or compelled medical tests.

“There is no clear scientific consensus that women with naturally occurring higher-than-typical testosterone have a performance advantage in athletics,” Worden stressed. “For these women athletes, being compelled to undergo a medical examination can be humiliating and medically unnecessary, as well as disrespectful of their rights.”

In addition, the Office of the United Nations High Commissioner for Human Rights has called for the regulations to be revoked.

Semenya also has supporters at the World Medical Association, which has asked doctors to not implement the World Athletics regulations, and questions the ethics and potential harm of requiring athletes to take hormone therapy not based on medical need. Such intervention could potentially be harmful.

“Excluding female athletes or endangering our health solely because of our natural abilities puts World Athletics on the wrong side of history,” Semenya told reporters. “I will continue to fight for the human rights of female athletes, both on the track and off the track, until we can all run free the way we were born. I know what is right and will do all I can to protect basic human rights, for young girls everywhere.”

Will she find a way to fight this? The New York Times reports Semenya’s attorneys said she was still considering her legal options.

And although Semenya is not transgender, and has never confirmed she is in fact intersex, The Times sees the Semenya ruling as impacting the inclusion of trans women athletes in women’s sports:

“The outcome of Semenya’s case has been widely anticipated for a number of reasons, including the separate issue of transgender athletes who have transitioned from male to female and whether they possess residual physical advantages that might be unfair.

“It has been expected that, after the Tokyo Games, the International Olympic Committee will adopt the same testosterone limits for transgender athletes that World Athletics has imposed on intersex athletes.”

And so it goes.