What is the IOC's policy on intersex athletes in the Olympics?

1. How the IOC shifted from strict tests to a human‑rights framework — a clear break with the past

The IOC abandoned decades of mandatory sex verification and invasive procedures and, in November 2021, issued the Framework on Fairness, Inclusion and Non‑discrimination on the Basis of Gender Identity and Sex Variations, which explicitly frames eligibility as a matter for each sport federation to determine while grounding decisions in human rights principles. The Framework removed prior blanket medical mandates and cautioned against “medically unnecessary” procedures, recommending a 10‑principle approach to balance fairness and inclusion; it is non‑binding, intended as guidance rather than a universal rule ^{[1] [2]}. This marks a clear policy pivot from earlier eras of chromosomal and physical examinations toward respect for dignity and avoidance of harm, though the IOC left concrete eligibility mechanics to sport governing bodies.

2. The result: inconsistent federation rules and divergent testosterone thresholds across sports

Because federations now craft their own rules within the IOC’s framework, eligibility criteria vary sharply. World Athletics and other federations have imposed event‑specific testosterone limits (with thresholds variously reported around 2.5–5 nmol/L for particular events), while World Aquatics and others have taken different stances, including restrictions tied to male puberty in some competitions. That fragmentation produces a system where an athlete’s eligibility can change depending on sport and event, and where one federation’s medical criteria are not universally applied across Olympic disciplines ^{[4] [3] [5]}.

3. High‑profile disputes show the policy’s legal and ethical fault lines

Cases such as Caster Semenya and others have exposed both scientific disputes and legal challenges to federation rules. Court challenges and independent critiques argue that event‑specific testosterone regulations can be discriminatory and harmful, particularly for athletes with differences of sex development (DSD), while proponents defend such limits as necessary to preserve fairness in female categories. The IOC’s framework did not settle these disputes; instead it shifted contested decisions into the federations’ legal and ethical arenas, where results vary and litigation continues to shape outcomes ^{[4] [6] [5]}.

4. Medical, social and regional concerns the IOC’s framework leaves unresolved

The Framework emphasizes health, dignity, and non‑discrimination, but it does not resolve core scientific questions about how testosterone or other biological traits translate to competitive advantage across sports. Critics point out that thresholds are often based on limited evidence, may be sexist or regionally biased in enforcement, and can disproportionately affect athletes from the Global South. Because the IOC’s principles are non‑binding and rely on federations for implementation, concerns about coercive medical interventions, confidentiality breaches, and unequal impact remain salient and unresolved ^{[2] [7] [5]}.

5. What to expect next: continued fragmentation, litigation, and pressure for evidence‑based reform

The near‑term trajectory is continued fragmentation: federations will keep updating event‑specific rules, athletes will continue to challenge regulations in courts and human‑rights bodies, and advocacy groups will press the IOC and federations for clearer, evidence‑based, and rights‑respecting standards. The success of the IOC’s human‑rights approach depends on federations’ willingness to adopt transparent, medically sound, and legally defensible criteria — a process already underway but far from settled. Observers should watch federation rule changes, court rulings, and independent medical reviews as the decisive forces shaping future policy ^{[1] [3] [8]}.