Endocrine Abstracts

The challenges of sport’s and their governing bodies to provide a balance between duty of care, inclusivity, fairness and safety when implementing eligibility criteria and policies in sport. Sport is an integral part of society contributing to health, social interaction, competitiveness, national identity, entertainment and the economy. Indeed, it both reflects and influences the culture of society. With that, the relationship between societal norms have seen the rules of sport constantly evolving. This is never more evident and complex than in inclusion of diverse populations within the sporting environment. In particular, this has become evident in women’s sports, where there has been longstanding balance between inclusivity, fairness and safety. An increasing number of countries and sports have now determined that protecting the integrity of female sport, fairness and sometimes safety, is best served by using biological sex as the determinant for participation, as per the UK Supreme Court ruling in 2025. This has seen the opportunity for transgender participation in many women’s sports now removed. However, the rules and policies to determine the participation of individuals with differential sex development are not captured in these rulings and indeed remain outdated or non-existent. This has seen high profile cases in Olympics, UK athletics and other sports reflect the lack of clarity in how to proceed when faced with a participant with a DSD condition. The impact of the decisions, testing methodology, social media and on the individuals are profound and supported by powerful testimony from those affected. There is no doubt that some DSD conditions produce advantageous masculinisation and performance benefits but characterising this is problematic and implications on new policy individuals of any widespread testing/screening program such as for SRY gene will be profound. The roles of the sports, through national and international governing bodies, working with expert groups are essential to create evidence based and measured policies. Prof Nick Peirce will attempt to illustrated some of the challenges of implementation from the perspective of a sport’s national governing body that oversees professional and recreational men’s and women’s sport and has a duty of care to its participants and the need to create, if necessary, case by case policies that try to marry the competing elements of complex medical condition and understandable eligibility policies.