DSD athletes ban: How testosterone ruined an Olympic dream

"When you are in your mother's womb, you can't decide how you are born."

Annet Negesa, a former Ugandan middle-distance runner, was once a rising star on the global athletics stage. 

As a teenager she broke national records in the 800 meters and the 1,500 meters and at the age of just 19, Negesa won gold medals in both disciplines at the 2011 All-Africa Games.

Having qualified for the 2012 London Olympic Games, and with her sights set on the ultimate success, she was dealt a blow she would never recover from.

Medical intervention that proved costly

As her preparations were gearing up, Negesa received a phone call from her international manager informing her World Athletics said she had been banned from competing due to her naturally high testosterone levels.

According to the now-32-year-old, with little time before the London Games she felt forced into a medical procedure to lower her testosterone levels in order to compete. 

"When I was told I was not going to be able to be in London, it distorted everything in my mind," she told DW. "It was my dream to be in the Olympics and was something which I was really well prepared for. I was in a rush and I felt there was no time for me to think about what I had to do."

"They came with a suggestion that if I didn't take the medication, I would no longer be running and they said if I didn't want to take medication, I should go and run with the men."

"So, because of the love of the sport and not knowing the consequences that would come, I agreed to the medication and did what the World Athletics doctors called a 'simple surgery'. I didn't know that it would bury me away from the sport."

Negesa went on to explain that she was flown to Nice in France to undergo medical tests immediately after her ban was imposed in 2011. It was suggested her internal testes be removed in order to facilitate lowering her testosterone levels – a surgery which took place in Uganda.

World Athletics strongly refuted the claims Negesa made regarding feeling forced into making any medical decisions, which first came to light in a 2019 documentary by German broadcaster ARD. On March 25, 2025, the organization tightened its rules on such issues, requiring athletes to take a non-invasive DNA test in the form of a cheek swab or dry blood test. The new rules also bar DSD athletes from competing in the female category.

"We’ve been to the court of arbitration on our DSD regulations," said the organizations president Sebastian Coe. "They’ve been upheld, and they’ve again been upheld after appeal. We will doggedly protect the female category, and we’ll do whatever is necessary to do it." 

Current rules being made by those with little understanding

After the surgery, Negesa took medication to reduce her testosterone levels in the hope of being able to compete once more. But the Ugandan found there were far-reaching consequences which left her with several health issues. Unable to compete at the same level, Negesa lost her scholarship, her career and her income.

"Mentally I was not well, and I had no one to talk to, explain what I was going through," she said.

"My body was never the same as it was at first. I developed high blood pressure, my heart rate was always high and my bones were starting to become weak because there were no hormones in my body." 

When Negesa's accusations against World Athletics came to light, it sparked outrage.

World Athletics said the claims that they forced any athletes into medical decisions were incorrect, saying they offered advice only to athletes on ways to help them compete. The organization justified its policies by citing the need for fairness in women’s sports. They argue that elevated testosterone levels provide certain athletes with a competitive advantage.

However, Negesa believes that those in a position to create the criteria for athletes to be eligible to compete do so without an adequate understanding or background.

"They should not be the ones to choose," she said. "Let them be born with high levels of testosterone. It's not something like taking drugs, you're naturally born this way."

Negesa turns struggles into advocacy

Even the 2019 decision to come forward with her story had far reaching consequences.

In Uganda, she struggled with social stigma, inadequate medical support, and the emotional toll of her ordeal.

Unable to rebuild her life in her home country, Negesa sought asylum in Germany where she found refuge and access to better healthcare.

While starting over in a foreign country, far from her family and support system was not easy, it also marked the beginning of her advocacy journey.

Negesa began working with the human rights organization Humans of Sport, advocating for other DSD athletes who have found themselves with few places to turn to.

While the Paris Olympics brought the issue of DSD athletes to fore and with the International Olympic Committee (IOC) having elected a new president in March, Negesa is hopeful that the future will be kinder to athletes in her position.

"I'm a whistleblower for those voiceless athletes there who are suffering," she said. "They're in silence, not even knowing what to do next and I want to help them.

"My biggest hope for the future, and with the new IOC president, is that sport becomes fair to everyone, no segregation, no discrimination and no violating people's human rights or athletes' human rights and dignity."

Edited by: Matt Pearson