"The Swiss-based Court of Arbitration for Sport addressed a complicated, highly charged question involving fair play, gender identity, biology and human rights... Since competition is divided into male and female categories, what is the most equitable way to decide who should be eligible to compete in women’s events?"

"Restrictions on permitted levels of naturally occurring testosterone are discriminatory, the court ruled Wednesday in a 2-to-1 decision. But, the panel added, such discrimination is a 'necessary, reasonable and proportionate means' of achieving track and field’s goal of preserving the integrity of women’s competition.... The [International Association of Athletics Federations] had argued that athletes classified with 'differences of sexual development' — particularly those who possess testes and natural testosterone levels in the male range — gain an unfair advantage in women’s events from 400 meters to the mile in terms of additional muscle mass, strength and oxygen-carrying capacity.... [Caster Semenya's] lawyers said in a statement that they might appeal Wednesday’s decision, arguing that 'her unique genetic gift should be celebrated, not regulated.' The I.A.A.F. accepts athletes with differences of sexual development as legally female. For competitive purposes, though, it effectively considers them biologically male. And now the federation has been given the go-ahead to put in place a rule requiring these athletes to medically limit their testosterone levels in certain women’s events that synthesize speed, power and endurance. This is necessary to provide a level playing field in races that can be won by a margin as small as a hundredth of a second, the I.A.A.F. contends. To do nothing, it has said, risks 'losing the next generation of female athletes.'"

From "Court Bars Women With High Testosterone From Some Track Races" (NYT).

Some bioethicists say "it's unacceptable to ban some female athletes for insufficient femininity."

The IAAF policy bans female athletes with with hyperandrogenism — that is, high testosterone levels — unless they treat their condition with surgery or drugs. The bioethicists are saying this violates the individual's privacy and that "testing for testosterone levels alone is inadequate and completely simplistic."

Rebecca Jordan-Young, a... co-author of the report, has said, "Individuals have dramatically different responses to the same amounts of testosterone, and it is just one element in a complex neuroendrocrine feedback system." Moreover, it's not known what typical testosterone levels even are for elite female athletes.

"[T]he IAAF now have the whole ANC and the whole of South Africa on their backs."

After the International Association of Athletics Federations finds that runner Semenya Caster lacks a womb and ovaries and has internal testes and that this is reason to disqualify her from women's competitions and strip her of her medals, South African politicians are saying it's "racist and sexist":

[A]n IAAF source was today quoted as saying: "There certainly is evidence now that Semenya is a hermaphrodite.... Everything is going to have to be done absolutely by the book, no question of a challenge to our findings. There's all sorts of scans you do. This is why it's complicated. In the past you used to do a gynaecological exam, blood test, chromosome test, whatever. That's why the findings were challenged, because it's not quite so simple. So what they do now is they do everything, and then they can say look, not only has she got this, she's got that and the other. The problem for us is to avoid it being an issue now which is very personal: of the organs being a hermaphrodite, of not being a 'real' woman. It's very dramatic."

And the family sees it in terms of religion and their own personal history:

"It is God who made her look that way but she IS a girl."...

The athlete's uncle Lesiba Rammabi, 51, said her relatives were 'very humiliated' by the reports.

He said: "I believe Caster is normal, inside and out. What does it matter whether she can have babies or not? Many people cannot have children, why else do parents adopt? Are those women not women also? We are a normal family who looked at a child when she was born, saw that she was a girl and raised her as any other family would do. Are we now being told that we are wrong? We are very humiliated by what has been said and do not understand how it can be true. This is a woman who was raised a female. She will always be female, no matter what people say."

That would all be fine except for the fairness to the other athletes. And there is also the question of what Caster herself wants to do. You could be raised as a female because that's what your parents thought you looked like but on reaching puberty decide they made a mistake. She didn't dress in a feminine style but she did go along with this makeover and photoshoot for You magazine:

 

But what does it mean? Quite aside from whether she looks feminine in that picture, it was, after achieving high status in women's running, in her interest to encourage people to think of her as female.