The International Olympic Committee may feel fine hitting the pause button on implementing stricter participation guidelines for transgender athletes, but the International Association for Athletic Federations (IAAF) felt the need to double down on such measures Tuesday.

The IAAF announced that trans women athletes’ testosterone levels must be under five nanomoles per liter, the same limit previously instituted for intersex women athletes’ participation in mid-distance events dominated by South African runner Caster Semenya.

Ironically enough, the new rules were announced after an IAAF meeting in Doha, Qatar, the site of Semenya’s last IAAF Diamond League victory in May 2019.

Singling out trans athletes alongside intersex athletes in the ruling is bad enough, continuing a trend of othering women athletes who don’t fit a discriminatory and pedantic definition of femininity. But the IAAF’s new measures add further restrictions on trans women athletes, which make up roughly 1% of IAAF competitors, that go beyond the testosterone argument.

According to the new ruling, the IAAF will no longer recognize trans women athletes as female by law. Those competitors will now have to submit a signed declaration of their gender identity along with proof that their testosterone concentration has remained under the limit for a period of 12 months prior to competing. The ruling that effectively banished Semenya and other female athletes with naturally higher testosterone levels required a compliance period of six months prior to competing.

The IAAF’s announcement continues a controversial campaign based on heavily criticized findings from an IAAF-sponsored study. Both the United Nations and the World Medical Association condemned those new regulations as measures that can negatively impact the health of athletes that submit to the hormone therapy needed to adhere to IAAF guidelines.

The medications regularly used to diminish testosterone levels can bring hefty potential side effects: infertility, bone wastage, blood clots and liver and kidney issues.

“A governing body has no right to force treatment on another person. I wonder if there will be a doctor willing to prescribe this. I wouldn’t prescribe it,” gender specialist Dr. Helen Webberley told iNews. “I’m trying to think of another situation where you force people to take medicine to do their job. Forcing people to take medication against their will to do their job is abhorrent.”