A/HRC/44/26 characteristics to reduce their blood testosterone to a specified level so as to maintain eligibility to compete in the female category. 32. Various athletes from around the world have been affected by these sex testing regulations, including María José Martínez-Patiño (Spain) and Ewa Klobukowska (Poland).60The most well-known women affected in the last decade, however, have been from sub-Saharan Africa and South Asia, including Santhi Soundarajan and Dutee Chand (India), Caster Semenya (South Africa), Annet Negesa (Uganda), Margaret Wambui (Kenya) and Francine Niyonsaba (Burundi). Reports of these and other athletes from the same regions undergoing investigations and/or medically unnecessary and potentially harmful procedures are being published and investigated, as well as challenged by the women themselves. 61 33. In a letter to IAAF regarding the 2018 regulations, three United Nations human rights experts raised concerns that the regulations effectively legitimize the surveillance of all women athletes based on stereotypes of femininity, adding that the regulations would in effect single out a group of women athletes, putting them at risk of repercussions far beyond the inability to compete while also subjecting them to shame, ridicule and intrusion upon their personal and private lives. Additional harms stemmed from the implication that the women need to be “fixed” through medically unnecessary interventions with negative health impacts.62 As Caster Semenya has stated, “I have been subjected to unwarranted and invasive scrutiny of the most intimate and private details of my being”.63 34. The implementation of female eligibility regulations denies athletes with variations in sex characteristics an equal right to participate in sports and violates the right to nondiscrimination more broadly. Current approaches to regulating female eligibility may have a negative impact on athletes’ enjoyment of their human rights and may amount to violations of the following rights: (a) The right to freedom from torture and other cruel, inhuman or degrading treatment or punishment. The Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, alongside other mandate holders, has emphasized that while the 2018 IAAF regulations do not force athletes to undergo any assessment or treatment, they leave athletes with a difficult choice: to undergo intrusive medically unnecessary assessments and/or interventions that have a negative impact on their health and well-being or to be banned from sport. Such treatments also entail the risk of harm to physical and bodily integrity that may amount to violations of the right to be free from cruel, inhuman or degrading treatment or punishment and even torture; 64 (b) The right to work and to the enjoyment of just and favourable conditions of work. Female eligibility regulations may be contrary to the right to work since, in practice, they may constitute a barrier limiting disproportionally equal access to work for athletes with variations in sex characteristics. Furthermore, they may require unnecessary physical alterations of one’s body as a precondition to working as an athlete and continuous invasive monitoring as an ongoing condition of work; 65 (c) The right to the highest attainable standard of physical and mental health. The enjoyment of this right may be put at risk when athletes are pressured into making critical 60 61 62 63 64 65 8 Vanessa Heggie, “Testing sex and gender in sports”. See, for example, P. Fénichel and others, “Molecular diagnosis of 5 alpha-reductase deficiency in 4 elite young female athletes through hormonal screening for hyperandrogenism”, Journal of Clinical Endocrinology and Metabolism, vol. 98, No. 6, (2013), pp. E1055–E1059; Z.K. Goh, Evelyn Watta and Ed Knowles, “DSD athletes: what does it mean to be DSD and how gender and sex are the big issues in athletics”, 25 September 2019 (available from www.olympicchannel.com/en/stories/news /detail/semenya-niyonsaba-wambui-what-is-dsd-iaaf-regulations); Ruth Padawer, “The humiliating practice of sex-testing female athletes”, The New York Times, 28 June 2016; and Geneva Abdul, “This intersex runner had surgery to compete. It has not gone well”, The New York Times, 16 December 2019. See www.ohchr.org/Documents/Issues/Women/WG/Communications/OL-OTH-62-2018.pdf. “Caster Semenya’s comeback statement in full”, The Guardian, 30 March 2010. Vanessa Heggie, “Testing sex and gender in sports”. Committee on Economic, Social and Cultural Rights, general comments No. 18 (2005) on the right to work, paras. 12 (b), 23 and 31, and No. 23 (2016) on the right to just and favourable conditions of work.