A/HRC/44/26 decisions based on concerns of sport eligibility rather than health and well-being. Female eligibility regulations may push some athletes to undergo investigations, tests and interventions, for example to lower testosterone levels, which may have negative physical and mental health impacts. The panel of the Court of Arbitration for Sport reviewing Ms. Semenya’s case agreed that the requirement to undergo intimate examinations to determine the extent of her “virilization” was “highly intrusive and could result in psychological harm”.66 The regulations also create the risk of unethical medical practice, particularly when the informed consent of the person concerned is not required, and violations of the general prohibition on medically unnecessary procedures.67 The Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health has stressed that informed consent to any medical intervention goes beyond mere acceptance and must be voluntary and sufficiently informed in order to protect human dignity and autonomy. Particular care is required where there are power imbalances resulting from inequalities in knowledge, experience and trust between health-care providers and individuals, particularly those from vulnerable groups.68 In sport, such power imbalances are compounded by athletes’ dependency on the sports federations requiring such medical interventions and the frequent absence of adequate and holistic support during the decisionmaking process; (d) The right to sexual and reproductive health. This right may be put particularly at risk by unnecessary medical interventions that affect hormones and reproductive anatomy and capacity;69 (e) The right of everyone to be free from arbitrary interference with their privacy. This right is at risk of being violated when women’s names and personal details are made public and/or are shared in the media. History demonstrates that, because these regulations are applied in hundreds of countries, among many actors, it is impossible to guarantee privacy. The panel of the Court of Arbitration for Sport has acknowledged that foreseeable circumstances (such as the absence of certain athletes in restricted events in international competitions for which they have qualified in national championships) “would be likely to render confidentiality meaningless in some cases”;70 (f) The right to respect for the dignity, bodily integrity and bodily autonomy of the person. This right includes the ability to make fundamental decisions about one’s life and health. Meaningful decision-making relies not just on formal legal capacity but on the material conditions, social support and freedom from harm or coercion. 71 Female eligibility regulations may therefore take away the ability of athletes to control their bodies and the trajectory of their sporting and post-sporting life.72 35. States’ human rights obligations include the application of the principle of due diligence enshrined in multiple human rights treaties, pursuant to which they must prevent, investigate and redress human rights abuses committed by others. 73 66 67 68 69 70 71 72 73 Court of Arbitration for Sport, Mokgadi Caster Semenya v. International Association of Athletics Federations, Case No. CAS 2018/O/5794, arbitral award, 30 April 2019; and Athletics South Africa v. International Association of Athletics Federations, Case No. CAS 2018/O/5798, arbitral award, 30 April 2019. World Medical Association, “Physician leaders reaffirm opposition to IAAF rules” (15 May 2019). A/64/272, para. 26. See communication of 18 September 2018 submitted by special procedures of the Human Rights Council to IAAF on regulations regarding eligibility for the female classification (athletes with differences of sex development) (OL OTH 62/2018). Mokgadi Caster Semenya v. International Association of Athletics Federations and Athletics South Africa v. International Association of Athletics Federations. UN Millennium Project 2005, Who’s Got the Power? Transforming Health Systems for Women and Children, (London, Earthscan, 2005). Walter Kälin and Jörg Künzli, The Law of International Human Rights Protection (Oxford, Oxford University Press, 2009). Submission of Sexual Rights Initiative. See Committee on the Elimination of Discrimination against Women, general recommendation No. 35 (2017) on gender-based violence against women, updating general recommendation No. 19. See also A/74/137, the Guiding Principles on Business and Human Rights, the Declaration on Fundamental Principles and Rights at Work and its Follow-up of the International Labour Organization (ILO), the ILO Discrimination (Employment and Occupation) Convention, 1958 (No. 9