A/HRC/32/33 spaces for girls and women to confidently participate in sport, this should not result in exclusion of others, such as transgender people. 54. States should identify groups that are currently excluded from sport and physical activity, and through participatory mechanisms, create an inclusive culture wherein lesbian, gay, bisexual, transgender and intersex people and other historically excluded groups and individuals can fully and safely participate in sport. Intersex people 55. Current and historic policies have resulted in intersex people — those born with sex characteristics that do not fit with typical binary sex categorization — experiencing multiple rights violations. Sex testing has frequently been conducted to avoid the apparent threat of “sex fraud” (participating under an assumed gender to obtain a competitive advantage).44 However, no single test “determines” gender. In the recent past, women athletes have undergone chromosomal testing, only to discover that they do not possess two X chromosomes. This has led to stigmatization and to spurious exclusion from competitive sport.45 56. Recently, certain international and national sporting federations have instead introduced policies banning women with testosterone levels exceeding a certain threshold from participating in competitive sport. However, there is insufficient clinical evidence to establish that those women are afforded a “substantial performance advantage” warranting exclusion.46 Although currently suspended, following the interim judgement in Chand v. Athletics Federation of India and the International Association of Athletics Federations,47 these policies have led to women athletes being discriminated against and forced or coerced into “treatment” for hyperandrogenism. In fact, a number of athletes have undergone gonadectomy (removal of reproductive organs) and partial cliteroidectomy (a form of female genital mutilation)48 in the absence of symptoms or health issues warranting those procedures.49 57. Sporting organizations must implement policies in accordance with human rights norms and refrain from introducing policies that force, coerce or otherwise pressure women athletes into undergoing unnecessary, irreversible and harmful medical procedures in order to participate as women in competitive sport. States should also adopt legislation incorporating international human rights standards to protect the rights of intersex persons at all levels of sport, given that they frequently report bullying and discriminatory behaviour,50 and should take steps to protect the health rights of intersex women in their jurisdiction from interference by third parties. Transgender people 58. Participation in professional sport is often deliberately or effectively denied to transgender people, and people of non-binary gender. There remains uncertainty regarding 44 45 46 47 48 49 50 14 J.C. Reeser, “Gender identity and sport: is the playing field level?” British Journal of Sports Medicine, vol. 39, No. 10. Erin Buzuvis, “Transgender student-athletes…” J.C. Reeser, “Gender identity and sport: is the playing field level?” CAS 2014/A/3759, Court of Arbitration for Sport. J.C. Reeser, “Gender identity and sport: is the playing field level?” Rebecca Jordan-Young, Peter Sönksen and Katrina Karkazis, “Sex, health and athletes”, British Medical Journal, vol. 348. Tiffany Jones and others, Intersex: Stories and Statistics from Australia (Open Book Publishers, 2016).