The USADA Allows Doping by Pretending There Are Sexless Runners

The ‘nonbinary’ category is a question-free zone where anyone can misrepresent themselves and gain approval to dope with impunity.

Image Credit: Mukhina1 on iStock

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About the Author

Sarah Barker

has been a journalist for forty years, a runner longer than that, and a woman her entire life. She has grown increasingly concerned about the rise of gender ideology and its implications for the sex-based rights of women and girls. As a lifelong runner, she is particularly disturbed by the intrusion of males who identify as women in female sports. In response, she has started a Substack-based publication called The Female Category where she publishes interviews, studies, and essays from those who support sex-segregated women's sports.

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This story started out as a straightforward account of what seemed like a doping incident in athletic competition. Cal Calamia, who earned second place in the “nonbinary” category at the 2022 Chicago Marathon and the 2023 Boston Marathon, has openly admitted to her use of testosterone, a substance banned in sports competition, in interviews with the San Francisco Chronicle and the New York Times. She also disclosed her consumption of exogenous testosterone over the past four years in a TikTok video.

This admission seems ill-advised for an athlete who podiumed at two World Marathon Majors. Testosterone is universally prohibited in competitive sports for both men and women, with rare exceptions granted to men via a Therapeutic Use Exemption for legitimate medical needs; women, according to the US Anti-Doping Agency (USADA), have never and cannot received such an exemption.

Calamia, a female who competed as such until 2018, underwent a mastectomy, changer her pronouns to “he/they,” and changed her name to Cal. Following this, she began a regimen of testosterone that resulted in the growth of facial hair. This transition appears starkly binary, raising questions about the true nature of the nonbinary category in athletics.

I reached out to both the esteemed Boston Athletic Association (BAA) and the organizers of the Chicago Marathon to inquire about their policies that appeared permit a high-ranking participant to openly consume a banned substance and the implications this might have for other runners. Their responses were disappointingly vague, and I began to suspect a troubling lack of clear policy regarding the nonbinary category.

The Chicago Marathon’s response was particularly evasive:

Thank you for reaching out! The Bank of America Chicago Marathon strives to create a welcoming experience for all participants. As a part of our commitment to inclusivity, participants starting in 2022 had the opportunity to select non-binary as a gender identity at the point of registration. While we were excited to introduce the non-binary division, we recognize the opportunity for continued dialogue and learning as we develop best practices related to this and all aspects of the race experience.

The response from BAA was similar. It appears that these esteemed racing organizations may have succumbed to the pressures of gender identity ideology without fully contemplating its implications. The nonbinary category is a seemingly unregulated space where any competitor could declare any gender identity and use the necessary drugs to “affirm” it without running afoul of anti-doping policies. Their worst fears seem to be materializing as the nonbinary category attracts opportunists who desire to use banned substances. Despite these realities, they are doubling down on their position.

Unsatisfied with the responses from BAA and the Chicago Marathon, I turned to the US Anti-Doping Agency (USADA), the trusted arbiters of fairness in sport with experts who brought down Lance Armstrong. A representative responded within an hour, but my questions were met with evasion and delay, under the pretext of representatives “traveling” for the next three weeks. The standoff ended when I threatened to airdrop this story onto the laps of every editor I could think of, and USADA responded promptly with answers that were a veritable assault on logic and decency.

Thus, the focus of the story shifts from Cal Calamia, the much-lauded diversity darling of the BAA, Chicago Marathon and New York Road Runners, to USADA’s uncritical adoption of untested, unverifiable gender ideology that is considered laughable by credible scientists.

I present below their replies to my inquiries, in all their incomprehensible detail.

USADA maintains a gold standard anti-doping program that is both inclusive and fair for all athletes under our jurisdiction in accordance with the applicable rules. We do not condone the use of any prohibited substances or prohibited methods without an approved and up-to-date Therapeutic Use Exemption (TUE) on file, including, but certainly not limited to, the use of testosterone. While we cannot comment on any specific athlete’s situation, as it relates to transgender and nonbinary athletes, we hold them to the same standard as all other athletes in their identified gender categories.

Inclusive? An anti-doping program is one of the few things you’d actually want to be inclusive of trans identified and purportedly sexless people, so kudos for that. However, this is just code for allowing trans and nonbinary people to do whatever they want all the time.

On the surface, the implication is that Cal Calamia holds a TUE for testosterone, but more on that later. The USADA continued:

Importantly, event organizers and sports organizations sanctioning events are responsible for determining eligibility criteria for participants, including any relevant transgender and nonbinary eligibility and category policies. USADA is responsible for administering anti-doping rules, as they pertain to prohibited substances and methods, including an athlete’s need for any Therapeutic Use Exemption (TUE) under the rules

The term “eligibility criteria” may imply that the nonbinary category is robustly vetted, but it’s not. The “criteria” amount to nothing more than checking a box. The winner of the Boston Marathon nonbinary category has raced in male, female, and nonbinary categories. By offering a nonbinary category, race organizations are relinquishing any grasp on reality, and must accept whatever identity the entrant tells them. By USADA’s account, the race organization—BAA or Chicago Marathon—informs them of the athlete’s declared gender, and it is their job to comply, regardless of any obvious discrepancies with biological reality.

Q: Are podium finishers in the nonbinary category of major marathons drug tested as are M/F podium finishers?

Under the World Anti-Doping Agency (WADA) International Standard for Testing and Investigations (ISTI), there is no absolute requirement to test podium finishers in all event categories. And doing so is not necessarily the best anti-doping strategy. That said, the ISTI does not exempt nonbinary category runners from testing, and they are therefore subject to the same anti-doping rules as competitors in the male and female categories. In the U.S., unless USADA selects the event for testing under its national anti-doping program, the event organizer or the sanctioning body for the event are responsible for contracting in-competition testing.

While it seems inconceivable that the top three male and female finishers at the Boston, Chicago, and NYC marathons would not be subject to drug testing, this policy provides USADA with an out if there are elements in the nonbinary category they would much prefer to leave undiscovered.

Q: Can female people who enter the nonbinary category receive a TUE for testosterone?

We understand that female athletes are not eligible for the nonbinary category. Only those who identify as nonbinary – neither male nor female – are eligible for the nonbinary category. These eligibility determinations are ultimately up to the event organizer and/or sanctioning body for the event. That said, all athletes, regardless of sex or gender identity, subject to the World Anti-Doping Code, can apply for a TUE for any substance if used for legitimate medical reasons, including testosterone. As mandated under the WADA International Standard for Therapeutic Use Exemptions (ISTUE), an independent process exists whereby any athlete may apply for a TUE and have their application evaluated by an independent TUE Committee of physicians. Each application is evaluated on a case-by-case basis according to its own merit. Depending on the competition level of the athlete, the TUE application may be evaluated by USADA (national-level athletes) or an International Federation (international-level athletes). Athletes may appeal any decisions as per the applicable rules. One of the key criteria is whether there will be a performance enhancing benefit if the TUE is granted. If there is one, then it will not be granted or will be limited to certain categories or only for certain uses.

The assertion that Calamia is neither male nor female simply because she declared herself to be nonbinary is insulting to reason. All those obviously female bodied athletes named Katie and Alice and Callie in the nonbinary category are apparently not female, they’re nonbinary. By USADA’s logic, they belong to a third sex or no sex at all because they ticked off the nonbinary box on their entry forms.

However, the USADA grants TUEs for testosterone based on biological sex, not gender identity. Is USADA pretending that Calamia is not female because she entered the nonbinary category? Does testosterone suddenly not enhance performance once certain gender identities are proclaimed? It is important to clarify that race organizations, USADA, and Calamia herself are all fully aware of her biological sex. It is therefore disingenuous to perpetuate this nonbinary narrative.

Q: Can female people who run in the female category receive a TUE for testosterone?

Yes, but USADA has never approved one. Cisgender females who compete in the female category can apply for a TUE for testosterone, but it would be exceedingly rare for it to be approved based on current medical practice.

The deference USADA exhibits towards gender pseudoscience is concerning for an organization purporting to be grounded in science. Women are not “cisgender,” they’re female.

USADA acknowledges there has never been an instance when a female requires testosterone, so they’re simply pretending that Calamia is not female. A female using testosterone in the female category is doping, but a female in the nonbinary category who uses testosterone is granted a TUE and is held up as a pioneer in the sport.

Q: Can males running in either NB or male categories receive a TUE for testosterone, and if so, under what circumstances?

Here again, it is our understanding that cisgender males are not eligible for the nonbinary category. For cisgender male or transgender male athletes in the male category, TUEs may be granted for testosterone in accordance with the applicable rules. WADA guidance documents are available to assist in evaluation of these TUEs.

The oft-repeated phrase “it is our understanding” seems to be a subtle evasion of responsibility by USADA. This whole con depends on maintaining pretense of ignorance regarding the sex of certain athletes.

Q: Cal Calamia thinks of herself as transmasculine/nonbinary (leaving a lot of options open) but science says she is and always will be female. What sex does USADA see Calamia as?

We cannot comment on any specific situation. We do not determine how an athlete identifies themself.

The only medical need for testosterone that Calamia could claim is to maintain masculine characteristics that align with her “gender identity.” But this is because she’s female. If she was a nonbinary-identified male like Jake Caswell, she would not need testosterone.

By issuing a TUE to Calamia, USADA is tacitly admitting that she is indeed female and that the nonbinary category encompasses individuals of male and female biological sex, despite “eligibility criteria.”

Q: Calamia told the San Francisco Chronicle she doesn't enter as male because she takes testosterone, so is the NB category the doping-accepted category?

No, there is no doping accepted category under the World Anti-Doping Code (Code), as that would be unfair to athletes and against the rules.

It seems that race organizations and USADA have been negligent with the doping rules pertaining to runners who identify as trans and nonbinary, allowing infinite flexibility. The formula for acquiring a TUE and using performance-enhancing drugs without restriction is this: First, check the nonbinary box. Second, start using testosterone. If you’re male, apply for a TUE citing fatigue. If you’re female, apply for a TUE in order to maintain alignment with a male or nonbinary identity. This allows you to legally cheat.

Q: Regardless of their gender identity, nonbinary runners are still either male or female. Calamia got tons of press in both Chicago and Boston, and was recently on a panel discussion of nonbinary runners sponsored by the NYRR. If it’s okay for Calamia to take an illegal substance in the NB category, why not anyone else?

Under the applicable rules, no athletes – cisgender, transgender, gender-diverse or nonbinary – are permitted to take prohibited substances without an up-to-date, valid TUE recognized by the relevant Anti-Doping Organization, such as USADA and/or an International Federation depending on their level and the level of the competition.

Indeed, it appears my initial suspicions were correct. The nonbinary category is the Wild West, a question-free zone where anyone can misrepresent themselves and gain approval to use prohibited substances from the very organization tasked with preventing it. Calamia, one high-profile individual, has publicly showcased her testosterone use on social media. Certainly there are others who aren’t on the podium, who aren’t advertising the fact, or who may have not applied for a TUE. The nonbinary category has already proven attractive to those desiring an easy route to success; it’s becoming a preferred choice for those who wish to dope with impunity.

By swallowing gender ideology, USADA has divorced itself from reality to an extent that it cannot effectively perform its primary function of ensuring fair play. It is regrettable that esteemed organizations like the Boston Athletic Association (BAA), the Chicago and NYC Marathons, and USADA are being played for fools by gender identity ideology. It is even more unfortunate that in doing so they’re dragging the running community down with them.

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