Sarah Teetzel never made it to the Olympics as an athlete. In fact the former competitive swimmer says she never even came close. But she is perfectly fine with that.

Sitting in her office within the Faculty of Kinesiology and Recreation Management, Teetzel acknowledges she wasn’t competitive enough. This despite spending much of her teenage years in a pool in small-town Ontario and racing at the national level throughout university in her specialty: the 400 and 800-metre freestyle.

“I didn’t care enough if I won or lost,” says Teetzel, 33. “I loved training and the environment but was never set on winning. That element of wanting to be the best that most Olympians have, I didn’t have that.”

What the assistant professor does have is the fire required to win when championing human rights in sport. A sports ethicist who takes on controversial topics like doping and gender testing, she’s quick to point out how many of the rules and policies that govern sport would never fly in most other settings.

Consider the drug testing of child athletes; Olympic officials do random tests on kids as young as 14 at the youth version of the world’s most elite competition. “We can contrast this with the public school system. If a principal required a student to go into a bathroom and provide a urine sample under his or her observation, that principal would likely be fired right away, with no other question asked,” she says. “So why do we allow this in sport?”

With funding from the World Anti-Doping Agency (WADA) and the International Olympic Committee (IOC), Teetzel examines policies, rules and values in sport. Her research addresses athletes’ right to privacy and autonomy. “I want to help ensure that our policies governing sport are fair and that they respect athletes’ basic human rights.” This requires she regularly immerse herself in contentious waters and explore issues that are growing more complex. While some ethicists are calling on sport to go ahead and allow doping to help level the playing field, Teetzel insists the better option is to improve education and find a way to do effective testing while still being respectful of athletes as individuals.

Over time the performance-enhancing drug of choice in sports has changed and continues to evolve. “It’s impossible for researchers to ascertain how far ahead of the drug testing agencies the athletes are because, unsurprisingly, athletes who dope are not inclined to divulge that information to researchers, even in anonymous surveys and questionnaires. It’s a constant catch-up battle for WADA,” says Teetzel.

In the 1990s, erythropoietin (or EPO) was popular among endurance athletes since there were no reliable tests then to detect this hormone that transports extra oxygen to the muscles, extending the time it takes to reach fatigue; it’s prescribed to people with anemia to increase red blood cell count.

Tests used today more effectively identify the use of EPO or steroids (which, when used legitimately for cancer treatment, combats muscle wasting) along with diuretics (a dehydration agent that can mask the presence of other drugs).

As tests became more specific and sensitive, athletes using performance-enhancing drugs figured out that by taking smaller amounts more frequently they could avoid a positive result. This tactic, known as micro-doping, was a contributing factor in WADA’s decision to implement the athlete biological passport, essentially a databank of blood and urine test results collected throughout the year. Researchers analyze the passport looking for changes that could correspond to the use of banned substances. This random and unannounced testing requires elite athletes to report where they’ll be for one hour every day in case they are asked to provide a sample. Three missed tests results in a violation and ban.

“It’s surveillance…This type of surveillance isn’t acceptable in many other areas,” says Teetzel. “We do a lot in sport that, if we don’t look at critically, we accept too easily I believe. There are many ethical and philosophical questions we can ask about sports and why we do what we do.”

Rights around drug testing have been further complicated by the new realm it’s about to enter: genetic modification. Already researchers in China have told media they can use gene transfer technology for athlete enhancement; instead of drugs they inject viral vectors to introduce or modify genes and alter a person’s genetic makeup. (Gene therapy has brought hope to people living with genetic conditions like muscular dystrophy.) “Theoretically, athletes could modify their own DNA for performance enhancement purposes and if they did this it would be undetectable using standard doping detection tests. So what happens to sport then?,” Teetzel asks.

Twice this year she has been invited to lecture at the International Olympic Academy, an institute in Olympia, Greece, just down the road from the ancient archeological site where it all began in 776 BC. In early writings the poet Homer describes Olympia as a majestical place. Teetzel agrees, noting people “are often reluctant to leave.”

She also felt something special when attending her first Olympics, in London in 2012. “There was an electric atmosphere that you don’t get from watching on TV,” she says. “You could feel the community spirit and the joy of the people in the streets.”

But the positive energy of the Olympics, as powerful and contagious as it is, can be undermined by the policies that govern international sport, Teetzel argues. Invasive drug testing and athlete surveillance are just two examples of how competition is controlled at the expense of the athletes’ rights. Stringent rules that exclude gender equality is another.

Teetzel points out how the IOC goes to great lengths to position the Olympic Games as supportive of fair play, equality and bringing people together globally yet some of the rules surrounding its sports do the opposite. Up until last year women’s beach volleyball rules stipulated players had to wear bikinis or specific one-piece bathing suits and in some competitions even went so far as to declare a maximum two-inch width for their bottoms. The rules also dictate the athletes can’t wear their tracksuits during postmatch media interviews unless the temperature dips below 18 C. Regulations were revised to allow athletes to compete wearing shorts and a T-shirt or a more modest one-piece swimsuit but the change still excludes women from countries where more conservative dress is expected, Teetzel notes.

When women’s boxing became an Olympic sport last year women’s sport advocates successfully fought for athletes to wear regular boxing shorts when told to wear padded bras and skirts. The very nature of sport with its ingrained rules of the game isn’t an environment conducive to bending. “There is not a lot of space for athletes to be advocates because they need to play within a certain structure of rules to remain eligible to participate,” Teetzel says. “Sports rules are implemented by international federations and if you don’t agree with them, their response is often: don’t play.”

The challenges

The rise of transsexual athletes and those whose gender falls into the grey area of intersex, has created a new set of challenges to inclusiveness in sports and a new set of questions for ethicists like Teetzel to ponder.

She was in the 2012 Olympic crowd in London when South African runner Caster Semenya completed the 800-metre for a silver medal. Semenya made international headlines when her masculine appearance prompted officials at the 2009 World Championships to question her gender. At only 18 years old Semenya involuntarily became the poster girl for the return of gender testing—another research area of Teetzel’s.

Like testing for performance-enhancing drugs, the ways of verifying biological sex has morphed over time; in 1966 female athletes at the Commonwealth Games in Jamaica, as well as at other competitions in the mid-1960s, were forced to parade nude in front of doctors to prove they were women. Until 1999 Olympic officials required all women athletes undergo a test to earn their “femininity certificate,” notes Teetzel. The testing included a swab of the cheek to ensure competitors had XX chromosomes. Women’s sports groups spoke out and the testing was dropped before the 2000 Olympics. Semenya’s situation brought it back, but on a case by case basis. “Which in itself is problematic. How are female competitors targeted now for sex testing: because of your appearance, because you’re too fast, because you’re not in line with ideals of what women athletes should look like?” Teetzel says.

Athletes under suspicion undergo a battery of tests, including an assessment of their chromosome patterns and testosterone levels, but the results aren’t always straightforward. Some women are considered intersex, which means they’re born with ambiguous genitalia; and some are born with androgen insensitivity syndrome, which means they produce higher levels of testosterone.

Researchers disagree on the extent to which this corresponds to a competitive advantage in sport. It’s speculated that Semenya—who was kept from competing for a year—must now take drugs to block her testosterone production to within a range specified by scientists consulting with the international governing body of track and field. “Thankfully her results were not released to the public,” says Teetzel. “There was enough of an invasion of privacy for her.”

The number of transsexual athletes competing at the elite level has risen in recent years, inviting sports ethicists to weigh in on the IOC policy put in place to allow them to compete in the category opposite their birth gender; they must have: undergone sex reassignment surgery, taken hormone therapy for two years to block or trigger testosterone, and provided legal recognition of their change from their native country. That third requirement is problematic, Teetzel says, since it excludes athletes from less liberal countries whose governments refuse to recognize sex change. “It’s progress. It’s attempting to be inclusive but it’s not perfect.”

Within the field of sports ethics itself there are no perfect answers, she adds.

“But I find the questions fascinating.”

This article originally appeared in the winter 2014 edition of ResearchLIFE, a University of Manitoba publication

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