South African track star Caster Semenya reportedly lost her appeal against new rules that regulate over an issue that has long been up for debate in the world of professional athleticism: gender identity.

As reported, the double Olympic champion, who is hyperandrogenous—meaning she has elevated levels of testosterone—will now have to take medication designed to reduce her testosterone level if she wants to compete in international middle-distance running events.

Per CNN, the Court of Arbitration for Sport (CAS) ruled in favor of the International Association of Athletics Federations (IAAF), who introduced a new policy focusing on female athletes who have differences in their sex development. According to reports, the medical condition of hyperandrogenism is estimated to occur in 5% to 10% of women. Critics note that an excess of testosterone, which has been found to increase muscle mass, strength, stamina and physical energy, creates an unlevel playing field for women whose body produces an amount synonymous with what has been declared the norm.

According to the IAAF policy, athletes cannot compete in women’s sports if their levels rise above a particular measurement (5 nmol/L) at least six months prior to competing in various races. Additionally, women must maintain these levels continuously for the rest of their athletic career in order to be eligible to compete. The rule, which was initially set to be enforced in November 2018, resulted in Semenya filing an appeal.

“I know that the IAAF’s regulations have always targeted me specifically,” Semenya shared in a statement through representatives. “For a decade the IAAF has tried to slow me down, but this has actually made me stronger. The decision of the CAS will not hold me back. I will once again rise above and continue to inspire young women and athletes in South Africa and around the world.”

According to the 28-year-old’s reps, she was pleased to learn that the CAS found the rules to be discriminatory against DSD athletes but was reportedly disappointed that two of the arbitrators found said discrimination to be “necessary.” CAS said in a statement that the discrimination is “a necessary, reasonable and proportionate means of achieving the IAAF’s aim of preserving the integrity of female athletics in the Restricted Events.”

While the CAS ruled in favor of the policy, they also noted concern regarding both the implementation of the policy and athlete’s ability to comply.

“The side effects of hormonal treatment, experienced by individual athletes could, with further evidence, demonstrate the practical impossibility of compliance which could, in turn, lead to a different conclusion as to the proportionality of the DSD Regulations,” the CAS said in a statement.

Semenya has 30 days to appeal the CAS ruling to the Swiss Federal Tribunal, with a spokesperson noting that an appeal is a likely next course of action.

“We are naturally very disappointed with the decision,” the statement issued on behalf of Semenya concluded. “This is not only against human rights but also a blow to all South Africans. We are committed to lobby other athletics bodies to stand behind us. This wasn’t only Caster Semenya’s case but also Athletics South Africa and we plan to study the report in detail. We plan to appeal this decision.”