Caster Semenya, the SA runner, was born female and remains female. There is no suggestion that she uses drugs, lotions or potions to maintain her femininity. She just happens to have a higher level of testosterone than 'normal' female athletes, so something had to be done....
She has now been ordered to take drugs to lower her testosterone or to stop competing... This has to be a dangerous precedent to set.
Will gymnasts who have naturally more flexible joints have to take drugs to make them less 'bendy'? Will sprinters with quicker fast-twitch muscles, Usain Bolt for example, have to take drugs to bring them in line with their competitors? Will swimmers who are naturally more buoyant have to carry ballast to even things up?
The whole thing is a minefield and a nightmare.
Unfortunately Semenya's case appears to have been driven because of transgender issues, especially when men who have undergone gender realignment wish to compete against women. The two are not the same, not even remotely.
Nature has always thrown up people who fall outside the normal distribution curves in all walks of life. That is why we have geniuses and idiots, entrepreneurs and workers, scientists and artists. We cannot all be equal, but this appears to be what some would like.