A13. Some sports organizations have adopted the level of 5 nmol/L as the upper limit for inclusion in the female category because it represents the outermost bounds that a healthy biological female – regardless of her legal or gender identity – can reach naturally. Almost all females, including elite athletes, have testosterone levels well below 5 nmol/L. The normal female range is between 0.06 and 1.68 nmol/L. Even females with the condition known as polycystic ovary syndrome (PCOS) – which can dramatically raise testosterone levels – only very occasionally reach 3 nmol/L, with rare readings up to 4.8 nmol/L. Setting the level at 5 nmol/L assures that no otherwise healthy biological female could be excluded by the standard. Given that 5 nmol/L is already high, however, some international federations are considering the lower limit of 3 nmol/L.