Maintaining both fairness and ethics remain highly relevant topics in high performance sport. The sport must be practiced in the best conditions of safety, the victory must be accessible to all, and should suffer from no contestation; that is why the Olympic movement was very early involved in the fight against doping. This fight was then organized, on the basis of an international entity in charge of enacting the rules and methods to be used, the World Anti-Doping Agency. Tools for the direct and indirect detection of prohibited substances, known as doping substances, are implemented during controls organized before and during the Olympic and Paralympic Games. The question of the actual prevalence of doping remains an open question not yet resolved, but which is essential to consider the athlete's health. Other situations than doping may negatively affect equity in sport, such as the participation of trans gender athletes in competitions and hyperandrogenism in female athletes, which fully justifies determining strict eligibility criteria for these athletes. (C) 2019 l'Academie nationale de medecine. Published by Elsevier Masson SAS. All rights reserved.
