The debate over whether Therapeutic Use Exemptions (TUEs) should continue to be anonymous was never going to be a straightforward one.
Former IRONMAN World Champion Sam Laidlow – and others – issued a plea to his fellow professionals this week, urging all those ‘that believe in a clean sport’ to join his crusade against anonymous TUEs after the International Testing Agency (ITA) released a batch of data.
TUEs are approved if an athlete has a genuine medical condition for which they require the use of a substance or substances that would otherwise be banned under World Anti-Doping Agency rules.
Set up with the belief that athletes should never be forced to choose between their health and their career, it means those with asthma, diabetes, ADHD, or multiple other conditions can safely use banned medication without fear of breaking regulations.
But, with medical records, the right to privacy and huge nuances involved it is a hugely complex area.
The one TUE denial in triathlon
And we’ve now had a perfect example of that.
Since 2019, the ITA has received 3,528 TUE applications from across a wide range of sports. Of those applications, 2,361 have been approved, 903 were withdrawn or no longer required, and 75 were denied.
Triathlon specifically has seen 78 applications between 2019 and 2025, with 54 approved, 17 not needed/withdrawn, six still pending, and one denied. The trend is increasing, with one application made in 2023, 34 in 2024, and 43 last year.
And that one denied in triathlon has now been revealed to the wider world as being American star Jocelyn McCauley.
She has posted a short video on her Instagram page which has generated a thoughtful, respectful and balanced response judging by the early comments.
But it also adds another layer of complexity as to why she was denied a TUE – especially as she has now found out that within triathlon she was the only person to be ‘rejected’ when many others were approved for a variety of reasons.
‘I’m not a massive advocate for it anymore’
McCauley said – and you can watch it below: “News out there. I haven’t read all the articles. I read some of them, but the most interesting thing to me is in triathlon, there has been one denied TUE in the last four years-ish. And that was me. So I wanted to give a little background about this.
“For those of you who don’t know what TUEs are, it’s a Therapeutic Use Exemption. So as professional athletes, we’re not allowed to take certain substances and if we need to take those substances for medical reasons, we have to apply for a therapeutic use exemption, a TUE.
“So, background on that. I used to want TUEs to be very public and public knowledge of who’s taking what and where and why and whatever. But until I faced this, until I went through this story.
“So here you go, Sam Laidlow. I’m not a massive advocate for it anymore. So Scott [her husband] and I were trying to get pregnant. We had been trying for a very long time, for over a year. And at my age, it’s really over six months, at least in America, where you start seeking fertility treatments, fertility, tests and everything like that.
“So we were doing all the fertility tests and, Scott had gone through stuff as well. And, I was actually going to two different doctors for more holistic fertility treatments and then more, conventional fertility treatments and stuff like that.
“So we had done a lot of testing and one of my fertility doctors wanted to put me on a medication to help with fertility. That medication was banned. And so I was going to go through the therapeutic use exemption application.
“This is my first time ever applying for one or anything. And actually, it took me a while to actually want to do it, so I went through the application process. You have to get all of the doctor’s notes. So got both the doctor’s notes, got all of mylLabs, got Scott’s doctor’s notes, got Scott’s labs and tests and everything.
“And then you also have to get, a whole note written by your doctor saying, this, this is the application use and why we need to have Jocelyn on this medication. So we got all of that together, everything together, sent it off, and then it’s reviewed by your National Anti-Doping Agency and three doctors that review it there, and then pass it on and try to get it approved that way.
Just one denial
“Anyway, so it was denied. And I, just thought it was really interesting that when, that came out and there was absolutely just one denial.
“There’s not many denials out there. So the one application that was denied was for fertility treatment and this is why I don’t think TUEs should be public knowledge because it can out people who are trying to get pregnant and I don’t think that is already hard enough, process and everything, to go through that.
“I don’t think that that should be public and out there knowledge. But people would know based on the medication that you’re on that you’re trying to get pregnant. So anyway, interesting information. Hopefully I don’t come back to my phone in a few minutes like an hour after my swim and it’s blown up with negative messages.”
The opposite happened.
Jocelyn added: “So anyway, interesting that fertility treatments are not approved and yet testosterone and growth hormone and things like that [are].”
There was wonderful news after IRONMAN New Zealand recently when Jocelyn announced that she is pregnant with her third child.
