I believe there’s specific criteria and tests published, you can probably look them up.

Personally, one of the reasons I don’t really care about all the arguments about who can compete in what category of olympic sport is that in most sports everyone at that level is some kind of high powered mutant. Yes they train a lot, but 99% of people could do the same and never be olympic level. To give a specific example, having Alpha-actinin 3 deficiency makes it impossible to become an elite level sprinter, but it isn’t considered a disease because 60% of the Caucasian population have it.

In some ways it would be more egalitarian to just let people take whatever drugs they want, instead of punishing people who use technology to make up for not winning the genetic lottery.