Some quick thoughts:
1. In my opinion, no-one should have to change how they were born (including drugging themselves) to compete - if you're born appearing female and find out that genetically you're XXY or XY with androgen insensitivity and have an advantage, so be it. Just like if you're born taller, stronger, with 6 fingers, whatever. I read that the English (?) rowing team a few years ago recruited women even with no rowing experience who were athletic and had a good ratio of arm to body length, for purposes of rowing, i.e. who had an inborn advantage in that sport. Unfair, or just, picking people born with an advantage?
2. Medical procedures, devices, drugs should be allowed if no serious competitive advantage. So someone who has artificial legs that may allow them to be significantly faster (like Pistorius, who was known for that before manslaughter conviction), that may be an issue. Or if someone identifies as female but is pre-op and not taking hormones, they have a significant competitive advantage in many sports. Whereas if it can be demonstrated that because of hormones etc. muscle mass has been lost and the person no longer has a significant competitive advantage, they should be allowed to compete.
3. I've read in the past that some wheelchair athletes etc. want their sports open to people who aren't disabled, so that it may be seen more as a sport with specific equipment, rather than a sport which only the disabled may pursue. Which makes sense to me. The only wheelchair sport I ever competed in (I'm not disabled, they needed more participants) was wheelchair fencing, and my recollection is that there were competitive categories, e.g. someone who had full upper-body strength and reaction times was in a different category from someone with more limited upper-body mobility or speed. Which also made sense to me, presumably those advocating an open policy on competing in wheelchair events mean only at the highest levels.