Bad Things but he's not required to, even Semenya was allowed 5n/mol. His difficulty isn't his circulating testosterone on any given day, it's his male body & male puberty.
IMO, the only hard case is CAIS, where complete androgen insenstivity means one can have an SRY gene but other than often above-average height compared to females, no male advantage, not even a male Q-angle.
My own feeling is that we need a bright line so a CAIS athlete would be unable to compete in the female category but I've never heard of an elite athlete with CAIS, perhaps that's a function of the poor early bone mineralisation that can be the result of late diagnosis?