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In the case of Justino, the application for a TUE was granted because the athlete had an unequivocally diagnosed chronic medical condition for which the use of Spironolactone is the appropriate standard of care. Further, it was determined that the athlete and her medical team pursued and exhausted all non-prohibited alternatives and that the low dose of the medication is consistent with best medical practice to treat her condition and would return the athlete to a normal state of health without providing a performance-enhancing benefit.
So they knew it was banned in September, and didn't even try for a TUE until she got caught. I've got no problem with granting a retroactive TUE if it was medically indicated (as it apparently was), but WTF Cyborg.