There are strong, (and, I believe, credible) rumours of abuse of thyroid medications in British Distance Running (basically questionable TUEs). This is apparrently led by governing body medical staff. Taking advantage of the rules to the limit. I am led to believe that some fairly high profile runners (in British terms for a relatively niche sport) are involved but can't remember if Steel was mentioned or not.
Kate Avery is at an american college and recently won the NCAA XC champs. She won't be part of the governing body system and I can't comment on the cleanliness, or otherwise, of the american college scene.
One thing however, is that at Junior level GB women have dominated these champs in recent years and there has been considerable success at U23 and senior level too. I don't think that the female depth of euro XC is especially strong so countries that take it seriously (and UK does) can sometimes produce performances that look exceptionally good.