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Revision as of 23:12, 3 August 2024

Sex verification and intersex athletes

See also: List of intersex Olympians, Testosterone regulations in women's athletics, Use of SRY test in Olympic screening, and Albert de la Chapelle

Since 1936,[1] and more rigorously since 1968, athletes who have been accused of competing in the wrong gender category have been subject to physical examinations.[2] All female athletes were required to undergo sex verification between 1968 and 1998, which was said to prevent men and "women with unfair ... advantage" from competing in women's events.[3][4][5][a] The issue of sex verification was first raised in the 1960s, when it was uncertain if masculine-appearing women were a product of systemic doping or were "male impersonators". Initial examinations involved physically appraising the genitals of the women before the IOC moved to use a less degrading chromosome test; this was also criticised as, while typically women have two X chromosomes and men one X and one Y, there are various possible deviations that do not have a substantial effect.[2][5]

In the 1980s and 1990s, the IOC and World Athletics (then, IAAF) had several meetings in which they confirmed that preventing "male imposters" in women's events – i.e. gender, not sex, verification – was the aim; their actions differed, however, with sex testing, especially for androgen bodies, persisting and excluding intersex athletes while never discovering a "male imposter". With genetic laboratories having stopped using the unreliable X chromosome tests in the 1970s, the IOC finally followed suit for the Winter Olympics in 1992; the IAAF abolished all testing later that year.[5][b] At the 1996 Games, eight (unknown) female athletes were discovered to have an intersex condition upon testing (seven with androgen insensitivity); all were cleared to compete and, after the Games, the IOC abolished the universal testing so as to protect the dignity of athletes who do not already know they have these conditions.[2][5]

Various international medical and sports professionals have, since 1986, advocated for sex verification in sport, and specifically the Olympics, to be abolished.[5][7] In 2000, following the 1999 IOC ratification of the 1996 decision to discontinue sex verification, the view was reiterated in the Journal of the American Medical Association; it included commentary that, while the purpose of such tests is to uphold a perceived fairness, the insufficiency of the tests can produce unfair results due to potential inaccuracies and the possibility of both false negatives and false positives.[5] The authors also deemed the tests unfair and discriminatory towards female athletes with disorders of sex development (DSD), whom it felt should be considered as women for the purposes of sport, as "few if any plausible athletic advantages exist".[5] It also considered the implications for female athletes who "fail" a test (either as a false positive or through unknowingly having a DSD), in their personal lives and future career, as too severe to impose the tests.[5]

However, since 2000, testing has still been enforced for athletes of any gender (though invariably women) when "serious doubts" have been raised.[2] In 2012, the IOC changed its mode of verification, testing for testosterone, also deemed unreliable and discriminatory, especially considering the effects of androgen insensitivity.[4] In 2018, World Athletics began requiring intersex women to medically or surgically alter themselves in order to be eligible, which could prevent them from attending events that serve as Olympic qualifiers.[3]

Timeline of regulations and methods of sex verification
Period Pre-1936 1936–1967 1968–1992 1993–1998 1999–2008 2011–2019 2020–2023
Regulations None, or ad hoc[1] Athletes in women's categories to be examined in cases of doubt[1] All female athletes to be tested prior to participation[5]
  • Majority of sport-specific federations do not mandate testing; five (including judo and volleyball) continue to require sex verification[8][9]
  • Female athletes at the Olympic Games to be tested[10]
  • Athletes who have undergone "sex reassignment surgery" may compete, two years after surgery and predicated on meeting standard requirements[2]
  • Female athletes to be tested in cases of doubt[2]
  • Athletes who have undergone "sex reassignment surgery" may compete, two years after surgery and predicated on meeting standard requirements[2]
  • Female athletes to be tested in cases of doubt[2]
  • National-level football federations to regularly test women's footballers with their own mandate; Olympic Games does not require testing of footballers[11]
  • Female athletes to be tested prior to participation in various athletics disciplines, predominantly middle-distance running[12]
  • Other female athletes to be tested in cases of doubt[2]
  • Athletes who would fail testing can have surgery or take medication in order to pass[3]
Verification test used Physical examination[1] Chromatin test: two X chromosomes[5] SRY test[8] Testosterone measurements;[4] then, in football, if hormone levels are unsatisfactory, a physical examination[11] Combination of chromatin test, testosterone measurements, and consideration of androgen insensitivity syndrome[12]
  1. ^ a b c d Walters, Michael (10 June 2024). "The 1930s Athlete Who Broke the Gender Barrier". History.com. A&E Television Networks. Retrieved 10 June 2024.
  2. ^ a b c d e f g h i Cite error: The named reference :10 was invoked but never defined (see the help page).
  3. ^ a b c Cite error: The named reference :6 was invoked but never defined (see the help page).
  4. ^ a b c d Bardin, Jon (2012-07-30). "Olympic Games and the tricky science of telling men from women". The Los Angeles Times. Retrieved 2023-01-09.
  5. ^ a b c d e f g h i j k Simpson, Joe Leigh; Ljungqvist, Arne; Ferguson-Smith, Malcolm A.; de la Chapelle, Albert; Elsas II, Louis J.; Ehrhardt, A. A.; Genel, Myron; Ferris, Elizabeth A.; Carlson, Alison (2000-09-27). "Gender Verification in the Olympics". JAMA. 284 (12): 1568–1569. doi:10.1001/jama.284.12.1568. ISSN 0098-7484. PMID 11000653.
  6. ^ "The only female competitor not to have to submit to a sex test at the 1976 Summer Olympics in Montreal was Princess Anne". Inside the Games. 2012-03-02. Retrieved 2023-01-09.
  7. ^ Ferguson-Smith, M. A.; Carlson, Alison; Chapelle, Albert De La; Ehrhardt, Anke; Ferris, Elizabeth; Ljungqvist, Arne; Genel, Myron; Simpson, Joe Leigh (1992). "Olympic row over sex testing". Nature. 355 (6355): 10. Bibcode:1992Natur.355Q..10F. doi:10.1038/355010a0. ISSN 1476-4687. PMID 1731195.
  8. ^ a b Office of Public Affairs and Communications. "Decision to Abolish Gender Testing at Sydney Olympics Supported By Yale Physician". Yale Medicine. Retrieved 2023-09-05.
  9. ^ Reeser, J C (2005-10-01). "Gender identity and sport: is the playing field level?". British Journal of Sports Medicine. 39 (10): 695–699. doi:10.1136/bjsm.2005.018119. ISSN 0306-3674. PMC 1725041. PMID 16183763.
  10. ^ Office of Public Affairs and Communications. "Decision to Abolish Gender Testing at Sydney Olympics Supported By Yale Physician". Yale Medicine. Retrieved 2023-09-05.
  11. ^ a b "FIFA issues gender verification regulations for all competitions" (PDF). FIFA. 8 June 2011.
  12. ^ a b Miller, Nick. "The sad, confusing case of Barbra Banda". The Athletic. Retrieved 2023-09-05.


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