Disorders Of Sex Development In Sport: What We Learned From The Olympics Controversy

As the world tuned into the 2024 Paris Olympic Games, they were treated to a plethora of controversy. After the strange, and frankly, disturbing tableau of The Last Supper that featured drag queens and children splashed across screens during the Opening Ceremony, women’s boxing lit up the internet after featuring what appears to be two males in two separate weight classes, decimating the female competitors in rapid succession.

Imane Khelif from Algeria in the women’s welterweight class and Lin Yu-Ting from Taiwan in the women’s featherweight class were known by the International Olympic Committee (IOC) to have failed tests by the International Boxing Association (IBA) that would've allowed them to compete as females. These tests were conducted by two independent laboratories that found the boxers both had XY chromosomes. The IBA also mentioned these athletes had “high testosterone.” Even though the IBA said their genetic test did not test for testosterone, it is likely this high T was found through standard anti-doping screens through the IBA. 

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Meanwhile, the IOC merely went to the lengths of checking the gender marker on the competitors' passports. Given the IOC's stance on “inclusivity,” and their decision during the last Olympic games in Tokyo to allow male weightlifter Laurel Hubbard to compete against females, this is not surprising. In a statement, the IOC spokesperson Mark Adams said there are no black-and-white tests that can determine eligibility: 

“Everyone wants a black-and-white explanation as to how to determine this,” he said, “That explanation does not exist. Not in the scientific community nor anywhere else. If we can find a consensus, we can certainly work to apply that.” 

A few days later, IOC President Thomas Bach said, “If somebody is presenting us a scientifically solid system how to identify men and women, then we would be the first ones to do it. We don’t like this uncertainty.” 

This begs the question: If there are no eligibility criteria other than self-identification, and if we can’t define what a man or woman is, then why bother having a women’s competition at all? The women’s category exists to provide women with a place for safe and fair competition due to the massive biological advantage males have over them. If we cannot define what a woman is, why does the sports category exist?

While Laurel Hubbard was a male athlete who identified as trans, Khelif and Yu-Ting are not claiming to be trans-identified. However, the claim is that the boxers are females with disorders of sex development that result in atypical chromosomes and higher than average testosterone levels. Thus, many claim, they are just “women with high T.” Many are wondering if this is true. However, from our outward assessment, and that of evolutionary biologists that we've consulted with in the past, it seems their claims are false.

DSDs and the Claims in Question
It's unclear which particular disorder the boxers are trying to claim, but some, such as political commentator Piers Morgan, have claimed that the athletes have Swyer Syndrome. While this disorder does result in a female with XY chromosomes, it does not result in male levels of testosterone and a typical male physique that both boxers feature.

Women with Swyer have very low androgen levels, female-typical bodies – including internal and external female reproductive organs such as a uterus and a vagina, and with hormone therapy involving estrogen and progesterone can even menstruate and carry a pregnancy to term with a donated egg. Swyer is considered a female condition because of the development of “Mullerian” structures that allow for female reproductive capabilities.

This has led to others online speculating that, perhaps, the boxers have 5-ARD (5 alpha reductase deficiency), like runner Caster Semenya. Semenya was allegedly raised as a girl in his native country of South Africa. Semenya was eventually ousted from running against women after his appeal to the Court of Arbitration for Sport (CAS) revealed he was indeed a male with 5-ARD. This disorder affects the development of the male’s external genitalia but leaves all the other male systems unaffected. Males with 5-ARD still have testes, male levels of testosterone, and functional testosterone response. They therefore benefit from androgenization across development. For Semenya, this gave him a disqualifying advantage over the female athletes.

5-ARD is a condition that is more common in countries with poorer prenatal care, such as the Dominican Republic and multiple countries in North Africa. The condition can result in ambiguous genitals that appear more female, and the babies are often misidentified as girls at birth. The families will often raise them as girls until puberty hits when the testosterone surges in these boys and their genitals develop to appear more in line with other males.

Unlike Swyer, a condition that results in female development, 5-ARD is a male condition because of the development of testes and the Wolffian structures that allow for male reproductive capabilities. It also results in a typical male physique, like what we see with Khelif and Yu-Ting. Though some have tried to say that some women can have more male-typical physiques like those of the boxers in question, it's often obvious how masculinized the builds of the two boxers are compared to those of any females brought up in comparison. If we combine the XY chromosomes and high testosterone, then androgenization through male puberty seems to be the most probable cause.

5-ARD can be destabilizing for the afflicted individuals, particularly in countries with rigid sex roles and stereotypes. It can also be difficult to change their legal sex back to male in these cases. One such case was featured in the 1968 Olympics with Erik Schinneger who, upon coming to terms with his condition, decided to identify and live more conventionally as others of the male sex, rather than continue to identify as female.

So, while the case of the boxers would not be the first of its kind in the Olympics, it is certainly driven the most controversy thanks to the surrounding circumstances and IOC policies.

More Cause for Outrage and Suspicion
While some may be understanding in the case of someone who has one of these conditions who did not know they were male, such as Erik Schinneger and, allegedly, Semenya, the fact of the matter is, no such condition has outright been claimed by either athlete at present. Further, when the IBA banned Khelif, the boxer started an appeal to the CAS like Semenya, but withdrew it at the last minute, drawing the suspicion that Khelif knew the appeal would fail and the boxer’s sex would be a matter of record. The failure to appeal made the ban binding and the athlete was banned from competing against females in the ring during IBA competitions.

As mentioned earlier, the IOC has opted not to do sex testing, stating that “No one wants to go back to the days of sex testing", which is contrary to over 82% of female athletes being in favor of doing so (Elsas 2000). Instead, the IOC policy relies heavily on gender identity and looks only at the gender markers on the passports of Khelif and Yu-Ting. However, this also drew suspicion when Khelif’s father showed the birth certificate, which shows “female” and an issue date of “2018.” Given that Khelif clearly wasn't born in 2018, this has been alleged to be a change solely to compete against females in higher level sport. This, however, has not been verified. Regardless, even if the birth certificate was never changed and in fact issued as female at birth, this could easily be from doctors mistaking the baby as female due to a DSD like 5-ARD.

Photos have also emerged of Khelif wearing men’s clothes exclusively in adulthood, along with a men's groin guard during training. There are also photos of the boxer not wearing a hijab, while women next to Khelif are. Despite a hijab not being required in Algeria, it has added to the speculation after the revelation about the birth certificate. To contradict this, photos alleged to be from childhood show Khelif wearing pink and dressed like a girl before puberty. However, it is unclear if these photos are of the boxer. And, even if they were, it does not prove Khelif was unaware of the biological reality (sex).

While less is currently known about the Taiwanese boxer, Yu-Ting, more information has come out daily, and what we do know is that this boxer was found to have the same disqualifying levels of testosterone and XY chromosomes as the other. At a minimum, it's clear that further testing should be done to protect the safety and integrity of female athletes who have no choice but to compete with the men who have made their way into their sports, knowingly or otherwise.

Cynthia Breheny is a digital artist, animator, and author. Her lifelong experience with gender dysphoria and her professional design skills provide her with unique abilities to communicate sex and gender concepts.

Zachary Elliott is the author of three books on sex and gender and the producer of 20+ animated videos on sex differences. His fascination with the biology of sex and desire to learn and educate led him to create the Paradox Institute in January 2020.

If you’d like to know more about disorders of sex development or the advantages of male sports performance over females, check out our animated videos and articles at theparadoxinstitute.com or follow our founder Zachary Elliott on X.

Wrong Speak is a free-expression platform that allows varying viewpoints. All views expressed in this article are the author's own.