Sex verification in sports
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Sex verification in sports (also known as gender verification, or loosely as gender determination or a sex test) occurs because eligibility of athletes to compete is restricted whenever sporting events are limited to a single sex, which is generally the case, as well as when events are limited to mixed-sex teams of defined composition (e.g., most ''pairs'' events). Practice has varied tremendously over time, across borders and by competitive level. Issues have arisen multiple times in the
Olympic games The modern Olympic Games or Olympics (french: link=no, Jeux olympiques) are the leading international sporting events featuring summer and winter sports competitions in which thousands of athletes from around the world participate in a multi ...
and other high-profile sporting competitions, for example allegations that certain male athletes attempted to compete as women or that certain female athletes had
intersex Intersex people are individuals born with any of several sex characteristics including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, "do not fit typical b ...
conditions perceived to give unfair advantage. Sex verification is not typically conducted on athletes competing in the male category. The first mandatory sex test issued by the
International Association of Athletics Federations World Athletics, formerly known as the International Amateur Athletic Federation (from 1912 to 2001) and International Association of Athletics Federations (from 2001 to 2019, both abbreviated as the IAAF) is the international governing body fo ...
(IAAF), the world's track and field governing body, for woman athletes was in July 1950 in the month before the European Championships in Belgium. All athletes were tested in their own countries. Sex testing at the actual games began with the
1966 European Athletics Championships The 8th European Athletics Championships were held from 30 August to 4 September 1966 in the Nép Stadium in Budapest, Hungary. Contemporaneous reports on the event were given in the Glasgow Herald. A new IAAF ruling was applied for t ...
’ response to suspicion that several of the best women athletes from the
Soviet Union The Soviet Union,. officially the Union of Soviet Socialist Republics. (USSR),. was a transcontinental country that spanned much of Eurasia from 1922 to 1991. A flagship communist state, it was nominally a federal union of fifteen nationa ...
and
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were actually men. At the Olympics, testing was introduced in 1968. In some cases, these policies have led to athletes undergoing unnecessary surgery such as
female genital mutilation Female genital mutilation (FGM), also known as female genital cutting, female genital mutilation/cutting (FGM/C) and female circumcision, is the ritual cutting or removal of some or all of the external female genitalia. The practice is found ...
and
sterilization Sterilization may refer to: * Sterilization (microbiology), killing or inactivation of micro-organisms * Soil steam sterilization, a farming technique that sterilizes soil with steam in open fields or greenhouses * Sterilization (medicine) rende ...
. Subsequent reports have shown that the tests could cause psychological harm. ''Sex verification''—identifying athletes whose hormone levels are abnormal compared to others of their ''purported'' sex — can cause sex identity crises, elicit demeaning reactions (publicly and privately), isolate athletes socially, and lead to depression and sometimes suicide.


History

Sex verification in sports began in the 1940s with "femininity certificates" provided by a physician. It subsequently evolved into visual inspections, physical examinations, chromosome testing, and later testosterone level testing. These tests were all designed to ensure that athletes were only allowed to compete as their sex, but mostly resulted in the exclusion of
intersex Intersex people are individuals born with any of several sex characteristics including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, "do not fit typical b ...
athletes. It is not always simply checking whether a person's sex chromosome ''pair'' is XX vs. XY, or comparing their levels of key sex hormones to distinct reference ranges, to determine an athlete's sex. Variations in ''pairings'' of inherited chromosome, other genetic aspects, and pre- and postnatal physical development at subcellular to organ levels mean some people are not unambiguously female or male. Fetuses start out as undifferentiated, then the SRY gene (which is usually—but not always—located on the Y chromosome) turns on a variety of hormones that differentiate by the time of birth the newborn as a male baby. But sometimes this differentiation does not occur while other times the SRY gene is located on a different chromosome: People with two X chromosomes can develop hormonally or phenotypically as a male; and people with an X and a Y can develop hormonally or phenotypically as a female.


Physical examinations

United States Olympic Committee The United States Olympic & Paralympic Committee (USOPC) is the National Olympic Committee and the National Paralympic Committee for the United States. It was founded in 1895 as the United States Olympic Committee, and is headquartered in Col ...
president
Avery Brundage Avery Brundage (; September 28, 1887 – May 8, 1975) was an American sports administrator who served as the fifth president of the International Olympic Committee from 1952 to 1972. The only American and only non-European to attain that p ...
requested, during or shortly after the
1936 Summer Olympics The 1936 Summer Olympics (German: ''Olympische Sommerspiele 1936''), officially known as the Games of the XI Olympiad (German: ''Spiele der XI. Olympiade'') and commonly known as Berlin 1936 or the Nazi Olympics, were an international multi-s ...
in
Berlin Berlin ( , ) is the capital and largest city of Germany by both area and population. Its 3.7 million inhabitants make it the European Union's most populous city, according to population within city limits. One of Germany's sixteen constitu ...
, that a system be established to examine female athletes. According to a ''
Time Time is the continued sequence of existence and event (philosophy), events that occurs in an apparently irreversible process, irreversible succession from the past, through the present, into the future. It is a component quantity of various me ...
'' magazine article about
hermaphrodite In reproductive biology, a hermaphrodite () is an organism that has both kinds of reproductive organs and can produce both gametes associated with male and female sexes. Many taxonomic groups of animals (mostly invertebrates) do not have ...
s, Brundage felt the need to clarify "sex ambiguities" after observing the performance of Czechoslovak runner and jumper Zdeňka Koubková and English shotputter and javelin thrower Mary Edith Louise Weston. Both individuals later had
gender reassignment surgery Gender-affirming surgery (GAS) is a surgical procedure, or series of procedures, that alters a transgender or transsexual person's physical appearance and sexual characteristics to resemble those associated with their identified gender, and all ...
and legally changed their names, to Zdeněk Koubek and Mark Weston, respectively. File:Zdenka Koubkova 1936.jpg, Zdeněk Koubek File:Mary Edith Louise Weston 1936b.jpg, Mark Weston Sex verification tests began in 1950 with the International Association of Athletics Federations (IAAF), using physical examinations. "Sex segregation and verification are mutually interdependent because, if there were no claims or basis for having separate male and female sporting events, there would be no need for sex verification testing." The Dutch athlete Foekje Dillema was banned for life in July 1950. The International Olympic Committee followed suit in 1968. Initially, women athletes "were asked to parade nude before a panel of doctors". For a period of time these tests were mandatory for female athletes, due to fears that male athletes would pose as female athletes and have an unfair advantage over their competitors.


Chromosome testing

Chromosome testing was introduced by the
International Olympic Committee The International Olympic Committee (IOC; french: link=no, Comité international olympique, ''CIO'') is a non-governmental sports organisation based in Lausanne, Switzerland. It is constituted in the form of an association under the Swis ...
during the
1968 Summer Olympics The 1968 Summer Olympics ( es, Juegos Olímpicos de Verano de 1968), officially known as the Games of the XIX Olympiad ( es, Juegos de la XIX Olimpiada) and commonly known as Mexico 1968 ( es, México 1968), were an international multi-sport ev ...
. This tested for the Y-chromosome, and was designed to identify males potentially disguised as females. This method of testing was later abolished, as it was shown to be inconclusive in identifying maleness. The
International Association of Athletics Federations World Athletics, formerly known as the International Amateur Athletic Federation (from 1912 to 2001) and International Association of Athletics Federations (from 2001 to 2019, both abbreviated as the IAAF) is the international governing body fo ...
ceased sex screening for all athletes in 1992, but retained the option of assessing the sex of a participant should suspicions arise. A resolution was passed at the 1996 International Olympic Committee (IOC) World Conference on Women and Health "to discontinue the current process of gender verification during the Olympic Games". The
International Olympic Committee The International Olympic Committee (IOC; french: link=no, Comité international olympique, ''CIO'') is a non-governmental sports organisation based in Lausanne, Switzerland. It is constituted in the form of an association under the Swis ...
's board voted to discontinue the practice in June 1999. Chromosome testing was last performed at the
Atlanta Olympic Games The 1996 Summer Olympics (officially the Games of the XXVI Olympiad, also known as Atlanta 1996 and commonly referred to as the Centennial Olympic Games) were an international multi-sport event held from July 19 to August 4, 1996, in Atlanta ...
in 1996.


Hormone testing

In August 2009,
South Africa South Africa, officially the Republic of South Africa (RSA), is the southernmost country in Africa. It is bounded to the south by of coastline that stretch along the South Atlantic and Indian Oceans; to the north by the neighbouring coun ...
n athlete
Caster Semenya Mokgadi Caster Semenya OIB (born 7 January 1991) is a South African middle-distance runner and winner of two Olympic gold medals and three World Championships in the women's 800 metres. She first won gold at the World Championships in 2009 ...
was subjected to mandatory sex verification testing at the request of the IAAF. In the wake of the Semenya case,
testosterone Testosterone is the primary sex hormone and anabolic steroid in males. In humans, testosterone plays a key role in the development of male reproductive tissues such as testes and prostate, as well as promoting secondary sexual characteristi ...
testing was introduced to identify cases where testosterone levels were elevated above a particular level, termed
hyperandrogenism Hyperandrogenism is a medical condition characterized by high levels of androgens. It is more common in women than men. Symptoms of hyperandrogenism may include acne, seborrhea (inflamed skin), hair loss on the scalp, increased body or facia ...
, with national Olympics committees tasked by the IOC to "actively investigate any perceived deviation in sex characteristics". In football,
FIFA FIFA (; stands for ''Fédération Internationale de Football Association'' (French), meaning International Association Football Federation ) is the international governing body of association football, beach football and futsal. It was found ...
's current gender verification policy dates to 30 May 2011. In June 2012, in advance of the
2012 Summer Olympics The 2012 Summer Olympics (officially the Games of the XXX Olympiad and also known as London 2012) was an international multi-sport event held from 27 July to 12 August 2012 in London, England, United Kingdom. The first event, th ...
, the IOC released ''IOC Regulations on Female Hyperandrogenism'' to address these cases. It includes the statement, "Nothing in these Regulations is intended to make any determination of sex. Instead, these Regulations are designed to identify circumstances in which a particular athlete will not be eligible (by reason of hormonal characteristics) to participate in 2012 Olympic Games (OG) Competitions in the female category. In the event that the athlete has been declared ineligible to compete in the female category, the athlete may be eligible to compete as a male athlete, if the athlete qualifies for the male event of the sport." Policies on hyperandrogenism were suspended following the case of '' Dutee Chand v. Athletics Federation of India (AFI) & The International Association of Athletics Federations'', in the
Court of Arbitration for Sport The Court of Arbitration for Sport (CAS; french: Tribunal arbitral du sport, ''TAS'') is an international body established in 1984 to settle disputes related to sport through arbitration. Its headquarters are in Lausanne, Switzerland and its ...
, decided in July 2015. Chand had been dropped from the 2014 Commonwealth Games at the last minute after the Athletic Federation of India stated that
hyperandrogenism Hyperandrogenism is a medical condition characterized by high levels of androgens. It is more common in women than men. Symptoms of hyperandrogenism may include acne, seborrhea (inflamed skin), hair loss on the scalp, increased body or facia ...
made her ineligible to compete as a female athlete. The ruling found that there was insufficient evidence that testosterone increased female athletic performance. In doing so the court immediately suspended the practice of hyperandrogenism regulation used by the IAAF and declared it void unless the organization could present better evidence by July 2017. A study published in 2017 by Stéphane Bermon and Pierre-Yves Garnier analyzed 2,127 performances and hormone concentrations in male and female elite track and field athletes during the 2011 and 2013 Track and Field World Championships. When compared with women with lower levels of the hormone free testosterone (fT), women with the highest fT levels performed significantly better in the 400 m, 400 m hurdles, 800 m, hammer throw, and pole vault with margins of 2.73%, 2.78%, 1.78%, 4.53%, and 2.94%, respectively. Such a pattern was not found in any of the male athletic events. The study concluded that female athletes with high testosterone levels have a significant competitive advantage over those with low fT in 400 m, 400 m hurdles, 800 m, hammer throw, and pole vault. Scholars question whether any advantage should be considered “unfair” if it occurs naturally and outside the control of the athlete. For example, elite athletes have greater aerobic capacity and endurance in comparison to the general population. Furthermore, these cases have elicited criticism of the elite sporting system by showing clear vulnerability of women athletes to unnecessary medical interventions under duress, applied even though there was no evidence of cheating and no evidence of athletic advantage. As with previous forms of sex testing, testosterone testing has been regarded by many as humiliating, unnecessary and discriminatory.
Katrina Karkazis Katrina Alicia Karkazis (born 1970) is an anthropologist and bioethicist. She is a professor of Sexuality, Women's and Gender Studies at Amherst College. She was previously the Carol Zicklin Endowed Chair in the Honors Academy at Brooklyn College ...
,
Rebecca Jordan-Young Rebecca M. Jordan-Young (born 1963), is an American feminist scientist and gender studies scholar. Her research focuses on social medical science, sex, gender, sexuality, and epidemiology. She is an Associate Professor of Women’s, Gender, and ...
, Georgiann Davis and Silvia Camporesi argued that the new IAAF policies on hyperandrogenism in female athletes will not protect against breaches of privacy, will require athletes to undergo unnecessary treatment in order to compete, and will intensify " gender policing". In fact, high-performing female athletes show a rate of Complete Androgen Insensitivity Syndrome much higher than the general population—which shows 1 in 20,000–50,000, compared with elite athletes’ 1 in 429. They recommend that athletes be able to compete in accordance with their legal gender. In November 2015, the IOC held a meeting to address both its hyperandrogenism and
transgender A transgender (often abbreviated as trans) person is someone whose gender identity or gender expression does not correspond with their sex assigned at birth. Many transgender people experience dysphoria, which they seek to alleviate through ...
policies. In regards to hyperandrogenism in female athletes, the IOC encouraged reinstatement of the IAAF policies suspended by the Court of Arbitration for Sport. It also repeated an earlier policy statement that, to "avoid discrimination, if not eligible for female competition the athlete should be eligible to compete in male competition". In February 2016, it was made known that the IOC would not introduce its own policies that would impose a maximum testosterone level for the 2016 Summer Olympics. On November 1 of 2018 the IAAF adopted new criteria regarding "Differences of Sexual Development" for female athletes competing in the following races: 400 m, 800 m, 1 mile, hurdles, and events that include a combination of these distances. Athletes with testosterone levels equalling or exceeding 5 nmol/L or who are "
androgen An androgen (from Greek ''andr-'', the stem of the word meaning "man") is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This in ...
sensitive" and want to participate in above-mentioned events at the global level (including recognition for setting an international record) must legally be female or intersex, must get their testosterone levels below 5nmol/L for six consecutive months and must ensure their levels stay below this level. This new regulation replaced all previous rules implemented regarding women with Hyperandrogenism. In April 2016, the United Nations Special Rapporteur on health, Dainius Pūras, criticized current and historic sex verification policies, describing how "a number of athletes have undergone gonadectomy (removal of reproductive organs) and partial cliteroidectomy in the absence of symptoms or health issues warranting those procedures". The cases of Dutee Chand and
Caster Semenya Mokgadi Caster Semenya OIB (born 7 January 1991) is a South African middle-distance runner and winner of two Olympic gold medals and three World Championships in the women's 800 metres. She first won gold at the World Championships in 2009 ...
were widely reported during the
2016 Rio Olympics ) , nations = 207 (including IOA and EOR teams) , athletes = 11,238 , events = 306 in 28 sports (41 disciplines) , opening = 5 August 2016 , closing = 21 August 2016 , opened_by = Vice President Michel Temer , cauldron = Vanderlei Cordeiro de ...
. Immediately preceding the games, Genel, Simpson and de la Chapelle were again published in ''
Journal of the American Medical Association ''The Journal of the American Medical Association'' (''JAMA'') is a peer-reviewed medical journal published 48 times a year by the American Medical Association. It publishes original research, reviews, and editorials covering all aspects of b ...
'' stating:


Sex verification of men

Sex verification is not conducted on athletes competing in the male category, and little data are available on their chromosomes or hormone profiles. However, a post-competition study of 693 elite athletes by Healy ''et al.'', published in 2014, found significant differences along many variables. The authors found that: Using these data, ''
Scientific American ''Scientific American'', informally abbreviated ''SciAm'' or sometimes ''SA'', is an American popular science magazine. Many famous scientists, including Albert Einstein and Nikola Tesla, have contributed articles to it. In print since 1845, it ...
'' estimated that "almost 2 percent" of male competitors had testosterone levels in the typical female range. The study authors also stated that average lean body mass differences might account for performance differences between sexes.


20th century

* Perhaps the earliest known case is that of
Stanisława Walasiewicz Stanisława Walasiewicz (3 April 1911 – 4 December 1980), also known as Stefania Walasiewicz, and Stella Walsh, was a Polish-American track and field athlete, who became a women's Olympic champion in the 100 metres. Born in Poland and raised ...
(aka Stella Walsh), a Polish athlete who won a gold medal in the women's
100 m 1 (one, unit, unity) is a number representing a single or the only entity. 1 is also a numerical digit and represents a single unit of counting or measurement. For example, a line segment of ''unit length'' is a line segment of length 1 ...
at the
1932 Summer Olympics The 1932 Summer Olympics (officially the Games of the X Olympiad and also known as Los Angeles 1932) were an international multi-sport event held from July 30 to August 14, 1932 in Los Angeles, California, United States. The Games were held duri ...
in
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, but who after her death in 1980 was discovered to have had partially developed male genitalia. * Before the advent of sexual verification tests, German athlete
Dora Ratjen Heinrich Ratjen (20 November 1918 – 22 April 2008), born Dora Ratjen, was a German athlete who competed for Germany in the women's high jump at the 1936 Summer Olympics at Berlin, finishing fourth, but was later determined to be male and/or in ...
competed in the 1936 Olympic Games in
Berlin Berlin ( , ) is the capital and largest city of Germany by both area and population. Its 3.7 million inhabitants make it the European Union's most populous city, according to population within city limits. One of Germany's sixteen constitu ...
and placed fourth in the women's high jump. Ratjen later competed and set a world record for the women's high jump at the 1938
European Championships The European Championships is a multi-sport tournament which brings together the existing European Championships of some of the continent's leading sports every four years. The inaugural edition in 2018 was staged by the host cities of Berlin, ...
before tests by the German police concluded that Ratjen was a man. Ratjen was likely an
intersex Intersex people are individuals born with any of several sex characteristics including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, "do not fit typical b ...
individual, based on the physician's description who conducted the examination. Though raised as a girl, Ratjen later took the name Heinrich Ratjen following an official registry change. * The Dutch sprinter Foekje Dillema was expelled from the 1950 national team after she refused a mandatory sex test in July 1950; later investigations revealed a Y-chromosome in her body cells, and the analysis showed that she probably was a 46,XX/46,XY mosaic female. * Sisters Tamara and Irina Press won five track and field Olympic gold medals for the Soviet Union and set 26 world records in the 1960s. They ended their careers before the introduction of gender testing in 1966. Although both sisters were accused of being men or hermaphrodites, there is no evidence of an intersex condition in these cases.Robert Pool, ''"Eve’s Rib - Searching for the Biological Roots of Sex Differences"'',
Crown Publishers The Crown Publishing Group is a subsidiary of Penguin Random House that publishes across several fiction and non-fiction categories. Originally founded in 1933 as a remaindered books wholesaler called Outlet Book Company, the firm expanded int ...
,
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, 1994,
* Polish athlete
Ewa Kłobukowska Ewa Janina Kłobukowska (born 1 October 1946) is a Polish former sprinter. She competed at the 1964 Olympics in the 4×100 m relay and 100 m sprint and won a gold and a bronze medal, respectively.4 × 100 m relay 4 (four) is a number, numeral and digit. It is the natural number following 3 and preceding 5. It is the smallest semiprime and composite number, and is considered unlucky in many East Asian cultures. In mathematics Four is the smallest ...
and the bronze medal in women's 100 m sprint at the
1964 Summer Olympics The , officially the and commonly known as Tokyo 1964 ( ja, 東京1964), were an international multi-sport event held from 10 to 24 October 1964 in Tokyo, Japan. Tokyo had been awarded the organization of the 1940 Summer Olympics, but this h ...
in
Tokyo Tokyo (; ja, 東京, , ), officially the Tokyo Metropolis ( ja, 東京都, label=none, ), is the capital and largest city of Japan. Formerly known as Edo, its metropolitan area () is the most populous in the world, with an estimated 37.46 ...
, is the first athlete to fail a gender test in 1967. She was found to have the rare genetic condition of XX/XXY mosaicism and was banned from competing in Olympic and professional sports. * In 1967 the IOC disqualified the Austrian 1966 female world champion in downhill skiing, Erik Schinegger (then named Erika, from the 1968 Winter Games in Grenoble after determining Schinegger had internal male sex organs. Schinegger later transitioned to male. * In 1986, Spanish hurdler
Maria José Martínez-Patiño Maria José Martínez-Patiño (born 10 July 1961) is a Spanish former hurdler, whose dismissal from the Spanish Olympic team in 1986 for failing the gender test is a notable moment in the history of sex verification in sports. Martínez-Patiño wa ...
was dismissed and publicly shamed after failing a chromosomal test. She fought the ruling against her, arguing that she could not have a competitive advantage because her intersex variation resulted in her having no functional testosterone. Two years later, the IAAF gave Martínez-Patiño the green light to compete again. Her plight brought attention to the issue of gender testing, which helped lead to the end of mandatory tests a decade later. File:Stanisława Walasiewicz na fotografii portretowej.jpg,
Stanisława Walasiewicz Stanisława Walasiewicz (3 April 1911 – 4 December 1980), also known as Stefania Walasiewicz, and Stella Walsh, was a Polish-American track and field athlete, who became a women's Olympic champion in the 100 metres. Born in Poland and raised ...
(aka Stella Walsh) File:Bundesarchiv Bild 183-C10379, Hermann Ratjen alias "Dora Ratjen".jpg,
Dora Ratjen Heinrich Ratjen (20 November 1918 – 22 April 2008), born Dora Ratjen, was a German athlete who competed for Germany in the women's high jump at the 1936 Summer Olympics at Berlin, finishing fourth, but was later determined to be male and/or in ...
File:Foekje Dillema.jpg, Foekje Dillema File:Tamara and Irina Press 1964.jpg, Sisters Tamara and Irina Press File:EwaKlobukowska.JPG,
Ewa Kłobukowska Ewa Janina Kłobukowska (born 1 October 1946) is a Polish former sprinter. She competed at the 1964 Olympics in the 4×100 m relay and 100 m sprint and won a gold and a bronze medal, respectively.Erik Schinegger in 2014


21st century

* In 2001, Indian athlete and swimmer Pratima Gaonkar committed suicide after disclosure and public commentary on her failed sex verification test. *
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the List of countries and dependencies by area, seventh-largest country by area, the List of countries and dependencies by population, second-most populous ...
n middle-distance runner
Santhi Soundarajan Santhi Soundarajan (also spelled ''Shanthi Soundararajan'', ta, சாந்தி சௌந்திரராஜன், born 17 April 1981) is a track and field athlete from Tamil Nadu, India. She is the winner of 12 int ...
, who won the silver medal in
800 m The 800 metres, or meters ( US spelling), is a common track running event. It is the shortest commonly run middle-distance running event. The 800 metres is run over two laps of an outdoor (400-metre) track and has been an Olympic event since the ...
at the
2006 Asian Games 6 (six) is the natural number following 5 and preceding 7. It is a composite number and the smallest perfect number. In mathematics Six is the smallest positive integer which is neither a square number nor a prime number; it is the second small ...
in
Doha Doha ( ar, الدوحة, ad-Dawḥa or ''ad-Dōḥa'') is the capital city and main financial hub of Qatar. Located on the Persian Gulf coast in the east of the country, north of Al Wakrah and south of Al Khor (city), Al Khor, it is home to m ...
,
Qatar Qatar (, ; ar, قطر, Qaṭar ; local vernacular pronunciation: ), officially the State of Qatar,) is a country in Western Asia. It occupies the Qatar Peninsula on the northeastern coast of the Arabian Peninsula in the Middle East; it sh ...
, failed the sex verification test and subsequently stripped of her medal. *
South Africa South Africa, officially the Republic of South Africa (RSA), is the southernmost country in Africa. It is bounded to the south by of coastline that stretch along the South Atlantic and Indian Oceans; to the north by the neighbouring coun ...
n middle-distance runner
Caster Semenya Mokgadi Caster Semenya OIB (born 7 January 1991) is a South African middle-distance runner and winner of two Olympic gold medals and three World Championships in the women's 800 metres. She first won gold at the World Championships in 2009 ...
won the 800 meters at the
2009 World Championships in Athletics The 12th IAAF World Championships in Athletics () were held in Berlin, Germany from 15–23 August 2009. The majority of events took place in the Olympiastadion, while the marathon and racewalking events started and finished at the Brandenburg ...
in
Berlin Berlin ( , ) is the capital and largest city of Germany by both area and population. Its 3.7 million inhabitants make it the European Union's most populous city, according to population within city limits. One of Germany's sixteen constitu ...
. After her victory at the 2009 World Championships, it was announced that she had been subjected to gender testing. The IAAF confirmed that Semenya had agreed to a sex-testing process that began in South Africa and would continue in
Germany Germany,, officially the Federal Republic of Germany, is a country in Central Europe. It is the second most populous country in Europe after Russia, and the most populous member state of the European Union. Germany is situated betwee ...
. On 6 July 2010, the IAAF confirmed that Semenya was cleared to continue competing as a woman. The results of the gender testing were never officially released for privacy reasons. In 2018, the IAAF announced new rules that once again prevented Semenya from running, rules that are thought to have been designed specifically to target Semenya. * In 2012, after female Indian track athlete
Pinki Pramanik Pinki Pramanik (born 10 April 1986 in Purulia) is an Indian track and field athlete who specialises in the 400 metres and 800 metres. Pramanik had success with the national 4×400 metres relay team, winning silver at the 2006 Commonwealth Game ...
was accused by a female roommate of rape and later charged, she was gender tested and declared a male although she and other medical experts dispute the claims. Pramanik disagreed with these results and police ordered a separate government-led test as part of the trial. The SSKM Government Hospital declared the results to be inconclusive. The Court then directed a chromosome pattern test. * Four unnamed women athletes from developing countries were subjected to gonadectomies (a form of sterilization) and female genital mutilation as part of a process to enable them to compete. The female athletes were discovered to have an intersex trait during testosterone testing; the case was first published in 2013. * Dutee Chand was dropped from the 2014 Commonwealth Games at the last minute after the Athletic Federation of India stated that
hyperandrogenism Hyperandrogenism is a medical condition characterized by high levels of androgens. It is more common in women than men. Symptoms of hyperandrogenism may include acne, seborrhea (inflamed skin), hair loss on the scalp, increased body or facia ...
made her ineligible to compete as a female athlete. Chand took a case to the
Court of Arbitration for Sport The Court of Arbitration for Sport (CAS; french: Tribunal arbitral du sport, ''TAS'') is an international body established in 1984 to settle disputes related to sport through arbitration. Its headquarters are in Lausanne, Switzerland and its ...
and won an interim judgment in mid-2015. In February 2016, it was made known that the IOC would not impose a maximum testosterone level for the 2016 Summer Olympics. In June 2016, Chand qualified to compete in the 100 metres race at the Summer Olympics. Notably, all three medalists in the women's 800 m were intersex, despite intersex people allegedly making up only 1% of the population (intersex testing is not common, true population ratios of intersex individuals are unknown); the 4th, 5th, and 6th placers expressed disappointment and concern. * In 2019,
World Athletics World Athletics, formerly known as the International Amateur Athletic Federation (from 1912 to 2001) and International Association of Athletics Federations (from 2001 to 2019, both abbreviated as the IAAF) is the international governing body fo ...
opted to set a maximum testosterone level for the 400, 800, and one-mile women's races in the
2020 Summer Olympics The , officially the and also known as , was an international multi-sport event held from 23 July to 8 August 2021 in Tokyo, Japan, with some preliminary events that began on 21 July. Tokyo was selected as the host city during the ...
.
Caster Semenya Mokgadi Caster Semenya OIB (born 7 January 1991) is a South African middle-distance runner and winner of two Olympic gold medals and three World Championships in the women's 800 metres. She first won gold at the World Championships in 2009 ...
, an intersex woman who won gold in the women's 800 m in both the 2012 and 2016 Olympics, filed to appeal the decision, which would effectively ban her from competing in middle distance races due to hyperandrogenism. She subsequently attempted to compete in the women's 5k, but failed to qualify by the June deadline.


Transgender athletes

In November 2015, the IOC held a meeting to address both its transgender and
hyperandrogenism Hyperandrogenism is a medical condition characterized by high levels of androgens. It is more common in women than men. Symptoms of hyperandrogenism may include acne, seborrhea (inflamed skin), hair loss on the scalp, increased body or facia ...
policies. In regard to transgender athletes it stated that transgender athletes cannot be excluded from an opportunity to participate in sporting competition. Transgender athletes who identified themselves as female would be allowed to compete in that category as long as their testosterone levels were below 10 nanomoles per litre for at least 12 months prior to the competition. There would be no restrictions on transgender athletes who identify and compete as male. In 2019, the IAAF lowered the maximum level to 5 nmol/L. * Professional tennis player Renée Richards, a transgender woman, was barred from playing as a woman at the 1976 US Open unless she submitted to chromosome testing. She sued the
United States Tennis Association The United States Tennis Association (USTA) is the national governing body for tennis in the United States. A not-for-profit organization with more than 700,000 members, it invests 100% of its proceeds to promote and develop the growth of tennis, ...
and in 1977 won the right to play as a woman without submitting to testing.


Ethics related to sex verification


Chromosome testing

The practice of chromosome testing came under scrutiny from those who feel that the testing was humiliating, socially insensitive, and neither accurate nor effective. The testing is especially difficult for people who could be considered
intersex Intersex people are individuals born with any of several sex characteristics including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, "do not fit typical b ...
. Genetic differences can allow a person to have a male genetic make-up and female anatomy or body chemistry. In the ''
Journal of the American Medical Association ''The Journal of the American Medical Association'' (''JAMA'') is a peer-reviewed medical journal published 48 times a year by the American Medical Association. It publishes original research, reviews, and editorials covering all aspects of b ...
'', Simpson, Ljungqvist and others stated,


Hormone testing

Women with higher levels of androgen (particularly testosterone) are often considered to have a competitive advantage over other women since women statistically have lower levels than men. This difference in androgen levels is the reason many sports requiring athletes compete only among their own sex. However, others argue that expecting women athletes with naturally higher levels of testosterone to lower these levels by medical/pharmaceutical methods completely contradicts the purpose of doping regulations, which require athletes to not take any substances that their bodies do not generate naturally. In January 2010 in Miami, instead of succeeding in improving the policies specifying whether an athlete should participate as a woman or a male, medical professionals experienced ambiguity in regards to these policies. Alice Dreger states it is risky to publicly reveal that an athlete is no longer allowed to compete as a woman without first informing the athlete. For example, Caster Semenya found out through public media that the tests she had taken were meant to determine whether she is female or male. Another athlete, Santhi Soundarjan, had a suicide attempt subsequent to failing the test for determining her gender and being stripped of her 2016 Asian Games medal. A scholar questions whether men with androgen levels similar to those of women will be permitted to participate in the women's category or instead be granted the opportunity to increase their androgen levels to those of other males. This is the logical and fair result how policies using functional testosterone to decide eligibility to compete as a female or a male work for women. Males with
Klinefelter Syndrome Klinefelter syndrome (KS), also known as 47,XXY, is an aneuploid genetic condition where a male has an additional copy of the X chromosome. The primary features are infertility and small, poorly functioning testicles. Usually, symptoms are sub ...
/XXY chromosomes are in this position but nonetheless usually cannot compete while utilizing testosterone because of their medical situation. In the Semenya case the fact that they found high testosterone levels and were going back and forth on her gender verification affected her mental health. By contradicting her sex they were violating laws by international and national genetic privacy laws. Gender verification impacts numerous dimensions of athletes' lives, including unfair disqualification in sporting events, identity crisis and confusion, social isolation, depression, and suicide.


Transgender athletes

Transgender athletes who wish to compete in the female category are allowed to do so if their testosterone levels are in accordance with the required levels. However, the IOC stated that requiring surgical anatomical changes as a requirement for participation may be considered a violation of human rights. Athletics may for some transgender people engage them within greater society in affirming ways. However, others opposed the participation of transgender athletes on women's teams state that the argument is unsound. Athletes who have faced opposition include
Mianne Bagger Mianne Bagger (born 25 December 1966) is a professional golfer from Denmark. In 2004, by playing in the Women's Australian Open, she became the first openly transitioned woman to play in a professional golf tournament. She also became the firs ...
,
Martine Delaney Martine Delaney (born 15 October 1957) is an Australian trans rights activist and former soccer player who became the first transgender woman to be inducted into the Tasmanian Honour Roll of Women in 2021. She first rose to prominence in 2005 when ...
(who participated in "Soccer Tasmanian's women's league") and
Lana Lawless Lana Lawless (born in 1953) is a professional golfer. Lawless is a transgender woman and underwent gender reassignment surgery in 2005 before playing golf professionally. She became a professional title-holding golfer and received recognition for ...
.


Hormone Testing in Post Secondary Education

In 2011, the NCAA made a statement of inclusivity for Transgender athletes competing in college athletics. Through this statement, the NCAA was able to structure an implementation plan for transgender athletes to participate in college sports, and some policies that would ensure an equitable opportunity for every athlete. The following are the specific guidelines for transgender athletes incorporated into the NCAA in 2011:
1. A trans male (FTM) student-athlete who has received a medical exception for treatment with testosterone for diagnosed Gender Identity Disorder or gender dysphoria and/or Transsexualism, for purposes of NCAA competition may compete on a men’s team, but is no longer eligible to compete on a women’s team without changing that team status to a mixed team. 2. A trans female (MTF) student-athlete being treated with testosterone suppression medication for Gender Identity Disorder or gender dysphoria and/or Transsexualism, for the purposes of NCAA competition may continue to compete on a men’s team but may not compete on a women’s team without changing it to a mixed team status until completing one calendar year of testosterone suppression treatment.
In 2021, however, the NCAA adjusted the previous policy of requiring one calendar year of testosterone suppressing therapy for transgender female athletes. Instead, now there is more frequent testosterone testing. The following passage describes these additional requirements:
Starting with the 2022-23 academic year, transgender student-athletes will need documented levels at the beginning of their season and a second documentation six months after the first. They will also need documented testosterone levels four weeks before championship selections. Full implementation would begin with the 2023-24 academic year.
More frequent hormone testing is seen in the IOC policy for sex verification. The motives behind these new implementations, according to the NCAA, is so that there is “consistency and further strengthens the relationship between college sports and U.S. Olympics” Overall, the topic and policies of transgender athletes in post secondary sports is highly controversial. The amount of open transgender athletes competing in college athletics in the United States is extremely small, as only 32 athletes are reportedly transgender. But some of these specific examples grab the public’s attention.


See also

*
Gender Gender is the range of characteristics pertaining to femininity and masculinity and differentiating between them. Depending on the context, this may include sex-based social structures (i.e. gender roles) and gender identity. Most culture ...
* Intersex human rights *
Sexual differentiation Sexual differentiation is the process of development of the sex differences between males and females from an undifferentiated zygote. Sex determination is often distinct from sex differentiation; sex determination is the designation for the dev ...
*
Transgender people in sports The participation of transgender people in competitive sports, a traditionally sex-segregated institution, is a controversial issue, particularly the inclusion of transgender women and girls in women's sports. Opponents argue that transgender ...
*
Testosterone regulations in women's athletics The testosterone regulations in women's athletics are a series of policies first published in 2011 by the IAAF (now World Athletics) and last updated following a court victory against Caster Semenya in May 2019. The first version of the rules applie ...


Notes


References

{{DEFAULTSORT:Sex Verification In Sports Sports medicine Sex