Athletes' gender row: The complex sex eligibility guidelines

Bengaluru: The inextricable nuance of gender seen in the Paris Olympics has once again left everyone scratching their heads. But the cases of Algeria’s Imane Khelif and Taiwan’s Lin Yu-Ting may well be collateral damage of a geopolitical tussle between the International Boxing Association and the International Olympic Council. The IBA says the two boxers are not female based on the tests they ran a year ago but are unwilling to reveal the results. The IOC, on the other hand, insists they are females based on the sex passport they have given to the athletes.

Roshan Thyagarajan tries to make sense of what has always been an amorphous concept.

The controversy around Khelif and Yu-Ting?

The outrage stems from the IBA claims that Khelif and Yu-Ting failed unspecified eligibility tests for the women’s competition at the IBA-organised World Championships in New Delhi in June 2023. Both women were then excluded, mid-competition. The IBA informed the IOC by letter of the tests, saying that they had XY male chromosomes.

But the Olympic body has repeatedly rejected the test as "arbitrary" and "cobbled together" and has argued against sex testing, which it scrapped in 1999. More pertinently, none of the IBA’s findings has been made public. Due to the banishment of the IBA, the IOC used rules from 2016 - which don’t include a gender test but only hormonal testing - to determine boxers’ gender eligibility. This allowed Khelif and Lin to compete in Paris because anyone recognised as a woman in their ‘sex passport’, which is not the same as a regular passport. 

What is a sex passport?

In 1966, the IOC established that female athletes must submit to a complete physical examination before each international competition. In 1968, they further established that each female participant be granted a ‘sex passport’ based on the findings of a medical and gynaecological examination as well as chromosomal sex determination. Based on these tests, both the athletes, in possession of the ‘sex passport’, were allowed to participate in the Olympics despite being disqualified at the Worlds last year. Athletes have to carry a ‘sex passport’ on them at all times.

What is genetic testing that the IBA had reportedly relied on?

A person typically has 23 pairs of chromosomes in each cell (23 pairs/ 46 total chromosomes). One of these pairs is called the sex chromosomes (X and Y). If you are male, you have an XY pair. If you are female, you have an XX pair. The other 22 pairs are called autosomes, and they are the same in males and females. This test looks for changes, or abnormalities, in the chromosomes that make up your body’s DNA, or genetic road map.

What is testosterone testing?

It’s a simple test designed to measure the amount of testosterone in the sample of your blood. Typically, testosterone is referred to as a ‘male’ sex hormone, but females have the same hormone in smaller amounts. The testosterone range for men, typically, is 400 ng/ dL (nanograms per decilitre) for younger males, and between 15-70 ng/ DL for adult females. There is plenty of evidence to suggest that higher testosterone levels provide an athletic advantage to athletes. Therefore, it has become imperative to test the levels athletes operate in before events to see if they are injecting themselves with testosterone or if it’s naturally high in occurrence in their bodies. These ranges, however, tend to fluctuate significantly on a case-by-case basis. And that is exactly why there is a lot of ambiguity when it comes to testing for athletes. The IOC has previously stated that testosterone concentration must be less than 10 nmol/l (nanomiles per litre) for at least 12 months prior to and during competition as a threshold for female athletes’ participation. Naturally, both Khalif and Yu-Ting had to maintain numbers below that in order to qualify for the Olympics.

What is DSD? What about Swyer Syndrome?

Although there is no case made for Khelif or Yu-Ting having Differences in Sexual Development (DSD), should IBA’s findings be proven, the two athletes can still be considered for women’s sports because DSD is not the same as being transgender. Someone with a DSD may identify as one sex while having strong characteristics of the other, but it is a natural biological mix. A transgender person is usually born one sex and then lives as the other because they feel that is their true identity. DSD involve genes, hormones and reproductive organs, but has nothing to do with gender identity. It's false to conflate transgender people with people who were born with DSD. Some people with DSDs are raised as female but may have sex chromosomes other than XX, or elevated testosterone levels, according to the National Institute of Health. People with Swyer Syndrome, according to the National Library of Medicine, have one X chromosome and one Y chromosome in each cell (typically found in boys and men), but they have female reproductive structures.

Are gender rules different for different international sports events?

Sports bodies - World Aquatics, World Athletics, and the International Cycling Union and so on - have all updated their gender rules bespoke to their sport since the Tokyo Games. The bodies ban transgender female athletes who have gone through male puberty from participating in women’s competitions. World Athletics hasn’t clearly defined its definition of what constitutes having “been through male puberty,” which is a multi-year process beginning as early as age nine. With World Athletics updating its rules on athletes with DSD, Caster Semenya, a two-time Olympic 800-meter champion, has not featured in 800-meter events since 2019.