Sex verification in sports
[2] Mandatory sex verification testing was fueled by anxieties surrounding the "unfemininity" of some female athletes, as more participated in historically "masculine" events (e.g., track and field).
This is due to variations in human biology where some people are not unambiguously female or male, not all cells in a person's body have the same genotype or the presence of other atypical genetic condition.
The downside of hormone testing, however, is that policies on hyperandrogenism (women with naturally higher testosterone) were required, which have sparked both public debate and legal battles.
[9] Future IOC president Avery Brundage requested, during or shortly after the 1936 Summer Olympics in Berlin, that a system be established to examine female athletes.
According to a Time magazine article about intersex people, 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.
[14] From 1958 to 1992, all female athletes underwent mandatory sex verification tests before taking part in any IAAF or IOC event.
Barr body tests were conducted by taking samples from inside the cheek to find evidence of XX chromosomes, supposedly indicating the athlete was female.
Ultimately, a central contention was whether a Y chromosome yields a competitive advantage because it is not always accompanied by "manly" attributes that provide greater strength, power, or flexibility.
[15] Martínez-Patiño was told to retire discreetly due to her results, which was commonplace among athletes who failed gender verification tests.
[16] Finnish geneticist Albert de la Chapelle worked alongside Martínez-Patiño to appeal the decision to the IAAF.
Furthermore, he pointed out that the finding of the abnormal sex chromatin and exclusion of these athletes from women's sporting events violated their rights and caused psychological damage.
[22] Athletes were provided with the option to undergo medical and surgical procedures to compete if they had failed the gender verification testing.
[22] In August 2009, South African athlete Caster Semenya was subjected to mandatory sex verification testing at the request of the IAAF.
The protocols rejected the terms "sex testing" and "gender verification" and placed emphasized importance on testosterone levels, as certain athletes would not be eligible to compete in the female category due to hormonal characteristics.
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 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.
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.
[6][33] Moreover, the requirement to lower testosterone levels can have adverse impacts on athletes' health, as side effects may include: excessive thirst, urination and electrolyte imbalances, disruption of carbohydrate metabolism, headache, fatigue, nausea, hot flushes, and liver toxicity.
As well, other factors, such as mitochondrial variations, acromegaly, a complete and balanced diet, and access to high level training at an early age, are said to be as relevant as testosterone, but are not considered.
In regards to hyperandrogenism in female athletes, the IOC encouraged reinstatement of the IAAF policies suspended by the Court of Arbitration for Sport.
[44][45] Immediately preceding the games, Genel, Simpson and de la Chapelle were again published in Journal of the American Medical Association stating: One of the fundamental recommendations published almost 25 years ago ... that athletes born with a disorder of sex development and raised as females be allowed to compete as women remains appropriate.
With the passage of time and the recurring public spectacle of young women ... having their underlying biology indiscriminately scrutinized in the world media, it has become evident that the hyperandrogenism policies are no more salutary than earlier attempts to define sharp sex boundaries.
[46]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.
[47] The World Medical Association (WMA) demanded the withdrawal of these regulations arguing that they discriminate based on gender variation of female athletes.
[49]In 2021, however, the NCAA adjusted the previous policy of requiring one calendar year of testosterone suppressing therapy for transgender female athletes.
Transgender athletes who identified themselves as female would be allowed to compete in that category as long as their testosterone levels were below 10 nmol/L for at least 12 months prior to the competition.
Athletes who have faced opposition include Mianne Bagger, Martine Delaney (who participated in "Soccer Tasmanian's women's league") and Lana Lawless.
