Decision to Abolish Gender Testing at Sydney Olympics Supported By Yale Physician

The decision by Olympic officials to discontinue, on a trial basis, gender testing at the summer games in Sydney, Australia, was long in coming, a Yale physician says.

“In reality, gender verification tests are difficult, expensive, and potentially inaccurate,” said Myron Genel, M.D., a pediatric endocrinologist at the Yale School of Medicine and co-author of a commentary on gender testing published in the September 27 issue of The Journal of the American Medical Association. “Furthermore, these tests fail to exclude all potential impostors, are discriminatory against women with disorders of sexual development, and may have shattering consequences for athletes who ‘fail’ a test.”

Gender testing was first initiated 34 years ago to insure that men were not masquerading as women to compete in women’s international athletic events. The first test at the 1966 European Track and Field Championships required women athletes to walk nude or almost nude before judges. Over the years, the gender testing evolved to physical examinations and then chromosome tests.

Genel said the tests resulted in substantial harm for women athletes born with relatively rare genetic abnormalities that affect the development of testes and ovaries, or the expression of secondary sexual characteristics.

The first test, the Barr Body test, looked for an inactive second X chromosome. Women usually are born with two X chromosomes and the second is inactivated and appears like a small dot in the nucleus of the cell. In men, who have XY chromosomes, there would be no such evidence in the cells. However, Genel said, women with Turner Syndrome only have one X chromosome and so would not show the tell tale sign in the cell nucleus. “In the most common form of Turner Syndrome, the girls do not mature sexually and they’re small,” he said. “Still, they are unequivocally female, but if they took the test, they would fail.”

Other women, he said, might have X and Y chromosomes, like men, yet their bodies are resistant to testosterone. “They have testes, but usually they do not descend and their external genitalia is entirely female,” he said. “They are women but they also would fail the test.”

The irony, Genel said, is that men with Klinefelter’s Syndrome have two X chromosomes and one Y chromosome. They very typically have small testes and are infertile, yet they would have passed the test as women because of the extra X chromosome.

The International Amateur Athletics Federation (IAAF) in 1990 convened a committee of physicians in Monte Carlo, including Genel, to develop an alternative method for gender verification. The participants included physicians from a number of specialties, among them genetics, pediatrics, endocrinology, and psychiatry. The committee concluded no testing was needed. The group said that revealing, contemporary athletic clothing left little doubt about a competitor’s gender. In addition, they said, routine drug testing requires that urine voiding must be observed by an official to verify that the sample from a given athlete is truly his or hers, which makes disguising gender virtually impossible.

In 1992 the IAAF did away with any type of gender testing. Soon after all but five of the 35 International Federations of Olympic Sports (IOC) abolished gender verification testing at their world championships. The only IOC sports that maintained the tests were basketball, judo, skiing, volleyball and weightlifting.

But the International Olympic Committee did not follow suit. The committee instead replaced the test with a new DNA-based method. The test was first implemented at the 1992 Winter Olympics in Albertville.

At the Summer Olympic Games in Atlanta in 1996, eight of 3,387 female athletes had positive test results with the new test. Of these, seven had androgen, or testosterone, resistance. The eighth athlete had previously undergone a gonadectomy, which is surgical removal of the testes, and was presumed to have deficiency of an enzyme necessary to activate testosterone in responsive tissues. All eight women were given appropriate gender verification certificates and were permitted to compete.

“Still, it was not until the IOC’s Athletes’ Commission called for discontinuation of the IOC system of gender verification that the IOC’s executive board, at its June 1999 meeting in Seoul, decided to discontinue the practice of gender testing on a trial basis at the forthcoming summer Olympic games in Sydney,” Genel said.

The IIAF, when it abandoned gender testing, reserved the right to have medical personnel examine individual athletes if there was any question regarding gender identity. The IAAF policies were instituted in 1992, yet this option has never been invoked, Genel said.

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