s or in some cases were actually
fitted with casts. In 1 celebrated case, a Spanish hurdler, Maria
Patino, was publicly disclosed after failing her femininity test
during an event in Tokyo, at the cost of public disgrace and loss
of her athletic scholarship. It took 2 years and the active intercession
of a number of medical authorities for Ms. Patino, who has androgen
resistance, to be reinstated.
Circumstances such as these and the efforts of a number of
dedicated professionals resulted in some changes by the early
1990s. This author has had the privilege of working with an international
group of professionals, some of whom were convened by the International
Athletic Federation (IAAF) for a Workshop on Methods of Femininity Verification held in late 1990 in Monte Carlo. Our group concluded that laboratory-based sex determination should be discontinued, a recommendation that was accepted shortly thereafter by the IAAF and subsequently by all but 4 of the international athletic federations. The IOC, however, instead replaced sex chromatin with DNA-based methods to detect Y chromosomal material, principally the SRY sex-determining locus on the Y chromosome, implementing this procedure at the 1992 winter games in Albertville. At the insistence of the organizers, the 1996 Summer Olympic Games in Atlanta included a comprehensive process for screening, confirmation of testing, and counseling of individuals detected. Eight of 3387 female athletes (1:423) had positive test results. Of these, 7 had androgen insensitivity, 4 incomplete, and 3 complete; the other athlete had previously undergone gonadectomy and is presumed to have 5-alpha-steroid reductase deficiency. All individuals were given appropriate gender verification certificates and were permitted to compete.
After the Atlanta Olympics, efforts continued to persuade the
IOC to abandon gender verification. Indeed, by the time of the
1996 Summer Olympic Games in Atlanta, essentially all of the relevant
professional societies had endorsed resolutions that called for
elimination of gender verification, including the American Medical
Association, the American Academy of Pediatrics, the American
College of Physicians, the American College of Obstetrics and
Gynecology, the Endocrine Society, the Lawson Wilkins Pediatric
Endocrine Society, and the American Society of Human Genetics.
It was argued that the current clothing used in athletic competition,
as well as the requirement that urine for doping control be voided
under direct supervision, made it virtually certain that male
impostors could not escape detection; furthermore, gender verification
procedures are complex, expensive, and counterproductive.
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 on a trial basis at the forthcoming
summer Olympic games in Sydney. The proposal by the Athletes'
Commission, similar to the IAAF plan that has been in place for
track and field since the early 1990s, permits intervention and
evaluation of individual
athletes by appropriate medical personnel if there is any question regarding gender identity. Since the IAAF policies were instituted in 1992, this has never been invoked, nor is it likely to be in Sydney under the circumstances described above, especially because of the requirement
for freshly voided urine for doping testing. I truly hope that the IOC's decision will become permanent with the conclusion of the Sydney games and that laboratory verification of the gender of female athletes will reside in the historical chronicles of the Olympic Games together with competition in the nude of their ancient male predecessors.
1. de la Chapelle A. The use and misuse of sex chromatin screening for "gender verification" of female athletes. JAMA. 1986;256:1920-1923.
2. Ferguson-Smith MA. Gender verification and the place of XY females in sport. In: Harris W, Williams C, Stanish W, Micheli L, eds. Oxford Textbook of Spor