Objectivity regarding sex, gender, and the Olympics

In response to the IBA's uninformative press conference and the ongoing Imame Khelif controversy.

This is a continuation of my post from Sunday with additional context given the IBA has given a press conference due to the controversies. Bear in mind that I am still of the belief that Khelif’s sex chromosome status is still unknown, as well as Khelif’s testosterone levels. That being said, I wanted to provide my perspective on how I view the situation and am trying to rationalize all of the noise that is running about, especially given that there’s still a lot of misinformation and confusion regarding sex and gender. Apologies for the long-winded article, but hopefully it helps to capture my thought process.

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Yesterday the International Boxing Association held a press conference to further elaborate their findings regarding Algerian boxer Imane Khelif as well as Taiwanese boxer Lin Yu-ting.

One can view the press conference in the link below. Note that there’s a delayed start and poor audio, and be careful of spontaneous noise feedback jump scares (around the 45 and 53 min mark for instance):

Unfortunately, what should have been a conference where details on the IBA’s eligibility requirements and Khelif’s disqualification are further elucidated, we instead were treated to further politicking and culture war shouting matches.

The press was obviously incongruent regarding their stances on the targeting on Khelif, suggesting that the events that have transpired were politically motivated and unfounded, leading to unnecessary attacks towards Khelif that is causing emotional and mental harm.

The IBA didn’t help themselves much as they spoke around the testing that their organization conducted. IBA president Umar Kremlev reiterated multiple times that both Khelif and Yu-ting had testosterone levels similar to that of men as reasons for the disqualifications, even though the IBA’s own accounts explicitly stated that no test for testosterone levels were ever conducted.

The only bit of elaboration came from Ioannis Filippatos, a former Chair of the IBA Medical Committee who alluded to genetic testing suggesting an XY karyotype status of both Khelif and Yu-ting. But even here amongst this attempt at clarification came moral grandstanding regarding the karyotype status of Khelif and the overall need to protect women in sports.

Granted, the whole reason this debacle has taken place is due to the unfair advantage and possible harm that could befall females if they were to combat males. But in instances where clarification is needed concise messaging is warranted- by getting wrapped up within the sociopolitical discourse you lose the ability to focus on the objective measures that are the root of the controversy.

This is obvious when Filippatos wanted to clarify on a question he was asked regarding gender-affirming care (??) given his status as a doctor. When Filippatos wanted to use that as a jumping off point to expound upon the clinical nature of gender, sex, and intersex, the journalist instead pivoted elsewhere, leaving an otherwise important piece of information out of the discussion.

It’s clear that no additional information would come from this press conference. But what was also clear was that the discussion around sex, gender, trans, etc. has been poisoned by ideology, narratives, groupthink, and many other subjective aspects.

The journalists asking questions during the press conference didn’t care to know about the scientific underpinnings of sex and gender, and instead focused on the idea that Khelif was- and always appears to have been- a woman, and therefore is a woman. Many conservatives/critics of Khelif have themselves suggested that Khelif’s alleged XY status would be enough to say that Khelif is male, and therefore is the end of the discussion.

The problem is that there is nuance that appears to be missing here, and the more the debate regarding sex and gender rages on the more important it is that people be objective in their criticisms, because as I see it there’s been egregious misuse regarding sex-related language and science that is constantly perpetuated. That includes understanding the significance of sex chromosomes, how this manifests phenotypically and sexually, as well as what happens in matters of those who are intersex.

Sex-based heuristics

As mentioned before people are aware of the heuristic that those who carry XY karyotypes overwhelmingly develop into males whereas those with XX karyotypes develop into females.

Heuristics, or mental shortcuts, are ways in which we perceive and conceptualize the world that doesn’t require us to spend a good deal of time having to consider finer details and considering all possibilities. They allow us to solve problems quicker even though they may not always be accurate.

We apply heuristics every day as a quick way to assess situations and come to conclusions. Although generally a good way to initially problem-solve, it also can leave us prone to biases, making errors in assessment, and may require routine corrections. Image from Simple Psychology

Take, for instance, when you go to the grocery store. If you’re looking for a loaf of bread, you’ll likely head to the bread aisle; if you want apples you’ll likely head to the fruit section. Both the bread aisle and the fruit section are heuristics- we can, on good assumption, generally find bread and apples within these respective areas.

But suppose you instead needed something more specific; a loaf of brioche to make French toast. Heuristics would suggest that you head to the bread aisle, and yet when you scour the shelves you may realize that there’s no brioche stocked. Wandering around the store you may realize that you should check the bakery section, and there you find that much-needed loaf of brioche.

In such a circumstance a heuristic doesn’t quite work- it relied on an assumption that isn’t always correct. In this case just because brioche is a type of bread doesn’t mean that it will be in the bread aisle, even if that’s our go-to assumption.

Ideally, in the instance that a heuristic is incorrect it requires that we rework our heuristic and understand why it wasn’t quite accurate and how to better fine-tune it for the future.

But there’s also an underlying aspect of heuristic that should also be cautioned against, in the sense that heuristics can cause us to forget why we are utilizing those exact shortcuts. Exactly why did we figure out that the best place to go for apples is the fruit section, and why would we look for a loaf of brioche in the bread aisle (which may prove to be wrong)?

Let’s consider this thought through the lens of the current controversy. More specifically, elaborating on sex-based heuristics and how this is causing many of the problems we are seeing today.

We are generally aware of the heuristic that our sex chromosomes act as sex determinants. That is, those who have XX sex chromosomes are female while those who have XY sex chromosomes are males. For the overwhelming majority of humans this heuristic is generally accurate- it’s not wrong to assume that someone with XY sex chromosomes will inherently develop male characteristics and present as a man. It’s only through modern proclivities and sensibilities is this heuristic now at the forefront of a culture war.

But there’s more to the story of sex chromosomes than just sex determination. That is, genes located on either the X chromosome or the Y chromosome are responsible for sexual dimorphism, or differences in physical traits and morphology between individuals from the same species but otherwise different sexes. Sexual dimorphism explains why male birds usually display vibrant, colorful feathers while females are usually brown or more monotone in their coloration. It explains why males of a mammalian species may be more aggressive, muscular, and larger while females may be more cooperative, nurturing, and smaller.

It's important to remember that our bodies follow a general (albeit extremely simplified) path, in that our genes generally dictate our physical traits (leaving out epigenetic factors for the time being).

Put another way, we can consider that our physical traits run downstream of our genetic makeup and gene expression.

Consider, for instance, that genes located on the Y chromosome dictate the development of testes. In the absence of a specific portion of the Y chromosome (as seen in those who have XX sex chromosomes) the default development generally moves towards ovaries.

Here, androgenic differences in production/exposure occur, with testes usually producing testosterone while ovaries generally produce estrogen.

From Gilbert, SF. A postulate for sexual phenotype formation in mammals. The purpose here is to highlight how genes direct sexual development and androgen production, which themselves cause changes within the body.

This difference in androgen exposure leads to variations in androgen signaling between males and females. Hence, more testosterone exposure in males, especially during puberty, results in male sexual development as well as larger bodies with a more muscular frame.

We can summarize this flowline the following way:

XY sex chromosomes -> male genes and gene expression -> male physical traits and characteristics.

This brings us to the Khelif controversy…

A case of intersex for perspective

As of now many conservative/gender critical individuals have commented that Khelif possibly having an XY karyotype is enough to warrant disqualification from competition. On the other hand, many on the ideological left are saying that Khelif appearing as a woman is enough to suggest that Khelif is a woman.

The problem with both stances is that they operate on only aspect of the above flowline. For those looking only at Khelif’s karyotype makeup they are operating far-too upstream and not elaborating on what the ramifications are for having an XY karyotype. For the ideological left, they are operating so downstream that they are dismissing the biological facets that are important to assessing sex and gender.

So one group is focusing far-too upstream, one is focusing far-too downstream, and none is following the stream to piece everything together.

Let’s consider this within the context of the Khelif situation. Note that I am not confident that Khelif is confirmed to have XY sex chromosomes, but for this thought experiment we will make that assumption.

Khelif bearing XY sex chromosomes would suggest that Khelif would carry genes that would direct male development. If so, this may suggest greater production of testosterone and therefore androgen signaling and response. As a result, the elevated testosterone could lead to greater muscle development and in turn athletic performance.

All this to say that it’s not just that Khelif may bear XY sex chromosomes that is the problem, but that XY sex chromosomes may suggest increased production and exposure to male androgens such as testosterone, and it’s through this elevated exposure that Khelif may be at an athletic advantage.

Thus, it’s the exposure to elevated testosterone through carrying XY sex chromosomes that is the problem, not just the sex chromosomes alone.

Now, this whole post may seem like a whole write up of redundancy, and many readers may find it completely unnecessary to the discourse.

That being said, it’s important that when we raise criticism we try to remain objective.

Because for all intents and purposes the world of athletics has been strict regarding the use of doping agents. It’s well known that use of exogenous testosterone and other anabolic steroids can have permanent, lasting effects on muscle development and athletic performance- once a juicer always a juicer.

Hence, many sports take to conducting rigorous doping tests in order to ensure a fair advantage among athletes.¹ And even within these circumstances we are talking about people who, by all accounts, are the same sex.

But what if, due to circumstances of genetic abnormalities, do we get people who have elevated testosterone but otherwise appear as a woman? While people are wrestling with morality and ethics the science seems rather clear.

That is, irrespective of whether the testosterone is exogenously synthesized and administered or endogenously produced, elevated testosterone is likely to confer an unfair advantage under many, if not all, circumstances.

A clear example of this comes from Caster Semenya, a two-time Olympian from South Africa who became the center of attention recently when it was found that Semenya carried an XY karyotype as well as a rare genetic mutation called 5α-Reductase 2 deficiency, an autosomal recessive mutation which leads to a loss-of-function in the enzyme called 5α-Reductase. 5α-Reductase is responsible for converting testosterone into dihydrotestosterone (DHT), a hormone critical for male development. Because of this loss-of-function many people carrying this trait may appear female, although this depends on the effects of other androgens as these individuals naturally continue to produce testosterone, and in fact this trait may be found during puberty in which elevated androgen production may still result in some degree of masculinization.

Based on reports it appears that Semenya has levels of testosterone within the normal range for males.

Image from The Independent, with caption noting the following: “Caster Semenya at the 2023 World Cross Country Championships (Getty Images for World Athletics)”

Because of this unique circumstance Semenya has become embroiled with many controversies, including whether such an individual should be allowed to compete against females. In some circumstances of disorders of sexual development (DSD) the response has been to put people such as Semenya on hormone blockers to reduce testosterone levels.

However, this response doesn’t address the fact that Semenya has been exposed to testosterone for many years and through development, all of which is likely to have permanent effects on muscle growth and performance.

Now, I didn’t want to dive deep into the role of people who are intersex, especially since I am still unsure of Khelif’s karyotype status. But in the case of Semenya the answer seems rather simple- it’s the XY karyotype status, as well as the naturally elevated testosterone levels as a consequence of the XY karyotype status that would confer an unfair advantage for Semenya when competing against females, and thus should be grounds for barring from competition against females.

Because, once again, irrespective of whether the testosterone is exogenously synthesized or endogenously produced elevated testosterone will inherently confer an advantage in competition and should act as a reason for disqualification.

A viable, science-based rubric is needed

It’s unlikely that the discourse surrounding Khelif will lighten up soon. But as misinformation and narratives continue to run amuck it seemed important to provide some framework to operate under.

Here, I’ve hopefully shown my path of logic when it comes to the discourse. If it happens that Khelif does in fact carry an XY karyotype and produces elevated levels of testosterone (likely as a consequence of the XY karyotype) that should be considered as reasons for disqualification. But for the time being I find the current evidence to not be adequate.

That being said, it’s important to note that it is not enough to exclaim that Khelif may carry XY sex chromosomes that we raise criticisms, but it’s through the ramifications of having XY sex chromosomes where we elaborate further on the issues at hand. It’s the latter that is never elaborated on within the discourse, even though it’s pretty important when viewing the current circumstances where uncertainty and speculation run abound.

This is why, unfortunately, the circumstances around the IBA’s testing allow room for doubt. If they so happened to have conduct both an examination of karyotype status as well as hormone testing we likely wouldn’t be quibbling as we are right now since the results would be rather conclusive.

But because of the confidential nature of their testing, and the fact that they explicitly stated they did not conduct tests for testosterone levels, we are left without anything objective.

And let’s be clear- the IOC is just as culpable in this debacle, as the IOC has allowed each sport to come up with their own rubrics for eligibility. In the case of boxing someone’s “sex” on their passport is sufficient enough for them to be considered within the aligned division.

This approach is even more unscientific since it is so subjective that even Filippatos made a comment that he could change his gender on a whim and fight within the women’s division if that is all that is required to consider eligibility.

In order avoid such a catastrophic event in the future it’s important that clear, evidence-based logic and reasoning are used when considering eligibility requirements, and not perceptions and subjectivity.

There’s likely to be a lot I have left out of the discussion, and here I’ve only hinted at intersex variation due to the complex nature of intersex. Again, remember that references to alleged intersex or XY karyotype status with respect to Khelif are speculations that are intended to provide for a thought experiment and more evidence is needed surrounded the status of Khelif before a full opinion can be made by me.

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1. Bear in mind that many athletes obviously find ways to maneuver around getting caught doping, and there are many instances where it’s an unspoken given such as bodybuilding.