Gender verification in sports

Gender verification in sports (also known as sex verification, or loosely as gender determination or a sex test) is the issue of verifying the eligibility of an athlete to compete in a sporting event that is limited to a single sex. The issue arose a number of times in the Olympic games where it was alleged that male athletes attempted to compete as women in order to win, or that an intersexed person competed as a woman. Sex testing began at the 1966 European Athletics Championships in response to suspicion that several of the best women athletes from the Soviet Union and Eastern Europe were actually men. At the Olympics, testing was introduced at the 1968 Olympic Winter Games in Grenoble. While it arose primarily from the Olympic Games, gender verification affects any sporting event. However, it most often becomes an issue in elite international competition.

While it would seem a simple case of checking for XX vs. XY chromosomes to determine whether an athlete is a woman or a man, it is not that simple. Fetuses start out as female, and the Y chromosome turns on a variety of hormones that differentiate the baby as a male. Sometimes this does not occur, and XX people with two X chromosomes can develop hormonally as a male, and XY people with an X and a Y can develop hormonally as a female.

Tests
For a period of time these tests were mandatory for female athletes. A New York Times article suggests it was due to fears that male athletes would pose as female athletes and have an unfair advantage over their competitors.

Nowadays, gender verification tests typically involve evaluation by gynecologists, endocrinologists, psychologists, and internal medicine specialists.

History
United States Olympic Committee 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 hermaphrodites, Brundage felt the need to clarify "sex ambiguities" after observing the performance of Czechoslovak runner and jumper Zdenka Koubkova and English shotputter and javelin thrower Mary Edith Louise Weston. Both individuals later had sex change surgery and legally changed their names, to Zdenek Koubek and Mark Weston, respectively.


 * Perhaps the earliest known case is that of Stanisława Walasiewicz (aka Stella Walsh), a Polish athlete who won a gold medal in the women's 100 m at the 1932 Summer Olympics in Los Angeles, but who after her death in 1980 was discovered to have had partially developed male genitalia. (See below for genitalia as indicators of a person's sex.)
 * Another Polish athlete Ewa Kłobukowska, who won the gold medal in women's 4x100 m relay and the bronze medal in women's 100 m sprint at the 1964 Summer Olympics in Tokyo, is the first athlete to fail a gender test in 1967. She was found to have a rare genetic condition which gave her no advantage over other athletes, but was nonetheless banned from competing in Olympic and professional sports.
 * Eight athletes failed the tests at the 1996 Atlanta Olympics but were all cleared by subsequent physical examinations.

Controversies
The practice has come under fire from those who feel that the testing is humiliating, socially insensitive, and not entirely accurate or effective. The testing is especially difficult and problematic in the case of people who could be considered intersexual. Genetic differences can allow a person to have a male genetic make-up and female anatomy or body chemistry.

A commentary published in the Journal of the American Medical Association stated, "Gender verification tests are difficult, expensive, and potentially inaccurate. Furthermore, these tests fail to exclude all potential impostors (eg, some 46,XX males), are discriminatory against women with disorders of sexual development, and may have shattering consequences for athletes who 'fail' a test." The article also states: "Gender verification has long been criticized by geneticists, endocrinologists, and others in the medical community. One major problem was unfairly excluding women who had a birth defect involving gonads and external genitalia (i.e., male pseudohermaphroditism). ... A second problem is that only women, not men, were subjected to Gender verification testing. Systematic follow-up was rarely available for athletes "failing" the test, which often was performed under very public circumstances. Follow-up was crucial because the subjects were not male impostors, but intersexed individuals."

Current status
Sex testing has been done as recently as the Atlanta Olympic games in 1996, but is no longer practised, having been officially stopped by the International Olympic Committee in 1999. This followed a resolution passed at the 1996 International Olympic Committee (IOC) World Conference on Women and Health "to discontinue the current process of gender verification during the Olympic Games." In individual cases the IOC stills holds on to the right to test on gender.

New rules permit transsexual athletes to compete in the Olympics after having completed sex reassignment surgery, being legally recognized as a member of the sex they wish to compete as, and having undergone two years of hormonal therapy (unless they transitioned before puberty). These controversies continue with the 2008 Olympic games in Beijing.

The International Association of Athletics Federations ceased sex screening for all athletes in 1992, but retains the option of assessing the sex of a participant should suspicions arise. This was invoked most recently in August 2009 with the mandated testing of South African athlete Caster Semenya.

The Olympic Council of Asia continues the practice.

Notable incidents

 * Prior to the advent of sexual verification tests, German athlete Dora Ratjen competed in the 1936 Olympic Games in Berlin and placed fourth in the women's high jump. She later competed and set a world record for the women's high jump at the 1938 European Championships before tests by the German police concluded that she was actually a man who then took the name Heinrich Ratjen.
 * The Dutch sprinter Foekje Dillema was expelled from the 1950 national team after she had failed a sex test; later investigations revealed a Y-chromosome in her DNA. She probably was an 46XX/46,XY mosaic person.
 * Sisters Tamara and Irina Press won five track and field Olympic gold medals for the Soviet Union and set 26 world records in the 1960s. They ended their careers before the introduction of gender testing in 1966. There is no proof of a disorder in sexual development in these cases.
 * Professional tennis player Renée Richards, a transsexual woman, was barred from playing as a woman at the 1976 US Open unless she submitted to chromosome testing. She sued the United States Tennis Association and in 1977 won the right to play as a woman without submitting to testing.
 * Indian middle-distance runner Santhi Soundarajan, who won the silver medal in 800 m at the 2006 Asian Games in Doha, Qatar, failed the gender verification test and was stripped of her medal.
 * South African runner Caster Semenya won the 800 meters at the 2009 World Championships in Athletics in Berlin. The International Association of Athletics Federations (IAAF), track and field's governing body, confirmed that Semenya had agreed to a sex-testing process that began in South Africa and would continue in Germany. On July 6, 2010, the IAAF confirmed that Semenya was cleared to continue competing as a woman, although the results of the gender testing were never officially released for privacy reasons.