The science and management of sex verification in sport

Abstract

The verification of gender eligibility in sporting competition poses
a biological and management challenge for sports science and medicine, as well as for sporting authorities. It has been established that in most sporting events, the strength and power advantage possessed by males as a result of the virilising action of hormones such as testosterone produce significant advantages in performance. For this reason, males and females compete largely in separate gender categories. Controversies arise as a
result of intersex conditions, where the classification of individuals into male or female is complex. The present review provides the historical context to the debate, identifying the origins of gender verification as a means to deter cheating. It describes how various testing methods have been attempted, including physical examinations of genitalia, molecular techniques including genetic screening, and complex multidisciplinary approaches including endocrinological, genetic and gynaecological examination. To date, none appear to have provided a satisfactory resolution to the problem, and appear instead to have unfairly discriminated against individuals as a result of inappropriate application of testing results. Sporting authorities have formulated position stands
for the management of such cases, but there is not absolute agreement between them and little evidence to support whether intersex individuals should or should not be allowed to compete in female categories.