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Original poster

Women with complete androgen insensitivity syndrome

262 replies

Tandora · 01/08/2024 17:22

https://www.nhs.uk/conditions/androgen-insensitivity-syndrome/symptoms/#:~:text=Girls%20with%20CAIS%20do%20not,make%20some%20sexual%20acts%20difficult.
Inspired by the dumpster fire of a certain thread that filled up just now -
AIBU to share some information about girls and women with CAIS. Many of these women and girls won’t learn about their variation in sex characteristics until adulthood. Some might never know and not without the assistance of modern technologies (that can test , eg, karyotype). For cases of CAIS identified at birth, most individuals are assigned/ registered/ raised female. (Yes sex can be assigned).

Anyone who could know a girl/ woman with CAIS in the real world, and tell her she is , in fact , unambiguously a boy/ man, because gametes, - well you would deserve worse than to be called a sexual fascist.

The NHS recognises the existence of girls and women with CAIS , and provides medical interventions accordingly.

https://www.nhs.uk/conditions/androgen-insensitivity-syndrome/symptoms/#:~:text=Girls%20with%20CAIS%20do%20not,make%20some%20sexual%20acts%20difficult.

https://www.ncbi.nlm.nih.gov/books/NBK1429/

Yes these conditions are rare, but the more we learn about the biology of sex development , the more complex the picture becomes, as with most areas of science/ biology/ medicine .

nhs.uk

Androgen insensitivity syndrome - Symptoms

Read more about the symptoms of androgen insensitivity syndrome (AIS), which vary depending on whether the insensitivity is partial or complete.

https://www.nhs.uk/conditions/androgen-insensitivity-syndrome/symptoms#:~:text=Girls%20with%20CAIS%20do%20not,make%20some%20sexual%20acts%20difficult.

OP posts:
SilenceInside · 01/08/2024 21:27

@Tandora it's been explained to you on this thread. If the person has a DSD then it is known which DSDs mean the person has been through male puberty and responds to testosterone.

Original poster
Tandora · 01/08/2024 21:26

This reply has been deleted

Message deleted by MNHQ. Here's a link to our Talk Guidelines.

😂😂. And that’s my queue to stop ignoring my husband and baby . Take care all x

OP posts:
RedToothBrush · 01/08/2024 21:25

This reply has been deleted

Message deleted by MNHQ. Here's a link to our Talk Guidelines.

Original poster
Tandora · 01/08/2024 21:24

SilenceInside · 01/08/2024 21:15

@Tandora of course it's possible. DSDs where the person has experienced male puberty and responds to testosterone means the person cannot compete in the female category.

Now it’s “male puberty”? Normally it is karyotype, or gametes on these threads. What is the medical test that proves whether someone has “experienced male puberty”?

OP posts:
ditalini · 01/08/2024 21:23

Tandora · 01/08/2024 21:13

The definitions of DSDs are well defined

you are not following. DSDs are well defined; having a well defined DSD, however, does not answer the question of whether that person who has that DSD is properly described as “male” or “female”, which is what the sporting authorities are trying to do.

(You acknowledge this yourself when you say that you can “see a case” that people with CAiS are properly described as female).

Edited
Show quote history

Can I just check, do you subscribe to the concept of "hormonal sex" and consider someone born male, who has passed through male puberty, but has altered their hormonal levels by supressing their testosterone (through orchiectomy or chemical means), and taking oestrogen, to be a type of female?

Is this part of the "it's really complicated" thing that might involve such a person legitimately, in your opinion, competing in the female category?

RedToothBrush · 01/08/2024 21:22

KeirSpoutsTwaddle · 01/08/2024 21:16

It’s like a bingo card.

She should have trained harder.
She should be used to being hit
Noone knows what sex anyone else is
Stop being genital nazis
Why do you care about other people’s genitals
Don't be so mean.

That's being charitable.

Original poster
Tandora · 01/08/2024 21:21

MissScarletInTheBallroom · 01/08/2024 21:15

I've explained it to you twice now. Go back and read the thread, I'm not wasting any more of my time by explaining it to you a third and then no doubt a fourth time.

Show quote history

No you haven’t. You have explained how there are tests for karyotype, ways to look at internal organs, ways to test hormone levels. Of course there are, no one is disputing this. I have repeatedly explained to you that all those tests can do is tell you exactly those things- a persons karyotype, their hormones, the structure of their internal organs. in cases where there is a mismatch the results of those tests cannot tell you - give you a definitive answer - as to whether that person with those mismatched characteristics is properly described as male or female. There is no test that can do that.

OP posts:
Original poster
Tandora · 01/08/2024 21:17

nameynamenamenamename · 01/08/2024 21:17

@MissScarletInTheBallroom you have been incredibly patient.

Ridiculous

OP posts:
nameynamenamenamename · 01/08/2024 21:17

@MissScarletInTheBallroom you have been incredibly patient.

KeirSpoutsTwaddle · 01/08/2024 21:16

It’s like a bingo card.

She should have trained harder.
She should be used to being hit
Noone knows what sex anyone else is
Stop being genital nazis
Why do you care about other people’s genitals
Don't be so mean.

MissScarletInTheBallroom · 01/08/2024 21:15

Tandora · 01/08/2024 21:01

I don’t need to. I have studied this, and I know that there isn’t such a test. You are telling me there is one, so I’m asking you if you know this, tell me what it is.
We can diagnose variations in sex development, yes, that doesn’t mean there is a test that can tell you what sex category a person belongs in where there is a mismatch between various different factors. .

Show quote history

I've explained it to you twice now. Go back and read the thread, I'm not wasting any more of my time by explaining it to you a third and then no doubt a fourth time.

SilenceInside · 01/08/2024 21:15

@Tandora of course it's possible. DSDs where the person has experienced male puberty and responds to testosterone means the person cannot compete in the female category.

Original poster
Tandora · 01/08/2024 21:13

SilenceInside · 01/08/2024 21:06

No it's not true. The definitions of DSDs are well defined, and we have the ability now to understand even very complex cases involving specific gene issues and things like mosaicism. So if any individual case is unusual, it can eventually be well defined.

Again, it's this idea that complex means not possible or somehow debatable.

Someone's sex category just means what reproductive category their body falls into, male or female. Someone with CAIS is male, although they present phenotypically as (apparently) female. They don't go through male puberty and don't respond to testosterone and so I can see a case for inclusion in female categories for sports and any other sex segregated space.

The definitions of DSDs are well defined

you are not following. DSDs are well defined; having a well defined DSD, however, does not answer the question of whether that person who has that DSD is properly described as “male” or “female”, which is what the sporting authorities are trying to do.

(You acknowledge this yourself when you say that you can “see a case” that people with CAiS are properly described as female).

OP posts:
RedToothBrush · 01/08/2024 21:12

OP thinks sex = gender.

You can't argue with that level of argument.

Original poster
Tandora · 01/08/2024 21:10

BreatheAndFocus · 01/08/2024 21:01

It doesn’t work like that. I speak as someone with a person close to me with a DSD. In the vast majority of cases, sex is clear. Very occasionally, the external genitalia are ambiguous or cause to question the sex. Then specialists do a number of tests - not just to determine the sex of the baby, but to see if there are any current or potential medical issues.

Those tests, which include chromosome testing, endocrine testing, scans, etc etc, will then lead to a diagnosis of a specific DSD, which will then allow the doctors to determine the sex of the baby.

Show quote history

I’m just going to repeat this as there is no other way to say it:

those tests/ investigations tell you what karyotype a person has, they tells you what their internal organs look like, etc. however, in cases where there is a mismatch in the various factors (eg between karyotype or phenotype) it doesn’t tell you which to prioritise or how to balance them. That becomes a matter of individual assessment, and clinical judgement , and often some guess of work . There are general trends in how doctors may chose to assign sex for certain conditions , but these are also variable.

OP posts:
SilenceInside · 01/08/2024 21:06

No it's not true. The definitions of DSDs are well defined, and we have the ability now to understand even very complex cases involving specific gene issues and things like mosaicism. So if any individual case is unusual, it can eventually be well defined.

Again, it's this idea that complex means not possible or somehow debatable.

Someone's sex category just means what reproductive category their body falls into, male or female. Someone with CAIS is male, although they present phenotypically as (apparently) female. They don't go through male puberty and don't respond to testosterone and so I can see a case for inclusion in female categories for sports and any other sex segregated space.

BreatheAndFocus · 01/08/2024 21:01

Tandora · 01/08/2024 20:50

tell me the series of tests, and how the different factors are to be prioritised/ balanced/ reconciled?

Show quote history

It doesn’t work like that. I speak as someone with a person close to me with a DSD. In the vast majority of cases, sex is clear. Very occasionally, the external genitalia are ambiguous or cause to question the sex. Then specialists do a number of tests - not just to determine the sex of the baby, but to see if there are any current or potential medical issues.

Those tests, which include chromosome testing, endocrine testing, scans, etc etc, will then lead to a diagnosis of a specific DSD, which will then allow the doctors to determine the sex of the baby.

Original poster
Tandora · 01/08/2024 21:01

MissScarletInTheBallroom · 01/08/2024 20:52

Why does anyone need to "tell you" the specifics? Go and find a book about it, or ask a doctor, or go back to uni and study medicine yourself, if you think you know better than the doctors who diagnose DSDs.

Show quote history

I don’t need to. I have studied this, and I know that there isn’t such a test. You are telling me there is one, so I’m asking you if you know this, tell me what it is.
We can diagnose variations in sex development, yes, that doesn’t mean there is a test that can tell you what sex category a person belongs in where there is a mismatch between various different factors. .

OP posts:
Moonmelodies · 01/08/2024 21:00

Why not use the same tests that vets use for other mammals?

Original poster
Tandora · 01/08/2024 20:57

SilenceInside · 01/08/2024 20:53

Someone up thread gave a pretty decent run down. I think the exact sequence of tests needed would vary depending on the initial investigations. Probably a fairly complex flow chart could be produced. It would start with identifying chromosomes and comparing that to expected body type, and go from there. In 99.9% of cases that would be all that's needed. Further investigation would be needed if there was a mismatch or ambiguity.

You're suggesting that "complex" means "not possible".

I’m saying there is not yet any scientific consensus around that flow chart, sequencing, series of investigations, etc in cases of mismatch/ ambiguity.

OP posts:
Original poster
Tandora · 01/08/2024 20:54

MissScarletInTheBallroom · 01/08/2024 20:51

I explained to you earlier in the thread that doctors will test for genetic karyotype, examine external genitalia, use ultrasound to look at internal reproductive organs, sometimes also test hormone levels, and on the basis of those tests they will diagnose a particular DSD, which is sex specific.

Show quote history

Yes but that doesn’t give you a definitive answer to what sex category someone belongs in. It tells you what karyotype they have, it tells you what their internal organs look like, etc. in cases where there is a mismatch in the various factors (eg between karyotype or phenotype) it doesn’t tell you which to prioritise or how to balance them. It doesn’t tell you whether a specific person, whose sex is in question, is male or female, because there is no one factor that determines this.

OP posts:
SilenceInside · 01/08/2024 20:53

Someone up thread gave a pretty decent run down. I think the exact sequence of tests needed would vary depending on the initial investigations. Probably a fairly complex flow chart could be produced. It would start with identifying chromosomes and comparing that to expected body type, and go from there. In 99.9% of cases that would be all that's needed. Further investigation would be needed if there was a mismatch or ambiguity.

You're suggesting that "complex" means "not possible".

MissScarletInTheBallroom · 01/08/2024 20:53

SilenceInside · 01/08/2024 20:49

@Tandora of course there are tests that can determine sex in complex cases. Are you concerned that because there is no single individual test that can be done? So the fact that a series of different tests might be necessary, that's an issue for you?

I think @Tandora is really only concerned that the answer might be "yes we can tell who is male and no they shouldn't be competing in women's sport".

MissScarletInTheBallroom · 01/08/2024 20:52

Tandora · 01/08/2024 20:50

tell me the series of tests, and how the different factors are to be prioritised/ balanced/ reconciled?

Show quote history

Why does anyone need to "tell you" the specifics? Go and find a book about it, or ask a doctor, or go back to uni and study medicine yourself, if you think you know better than the doctors who diagnose DSDs.

MissScarletInTheBallroom · 01/08/2024 20:51

Tandora · 01/08/2024 20:49

Where?

Show quote history

I explained to you earlier in the thread that doctors will test for genetic karyotype, examine external genitalia, use ultrasound to look at internal reproductive organs, sometimes also test hormone levels, and on the basis of those tests they will diagnose a particular DSD, which is sex specific.

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