Cheek swabs for World Athletics

Somebody tweeted the attached from WA. I can't 100% vouch for it as it may come from a pdf in the members only part of their website, but it's similar to a press release from last month, with the additional information that there will be a pre-clearance test for SRY.

This suggests they are looking at the exclusion of 5-ARD, PAIS etc, but not Swyer (SRY missing or damaged) and that CAIS will be subject to discussion (they are not currently excluded because they are legally female at birth and the existing regulations only cover individuals who are at least partly androgen-sensitive)

Good news, we now just need a few more sporting organisations to follow suit and the IOC will be forced to follow although the more that do it will mean their rules will become largely irrelevant as we will all know already who has been tested and it will be hard to dodge.

Link for the above

https://worldathletics.org/download/download?filename=2ffb8b1a-59e3-4cea-bb0c-5af8b690d089.pdf&urlslug=C3.6A%2520%25E2%2580%2593%2520Eligibility%2520Regulations%2520for%2520the%2520Female%2520Classification%2520%25E2%2580%2593%2520effective%252031%2520March%25202023

And for the consultation that began last month and finished a couple of weeks ago.

worldathletics.org/download/download?filename=f60e2417-fcdd-4a13-8ce8-6cf9897e59ce.pdf&urlslug=Recommendations%20to%20the%20eligibility%20conditions%20for%20the%20Female%20Category

This is the current policy, I checked since I posted it yesterday and it is the current one.

Version 3.0, approved by Council on 23 March 2023, and coming into effect on 31 March 2023:

3* *Eligibility Conditions for Relevant Athletes

3.1 A "Relevant Athlete" is an Athlete who meets each of the following three criteria:
3.1.1 they have one of the following DSDs:
2.7.1.1 ensure that the information is accurate and complete; and
2.7.1.2 not provide any information in bad faith, to harass, stigmatise or otherwise injure an athlete, or for any other improper purpose.
3.1.1.1 5α-reductase type 2 deficiency;
3.1.1.2 partial androgen insensitivity syndrome (aka PAIS);
3.1.1.3 17β-hydroxysteroid dehydrogenase type 3 (17β-HSD3) deficiency;
3.1.1.5 any other genetic disorder involving disordered gonadal steroidogenesis; and
3.2 3.3 3.1.1.4 ovotesticular DSD; or
3.1.2 as a result, they have a concentration of testosterone of 2.5 nmol/L or more in their serum; and
3.1.3 they have sufficient androgen sensitivity for that testosterone to have a material androgenising effect.

3.2 To be eligible to compete in the female classification at a World Rankings Competition, and/or to have recognised any World Record performance in a competition that is not a World Rankings Competition, a Relevant Athlete must meet each of the following conditions (the "DSD Eligibility Conditions"):

3.2.1 they must be recognised at law (for example, in a birth certificate or passport) either as female or as intersex;
3.2.2 they must have continuously maintained the concentration of testosterone in their serum below 2.5 nmol/L3 for a period of at least 24 months; and
3.2.3 they must continue to maintain the concentration of testosterone in their serum below 2.5 nmol/L at all times (i.e., whether they are in competition or out of competition) for so long as they wish to retain eligibility to compete in the female classification at World Rankings Competitions and/or to have recognised any World Record performance in the female classification at a competition that is not a World Rankings Competition.

my bolding to highlight the testosterone and androgenisation clauses.

these stories are always so badly reported (through I think a mixture of ignorance and sometimes dishonesty) that it's really hard to know what to make of them without yourself poring through the pages and pages of legal documentation (once they're in the public domain), which is a bit much for most of us.

so my part guessed understanding of this new rule about cheek swabbing is that:

1. it doesn't change the WA eligibility criteria (at the moment, DSD athletes are allowed into the female category provided they satisfy at least one of the following three criteria - (i) they're female in terms of organs, chromosomes, etc; (ii) their T levels are close to the female range, either naturally or through taking synthetic hormones; or (iii) they don't react to male level T, eg they have CAIS.

2. but at the moment, not every female athlete takes a test along the above lines, instead, who takes it is basically at WA's discretion, they'll single people out based on eg their psychical appearance or maybe eg things that have been spotted through urine (drug) testing (eg things that are correlated with high T levels).

3. what this new rule will do is basically take that discretion away over who is subjected to some kind of testing, since everyone will take the initial screening cheek swab test, without changing the full on determinative test itself.

so I suppose a great advantage of this new approach (in addition to probably catching a few more people) is that it's less potentially discriminatory/won't lead to individuals being subject to full testing based on arguably subjective criteria which I suppose could have eg a racial element sometimes.

a possible disadvantage will be the cost and hassle of many more people being tested, and that very few people who aren't already being targeted because they look and sound male will be likely to fail all of tests (i) to (iii) above.

Actually, I just remembered that WA rules already ban individuals who have been through male-type puberty regardless of their karotype or current testosterone levels. Same as UCI.

I note the usual TRA suspects are melting down and being racist comparing black women to men as they like to do.

This wouldn’t catch XX individuals with an active SRY gene. Such individuals have male puberty advantage even if they later suppress testosterone.

As far as we know it will initially just be a test for the presence of an SRY gene. If the SRY gene is detected then further investigations. If it is not detected then you’re good to go. So potentially some XY individuals with a completely absent SRY gene (some cases of Swyer’s) could pass the test.

(The SRY gene is the gene for maleness and is usually on the Y chromosome. The ‘default’ is for mammalian embryos to develop as females, males are basically a weird mutation triggered by an active SRY gene,)

I wonder also though, will this sex testing then produce the very detailed information that then can be used to study those that are included (if the new regulations do include any male people with DSDs) ?

Or will there be an ethical constraint that means that the WA will not be able to use this information for such review purposes?

Wouldn’t it be great if all that funding that was used by Hamilton and Harper had been used instead to review that group so that at the same time all males with DSDs would be excluded? It is just another element of the disadvantages that female athletes have had to put up with.

Sadly, I think we are going to be left with a partial exclusion and have to campaign further for full exclusion. I would welcome being wrong and that WA pull out a full exclusion.

Absolutely CAIS athletes have male advantage and should be banned also. Not only do they have skeletal advantage, they never, ever have to worry about periods, training around them, altering training, suppressing them, competing with them, losing a block of training because of them, picking up injuries because of them.

Think how many days per year per career that involves.

The WA seems to be effectively implementing the recommendations of this paper that many of the people we quote in these discussions authored.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/sms.14715

And yet Jon Pike, Dr Emma Hilton and I also believe Ross Tucker, who you are quoting and using their arguments all have said that for the moment those particular groups of male people who don’t have bodies producing and/or processing testosterone are not likely to be excluded at this time.

I suggest you take it up with them.

At this stage, I would suggest that they do have some advantage. It remains to be measured however.

That is the nub of my disagreement. We don't need to measure the advantage, we only need to know that the source of it is being male. Not natural advantages which occur in the female population.
Height is also notable because tall women are rarer than tall men.

Ross Tucker gives the example of an unfit cyclist hiding a small engine in the frame of the bike - that competitor wouldn't win the bike race but having the engine would still be an unfair advantage. Ditto a very small amount of exogenous testosterone - the cheater might not win but they would do better than they would otherwise due to an illegitimate source of advantage.

Debating whether the advantage is insurmountable is so close to the meaningful competition argument which Jon Pike writes about - that if women have some chance of winning against males who claim to be women who are testosterone suppressed and taking cross-sex hormones, ie if MCWs don't always win women's competitions, then that that is meaningful competition. Whereas of course it is not fair competition because the males have something that women cannot train for, ie male advantage.

In the case of CAIS they are thought to be over-represented among female athletes, so there is clearly some advantage there, despite them being phenotypically female. I don't think there are any figures for Swyer's as it is a much rarer condition and often goes undetected until much later in life.

I imagine the "follow-up tests" that are being proposed should an athlete test SRY-positive are there to make these determinations.

They also need to be careful not to eliminate XX individuals who have an inactive SRY gene (those with an active SRY gene would be banned on testosterone levels anyway, despite being women).

That's just weird and unscientific, but I suppose it doesn't greatly matter for equestrian categories.

The Guardian sports pages, and Sean Ingle in particular, have been reporting (as opposed to opinion-writing) on trans and DSD issues for years.

Go for it!

We all have our limits.

Yes. That is my point.

We have to be careful in how we quote statistics surrounding CAIS and Swyers.

And of course they are 'male' genetically. However, if they really don't process testosterone due to lack of receptors, or lack of testes etc there needs to be robust information about where their advantage lies to exclude them.

The advantage could be the general height and skeletal proportions. Or even their pelvic shapes. But, do those, once a very firm number has been established where it can be accurately stated that no testosterone advantage has been delivered to specific group, deliver an advantage that is insurmountable for female people. At this stage, I would suggest that they do have some advantage. It remains to be measured however.

Thanks, that's interesting and helpful.

(Edited because I misread tweet originally!)

I think you will find that Dr Hilton has explained her workings on this 2018 tweet.

She has just posted this in response. I remember she has clarified this quite a number of times in the past, particularly during discussions about Khelif.

https://x.com/FondOfBeetles/status/1096019343891226624

"This is getting some attention today. To ads a caveat: some people previously responding have pointed out, perhaps correctly, that the numbers of XY athletes competing in female sports will include PAIS and Swyer syndrome. PAIS athletes will have some testosterone response."

Well, I just don't agree with Emma Hilton, then. Her conclusion is illogical and unfair to women. Having a female phenotype is obviously not the whole story and does not negate male advantage.

Anyway, got that off my chest!