Women with complete androgen insensitivity syndrome

[Tandora]

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 .

No. Just no.

You're doing the old, and now very tired, transactivist spiel of Oooh, DSDs are sooo complicated! How can any of us know what sex we really are, never mind anyone else, when there's all these mystical medical acronyms to consider?!

It's bollocks (even if the testes are internal for some).

Your title mentions COMPLETE androgen insensitivity, an unusual situation in which a male foetus fails to respond to masculinising hormones, so develops as physically female. They obviously have no testosterone advantage because their bodies are immune to it.

The NHS link you posted also covers PARTIAL androgen insensitivity syndrome, in which male hormones do affect development and do kick in stronger at puberty.

There are multiple DSDs that can make a boy baby appear a bit like a girl, but give that child the physical advantages of male hormones as he grows. If you want to discuss them, please be specific and drop the faux wonderment. Plenty of well-informed MN regulars will be able to provide clarity.

From the NHS website.

Complete insensitivity to androgens makes a person with XY chromosomes female. Partial insensitivity to androgens can mean that some people are male and others are female.

www.nhs.uk/conditions/differences-in-sex-development/

can mean that some people [with PAIS] are male and others are female

Coming from the gender-captured NHS, @Tandora, I'd read that as more of an ideological statement than a medical one. They have - at least twice - insisted that female patients in women's wards could not have been raped as no males were present on the wards.

Yeah I don't think we can rely on an organisation which believes in the female penis as a sensible authority.

Plenty of well-informed MN regulars will be able to provide clarity.

For the avoidance of doubt I have a PhD in the subject , but thank you my dear 😘.

And due to that PhD I am perfectly well informed that the biology of human sex development is complicated despite what most pundits would like to believe.

In terms of the athletes in question, we know that they were assigned female at birth. They were excluded from boxing championships last year; a decision which the Olympic committee has called arbitrary. The boxing authority has failed to disclose what “test” they use to determine they were not eligible to participate, but has said it didn’t involve measuring testosterone. Based on public statements made at the time it is likely that these women may have xy chromosomes. We know nothing more about their medical circumstances .

This thread is educating people that some females have XY chromosomes, because a lot of those (oh so knowledgable) mumsnetters you refer to seem to be really struggling with that concept.

There is no faux wonderment here.

HTH.

YABU to suggest that the man who beat up a woman is anything other than a man beating up a woman.

If she had been brain damaged would you be posting this today to build awareness?

There isn’t a mismatch, as you put it. DSDs are medical conditions. There are a variety of DSDs, all defined. The tests identify which DSD a person has Knowing the DSD - ie what has gone wrong in their sexual development in the uterus - allows the specialists to correctly sex the person.

They don’t go, “Well, this person has A, B and C, so that equals Klinefelters. Now, are they male or female?” 🤔 All people with Klinefelters are male. (I’m just using Klinefelters as an example.)

As for the question, how do we know if someone has gone through male puberty? It’s obvious physically, and hormone tests can confirm it.

But they’re not women. They’re described in medical literature as under masculinised, or feminised, men, due to their genitalia failing to develop normally.

One of the key tests for checking for the presence of an androgen sensitivity disorder is the presence of a Y chromosome. This is how they rule out other DSDs such as MRKH where the woman will present with XX chromosomes.

They are absolutely not typically referred to in the literature as “men”.

If you are going to continue insist that people with CAIS are “men” simply because they have an XY chromosome, then there’s really nothing more I can say.
This contradicts what we know about the biology / science of human sex development, medicine,
law and lived realities of women with CAIS and those who know them, but you do you.

Someone with CAIS is male. They may present as female but genetically they are male. If a way was found to induce androgen sensitivity they would go through male puberty not female.

Yep I hate these threads as people state opinions as if they were facts.

my phd is not in this area but I did a year of embryology, so I prefer to believe what I learned there than mumsnetters stating FACTS.

athletes with dsd are not my area of expertise, and I would therefore not offer an opinion. I believe generally though those who rise to the top probably do have an unfair advantage. I also believe we don’t have access to their full medical records and unless you do again you can’t have an informed opinion.

from a general population view though I think those with dsd have a right to live how they choose. Nobody should be pointing and shouting MAN. It’s a very different conversation to the trans argument which is biological males behaving like women.

imagine if you had a daughter. Physically she looks like a girl in every respect. You take her to the doctor at 16 because her periods haven’t started, and find out she has a dsd, has xy chromosomes, internal testes etc.

nobody should be telling that child YOU’RE A MAN. Have some empathy.

there used to be a lady with dsd on here. She left because of all the “you’re xy you’re a man” comments. She was born a girl, brought up female, had a blind vagina, and only found out as a teen she had a dsd.

They don’t go, “Well, this person has A, B and C, so that equals Klinefelters. Now, are they male or female?” 🤔 All people with Klinefelters are male.

that is now the consensus around people with Klinefelters yes (it wasn’t always the consensus). But there are many other conditions where the situation isn’t clear cut , and deciding whether that person should be assigned male or female is exactly what medics need to do. The decision to assign someone’s sex in itself, of course, isn’t simply about whether they are properly described as male or female, that’s an even trickier question, and no, there isn’t any scientific consensus are a test , or sequencing of tests, to determine this.

I think there are two separate issues an individual one and a societal one.

On an individual level people with CAIS should be free to live their lives in a way that matches how they present.

On a societal level redefining the concepts of woman and female to include people with XY chromosomes has implications far beyond CAIS, so the existence CAIS is only a small consideration in a very much bigger picture.

Someone with CAIS is male. No. Somebody with CAIS has a male karyotype, that is all you can accurately say. The assumption that having a male karyotype is sufficient to make a person male is entirely yours , and contradicts the physiology of sex development , science, medicine, law and the self knowledge of women and girls living with CAIS.

If a way was found to induce androgen sensitivity they would go through male puberty not female

but there isn’t, so they didn’t!
It’s like saying, “well if we could cure autism, then autistic people would be neurotypical”!

Yes, I chose Klinefelters as a simple one to illustrate my point. It’s more difficult with something like PAIS where the presentation can vary. In those cases, judgement has to be used. Not just a ‘social’ judgement, but medical judgements about how the external genitalia will develop, removal of any internal testes, hormone treatment.

Correct

and contradicts the physiology of sex development , science, medicine, law and the self knowledge of women and girls living with CAIS.

Which specific laws were you thinking about? You make broad assertions so feel free to link peer reviewed research on the legal status of people with CAIS.

These areas of law are hugely complex as they involve an intersection of rights. Sex is a protected characteristic under the Equality Act and the ordinary meaning of the word would mean genetics.

But what about the rights of the other competitors to fight against other females? People will be excluded from elite sport for many reasons, maybe they need medication that is a performance enhancing drug, but it’s not one they can get a therapeutic exemption for. Should Russian athletes have the right to compete, I’m sure they all are not personally responsible for the war in Ukraine, what about their rights?

Khelif probably has a DSD. It is hard to believe that Khelif and his family, coaches and the Algerian boxing association and Algerian Olympic association don’t know that he has a DSD. It must be hard to have a DSD in a country where they aren’t routinely picked up at birth, however that doesn’t give him the right to fight against women. The corrupt IOC do have a lot to answer for in allowing this situation to even occur. A once in a lifetime sex test, would have prevented this. A check swab is all that is needed.

Sharron Davies’ book Unfair play, the battle for women’s sport is an excellent read. Sharron competed in the era of state sponsored doping in East Germany (and other countries) so was cheated out of medals by women who were pumped up on testosterone.

I would be happy to agree that some people don't fit neatly into male and female categories.

I also don't think that not fitting neatly into male means you get into female. I think the opposite, even if your DSD makes you weaker than other men and/or you think you are a woman, if you don't fit neatly into the female box you compete in the open category.

Female is the protected characteristic and these boxers do not meet the criteria, it is that simple.

Every day, all over the world, people are receiving diagnoses that limit their life and what they can do. I don't see any reason why males with DSDs can't have their limitations spelt out to them as well - they'll cope.

There’s no suggestion that either of these boxers have CAIS. The IOC seems to think their passports are enough, which is ridiculous.

People with DSDs need specific rules, eg the ones around Semenya and others with 5-ard, but basically no male person should be in a competition for females. The OP mentions CAIS. That’s an area of disagreement as far as I understand, but neither of these boxers are believed to have CAIS.

IMO, it would be better to release information - with the agreement of the competitor obviously - because that would stop the speculation. It would also stop blatant lies and propaganda, as well as the use of racist tropes.

I also don't think that not fitting neatly into male means you get into female. I think the opposite, even if your DSD makes you weaker than other men and/or you think you are a woman, if you don't fit neatly into the female box you compete in the open category.

Male with unusual phenotype does not = female.

We wouldn't know if it wasn't for these tests. I wonder if it has happened in the past but been unaware as the person has female reproductive organs.

you've created a thread about a thread
Seems MN is fine with this now so I look forward to being able to do the same in future.

They were excluded from boxing championships last year; a decision which the Olympic committee has called arbitrary.
I wonder what they think about their decision to let them compete now.

Oh for god sake, are some people still trying to convince us all that it’s fine for men to hit women?

Apparently so. Ludicrous, isn’t it?