AIBU to think it was never that complicated to define a woman.

[Abisequer]

The International Olympic Committee (IOC) has ruled that eligibility for the women’s category of Olympic events will now be limited to biological females, starting from the LA 2028 Games.

AIBU to think the category ‘women’ was never complicated and the obfuscation by certain governing bodies has compromised fairness in sport for women.

Examples of obfuscation include claims that genital checking would be needed or that biological men with lowered testosterone would be on an even playing field with biological women.

AIBU to think it was never complicated to define a woman and a cheek swab is all it takes.

Article

Exactly, athletes on elite pathways spend a LOT of time around doctors, whatever continent they live in.

Not every person with a DSD presents as Semenya. Semenya has notably and visibly masculine characteristics. I can understand the disbelief that their DSD wasn't at least suspected.

People with Androgen Insensitivity Syndrome (which does not include Semeyna), in particular, can present very differently.

It's graded on a 1-7 scale, with grades 6 and 7 being considered Complete (CAIS). They are the rare category of genetic male that the IOC have said can continue to compete as women.

Some with grade 5 (Partial/PAIS) could have genitalia that appears typical female at birth, with only slight variance in adulthood (like an enlarged clitorous). They will not develop male-typical muscles, and may develop breasts.

Where someone has grade 5, female-phenotype CAIS (like in the story I mentioned), it is commonly diagnosed in puberty, due to primary amenorrhea.

If someone with those symptoms is told, for example, that their primary symptom is most likely due to another factor (like endurance running), surely you can see why they might accept it?

Again, I'm not saying that its plausible that all or even most DSDs could go undetected or unsuspected, but I fully expect there are entirely genuine cases of it, and the average age of detection is generally higher in developing countries vs developed (whether the individual is an athlete or not).

I absolutely expect that colleges in developing countries, do not have, and traditionally have not had, the benefit of similar multi-disciplinary teams and specialist physicians with on-site labs, that the top US colleges now have.

And I absolutely expect that countries like Burundi, Kenya etc were deliberately scouting for men with dsd's, which shows a resource of specialist physicians.

If someone with those symptoms is told, for example, that their primary symptom is most likely due to another factor (like endurance running), surely you can see why they might accept it?

Why would they be told that when it’s rare for runners to have never had a period?

WHO is telling them this? Seems unlikely it’d be experienced coaches. It also seems unlikely that coaches at elite level wouldn’t have access to medical input. An US of the pelvis would be a standard, non-invasive screening test for primary amenorrhoea and would show no uterus and internal testes.

For this level of sustained ignorance to be valid, you'd need :

• no level of concern from the athlete and no discussion with other other athletes about periods, ever, even though nearly all of them would have at least started their periods.
• ignorant coaches about girls’ bodies and the rarity of primary amenorrhoea.
• equally incurious medical staff. In the article you posted about the woman who didn’t get her periods she had loads of investigations, scans, yet we’re supposed to believe that an elite female runner with no period by 17-18 years wouldn't have even had an US? This can be external only, non invasive, and would demonstrate no uterus and internal testes.

I don’t believe that these athletes are reaching their 20s, competing at high levels with high level medical staff and they haven’t even had an abdominal US.

The public are told - well, they’re training hard and they are poor, uneducated and black/brown and it seems some have fallen for it.

And both can be true.

Where, though, you have instances of athletes who do not have anything approaching typical male physiology, who were believed to be female by those around them, say they were unaware of their intersex condition, readily submitted to a sex determination test and, upon failing, were told they cannot compete again (and did not seek to), and experienced immense trauma (perhaps including a suicide attempt), I'm not going to denounce them as a liar and a cheat.

They will have an ultrasound though. That’s enough to show internal testes. You’ve been played by the sob stories.

If you'd be interested in an academic study, rather than wild guesses, try Menstrual health and athletic performance: A study of female athletes in Indian educational institutions, International Journal of Physiology, Health and Physical Education (2023) - which describes the state of menstrual health knowledge and monitoring in I dia as of 2023 (one would assume it was even worse 15-20 years ago).

From its abstract:

"Data from athletes in disciplines such as athletics, boxing, swimming, judo, and wrestling reveal high prevalence of menstrual irregularities, including amenorrhea, oligomenorrhea, and heavy bleeding, with nearly 90% showing iron deficiency.

These conditions often impair training readiness, sleep quality, and recovery, increasing injury risks. Stigma and inadequate awareness hinder open discussion, leading many athletes to train despite discomfort and without medical guidance.

Coaches’ limited understanding further compounds the problem.

Some athletes use hormonal interventions to suppress or delay menstruation, often without professional supervision.

The study identifies significant gaps in infrastructure, education, and menstrual health support in Indian institutions.

Recommendations include integrating menstrual health education into sports programs, regular medical monitoring, access to hygiene facilities and products, trained health professionals in sports teams, and the use of cycle-tracking tools to tailor training.

Addressing stigma and fostering athlete-centered approaches can enhance performance, protect long-term health, and empower women in sports.

The findings underscore that menstrual health is integral to athletic success and overall well-being, calling for systemic changes to create inclusive, supportive environments for female athletes."

https://www.physiologyjournals.com/archives/2023/vol5issue1/PartA/7-2-4-582.pdf

This paper, which I assume you haven’t properly read, is a report of menstrual difficulties in educational institutions so, schools? colleges? High school coaches, essentially, not coaches for the elite.

The recommendation, which you have posted, is for “trained health professionals in sports teams”. The kind of trained health professionals that will be part of an elite training program.

What would a trained health profession appreciate? That primary amenorrhoea in runners is unusual and needs further investigation.

Both the articles you have posted emphasise the importance of menstrual awareness in female athletes.

The first, of an 22 year old who had never had a period, had scans, bloods, endocrinology reviews because it was uncommon and serious.

The second, highlighting menstrual difficulties in school/college athletes - mainly irregular periods, menorrhagia, secondary amenorrhoea - emphasised that girls with menstruation difficulties needed medical review. Again, primary amenorrhoea wasn’t the main menstrual disorder in girls in athletics - irregular periods seemed common, primary amenorrhoea is not.

These articles are NOT saying that primary amenorrhoea in elite women in high performance, national and international teams is nothing to worry about or doesn’t need investigations. They are saying the opposite - it’s rare and important and serious.

The sob stories obfuscate the likely truth - once the athletes were into their 20s they knew, the high performance coaches and medical teams knew, everyone was trying to cover it up as long as possible.

The primary research source focuses on colleges and sports academies, where eligibility criteria required female athletes to be competing at the district, state, or national level. This is the same developmental pipeline Santhi Soundarajan progressed through prior to her national-level success in 2004.

Between 2004 and 2006, Santhi would have periodically attended national coaching camps. Medical screenings at the time were typically basic fitness clearances rather than the deep, diagnostic, and holistic evaluations seen in the modern US college syste..

While competitions included anti-doping protocols, routine sex verification testing had been abolished by the IOC in 1999 and was not a standard requirement.

The prevalence of amenorrhea was not widely perceived as a medical concern, at the time, and was significantly more normalized among female athletes until the 2005 IOC Consensus Statement on the Female Athlete Triad (the first time the IOC officially recommended the monitoring of menstrual dysfunction).

Even since that shift, implementation has progressed at an uneven pace globally, and cultural taboos regarding menstrual health persist in many regions.

Mandatory SRY testing - a good thing - will, I expect, will still deliver surprise results to some athletes.

Medical screenings at the time were typically basic fitness clearances rather than the deep, diagnostic, and holistic evaluations seen in the modern US college syste..

Do you have proof for that?

In the early 2000s doctors still knew that women should have periods.

Santhi was 24(!!) in 2006 when the supposed surprise genetic result was available and somehow a 24 year old never having a period wasn’t flagged even though chromosomes, hormone tests and all sorts of imaging (US, CT, MRI) were available.

She was getting worse medical care than a girl/woman presented to a standard outpatient gynae clinic.

In 2006 I was having full fetal anatomy scans with my first pregnancy, including fetal echocardiography at 18 weeks’ gestation, yet somehow medical care for elite athletes was so primitive that a 24 year old who had never had a period wasn’t scanned.

It’s implausible that Santhi and team didn’t know and naive to assume otherwise.

-Mandatory SRY testing - a good thing - will, I expect, will still deliver surprise results to some athletes

I disagree. The athletes will know, just like they’ve always know that women have periods. There’s a few basketball players who I think won’t play at the next Olympics though.

I disagree. The athletes will know, just like they’ve always know that women have periods. There’s a few basketball players who I think won’t play at the next Olympics though.

Absolutely. In fact I think so many of the athletes who know they are male will self select out of testing and stop competing, which will mean the number of positive tests for the SRY gene will drop, and lead people to claim it’s not necessary because of how few will be found.

They absolutely know they are male. 50-60 athletes in major athletics finals in the last 25 years. It was all such a shock to them?! How naive to think so at best. At worst it’s deliberate gaslighting.

But they would have had other developments of female puberty.

For the record, this is the man DeepBluDeer joined MN to defend.

The man with an Adam’s Apple and no other features of being female.

What about all the athletes that absolutely do and did know they were male and competed anyway.

What about the actual female athletes, thinking Angela Carini, who was vilified for quitting against Khelif. Even at my work colleagues were pulling her apart for the XX sign she signalled. Calling her a cry baby etc.

Imane knew he had failed a sex test before he went into that ring, didn’t he?

It’s unfathomable that in the early 2000s standard tests for primary amenorrhoea - starting with an external US scan - would have been widely available to women in the community, but somehow NOT to a 24 year old elite athlete who had never had a period.

The sob stories come thick and fast to hide the duplicity

Gosh, the brow ridge.

Which many genetic males with AIS (Complete or Partial) do experience - e.g., breast growth.

CAIS generally results in typical female bodies (pre and post puberty) externally, and its usually the absence of a period that leads to a diagnosis.

PAIS presentations are more varied, but can include typical female genitalia at birth, with minor variations at puberty, along with breast tissue growth.

You chose to ignore the photo I see

@DeepBluDeer

Do you have any sympathy for Anglea Carini for example due to the fact that Khelif had already been tested and knew but went into the ring anyway.

Really??

No one knew?

I’ll save my sympathy for the women who lost their medals.

You can’t develop an Adam’s apple like that if you are not sensitive to testosterone.

This is all just bullshit. He was found to be male. He is clearly male. He was appropriately banned from women’s competitions for being male. He would have known he was male because he clearly didn’t develop any female secondary sex characteristics at puberty, didn’t have periods, and despite DeepBluDeer’s assertions, is not some dumb uneducated poor Indian who didn’t know any of that was abnormal.

The very idea these athletes “don’t know” or are too stupid to understand is so offensive it’s hard to see how anyone can think using it in their defence thinks they are making a good argument.

I am also really suspicious of the focus on the ‘it will be a surprise and that will be so unfair to find out’ being used as some kind of defence at the moment for campaigning to now reverse the new IOC policy.

Every single day elite athletes are told career ending news. Why is this particular news being leveraged to allow these groups of male athletes to continue to harm female players?

Not to mention, that was pretty much the same argument used in the very first place to stop sex testing.

Unfathomable if you choose not to fathom it, sure.

In the real world, menstrual health knowledge remains poor - including among athletes - in many regions, as do cultural taboos about discussing them.

See, for example, that among female elite and sub-elite athletes as of 2025, the majority still have poor knowledge of menstrual health.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12102870/

And the notion that female athletes losing their periods was normal (and not a cause for concern) was long prevalent.

https://www.nytimes.com/athletic/6582086/2025/10/10/women-sports-period-athletes-menstrual-health/

It was not until the the 1992 American College of Sports Medicine* *conference that coined "female althete triad" that generally attitudes towards the menstrual health of athletes began to change, and - again - not until 2005 until the IOC first reccomended screening for menstrual health.

The focus of athlete's healthcare, even in developed nations in the 90s, was on PPE (itself heavily focused on cardiac screening) and attempts to promote the importance of menstrual health remain ongoing in various developing ones.