Does Imane Khelif even have a DSD?

[BeLemonNow]

Giving the widespread reporting of a previous test showing Imane Khelif is biologically male / XY is there actually any evidence as to whether or not they even have a Disorder of Sexual Development (DSD). Or is this straightforward fraud? I know there was speculation before...

By DSD, going by NHS information, in this case I mean XY chromosomes with an abnormality causing a baby's genitals to look female (but not a DSD where there's XY and some sort of penis even if smaller than normal). To be clear, I am aware that these differences are usually apparent by puberty. It looks likely Imane went through male puberty.

Apologies if this has been covered in a different thread, but I cannot see it anywhere. I am aware that the only IOC criteria to compete at the Olympics was a female passport - ridiculous really - but that Imane has been claiming to be living as a woman since birth.

Does it matter either way?

BeLemonNow I did start this thread as I was wondering if there was actual evidence of a DSD. I think my conclusion is no there isn't, and I don't know which of the above is the case. I wish the media would stop effectively excusing this as a DSD.

I think that boat has sailed, OP.

There have been doubts about IK being a woman for several years, but test results were not made public because of data privacy.

In 2024 Le Correspondant published a leaked a medical report from a French hospital which - assuming it was authentic, and nobody has said otherwise - definitely proved that IK has a form of DSD 5-alpha reductase deficiency - which only males get.

So from 2024 it has been 99.9999% certain that IK is male, and has a DSD.

The discussions on here have long since moved past what sex IK is; we've mostly been following the stubborn refusal of authorities and the media to accept that he is male, and keeping up to date on the latest revelations.

World Boxing's belated decision to introduce sex testing, and the implications for IK's participation in the Eindhoven competition, is a huge step towards getting proof which is as near to categorical as possible, that we were right all along.

There is disagreement on here about the authenticity of IK's alleged childhood a girl, and consequently how much of a cheat he is - has he been cheating since the first tests came up dodgy, or has he been cheating all his sporting life?

But a man, with a male DSD? Everyone knows.

Yes, XY 5 ARD and it's a condition that, like all DSDs, affects only one sex as a variation in that particular sexual development pathway. In his case, males.

@ThatCyanCat
This is not relevant to IK’s case, but …though there is no ambiguity regarding sex with most DSDs (even at birth, and indeed many people with DSDs don’t know they have one) some DSDs are exceptionally complex.

Very rarely some individuals can have some cells that are XX and others that are XY in their body. Or it is possible to have a gonad of either sex (or a type of hybrid gonad) in a single individual. Or you can be XY but the part of Y that codes for ‘male’ be completely nonfunctional, so you develop a female body type (without ovaries, but with hormone treatment and egg donation these women can get pregnant and give birth.)

Again, it’s nothing to do with this case, but sometimes assigning sex is more complicated that the prevailing narrative on MN allows.

The Paralympics should create a division for this.

I think the OP is confused about DSDs, and thinks that being male is separate from having a DSD.

Passmeby Again, it’s nothing to do with this case, but sometimes assigning sex is more complicated that the prevailing narrative on MN allows.

'The prevailing narrative on MN' has included very detailed and well-informed discussions of rarer forms of DSDs on this board in the past. The fact that they are not mentioned in all discussions, and particularly in reference to IK who does not have one of the rarer DSDs, doesn't mean that we are not aware of them.

A lot of people, including pp, don’t seem to be aware of them @MarieDeGournay. Every thread you see people trying to simplify DSDs when some are exceptionally complex and very rare. I apologise to those who do understand this but my experience on MN is that a majority don’t, even on this board.

Yes the CAS ruling made Caster’s condition clear. But the mainstream reporting has been very misleading.

Or you can be XY but the part of Y that codes for ‘male’ be completely nonfunctional, so you develop a female body type (without ovaries, but with hormone treatment and egg donation these women can get pregnant and give birth.)

That's Swyer syndrome and yes, it's a female DSD. That is why sex is classed not by karyotype but by whether the body is formed around the production of large or small gametes, even if it does not actually produce those gametes. Chromosomes dictate sex but they do not define it. For example, it's also possible to be XXY. That's Klinefelter syndrome and it affects males.

What is this hybrid gonad and what is the condition whereby a person's body is formed around the production of both eggs and sperm and has gonads for both?

@ThatCyanCat
An ovotestis is a gonad with both ovarian and testicular aspects.
Ovotesticular syndrome is the condition whereby someone has both ovarian and testicular tissue, a mix of ovary, testis or ovotestis. It’s very rare.

One of the rarest, and yet those people will still be male or female.

Molecular research has developed multiple causation theories, ranging from translocations of the SRY gene onto an X chromosome to duplications or inactivation of specific genes. Those with this condition do not have both sets of functioning reproductive anatomy, nor both sets of external genitalia, and therefore, cannot fulfill both reproductive roles. Thus, affected patients develop one reproductive role, and are therefore male or female...

Sex development in humans and other mammals is mutually antagonistic: if one reproductive system starts to develop, it inhibits the other. This is why individuals with Ovotesticular Disorder still develop towards one or the other reproductive role—the genetic and hormonal mechanisms do not allow both male and female systems to fully develop in the same individual. Thus, the inability for the complete development of both systems means that individuals with OT-DSD will have one main reproductive system and one secondary system with partial non-functioning elements. For example, an individual with 46,XY OT-DSD may have a male reproductive system with vestigial remnants of the Mullerian structure, such as a partial uterus. Or an individual with 46,XX OT-DSD may have a female reproductive system with vestigial remnants of the Wolffian structure, such as testicular tissue mixed with the ovarian tissue.

https://www.theparadoxinstitute.com/watch/biology-of-dsds-otdsd

And yet there’s a report in the literature of someone who fathered a child but whose ovary showed evidence of previous ovulation.

And of someone who has a DSD of a type classified as male, but who developed phenotypically as a woman, went through puberty and gave birth twice without any medical intervention. The DSD was only discovered later on when her child was being investigated.

These conditions can be incredibly rare and complex and each such case needs to be considered independently. The fact is that gender assignment is often a difficult decision for parents of children with this sort of syndrome. It’s really not as straightforward as you think.
You can’t put everyone in boxes so easily, that’s all I’m saying.

And I’m speaking about DSDs when I say that, just to be clear.

It’s really not as straightforward as you think.
You can’t put everyone in boxes so easily, that’s all I’m saying.

But nobody is trying to put 'everyone' in boxes, Passmeby.

It’s really not as straightforward as you think sounds very patronising, but I'll put it down to your late arrival in the extensive discussion of DSDs here.

There has been a great deal of detailed and well-informed discussion of DSDs in general on this board. It looks like you aren't aware of that, so you are making assumptions that we don't understand things as well as you do.

As for the specific issue of men with DSDs taking part in women's sports, testing seems to be doing an OK job of putting them 'in boxes'. This may be because rarer DSDs don't confer advantages in sports, which 5-ARD clearly does.

I was replying specifically to @ThatCyanCat’s comment with my last remarks, not addressing everyone @MarieDeGournay. Particularly her remarks upthread about DSDs always either being male or female. A minority of DSDs are by their nature exceptionally complex. Even if they are ultimately assigned male or female it is sometimes not at all a straightforward decision. There is still a lot we don’t know.

That said, I do also think some pp have been a little dismissive of the emotional and psychological ramifications of being raised as one sex and later being told you’re another, which seems to have happened to CS and IK. Some seem to feel that it’s all posturing now, all an act with them and I’m not so sure.

As I said earlier I completely agree that IK and CS should not be competing in women’s sports as they have been through a male puberty with the physical advantages that brings. But I wouldn’t be as quick to call them male if they don’t identify as such, even though I’m GC.

Also, I’ve name-changed. I’ve been here awhile.

There has been a great deal of detailed and well-informed discussion of DSDs in general on this board. It looks like you aren't aware of that, so you are making assumptions that we don't understand things as well as you do

The opposite really. Science doesn’t know everything. No matter how detailed the discussion has been none of us can have the full picture. We don’t know all the cellular pathways. That’s what I’m warning against. Being too prescriptive, being over confident, making sweeping statements about extremely rare medical conditions. Nature constantly surprises.

A minority of DSDs are by their nature exceptionally complex.

Yes, nobody denies that.

Even if they are ultimately assigned male or female it is sometimes not at all a straightforward decision.

They are male or female, though, and this is not assigned, it is observed. It might initially be observed incorrectly but the additional markers, when checked, will indicate it.

If we're talking about sport then to me the most significant question is whether a potential competitor has gone through a male puberty.

I don't find that vanishingly-rare chromosomal conditions inform me much after I've considered that question.

This really has been discussed so many times.

If it came up that someone with a vanishingly rare DSD thought they should be able to participate in the female category but was denied doing so, they could rightly argue their case with the relevant sporting authority.

As could IK. He was given the option to appeal and did not take it.

This isn't complicated.

Yep.

Virilisation from a male puberty will disqualify a person from female sport.

@ThatCyanCat I think we’ll have to agree to disagree on some things and leave it at that 😁

I still think you’re oversimplifying but at least we’ve moved on from yesterday when you said
That is why sex is classed not by karyotype but by whether the body is formed around the production of large or small gametes.

And, you’re right it is - usually. The usually bit is important though.

There’s a reason the World Boxing say they’ll be looking further.
For an athlete who wants to compete in the female category but is found to have Y chromosome genetic material or a disqualifying DSD, “the initial screenings will be referred to independent clinical specialists for genetic screening, hormonal profiles, anatomical examination or other valuation of endocrine profiles by medical specialists”.

Medical guidance currently looks something like this.
Expert opinion has shifted [from being guided by external genitalia in the past] to understanding that chromosomal, neural, hormonal, psychological, and behavioral factors can all have an influence on an individual.
Many experts now urge delaying definitive surgery for as long as is healthy, and ideally involve the child in the decision (Medlineplus).

It is…likely that the practice of assigning sex, especially in those cases where sex assignment is unclear on expert assessment, will continue to show temporal, social and geographical variations. It is imperative that clinical data for rare conditions such as these are collected in a standardized format and shared through a common registry so that any evidence that is used for future shifts in practice has a stronger foundation than that which is currently available.
(J Clin Res Pediatr Endocrinol 2017)

Yes, I went off the point a bit into a broader discussion of DSD classification with pp. Sorry about that.

IK’s case seems straightforward enough.

I appreciate that you're explaining some of the finer details, but people really do remain male or female even on the extremely rare occasions when it can be difficult to see why if, for example, one doesn't understand the difference between reproductive sex and karyotype. I know I was confused for a while when I found out that XY isn't ALWAYS male, or that genitals don't ALWAYS tell the full story, although really it is that simple over 99% of the time. That's the purpose of people who constantly fling DSDs into the discussion when they arent relevant (I realise that they are here because we are discussing Khelif's); they are trying to muddy the waters around sex to make it look like it's not absolutely straightforward in around 99.9% of cases (and as it is with Khelif; he's quite unquestionably male, he essentially just has unusual external genitalia for it).

But humans are not built around the production of both sets of gametes. Even in the case of OT syndrome, of which I think there are no more than a few hundred recorded cases, there's one developed pathway and a few small, non working bits of another. It's like making a Toyota with a few incomplete and non-working bits from a Peugeot accidentally thrown into the interior. It's still a Toyota.

@ThatCyanCat
Okay we’ll have to agree to disagree on the subject of extremely rare DSDs 😁

I agree it’s straightforward the vast majority of the time and even when a DSD is involved it’s mostly fairly straightforward to find out if a body type is male or female. And as I mentioned upthread many people with DSDs are unaware they have one.
But occasionally things are a lot more complicated.

And those exceptionally rare cases are fascinating for developmental biologists and geneticists. But really not relevant for the classification of sports categories.