What is confusing?
The organisation will have rules about who can play on the womans teams. It could include testing if clubs choose to fund it.
Women sport will be open to all women including TM just closed to all men.
Under general sporting rules TM who take "doping" banned substances would be excluded from any womens teams which test already. TM who take "doping" banned substances may be excluded from mixed sex teams who test if she breaks their hormone rules.
People who meet olympics standards know which sex they are. The olympics is all about the physical body. So women in top level sports would investigate why they are not having a normal reproductive cycle.
In the UK parents of girls can and should bring their child to a GP and be referred on for investigations if they are not going through a "normal" puberty.
So testing could prove helpful to people who had medical complications from DSDs but were not aware of their condition.