What is DSD? The condition at the heart of Imane Khelif boxing gender test scandal
Khelif found herself in the midst of controversy last Thursday last week after Italian fighter Angela Carini abandoned her bout with Khelif after less than a minute.
Both Khelif and Lin were disqualified by the International Boxing Association (IBA) during last year’s World Championships for failing to meet gender eligibility criteria.
They said at the time that the pairâs âelevated levels of testosterone failed to meet the eligibility criteriaâ for womenâs competition. She has, however, been ruled eligible for the Games by the International Olympic Committee and now advances into the final of of the womenâs 66kg tournament.
In her previous fight which stirred the controversy, her Italian opponent Carini broke down in tears as she pulled out of the fight, having been caught twice by powerful blows from Khelif.
The fight attracted worldwide attention and many weighed in on the incident, leading to Khelif having to defend herself.
In an interview with SNTV on Sunday, Khelif spoke out. “I send a message to all the people of the world to uphold the Olympic principles and the Olympic Charter, to refrain from bullying all athletes, because this has effects, massive effects,” she said in Arabic.
“It can destroy people, it can kill people’s thoughts, spirit and mind. It can divide people. And, because of that, I ask them to refrain from bullying.â
After their fight, Carini explained she had never been hit so hard and decided to withdraw because of the intense pain in her nose. Carini has since apologised to Khelif and has said she would embrace her if she saw her again.
Khelif was one of two boxers allowed to compete in Paris despite being disqualified from the World Championships in Delhi.
The UNâs special rapporteur on violence against women and girls has condemned the decision to allow Imane Khelif to compete in womenâs boxing at the Olympics, with MPs and JK Rowling among other critics.
International Olympic Committee (IOC) spokesperson Mark Adams said the two boxers fighting at the Olympics after being disqualified from last yearâs world championships are âreal peopleâ who have been competing âfor many yearsâ and that âthis is not a transgender issueâ, the BBC reported.
Differences in sex development â also known as DSD â are a group of about 40 rare conditions involving genes, hormones and reproductive organs, including genitals, that develop in the womb. It means a person’s sex development is different from most other people’s. Some people prefer to use the term intersex.
Others could have a very rare type of DSD where they have both ovarian and testicular tissue (sometimes one ovary and one testis). Their genitals may appear female or male or could look different from either.
What is the science behind DSD?
When born, some people have a chromosome pattern other than the usual XY or XX. They may have one X chromosome (XO), or they may have an extra chromosome (XXY).
Their internal and external sex organs can be either male or female, but they may not go through full physical development at puberty. For example, a child with female sex organs may not start having periods.
Algeria’s Imane Khelif (in red) takes a punch from Italy’s Angela Carini
AFP via Getty Images
Doctors tend to check a baby for DSD soon after birth if they are showing signs such as undescended testicles or if a baby’s genitals look different. Tests including ultrasounds and blood tests can be done before a babyâs sex is registered.
Many forms of DSD do not require any medical care other than understanding the baby’s development and knowing what to expect as they grow older.
Other people with DSD are sometimes only diagnosed once puberty begins and it becomes clear something is not right.
What is the controversy around athletes with DSD?
The issue has caused a lot of people to share their opinions on the matter. Some commentators have said it is wrong for a person who is considered biologically as strong as a man to compete against a biological woman, as it would give an unfair advantage.
Former GB swimmer Sharron Davies said: âThis is a biological male fighting a female & absolutely everyone can see it, they have also failed gender screening, twice & have XY chromosomes. There is no ambiguity that the IOC do not care if a female gets seriously hurt. Or worse. Iâm astonished at the weakness of the media.â
A string of MPs made similar condemnations.
Anna Turley, Labour MP for Redcar, said: âThis is just not acceptable @Olympics â enough.â
And Labour MP Rosie Duffield said: âThis is not ok @iocmedia #Paris2024 Listen to women.â
Jim Shannon, of the Democratic Unionist Party, also chimed in: âHow in the name of sanity is this supported by the IOC? When Pierre de Coubertin said âall sports for all peopleâ he would never have intended for men fighting women to be one of those sports. Male violence on females cannot be tolerated as a spectator sport.â
On Thursday morning, Mark Adams, an IOC spokesman, said those competing in the boxing are compliant with the eligibility rules.
He said: âWhat Iâd repeat is all the competitors comply with the competition eligibility rules and thatâs as it should be. Thatâs how these boxers concerned have taken part in these Games, have taken part in previous world championships, have taken part in previous Olympic Games, have taken part in regional and continental competitions.
âThe IOC is saddened by the abuse that the two athletes are currently receiving. The IBAâs recognition was withdrawn by the IOC in 2023 following its suspension in 2019.â
South African runner and Olympic gold medallist Caster Semenya has a DSD called 5-alpha-reductase deficiency, which means she has the male XY chromosomes and produces higher levels of testosterone than normal for women.
This DSD can occur in people with female reproductive anatomy and genitalia, as in Semenya’s case. She has previously detailed how she has internal testes and no uterus, but does have a vagina.Â
Semenya, who dominated women’s running events between 2009 and 2019, learned at the same time as the rest of the world that she had a DSD. She was forced to take drugs such as the contraceptive pill to lower her testosterone to align with new rules that limited the level of the hormone in women’s events.Â
Fellow runners Francine Niyonsaba of Burundi, Kenya’s Margaret Nyairera Wambui and Namibia’s Christine Mboma and Beatrice Masilingi have also been ruled ineligible to compete in competitions due to DSDs.Â
