Return to sex testing at the Olympics: IOC edges closer to banning transgender women

Just days before the opening of the Winter Olympic Games in Milan on Friday, February 6, International Olympic Committee (IOC) President Kirsty Coventry will likely make her first major decision by implementing a genetic test using PCR to determine the biological sex of all women who qualify to participate in future Olympic Games. The IOC will be following the path set last July by World Athletics (WA), the international athletics federation, which required the 1,015 women participating in the World Championships in Tokyo to undergo an SRY PCR test that identifies the gene on the Y chromosome, which is present in males.

Women who do not pass the test will be eliminated from international sports competition in the female category of any sport, whether they are transgender athletes, athletes with Differences of Sex Development (DSD), women who were assigned female at birth but have male chromosomes, women like Caster Semenya, the South African Olympic champion, or Imane Khelif, the Algerian boxer who won a gold medal at the Paris Games.

Indeed, the significant impact of the Algerian boxer’s victory at the last Olympic Games was one of the reasons why Coventry created a study commission. The members of the commission are kept secret, but it is chaired by the IOC’s new chief medical officer, Canadian Olympic rower Jane Thornton. Both her athletic experience and Coventry’s own as a 2004 Olympic swimming champion also influence their regulatory decisions.

“There has never been a transgender woman who has achieved international success in athletics,” says Joana Harper, a Canadian transgender athlete and researcher at the University of Ontario. “I think the reason for WA’s policy and its potential extension to the IOC is more political than scientific. In many parts of the world, such as the U.K. and the U.S., where Donald Trump has announced he will not grant entry visas to transgender athletes for the Los Angeles Games, there has been a significant political movement against transgender women, and WA has also used this existing political climate to justify the exclusion of both transgender women and women with DSD from its sport.”

One of the main points of Coventry’s agenda, after she won the Olympic presidency election in March, was the “protection of the female category,” meaning an end to the IOC’s usual open policy, which never imposed rules but left each federation free to set its own. The most widely accepted standard had been a natural testosterone threshold: anyone exceeding it was excluded.

Both transgender women and athletes with DSD had to take estrogen to stay below the limit. While transgender women could generally do so without major issues due to their desire to be as feminine as possible, DSD athletes, like Semenya, suffered severe physical and psychological problems and ultimately left competition. Despite this, World Athletics unified both categories in terms of regulations, and the IOC appears to want to follow the same policy. So far, only two other international federations — the skiing and boxing federations — have announced plans to make sex testing mandatory, a practice Olympic sport abandoned in the early 1990s.

The reasons for abandoning sex testing were summarized by Finnish geneticist Albert de la Chapelle in a private letter sent in 1988 to Spanish athlete María José Martínez Patiño, who had been barred from competition for having a Y chromosome, even though her body is insensitive to testosterone and it provided no anabolic effect or advantage in muscle strength, speed, or power.

“Your case, and those of many, many others is a tragic illustration of the inadequacy of the sex chromatin screening procedure,” De La Chapelle wrote to Patiño, who used this letter to secure her reinstatement by the athletics federation. “I and many other scientists have for many years tried to convince the sports organizations to abandon the sex chromatin screening so that further mistakes of this type can be avoided.”

“Unfortunately, the sports organizations, notably the IOC and the IAAF [World Athletics was formerly known as the International Association of Athletics Federations], have not yet decided to abandon the sex chromatin screening. They have refused to do so even after they have come under severe pressure from scientific organizations, which have passed resolutions asking them to reconsider their procedures in order to avoid further human suffering.”

De la Chapelle’s letter was in response to the Spanish athlete’s plea for help. She explained that doctors in Japan discovered a chromosome “alteration,” and that another doctor and member of the Spanish expedition revealed this to the press.

“The journalist published the event in newspapers and magazines, T.V. etc. And as a result of that, every body knew about it,” she wrote. “My federation and not support me, and they expelled me from the residence sport (the place where I lived). I left the university and so I had to work because I had no money to live. I have lost my friends, and my boyfriend left me when the event came to light; Twelve years of hard work for nothing. I thought I was going to die [...] It looked as if I were a man instead of a woman.”

Patiño said she had written to the King of Spain, and hoped her case would receive attention from specialists in genetics and sports medicine. “I wonder what are my possibilities, and if it is possible, before I die, to compete again. I will go on fighting and I hope to find someone in this world that will help me,” she wrote. “I have not deceived anybody; and I felt ashamed and humiliated [...] I have lost everything.”

Both letters were published in an article in the scientific journal Frontiers, led by scientist Silvia Camporesi of the University of Leuven, with collaboration from Jonathan Ospina of the University of Valladolid. The authors of the study oppose genetic testing: “First, in referring to women’s events specifically and exclusively as female events it signals that the organization prioritizes biological sex, not gender, in its eligibility considerations. Second, it merges regulations for women with variations of sex characteristics and transgender women into one set of regulations, ignoring the differences between these two groups of women athletes. Finally, it marks the return of systemic sex testing for all elite women athletes competing in track and field, a practice that ended in the 1990s for good reasons, given the substantial legal, ethical, and cultural objections voiced by a myriad of medical and scientific bodies, as well as by athletes who bravely shared their experiences.”

If the IOC approves the implementation of these controls during the Milan session ahead of the 2028 Los Angeles Games, the problems it will face — once ideological issues are overcome — will be practical in nature. World Athletics has already run into such issues: after its success with testing senior athletes in Tokyo, it had to delay the testing of athletes eligible for this summer’s U-20 World Championships in Oregon until March. Some of these athletes will not yet have turned 18, meaning the federation will need a protocol for obtaining informed consent from their families, as well as the establishment of at least a psychological counseling team to support young athletes who discover — painfully, as Martínez Patiño did in 1988 — that in the eyes of the sport, they are not considered women.

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