F.D. Flam: Olympic boxer's gender is a manufactured controversy

When Italian boxer Angela Carini reported that she had “never felt a punch like that” after conceding to Algeria’s Imane Khelif 46 seconds after their Olympic match began, social media exploded with accusations. Elon Musk and J.K. Rowling chimed in, accusing Khelif of being a man posing as a woman to cheat.

The case highlights what’s wrong with Musk, Rowling and others who think of themselves as bravely opposing excess political correctness. They’re too in love with their own assumptions and superficial judgments. Khelif’s jawline and strong torso may look stereotypically masculine, but biological sex is about more than looks — and is sometimes more complex than chromosomes.

Consider Jeffrey Eugenides’ Pulitzer Prize-winning novel Middlesex, in which a Greek-American girl named Callie grows up as a pretty, happy child until, as a teenager, her height shoots up and she develops a mustache. As a teen, Callie isn’t sure if she’s a boy or a girl, and the girl who loves her isn’t sure if she’s gay or straight. At first, their love transcends those identity concerns. I read the book years ago, but it’s hard to forget a story like that.

Eugenides wasn’t taking poetic license. The character is based on the author’s meticulous study of a real genetic disorder called 5-alpha-reductase deficiency, which is rare, but somewhat more common in a few parts of the world including Greece and the Dominican Republic.

5-alpha-reductase is an enzyme that’s necessary in the chain of molecular level events leading male embryos — those with a Y chromosome — to grow a penis. The disorder can lead to genetically male (XY) babies emerging into the world looking female and being classified as girls.

Two-time 800-meter running champion Castor Semenya reportedly has a Y chromosome and 5-alpha-reductase deficiency, which has led to endless controversy about her eligibility to compete in women’s events.

Khelif was disqualified from a 2023 championship event based on a sex test of undisclosed nature, but the International Olympic Committee says she meets their criteria. Some reports say she was disqualified for having a Y chromosome, others because her testosterone level is above a particular threshold.

I don’t want to speculate on which it was, but suffice it to say there are a number of ways an XY individual might develop what looks like female genitalia, or an XX individual might have male-like testosterone-levels.

Our system of sex determination isn’t simple. Different animals use other kinds of sex chromosomes — in birds, the females are ZW and males are ZZ, while in some amphibians and reptiles, there are no genetic differences between the sexes and temperature at a critical stage in egg development determines sex. The duck-billed platypus uses a system of 10 sex chromosomes.

Humans use a system of XX for female and XY for male. Embryos all start out with a sort of starter kit for the reproductive parts for both sexes, and a series of activated genes and hormonal surges usually steers things in one direction or the other. Usually, but not always.

A number of genetic mutations can interfere with different stages of that process, leading to differences of sexual development (DSD) — in anywhere from 1,000 to 4,500 live births. (That makes such sex differences vastly more common than going to the Olympics.) And some babies develop from two early embryos that merged; if those embryos were opposite sex, the baby might have a combination of male and female traits.

Among Olympians, it’s more likely we would see people with unusual physical traits. The Olympics and other elite sporting events select for extreme body types — people who are unusually strong, incredibly tall, or short but extremely powerful. They may be wildly fast or insanely flexible, not to mention extraordinarily determined and capable of overcoming pain. Women’s bodies normally produce testosterone — some more than others — and certain sports likely favor those with a higher level.

This Olympic flap comes at a time of confusion and disagreement about the nature of sex and gender. But there’s no excuse for bullying or aiming cheating accusations at athletes who don’t conform to expectations. Things are not always what they appear on the surface. If the current rules allowed Imane Khelif to compete, then she deserves her medals and the world’s admiration.

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F.D. Flam is a Bloomberg Opinion columnist covering science. She is host of the “Follow the Science” podcast.

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