At the 2024 Summer Olympics in Paris, Algerian boxer Imane Khelif made headlines after a match with Italian boxer Angela Carini, during which Carini dropped out after just 46 seconds, declaring that she’d “never felt a punch like this.” A subsequent right-wing media firestorm, spurred by prominent online figures, spread disinformation that Khelif was transgender, and was further fueled by the news that she had previously failed a gender eligibility test (the test’s legitimacy has also been called into question). Khelif went on to win gold for her weight class. 

As the article below from the October 1988 issue of Ms. reminds us, sex testing in women’s sports is nothing new—and its origins are blatantly unscientific.

In the 21st century, as conservatives increasingly use rhetoric of “fairness” to try to prevent trans women and girls from competing in sports—all while neglecting actual supports for gender equality in sports like Title IX—it’s worth interrogating the motivations behind these tests, which more often than not end up singling out Black women (and categorically exclude trans people from the world of professional sports).

Why are women like Khelif harassed and invasively tested, while men like Michael Phelps—with his abnormal wingspan and extraordinarily low lactic acid levels—are celebrated? 

Chromosome Count

From the October 1988 issue of Ms. magazine:

I am an athlete, and I am a woman. At least, I think I’m a woman. But if I were among that dazzlingly gifted number of female athletes preparing to compete in Seoul, my gender, like theirs, would be considered suspect—so much so that before any athlete is allowed to compete in women’s events at the Games or in most other major international competitions, she must first submit to a “gender verification test” of her chromosomes.

As a tennis pro who has competed on the regional level, I have never had to subject myself to this Orwellian inspection, nor contemplate the traumatic possibility of being told I am not female. But this is precisely what has happened to other women athletes, despite the fact that gender is far too complex to be evaluated by a laboratory test.

Since 1968, the International Olympic Committee (IOC) has been screening the chromosomes of all women competitors “to insure femininity in the competitors” and “establish equality among athletes.” Passing the test, which is called the buccal smear, has nothing to do with the way a woman looks, her birth records or her sense of self. Getting “certified feminine” depends on the results of a microscopic analysis of cells scraped from inside the athlete’s cheek to determine the pattern of her sex chromosomes.

Normally, the female pattern is XX and the male is XY. But that is not always the case. And when an abnormality appears, the athlete is subjected a battery of gynecological and clinical exams to decide whether she is “feminine” enough to compete. So far, it is estimated that a dozen women have been disqualified from Olympic competition.

Those numbers don’t begin to tell the chilling story of what’s happening to young girls who are being pre-tested today at lower levels of competition, or of the inaccuracies in the test itself and the flawed assumptions about the very nature of sexuality or the narrow definitions of femininity that its use is based upon. Neither do they reflect the havoc it wreaks in the lives of those who do not pass, or the stress the test imposes on female athletes on the eve of their competition.

As Olympic high jump champion, Debbie Brill, who was first “certified feminine” in 1972, said, “It is scary having to report to a ‘sex control’ station. You go through all these ‘what ifs.’ You know you are a girl, but what if the test doesn’t show that?”

Which is what happened to Ewa Kłobukowska. The Polish sprinter was the first woman to be disqualified by the test when it was used on a trial basis at the European Track and Field Championships in 1967. Kłobukowska may have had some internal male organs due to a birth defect, which is not unusual. Estimates of the incidence of sex chromosomal defects range from 1 in 1,000 to 1 in 4,000 births.

At one end of the spectrum are people who look female; while at the other extreme are those who can have some ambiguity in their sex organs and secondary sex characteristics, and are almost always treated medically and surgically to produce as concordant a sexual identity as possible.

What the officials told the 21-year-old Kłobukowska was that her test revealed an irregularity. Upon further examination, they said she showed “male-like characteristics.” Despite the fact that she was neither hypermuscular nor particularly more successful than her peers, their conclusion was that she had been competing “unwittingly as a man.” Kłobukowska was quoted as saying, “I know what I am and how I feel. … It’s a dirty and stupid thing to do to me.”

After her disqualification, she went through severe and long lasting depressions. It was rumored that she even submitted to surgery to try to correct her internal abnormalities and retain her eligibility. Although Kłobukowska was an Olympic gold medalist and world record holder in the 100-meter dash, her name was removed from the books and all public recognition of her awards taken away. Today, she works for a Polish computer firm in Czechoslovakia and has broken off all contact with the sports world.

“What is so ridiculously sad about the whole affair is that she was probably just as much a woman as anyone else, especially if she had male internal organs that were removed and she was given the female hormone estrogen, which is standard procedure,” said John Money, a psychologist at Johns Hopkins and one of the world’s authorities on disorders of sexual differentiation.

So why are female athletes being subjected to this? Because of rumors about men masquerading as women and of women “who were not really women” competing at the Games. Although these allegations were not unfounded, they were greatly exaggerated and reflected a fundamental ignorance of the biological conditions of women like Kłobukowska who were singled out.

There is only one documented case of a man masquerading as a woman at the Olympics. In 1957 Hermann, a.k.a. “Dora” Ratjen, from Bremen, Germany, went public when the news that in the 1930s he had been forced to pose as a woman for three years by officials of the Nazi Youth Movement. Entered in the women’s high jump in the Berlin games. In 1936, he qualified for the finals and came in fourth. And then in 1938, Ratjen went on to set a world record in the event at a lesser meet.

Other cases cited as justification for the IOC sex-testing policy involved individuals who lived and competed as females, but later, through surgery, became males. Between the late ’30s and the mid-’60s, there were reports that three track and field athletes and one top skier had sex-change operations after winning medals in women’s competition. It was generally assumed that these athletes, described as “imposters” by the IOC, had had an unfair physical advantage.

As a result of those cases and persistent rumors, the sex of some very dominant Eastern Bloc athletes came into question. Because of their strength and masculine appearance, suspicion focused on Tamara and Irina Press, two famous Soviet athletes who from 1958 to 1965 won five gold medals and set 26 world records between them.

At the same time, men from one Eastern European nation were rumored to be binding their genitals and taking estrogen in order to develop breasts and pass for females in competition.

And so for the first time, at the 1966 European Track and Field Championships in Budapest, women were required to undress for what the press called a “nude parade” in front of a panel of gynecologists. All 234 competitors were inspected, and all of them, including Kłobukowska, passed. But several of these dominating Eastern Bloc athletes, among them, the Press sisters, failed to appear. Their absence was construed as confirmation that they were afraid of failing the sex test.

By 1968, the visual check was not enough. A year after Kłobukowska’s very public disqualification, the IOC decided to adopt the newly discovered buccal smear test, which it considered a simpler, more objective and more dignified method of distinguishing the sexes. The IOC Medical Commission further justified its use by stating, “It would be unfair in a women’s competition to allow chromosomally abnormal athletes with male-like characteristics.”

Sports are not democratic. They’re elitist. The tallest play basketball. The shortest are jockeys. The ultimate would be to break the Olympics into biological classes and run them like the Westminster Dog Show.

John Money

From the first, concerned medical specialists have protested using the buccal smear. In this context, the American College of Physicians and American College of Obstetricians and Gynecologists recently passed resolutions calling for the test to be banned. Not surprisingly, critics are labeling the entire theory and practice of sex testing discriminatory—not just because men are not tested, but because athletes are disqualified on the basis of a postulated advantage that may not be an advantage at all. But at the very heart of the debate is the far more disturbing and complex question of whether testing should be done in in the first place.

For decades, the Finnish geneticist Albert de la Chapelle spearheaded a movement to get the IOC to reconsider its policy. He reasoned that if the intent of the test is to exclude men and women whose body structure or muscle strength confers a “male-like” advantage, then “the buccal smear is the wrong test.” He contended it catches some women with genetic abnormalities that bear no relation to any conceivable advantage in strength, while it fails to detect up to 90 percent of the women who might have such an “advantage,” the majority of whom have normal chromosome patterns, but increase their muscle bulk and strength by taking steroids, who have other disorders that give them a similar advantage.

Although all normal women and men produce both male and female hormones—it is their relative proportion that is important in sexual development—there are also genetically normal women with medical conditions causing an overabundance of testosterone.

• One of these, congenital adrenal hyperplasia, accounts for many, if not most, innately hypermuscular women.
• Then there are women who have testosterone-producing tumors on their ovaries, which can induce “male-like” characteristics.
• Even some intersex people, who are bone born with both male and female internal organs, have the female XX pattern.
• And there are men who have the XX chromosome pattern, although that is extremely rare.

All of these people would pass through the chromosome screen undetected, would never be subjected to further examination and would not be banned.

Considering the IOC standard, de la Chapelle pointed this out as “inconsistent” and “unfair” to those with similar characteristics who do get disqualified.

And what of those women with abnormal chromosomes who fail the test but have no hormonal or physical advantage? The most common example is a child born with the male chromosome pattern and testes but an impaired ability to either produce or respond to testosterone. Most are raised female and, if necessary, treated surgically and hormonally to correct their abnormalities.

As psychologist John Money explained in his book, Sexual Signatures: On Being a Man or a Woman, “The easy assumption has been that there are two quite separate roads [to gender identity], one leaving from XY chromosomes at conception to manhood, the other from XX chromosomes at conception to womanhood. But … scientists are uncovering a different picture. The fact is, there are not two roads, but one road with a number of forks where each of us turns in either the male or the female direction. You become male or female by stages. Most of us turn smoothly in the same direction at each fork.”

If there is complete nonresponsivity to testosterone at each of the forks after the embryonic development of testes, the child develops as a female, except that she has no uterus or Fallopian tubes and is sterile. She has a vagina, and what is commonly perceived as female body proportions and muscle strength. Most of these people don’t even know they have discordant chromosomes, and wouldn’t find out unless they investigated their infertility or got tested by a sporting federation or at international competitions.

When a person is born with a high degree of apparent sexual ambiguity, it can be the result of having both ovaries and testes. According to prevailing medical opinion, it is more than likely that all the historical cases of sex change cited as justification for gender testing were, in fact, not imposters, but intersex people who were assigned to the female gender at birth.

An IOC magazine editorial asserted when the buccal smear was adopted, that “the chromosome formula indicates quite definitely the sex of a person.”

But critics disagree, countering that a person’s “genetic sex” is the least relevant parameter of gender. Once the chromosomes have given their message to the embryo to develop testes or ovaries at the first fork in the road, they never again play a role in the process of sexual differentiation. Hormone levels, internal and external organs, and overall body build all have greater influence on gender.

Money, who considers psychosocial influences a major factor, says the boy, “The label ‘boy’ or ‘girl’ has tremendous force as a self-fulfilling prophecy.”

What makes a woman a woman? What it comes down to is the definition of femininity. Should it be left to a handful of people at the IOC—most of whom are men—to decide who is ‘feminine enough’ to compete?

Myron Genel

Asking, “How often do competitors willingly seek to deceive the IOC?” an editorial in the Journal of the American Medical Association took the position that genetic males raised as females universally believe they are women. “We physicians tell them so. To accuse such individuals of willful deception would be churlish.”

“It is imperative that this minority of individuals not get discriminated against,” added Dr. Jean Wilson, an endocrinologist who wrote a letter to the IOC in 1968 elaborating on the dangers of the buccal smear. “It would be better for individual athletes to receive a competitive advantage than for underlying diagnoses to be exposed in this cruel and heartless manner.”

For a young girl, the news could be utterly devastating. In cases when a patient has to be informed of her condition, most doctors wait until she reaches her mid-20s and is mature enough to handle it. Yet most of the athletes getting tested these days are in their teens.

What Dr. de la Chapelle views of the worst consequences of the IOC position is this testing of younger and younger girls, often in situations where there isn’t even the guarantee of quality control. And technical inaccuracies in the test itself are not unusual. De la Chapelle estimates that between 6 and 15 percent of the time, individuals tested for the presence of the Y will score falsely positive—as was the case with U.S. swimmer Kristen Wengler.

Myron Genel, a pediatric endocrinologist and associate dean at the Yale University School of Medicine, is concerned about the philosophical implications of the test as well. Asking, “What makes a woman a woman?” Genel said, “What it comes down to is the definition of femininity. Should it be left to a handful of people at the IOC—most of whom are men—to decide who is ‘feminine enough’ to compete?”

The IOC Medical Commission says its intention is not to issue “ex cathedra” decisions about who is a man or a woman.

Eduardo Hay, a 73-year-old gynecologist from Mexico City, is ultimately responsible for making all disqualification decisions at the Olympics. He emphasizes that the buccal smear was never meant to be more than an initial screen, and that it is always followed by more detailed chromosomal analysis as well as gynecological and clinical exams. If the woman refuses these, she can quietly withdraw from competition. If she is disqualified, the IOC will help her invent an “injury” or some other excuse for withdrawal.

According to Hay, the IOC aim is simply to prevent unfair competition. “At the moment, when you have genetic abnormalities such as [intersex], you also see anatomical differences. If there is a classically male-shaped pelvis and body configuration, then you can assume there is an advantage. You can see very well that men’s records are better than women’s, generally by a margin of 8 to 17 percent depending on the sport. That difference overall is only on account of anatomical differences.”

But to assert that a woman’s “male-like” characteristics automatically account for her success dismisses the many interactive factors that contribute to athletic victory, such as training, intelligence, coordination and discipline. According to Dr. Genel, not only is the assumption of advantage based on the anatomical measures scientifically unsound, but the issue of whether the presence of typically male traits creates an advantage is far from being settled.

John Money emphasizes, “The difference between male and female is not black and white. It is a biologic continuum. I don’t know of any statistical studies anywhere that could tell you what isn’t overlap between men and women on anatomical scales. … Really, the range of difference within the same sex can be as great as bad between men and women. Any dividing line is a matter of context.”

Inevitably drawing that line is a subjective decision just how much “male-likeness” is too much? When does it start to mean an unfair advantage?

Genel deems it absurd that the IOC is trying to guarantee such things as “physical equality,” “unfair advantage” and “fair competition”—concepts, he says, can’t even be defined consistently in the first place. “If some women get disqualified for being extra strong, then why not also disqualify those with unusual height or more oxygen capacity?”

Or, for that matter, why disqualify only some women who have so called genetic disadvantages? Genel cites the case of Flo Hyman, who suffered from Marfan’s syndrome, a genetic disorder that causes extra height. At 6’5″, she was one of the best volleyball players in the world. If anything, height is the anatomical parameter that correlates best with athletic success. Following the IOC standards, should she have been disqualified?

If authorities begin selecting out designated bits of anatomy, John Money wonders, “What of the Maasai, with their huge long legs, or the Mexican-Indian tribals with their extraordinary oxygenation capacity. Who gets excluded?”

He contends, “Sports are not democratic. They’re elitist. The tallest play basketball. The shortest are jockeys. The ultimate would be to break the Olympics into biological classes and run them like the Westminster Dog Show.”

Dr. Genel says, “If the tests were applied across the board to men as well, people would quickly see how useless it is, because it sure wouldn’t tell which men had an unfair advantage.”

Although not convinced that someone who is intersex is more successful athletically because of that condition, he concedes that if the results achieved by intersex individuals could be proven to be unattainable by “genetically normal women, then the IOC might have a leg to stand on.”

But the records of those athletes have consistently been superseded by women of normal genetic makeup, generally within an Olympics or two.

Not surprisingly, women athletes are divided on the subject. Long jumper Willye White had the world record she set at a U.S.-USSR meet in 1964 broken soon afterward at the same event by a Russian whose femininity was in question. Today, White unconditionally supports sex testing: “If she hadn’t been a man, I would have been the world record holder.”

Kate Schmidt, a world-class javelin thrower who competed in the 1972 and 1976 Olympics, considers sex testing “just another us-against-them thing that is being done in the name of protecting women. It is a Cold War mentality, because most of the athletes involved were Eastern Bloc.”

Schmidt would never protest the presence of people with birth defects or make them feel bad for being good: “That is a sour grapes, ungracious, win-at-any-cost attitude. People like that are bad sports.”

Heptathlete Jane Frederick said she doesn’t believe the official explanation of the test. “I think they are just saying, ‘You are so good we can’t believe you’re a woman. So prove it.'”

The IOC’s response to the debate? “If there is a better way, we would welcome suggestions,” says IOC medical commission chairman, Prince Alexandre de Merode.

The IOC eventually agreed to set up a “working group” to address the problem. Chairman de Merode promises that by Seoul the medical commission will have decided “how and when the IOC will look into the issue.”

Dr. de la Chapelle, although a member of that group is somewhat skeptical. “For so long, I have asked the IOC to reassess their policy, and every four years they tell me, ‘Let us just get through those next Games, and then we will look into it.’ I know the IOC means no harm, but their policy is misguided.”

One of the suggestions sure to be made will be to replace the chromosome test with a simple physical exam by female doctors. Another might be the introduction of a hormone test for allowable testosterone limits, but that is fraught with the same technical and ethical inconsistencies engendered by chromosome testing. A post-competition “appeal system” for cases where there’s controversy has also been proposed. But the resulting publicity could potentially damage an unwitting athlete’s psyche and reputation. Some just want to see testing dropped altogether.

Whatever is decided the people the IOC claims it is trying to protect should be included in a discussion. To date, there has been no indication that women athletes have ever been asked.

Editor’s note: The original version of this article from 1988 used the term “hermaphrodite,” a term that is outdated and should be avoided. Instead, we replaced it with the term “intersex” or “intersex people” to describe people born with genitalia or chromosomes that don’t fit typical definitions for males or females.

To pay tribute to five decades of reporting, rebelling and truth-telling, From the Vault includes some of our favorite feminist classics from the last 50 years of Ms. For more iconic, ground-breaking stories like this, order 50 YEARS OF Ms.: THE BEST OF THE PATHFINDING MAGAZINE THAT IGNITED A REVOLUTION (Alfred A. Knopf)—a stunning collection of the most audacious, norm-breaking coverage Ms. has published.

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