Boxer Imane Khelif Probably Isn't Transgender, She More Likely Has a Disorder of Sexual Differentiation

Many have been quick to label this athlete as male use this Olympic women's boxing controversy against the inclusion of transgender athletes in women's sports. As a doctor and scientist, I want to clarify a crucial point: this athlete is not a "transgender person." Instead, she likely has a condition such as Androgen Insensitivity Syndrome (AIS) or Swyer Syndrome, which makes her situation very different.

The difference between transgender athletes and athletes with disorders of sexual differentiation (DSD) is significant. Transgender athletes are individuals whose gender identity differs from the sex they were assigned at birth, involving a psychological and often medical transition process. On the other hand, athletes with DSD, such as those with AIS or Congenital Adrenal Hyperplasia (CAH), are born with atypical chromosomal, gonadal, or anatomical sex development.

Androgen Insensitivity Syndrome (AIS) is a condition where individuals have XY chromosomes but are resistant to male hormones (androgens) due to a mutation in the androgen receptor gene. As a result, they develop external female anatomy despite having male chromosomes and are raised and identify as females. Many do not even know they are chromosomally "male" until they experience infertility as adults! They have little to no androgen activity, meaning they do not develop typical male characteristics. Similarly, individuals with Swyer Syndrome also have XY chromosomes but lack functional gonads (ovaries or testes), leading them to develop as females with female external anatomy.

Imane Khelief Isn't Transgender, She's Likely Has a Condition Such as Androgen Insensitivity Syndrome

It is essential to understand the nuances and complexities of these conditions before forming opinions or making judgments. Conflating DSD with being transgender is not only scientifically inaccurate but also unfair to those with these medical conditions. People with AIS or similar conditions did not choose this; they were born with a mutation that affects their body's development and function.

This athlete has a medical condition, not a psychological one. She competes as a woman because she is, in every significant way, a woman. While preserving women's sports for biological females is important, we must recognize that rare edge cases like this require compassionate and thoughtful policy discussions.

It is crucial that we approach this topic with empathy and an open mind. Let's educate ourselves and others about the differences between transgender individuals and those with disorders of sexual differentiation. Misinformation and misguided anger only serve to harm people who are already facing unique challenges. Together, we can craft policies with compassion and science.

Thank you for taking the time to read and understand this important issue. I would love to hear your thoughts and open to answering questions. (reposted from X.com).