The division of athletes into male and female categories is a widely accepted practice throughout sport. The obvious rationale behind this derives from the differences in testosterone and oestrogen levels, which can result in differences in performance between the sexes. The previous use and/or current exposure to androgens are considered as criteria for unfair competition in general.
Some individuals have “disorders of sexual development”. This controversial term includes a broad variety of different conditions where the gender of the individual cannot be easily defined. This is due to a discrepancy between genders as defined by their chromosomes as opposed to their bodily characteristics, an ambiguity of their chromosomal sex itself, an underdevelopment of their adrenal glands leading to hormone disturbances as well as several other conditions. It is possible that these conditions may lead to variances in hormone levels and an unfair competitive advantage.
The FIFA Gender Verification Regulations apply for all FIFA competitions and have been adopted by the confederations. The two main goals of these regulations are to ensure a level playing field and to protect the privacy and dignity of players.
If a request for a gender verification procedure is accepted by FIFA, the team doctor and player have to provide medical documentation establishing the gender of the player. If further investigations are justified based on these files, the player shall undergo an examination by an independent expert. If the gender found is inconsistent with the one declared, the case would be referred to the FIFA Disciplinary Committee. In many cases, a further review of the case may be sought from an expert panel. This panel may include a gynaecologist, endocrinologist and/or a genetic expert.
Dr Mark Fulcher
Sports and Exercise Physician