Simpson J L, Ljungqvist A, de la Chapelle A, Ferguson-Smith M A, Genel M, Carlson A S, Ehrhardt A A, Ferris E
University of Tennessee, Memphis.
Sports Med. 1993 Nov;16(5):305-15. doi: 10.2165/00007256-199316050-00002.
The possibility that men might masquerade as women and be unfair competitors in women's sports is accepted as outrageous by athletes and the public alike. Since the 1930s, media reports have fuelled claims that individuals who once competed as female athletes subsequently appeared to be men. In most of these cases there was probably ambiguity of the external genitalia, possibly as a result of male pseudohermaphroditism. Nonetheless, beginning at the Rome Olympic Games in 1960, the International Amateur Athletics Federation (IAAF) began establishing rules of eligibility for women athletes. Initially, physical examination was used as a method for gender verification, but this plan was widely resented. Thus, sex chromatin testing (buccal smear) was introduced at the Mexico City Olympic Games in 1968. The principle was that genetic females (46,XX) show a single X-chromatic mass, whereas males (46,XY) do not. Unfortunately, sex chromatin analysis fell out of common diagnostic use by geneticists shortly after the International Olympic Committee (IOC) began its implementation for gender verification. The lack of laboratories routinely performing the test aggravated the problem of errors in interpretation by inexperienced workers, yielding false-positive and false-negative results. However, an even greater problem is that there exist phenotypic females with male sex chromatin patterns (e.g. androgen insensitivity, XY gonadal dysgenesis). These individuals have no athletic advantage as a result of their congenital abnormality and reasonably should not be excluded from competition. That is, only the chromosomal (genetic) sex is analysed by sex chromatin testing, not the anatomical or psychosocial status. For all the above reasons sex chromatin testing unfairly excludes many athletes. Although the IOC offered follow-up physical examinations that could have restored eligibility for those 'failing' sex chromatin tests, most affected athletes seemed to prefer to 'retire'. All these problems remain with the current laboratory based gender verification test, polymerase chain reaction based testing of the SRY gene, the main candidate for male sex determination. Thus, this 'advance' in fact still fails to address the fundamental inequities of laboratory based gender verification tests. The IAAF considered the issue in 1991 and 1992, and concluded that gender verification testing was not needed. This was thought to be especially true because of the current use of urine testing to exclude doping: voiding is observed by an official in order to verify that a sample from a given athlete has actually come from his or her urethra. That males could masquerade as females in these circumstances seems extraordinarily unlikely. Screening for gender is no longer undertaken at IAAF competitions.
男性可能伪装成女性并在女子体育赛事中成为不公平竞争者的这种可能性，运动员和公众都认为是令人愤慨的。自20世纪30年代以来，媒体报道引发了这样的说法，即一些曾经作为女性运动员参赛的人后来看起来像是男性。在大多数这类情况下，可能存在外生殖器模糊不清的情况，这可能是男性假两性畸形的结果。尽管如此，从1960年罗马奥运会开始，国际业余田径联合会（IAAF）开始制定女子运动员参赛资格规则。最初，体格检查被用作性别验证的方法，但这一计划遭到了广泛不满。因此，1968年墨西哥城奥运会引入了性染色质检测（口腔涂片）。其原理是，基因女性（46,XX）显示单个X染色质块，而男性（46,XY）则没有。不幸的是，在国际奥委会开始将其用于性别验证后不久，性染色质分析就不再是遗传学家常用的诊断方法了。缺乏常规进行该检测的实验室加剧了 inexperienced workers 解释结果时出现错误的问题，导致出现假阳性和假阴性结果。然而，一个更大的问题是，存在具有男性性染色质模式的表型女性（例如雄激素不敏感、XY性腺发育不全）。这些个体由于其先天性异常并没有运动优势，合理地说不应被排除在比赛之外。也就是说，性染色质检测只分析染色体（基因）性别，而不分析解剖学或心理社会状况。由于上述所有原因，性染色质检测不公平地排除了许多运动员。尽管国际奥委会提供了后续体格检查，本可以恢复那些“性染色质检测不合格”运动员的参赛资格，但大多数受影响的运动员似乎更愿意“退役”。所有这些问题在当前基于实验室的性别验证测试中仍然存在，即基于聚合酶链反应的SRY基因检测，SRY基因是男性性别决定的主要候选基因。因此，这一“进步”实际上仍然未能解决基于实验室的性别验证测试的根本不公平问题。国际田联在1991年和1992年考虑了这个问题，并得出结论认为不需要进行性别验证测试。人们认为尤其如此，因为目前使用尿液检测来排除兴奋剂：有官员观察排尿情况，以核实来自特定运动员的样本确实来自其尿道。在这种情况下，男性伪装成女性似乎极其不可能。国际田联的比赛不再进行性别筛查。
