The Olympic controversy in Paris surrounding biological men competing in women’s boxing brought the Gender Wars to the attention of millions around the world, as two medals in women’s boxing are poised to land around the necks of two bio-males: Algerian Imane Khelif and Taiwanese Lin Yu-ting.

That says it all.

Or does it?

As I explain below, the situation is much more nuanced than that. To craft policy or rules that are fair to all, we need a thorough understanding of the science behind intersex conditions. Mistakenly equating transgenderism with congenital intersex conditions (as many are doing) and demanding a blanket ban against all “bio-males” competing in women’s sports might not be the optimal approach. Stick with me.

There is a small class of medically diagnosable intersex conditions that are incredibly rare and occur when chromosomal sex and phenotypic sex do not match—in other words, an individual might have male XY chromosomes but female genitalia or ambiguous genitalia.

Image by Andrea Widburg

According to his seminal article “How Common is Intersex,” medical doctor and psychologist Dr. Leonard Sax highlights two such intersex conditions:

(1) Congenital Adrenal Hyperplasia (CAH) occurs when excessive androgen production “masculinizes a female fetus (XX) in utero,” resulting in either masculine appearing or ambiguous genitalia and

(2) Complete Androgen Insensitivity Syndrome (CAIS) occurs when a genetic male (XY) is born with a vagina and clitoris but no male sex organs. They are usually raised as girls. When they fail to menstruate, testing typically reveals they have undescended but functioning testicles and no uterus or ovaries. They will often go through male puberty as the testes produce testosterone.

People with intersex conditions should not be confused with Bruce Jenner-style transgender women who are 100% chromosomal males with fully functioning male sexual organs that produce testosterone and enable them to procreate. At this point in our medical technology, while he can dress like a woman and take ungodly levels of hormones to become more feminized, he can never become a woman. Having gone through male puberty and a lifetime of body-strengthening testosterone, transgender “women” like Jenner should never be allowed to compete against women.

As upsetting and wrong as the decisions in Paris were, boxers Imane Khelif and Lin Yu-ting likely have a variation of CAIS. Because it’s a medically-diagnosed condition over which no human has any control, it demands an understanding of the science as well as, dare I say, empathy as we navigate the issue. Again, stick with me.

While exceedingly rare—Dr. Sax concludes that true instances of intersex conditions occur in less than 2 out of every 10,000 births (.018%) and that 99.98% of people are born either male or female—their stories are often tragic. Their lives are filled with pain, confusion, and feelings of inadequacy, exacerbated by mockery, disparagement, and societal shunning.

Despite being part man, part woman, they want to live as normal a life as possible and, for some, that might include competing in an Olympic sport. Like it or not, they exist, and if they want to qualify to compete, we need clear rules.

Imagine if this were your lot in life or that of your child, and you had to decide his or her gender at birth. Some of you may have experienced this. Imagine that decision doesn’t match with your child’s development during puberty, and note again that this isn’t about a boy who decides he is a girl because it’s trendy or because that’s just how he feels (a psychological condition). These children are born looking like girls from the outside while literally going through male puberty on the inside. They’re agonizingly a little bit of both.

In deciding whether intersex bio-males should be allowed to compete with females, it really comes down to testosterone and male puberty. While individuals with CAIS have XY chromosomes and a vagina and clitoris, they also have undescended testicles that will still spew testosterone during puberty, causing them to masculinize, so they develop stronger musculature, bone structure, cardio systems, and higher lung capacity, etc. They should not be allowed to compete against women.

By all accounts, Khelif and Yu-ting seem to fall within this category, and this is precisely why the decision to allow them to compete was wrong.

However, because this is a congenital medical condition, we could make an accommodation as we do for people with disabilities. The Khelifs and Yu-tings of the world should either compete against men or in a separate category altogether or perhaps we should consider an LGBTQ+ Olympics and let them sort it out. (The radical LGBTQ+ Cartel won’t like that because it would interfere with their quest to normalize all gender categories and obliterate the male-female binary.)

But what do we do if CAIS is diagnosed and treated early in a fetus, baby, or young child—way before puberty—and the decision is made to defer to the female genitalia, administer female hormones, and remove the undescended testicles so they never go through male puberty, never produce testosterone, and have nothing male in them save for the XY chromosomes? For all intents and purposes, this person will look like a girl, likely act like one, and be on a physically competitive level with females. An argument could be made that they should be allowed to compete as girls.

It is absolutely dizzying but take heart. Much of this intersex controversy will be moot in the very near future as gene-editing technology like CRISPR can correct these genetic anomalies in utero, allowing a fetus to develop as either a male or female. No one will ever know these individuals had the potential to be born and live their lives caught between two sexes.

Until then, we must contend with a small number of athletes who are victims of a cruel biological accident no different than children born deaf, blind, with Down’s Syndrome, or any other congenital condition.

Just a quick note: You may not see “intersex” used anymore as the medical profession, under the influence of the LGBTQ+ cartel, is now classifying these conditions as Differences of Sex Development (DSDs). This allows them to inflate the numbers by including medical conditions that are not intersex.

For example, the Cleveland Clinic includes Turner’s Syndrome where, despite missing an X chromosome, the girls are indisputably phenotypical females with varying degrees of infertility, often treatable with IVF which allows them to carry a child to term. The plumbing is there but just doesn't work.  They are not by any stretch intersex. 

They also include Klinefelter’s Syndrome, where, despite having an extra X chromosome, these XXY males are phenotypically indistinguishable from XY males. They are capable of erection and ejaculation but are often infertile, many with small testicles.  Those who can procreate are likely unaware of the extra chromosome.  Again, they are absolutely not intersex.

This change in classification derives from the work of radical Brown University professor Anne Fausto-Sterling, who includes numerous non-intersex conditions in her definition of intersex, boosting the incidence from .018% to 1.7% of the population. According to Dr. Sax, that’s a change from 50,000 people born this way to five million!

Expanding the definition serves the interests of the LGBTQ+ cartel, which seeks to upend the status quo in everything, including sports, and queer as much of the population as possible.

Until CRISPR technology eliminates the need to have this conversation, a committee will have to consult with athletes, their families, and doctors to ascertain an individual’s condition and identify the medical or surgical procedures performed and what impact they have had on puberty and hormone levels. This should be done in a way that respects privacy but also ensures accountability to the public so it can trust the decision-makers.

It’s intrusive but, without it, men like Khelif will be able to compete against women like Italy’s Angela Carini, who had to withdraw because Khelif’s blows were just too intense.

A reasonable starting point for such a committee would be to acknowledge (1) that bio-males born with medically diagnosed intersex conditions cannot compete against women if they have gone through male puberty and have had or continue to have testosterone levels greater than those acceptable for women; and (2) that so-called “transgender” women who are bio-males, with male sexual organs, who went through male puberty and produce testosterone, cannot compete in women’s sports.

In the meantime, we anxiously await the refinement of a medical technology (CRISPR) that can eradicate this medical anomaly and take this controversy out of the Olympics and, quite possibly, our politics.