Sports and XY-DSD (Disorders of Sex Development)

International sports federations (IAAF, IOC, boxing federations, etc.) have in the past investigated cases in which female athletes had XY chromosomes and an SRY gene. This is not about cheating, but about biological variations (DSD = Disorders/Differences of Sex Development).

SRY Gene

The SRY gene (Sex-determining Region Y) is a gene located on the Y chromosome. It plays a decisive role in sex development in humans and many other mammals.

  • Location: On the short arm of the Y chromosome (Yp11.3).
  • Function: The gene encodes a protein (the SRY transcription factor) that acts like a “switch.”
  • Effect:
    • Activates other genes that lead to the development of the testes.
    • In the developing testes, testosterone is produced, which in turn controls the formation of male sexual characteristics.
  • If the SRY gene is missing (e.g., on an X chromosome or due to a mutation), an organism usually develops a female phenotype despite having XY chromosomes.
  • Special cases:
    • Mutations in the SRY gene can cause disorders of sex development (DSD), e.g., Swyer syndrome (XY gonadal dysgenesis).
    • In rare cases, the SRY gene can also be transferred to an X chromosome → resulting in XX males.

The SRY gene is the “start button” for male development in the embryo.

Why a chromosome test is not always sufficient in sports

A simple chromosome test (XX or XY) is not always enough to clearly determine biological sex for sporting purposes. Reasons include:

  1. SRY translocation (XX males)
    • Normally: XY → SRY present → male development.
    • But: In rare cases, the SRY gene can be transferred to an X chromosome.
      • Result: XX individual with male development.
      • A chromosome test would only show “XX” → apparently “female,” even though the person has male characteristics.
  2. XY without SRY (Swyer syndrome)
    • Some people have XY chromosomes, but due to a mutation lack a functional SRY gene.
      • Result: Female development (no testes, female phenotype).
      • A chromosome test would show “XY = male,” although the person is phenotypically female.
  3. Sporting fairness
    • The boxing federation (as well as other sports organizations) wants to ensure that female athletes do not unknowingly compete with genetic or hormonal advantages derived from male development.
    • Therefore, the presence of the SRY gene is more decisive than chromosome count, since it actually gives the starting signal for male development.
  4. Additional factors
    • The hormone profile (especially testosterone level) is also often examined, since this ultimately influences physical performance.
    • Testing only chromosomes would therefore be too rough and error-prone.

An SRY test is more precise because it checks whether the “male development switch” was activated – something a chromosome test alone cannot reliably show.

The SRY gene is not always functionally active and not automatically associated with increased androgen production.

  1. SRY is only a starting switch
  • The SRY gene is activated only briefly in the early embryo (around the 6th–7th week of pregnancy).
  • It initiates testis development by activating other genes (e.g., SOX9).
  • Later, SRY is not kept permanently active; testis development continues via other regulatory networks.
  1. Not always functional
  • Mutations in the SRY gene can lead to loss of function, even if the gene is present.
    • Consequence: XY karyotype, but no normal testis development → Swyer syndrome (46,XY gonadal dysgenesis).
  • This means: SRY ≠ automatic male development.
  1. Androgen production depends on functional testes
  • Even if SRY is correctly activated:
    • It must lead to the formation of functional testes.
    • Only the testes produce testosterone (androgens), which then drive male sexual development.
  • Disturbances “after” SRY (e.g., defects in testosterone synthesis or in androgen receptors) can still lead to atypical development (e.g., androgen insensitivity syndrome, AIS).
  1. Conclusion
  • SRY = starter switch, not engine.
  • Without functional SRY → no testes → no androgens.
  • With SRY, but defective testes or receptors → possibly still low or ineffective androgen levels.
  • Only with functional SRY + intact testis development + intact hormone action → typical male androgen production.

 

Distinction: Presence vs. functionality of SRY

  1. Occurrence of SRY mutations
  • In the vast majority of cases, the SRY gene is functional.
  • Inactive/defective only in very rare cases:
    • Estimates: about 10–15% of cases of 46,XY gonadal dysgenesis (Swyer syndrome) are due to SRY mutations.
    • Swyer syndrome itself is extremely rare: about 1 case per 80,000–100,000 births.
    • This means: only a tiny fraction of all XY individuals have an inactive SRY.

 

  1. Other causes of missing male development despite XY
  • Even if SRY is intact, errors further down the pathway can occur, e.g.:
    • Mutations in SOX9, SF1, DAX1
    • Defects in testosterone synthesis
    • Mutations in the androgen receptor (→ AIS)
  • These are more common than direct SRY mutations.
  • Inactive/mutated SRY gene: extremely rare, <0.01% of all humans.
  • Among people with DSD, defective SRY accounts for only a small proportion.
  • In the vast majority of cases, SRY is functionally active – problems arise elsewhere in the sex development pathway.

 

  1. Is testosterone the key to athletic performance?
  • No, not alone.
    Testosterone plays an important role:
    • Increases muscle mass and strength (anabolic effect).
    • Promotes red blood cell formation (→ more oxygen transport).
    • Influences aggressiveness and risk-taking, which may help in competition.
  • But: Athletic performance is multifactorial.
    It depends on:
    • Genetics (muscle type, metabolism, heart-lung function)
    • Training
    • Nutrition
    • Environment (altitude, climate, culture, resources)
    • Psychological factors
  1. Could other genetic variations play a role, e.g., in endurance?
  • Yes, many genes are associated with endurance performance:
    • ACTN3 gene: influences muscle fiber type (fast vs. slow-twitch).
    • EPO gene & HIF-1α: regulate oxygen transport and adaptation to altitude.
    • ACE gene (angiotensin-converting enzyme): certain variants promote endurance, others power.
  • There is no single “super-gene,” but many small contributions (polygenic basis).

 

    • Why do so many top marathon runners come from East Africa?
  • A striking number of world-class runners come from Kenya (Kalenjin people) and Ethiopia.
  • Possible reasons (combination of genetics, environment, culture):
    • Genetic factors:
      • Some studies point to favorable combinations in muscle metabolism, VO₂max, and energy efficiency.
      • BUT: No single “marathon gene” has been found.
    • Environment:
      • Living and training at high altitude → natural endurance stimulus (more red blood cells).
    • Sociocultural factors:
      • Running is part of daily life (to school, work, etc.).
      • Strong motivation: running offers economic opportunities.
    • Body build:
      • Lean bodies with long legs and low muscle mass → more efficient energy use over long distances.
  1. Conclusion
  • Testosterone: important, but not the only factor.
  • Athletic performance: result of many genes + environment + training.
  • African marathon runners: do not have a “magical genetic advantage,” but benefit from a unique mix of body build, lifestyle, altitude, and training tradition.

 

  • Strength sports: where testosterone is crucial.
  • Endurance sports: where many other factors are more decisive.

 

XY-DSD (Disorders of Sex Development)

Genotype

Testes present?

Testosterone production

Androgen action

Typical phenotype / upbringing

Notes

Complete Androgen Insensitivity Syndrome (CAIS)

Yes (often intra-abdominal)

Normal to high

None (defective receptor)

Female, no body hair, no hirsutism

Very feminine body habitus; usually discovered at puberty due to absent menstruation

Partial Androgen Insensitivity Syndrome (PAIS)

Yes

Normal to high

Partially reduced

Female, male, or ambiguous

Wide variability: from almost female to masculinized

5α-Reductase Deficiency

Yes

Normal

Testosterone present, but no DHT (dihydrotestosterone)

At birth: usually female; at puberty: partial masculinization

Some raised as girls, then virilize in puberty

Gonadal Dysgenesis (XY with SRY, but defective gonadal development)

Dysgenetic or absent testes

Low to none

Normal (but no hormone)

Female, absent puberty

Risk of gonadal tumors; often requires estrogen therapy

Swyer Syndrome (complete XY gonadal dysgenesis)

No (streak gonads)

None

–

Female, absent puberty

Raised as girls; no androgens because no testes

Turner Mosaic with Y material (45,X/46,XY)

Variable

Variable

Variable

Often female

May carry Y material without functional testes

  • SRY enables testis development — but functional testes are not guaranteed.
  • A sports advantage exists only if there is significant testosterone and androgen action.
  • If an athlete grew up as a girl, shows no virilization and no hirsutism, this suggests little or no androgen effect.