RunRagged wrote:
sttrunner20 wrote:
I hesitate posting this to the lets run board because this is supposed to be kept private, but I actually personally know someone who has an intersex condition - XY chromosomes but fully female
in terms of being intersex, her case isn't as complicated in that she actually doesn't produce any testosterone and finished in the middle of the pack in all high school races. You could not tell she was intersex just by looking at her.... she literally looks like any other girl.
Should she compete in boys races? HELL NO. yes she has XY chromosomes, but she has a vagina and the outward physical appearance of a girl. she is at no advantage (maybe a slight disadvantage if I had to guess).
she didn't tell anyone because there was no reason too (the only reason she told me and my sister is because 1) we are very close family friends and 2) one of my siblings is transgender).
I know and care for someone with CAIS too. We met many decades ago whilst working as lifeguards and taking a course to get certified as water safety instructors. I've seen her most summers all my adult life. We've competed over the years in in tennis, swimming, sailing and contests involving the kinds of stuff lifeguards do.
I have no problem considering persons with CAIS to be women socially and legally, but I disagree with you that anyone with CAIS is "fully female." My friend with CAIS would disagree with you too. She's not happy about that, but she's a realist - as are most of the other persons she knows from her CAIS support group who are into or past middle age.
Yes, a person with CAIS "literally looks like any other girl" - particularly when in the bloom of youth as it sounds like your friend is. But sex is about far more than outward phenotype. Being XY and SRY positive, fetuses with CAIS go down the developmental path meant to equip them with the capacity to fulfill the male role in human reproduction upon maturity - meaning they have male gonads, testes, whose reproductive purpose is to make sperm. But because their male androgen receptors don't work, their bodies convert the T their testes make into estrogen and they develop to appear outwardly female. Their testes also do not make sperm, so they are sterile.
But being an androgen-insensitive, sterile XY person isn't the same as being "fully female" as you allege. Biologically the two are very different. Whilst persons with XY CAIS don't go through the male puberty of infancy or adolescence, they also don't go through female puberty.
internal female genitalia are also absent because the abdominal testes normally produce AMH, which impedes the development of the uterus, cervix and proximal vagina. However, the distal part of the vagina can be observed because it is not under AMH control, but it is always shorter than normal and blind-ending. In patients with CAIS, puberty typically appears later and has a slower advance than in the general female population. However, breasts and female adiposity can develop regularly due to the action of oestradiol deriving from the peripheral aromatization of testosterone. In contrast, pubic and axillary hair is absent or very rare because it mostly depends on androgen action. In regard to final height, CAIS patients are typically taller than the healthy female population due to the presence of the Y chromosome, which intervenes on statural growth independently of hormonal status.
Interestingly, patients with CAIS seem to have a different hormonal status that does not follow a physiological male or female profile. In particular, postpubertal CAIS patients with intact gonads show increased levels of LH with normal levels of FSH and of sex hormone binding globulin (SHBG) for the female range; moreover, basal testosterone and oestradiol values, free androgen indices and androgen aromatization indices are in the normal male range.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480640/Contrary to what you say, persons with CAIS don't have fully developed vaginas, either. They have what is known as vaginal hypoplasia or vaginal agenesis, and often other urogenital features different to what XX females have. This causes persons with XY CAIS to have the blind lower end of a vagina, or a structure that resembles one. It's common for persons with CAIS to require regular dilation and vaginoplasty surgery too in order to have penetrative sex. Moreover, their vaginas are not the same as XX female vaginas in terms of muscularity, elasticity (in length as well as width), mucosa or flora.
For decades, it was common to do "feminizing" urogenital surgeries including vaginoplasty on babies and children with CAIS and some other DSDs. Fortunately, that kind of treatment is being phased out; nowadays, it's considered best and most humane to wait until a child is old enough to make medical decisions for herself. Significantly, there's emerging evidence that persons with XY CAIS who eschew genital surgeries and removal of their testes and instead learn to accept and love their bodies "as is" end up doing much better psychologically - and they report having more satisfying sex lives and intimate relationships too. Moreover, it's been shown that many of those who do have their testes removed and thus have to take exogenous estrogen do best if they do not try to achieve female estrogen levels.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3593621/https://pubmed.ncbi.nlm.nih.gov/24899229/Also, FWIW, the person I know with CAIS has led a life that has been different to her friends and family who are female in significant ways. For example, though she's had to deal with disappointment and sorrow over being infertile, because her infertility comes from being born with testes that never matured to make sperm, she's not experienced any of the social pressure or arduous, invasive treatments that middle-class female people with infertility in well-off countries typically have gone through for many decades now. Since the reason she is infertile is clear, there was no need for her to get invasive pelvics, vaginal ultrasounds and laparoscopy surgery to investigate what's wrong. No worried tracking of her cycle, taking her temp several times a day, checking her cervical mucosa, etc. No pressure to take awful drugs to hyperstimulate her ovaries so a tube can be inserted in her vagina, piercing each side to reach each ovary to extract eggs for use in a lab. No expectation that she undergo invasive, grueling rounds of IVF or medical IUI.
Moreover, since my friend with CAIS has never had to deal with any of the downsides of having a female reproductive system and female physiology, she has been advantaged in sports training and performance over us bog standard female people in numerous ways. I'll spare you the details, but never having to deal with periods, contraception, pregnancy, miscarriage, abortion, tokophobia, labor, childbirth, childbirth injuries, breastfeeding, weaning, Pap smears, perimenopause, menopause, gynecological conditions etc really is a huge advantage. My friend has never had to miss a single practice, lesson or competition - nor has her performance in any sports or physical activity ever been impaired even in the slightest because of any of the female-specific physical issues that XX girls and women have to deal with as a matter of course starting from about age 11-12, the average age of menarche.
Because I have done some research into this area, I've also come to know and personally like a number of other people with other kinds of DSDs beyond CAIS. I wish them and all people with DSDs well, and support measures advancing greater understanding of DSD conditions, full social acceptance of people with DSDs, as well as respect for their dignity and rights. Nevertheless, the individuals whom any one of us knows and likes personally shouldn't be the basis on which sports policy is made. Particularly when it comes to a protected category that is supposed to be tightly ring-fenced to insure fairness for the sex class for whom the category was created in the first place.