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To: Multiple recipients of list HUM-MOLGEN <HUM-MOLGEN@NIC.SURFNET.NL>
Subject: ETHI: gender testing responses
From: Hans Goerl <GENETHICS@delphi.com>
Date: Wed, 7 Aug 1996 23:21:13 -0500

Well, the Olympics are over and I now have had time to review the responses
to my inquiry. There were quite a few duplicates and I thank those whose
responses are not included below.

Hans Goerl
ETHI editor
*****************************************************************************
****************


From:   IN%"Marilyn_Owens@cc.chiron.com"  "Marilyn Owens" 30-JUL-1996
19:36:08.7


     Your inquiry was forwarded to me by a co-worker.  I was responsible
     for the Gender Verification Program at both the Los Angeles 1984
     Olympic Games and the Calgary 1988 Winter Olympic Games.  Our testing
     procedure was mandated by the IOC Medical Commission.

     Briefly:  we obtained multiple buccal smear specimens from each female
     athlete (about 3600 in LA, 1600 in Calgary) which were immediately
     fixed in ethanol for transport to the laboratory.  One slide per
     athlete was stained for Barr bodies and a second (with quinacrine) for
     y chromatin.  All staining batches included blind controls.

     There were no misreads in the controls.  Four athletes had "abnormal"
     results for presumptive XX females in LA: Two XY females, one XO
     mosaic and one XY male!  In Calgary: only one "abnormal", an XO
     mosaic.  These were detected as having "lower than expected" Barr
     bodies and/or presence of y chromatin.  In each case, the athlete was
     called in with coach and team physician for discussion of results, had
     a physical exam, and then some were asked to give blood for a complete
     karyotype.  I don't know if any abnormals were "missed" in this
     process, but I do know that one of our XO mosaics brought in her
     medical files and verified that she was mosaic.

     My understanding is that these tests were eliminated from the Olympic
     Games in the early 1990's.  I believe, although am not certain, that
     routine physical exams have been substituted for the buccal smears.

     Would appreciate your feedback if you obtain any more data on the
     current practice in the Olympics,

     Marilyn Owens
*****************************************************************************
****************

From: Betsy Gettig <bgettig@HELIX.HGEN.PITT.EDU>

Sechin Cho, MD did the gender testing for the Korean Olympics and has
fascinating stories of the experience.  Athletes who are in previous
Olympics have certificates for testing and therefore are not
re-tested but those new to the Olympics must be tested.  The 1%
figure appears to be correct.  Sechin can be reached at the
University of Kansas -

Louis "Skip" Elsas is doing the testing in Atlanta but I would not
call now as he probably is mega busy. He is at Emory.
*****************************************************************************
******************

From: Teresa Binstock <Teresa.Binstock@UCHSC.EDU>

I am among the watchers of SRY studies; hopefully as results of Mr.
Goerl's quiry arrive, they shall be shared by posting to the list.

Thank you,


Teresa C. Binstock, Researcher
Developmental & Behavioral Neuroanatomy
B140 Fragile X Section
The Children's Hospital
1056 E. 19th Avenue
Denver CO 80218 USA
*****************************************************************************
******************

From: "<Allan T. Bombard, MD>" <ATB28@AOL.COM>

You might be interested in reading the collection of related articles in
this week's (17 July, 1996) Journal of the American Medical Association.


Allan T. Bombard, MD
Director, Division of Reproductive Genetics
Department of Obstetrics and Gynecology
Albert Einstein College of Medicine/Montefiore Medical Center
1695 Eastchester Road, Suite 301
Bronx, NY 190461
*****************************************************************************
********************

From: "Angela Scheuerle, M.D." <ascheuer@PED1.MED.UTH.TMC.EDU>


Well, the Olympics were using Barr body testing of cheek scrapings up until
a few years ago.  Doesn't that have a higher error rate than SRY testing?
What was the false positive rate for any gender testing in the past?  And
what confirmatory testing is used?

In a more general sense, the whole purpose of doing 'gender identity'
testing of the women participants seems to be based on a few assumptions 1)
all male athletes are inherently stronger/faster/more coordinated than all
female athletes, and 2) all male athletes would outperform all female
athletes in any given Olympic sport.  I'm not sure that there is support
for 1) given the wide range of somatic variability of people.  Likewise for
2) there are some sports (equestrian events and archery come to mind) in
which gender is probably really irrelevant.

So, texting modality aside, the bigger ethical questions that I see are:

A) Is this sex-discrimination parading as 'protecting the women' since the
male athletes don't have to undergo the testing?

B) Should gender testing only be used in those events which are direct
measures of physical prowess of the athlete and not test those competing in
events that do not divide parcipants by gender such as equestrian, archery
(?), bowling, ping pong, etc.

C) Is any genetic test really more accurate than a thorough standardized
physical exam which is more easily performed and significantly less
expensive? (and has the added benfit of being able to asses the overall
health of the athlete and their fitness to compete.)

D) Understanding that the purpose of testing is to try to 'level the
playing field' (as it were) should we extend catagorization of competitors
in all sports into flyweight -> heavyweight type catagories so that each
athele is competing only against those with whom they are 'fairly' matched?


Lastly, it is less likely that a male athlete would undergo the necessary
modifications to pass as a female than that a female would use anabolic
steroids or other enhancing medications, and use them far enough in advance
that they would be cleared from the system at the time of testing. Should
we take testing so far as to do muscle biopsies on everybody to look for
evidence of steroid use?

-A


Angela E. Scheuerle, M.D.
Assistant Professor
Division of Medical Genetics
Department of Pediatrics
UT Health Science Center - Houston
6431 Fannin, MSB 3.144
Houston TX  77030
ascheuer@ped1.med.uth.tmc.edu
*****************************************************************************
******************

From: David Barton <dbarton@IOL.IE>



Malcolm Ferguson-Smith in Cambridge has been very active in
correspondence and lobbying over this question in the recent past.  You
might want to contact him about current practice and associated problems.


  | Dr David E Barton
  | Chief Scientist & Honorary Lecturer in Molecular Genetics
  | National Centre for Medical Genetics
  | Our Lady's Hospital for Sick Children
  | Crumlin, Dublin 12, Ireland.
  | Tel +353 1 455 0515 Fax 455 8873




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