HUM-MOLGEN archive: ETHI: gender testing responses

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 .