The case of athlete Caster Semenya reignited a global debate about sex, gender, and fairness in sport. Whatever our views on policy, most people can agree that medical evaluations should be handled with privacy and care. Public scrutiny can be profoundly distressing, as previous high-profile cases have shown.
Sex, Gender, and Sex Characteristics
It helps to separate a few related ideas. Gender usually refers to social role and identity. Biological sex is a broad term covering chromosomes, hormones, reproductive anatomy, and secondary sex characteristics. For many people these align neatly; for others, they do not. Variations in sex development (often called DSD or intersex variations) are a natural part of human diversity.
Chromosomes Aren’t the Whole Story
School biology often presents a simple picture—46,XX for females and 46,XY for males. In reality, human biology includes other chromosomal patterns such as 47,XXY (Klinefelter syndrome) and 45,X/46,XY mosaics, among others. These patterns can influence development in different ways and do not, by themselves, determine personality, ability, or moral worth. Older claims that linked specific karyotypes to aggression or criminality are not supported by contemporary evidence.
How Hormones Shape Development
Sex differentiation involves timing and sensitivity to hormones. For example, in androgen insensitivity syndrome (AIS), a person with XY chromosomes does not respond typically to androgens. As a result, they may develop predominantly female external characteristics and live their lives as girls and women. In 5-alpha-reductase deficiency, some children raised as girls develop typically male secondary sex characteristics at puberty. In certain communities (famously reported in parts of the Dominican Republic), families and peers often know this pattern well and help young people navigate the transition.
These examples show why decisions about identity and category benefit from compassion, evidence, and individual choice—rather than rigid rules. Cultural expectations about “being a real man” or “a real woman” can add pressure and stigma, which many people experience as harmful. If this interests you, you might also explore how cultural ideals of masculinity can become oversimplified in public debate (The Straw Man of Masculinity) and why the idea that “boys don’t cry” is being re-examined in modern psychology (Boys Don’t Cry?).
Human Dignity First
In our culture, gender carries moral weight and social expectation. People with DSD—and their families—often face misunderstanding, unwanted attention, or pressure to “fit” neatly into one box. A more humane approach is to support individuals to live in ways that make sense to them, medically and personally, with qualified care and without ridicule or ostracism. Hormones influence development across the lifespan, including parenting and social behavior, but biology never fully scripts identity (Hormones And Men’s Parenting Behaviour).
Learn More
For an accessible, evidence-based overview of differences in sex development, see the NHS guide: Differences in sex development (DSD).