Genetic gender abnormalities in Algerian children and a Boxing Match
Yes, God made them male and female, but unfortunately since the fall, things are not always that simple.
Two genders? Jesus Himself held this discussion with a little more nuance.
A long while ago, I fact checked the assertion that the Bible only mentions two genders. In fact, in the ancient world, it was recognised that there were people who biologically speaking had ambiguous biological gender — these people Jesus mentioned in his discussion of marriage in Matthew 19 as “eunuchs who were born that way” — under Roman and probably Jewish law, hermaphrodites (or intersex people as they are called in the medical literature today) were not allowed to marry.
Algeria and 3β-hydroxysteroid dehydrogenase deficiency
There is in fact a type of genetic defect that can occur which affects the development of sexual organs, called congenital adrenal hyperplasia due to 3β-hydroxysteroid dehydrogenase deficiency (3β-HSD CAH) that is quite common in Algeria.
On this fairly uncontroversial topic (possibly up until now), Wikipedia has an excellent summary of this medical condition. '
To summarise: some people are born with a genetic abnormality that results in a deficiency in a particular key enzyme, which catalyses (helps along) some very important reactions in the adrenal glands, ovaries, testis and placenta, including the development of sexual organs in the womb1.
In other words, the biological development of babies in the womb is disturbed: in the most extreme instances of 3β-HSD CAH, the cells cannot properly metabolise salt, and the unborn child or baby dies very quickly.
In the less extreme examples, the development of sexual organs of the child in the womb is disturbed. The male (XY chromosome) babies can end up having testes in the abdomen instead of outside of the bodies, and sexual organs that resemble female sexual organs more than they resemble male sexual organs. In the more severe cases, decisions have to be made at birth, whether to operate and try to bring the testes out from the abdomen and create a sack for them, or whether to just leave things as they are and make a decision about what gender the baby will be brought up as.
The reverse can also happen to female (XX chromosome) babies. In the most extreme examples, a female with XX chromosomes is externally completely male, with male sexual organs; infertility is the result in these cases.
Interestingly, this genetic condition is highly prevalent in Algeria. I have put links to some studies at the bottom of this article.
Algerian boxer: a male pretending to be a female? Or someone born with 3β-HSD CAH?
This brings us to the story in the media today.
Italian boxer Angela Carina abandoned her boxing match with the very manly looking Algerian boxer Imane Khelif after 46 seconds.
Carina gave a statement to the media afterwards, saying, “I am heartbroken. I went to the ring to honour my father. I was told a lot of times that I was a warrior but I preferred to stop for my health. I have never felt a punch like this. I got into the ring to fight. I didn’t give up, but one punch hurt too much and so I said enough. I’m going out with my head held high. After the second punch, after years of experience, I felt a strong pain in the nose. I said enough, because I didn’t want. I couldn’t finish the fight after the punch to the nose. So it was better to put an end to it… I am in pieces because I am a fighter, they taught me to be a warrior. I have always tried to behave with honour, I have always represented my country with loyalty. This time I didn’t manage to because I couldn’t fight any more. Regardless of the person I had in front, of me, which doesn’t interest me, regardless of all the row, I just wanted to win. I wanted to face the person that I had in front of me and to fight.”
Carina’s dramatic withdrawal sparked a social media storm. J K Rowling and Elon Musk immediately came to the defence of Angela Carina, saying how disgusting it was that a transgender athlete was allowed to compete.
Several facts have subsequently come into the public arena, however: firstly, the International Boxing Association (IBA) last year excluded Khelif and a Chinese athlete, Yu-Ting, from the boxing competitions after they were tested; IBA president Umar Kremlev said DNA tests had “proved they had XY chromosomes and were thus excluded”.
The IBA also said that other examinations were performed, but refused to go into any detail, which to my mind says that they were unwilling to intrude on Imane Khelif’s privacy; I think this would be logical, since the IBA otherwise has every reason to reveal all the results of their examination and justify their decision.
It has also subsequently been revealed that Imane Khelif grew up as a girl in Algeria. Pictures have been posted by her relatives on facebook:
Here is Imane Khelif showing the medal.
Things in life are not always as simple as we would like them to be
This whole episode is clearly very troubling: I think we all felt a good degree of sympathy for Angela Carina, when it seemed very obvious to everyone that the person she was fighting was a transgender female; i.e. a male posing as a female, and the Olympic Committee did nothing to disabuse us of this: all they said they had done was to look at Imane’s passport and identity papers, which said she was female, and left it at that; well, that’s probably not enough to reassure people who saw them rubbishing Christianity in the opening ceremony with a transgender Jesus — it certainly looked ideological at this stage.
However, it might not be as simple as it looked at first: biological gender, since the fall of Adam, is not always as clear cut as people would like it to be. Perhaps Imane Khelif’s biological gender is not quite as clear cut as an either/or. Perhaps Khelif has 3β-HSD CAH or has another biological birth anomaly that means her gender is not as easily definable as people would like it to be. With 3β-HSD CAH, a person with such an anomaly either has extra testosterone in the case of XX females, or a person who is essentially male in strength and testosterone levels and genetically XY, but has genitalia that tend towards the female; either way, a person with this genetic anomaly will have more strength and power than the average female.
I cannot help thinking that this is a very difficult situation, and I am certainly glad that I am not on the IOC. Sport has to have rules, and it is very clear that it is dangerous and unfair for female boxers to be fighting males. But what is a male? In 99.99% of instances, it is very obvious that a person is either male or female, biologically speaking.
Algeria, however, is one of those places where there is a much higher percentage of people with genetic conditions that can make their biological gender hard to determine or decide at birth2. To my judgement, in the photograph above, Khelif does not look like someone with an unclear conscience. I’m just glad that I’m not the person who has to decide this issue.
I suppose it’s a lesson to us all, not to rush to premature judgement. God bless you all.
UPDATE: Imane Khelif does indeed have a genetic gender disorder
I wrote this article in August 2024.
In fact, a medical report has now been published pointing out that Khelif is afflicted with 5-alpha reductase deficiency.
Khelif also had a testosterone level typical of males. The report was a collaboration between expert endocrinologists Jacques Young of the Kremlin-Bicêtre hospital in Paris, France, and Soumaya Fedala of the Mohamed Lamine Debaghine hospital in Algiers, Algeria.
One must have some compassion for Khelif: Khelif has XY (male) chromosomes, but was born with apparently female genitalia, a “blind vaginal pouch” according to the report.. The medical examination revealed that Khelif has no uterus, but possessed internal testicles and a ‘micropenis’ resembling a clitoris. The report, which I assume was supposed to be confidential, recommended gender correction surgery as well as counselling, and said that there was likely to be a “neuropsychiatric” impact.
The fact that Khelif has XY chromosomes was enough to get the boxer banned from competing as a woman in 2023 by the by the International Boxing Association (IBA).
The story was broken by the French journalist Djaffer Ait Aoudia in a rather nasty article published in the French online magazine “Le Correspondent.” One can hardly blame Khelif for this situation.
Sources
Studies
Quote: “The prevalence of 3βHSD2 deficiency in Algeria appears high, with p.Pro222Gln being the most frequent mutation.”
Ladjouze Asmahane , Donaldson Malcolm , Plotton Ingrid , Djenane Nacima , Mohammedi Kahina , Tardy-Guidollet Véronique , Mallet Delphine , Boulesnane Kamélia , Bouzerar Zair , Morel Yves , Roucher-Boulez Florence Genotype, Mortality, Morbidity, and Outcomes of 3β-Hydroxysteroid Dehydrogenase Deficiency in Algeria Frontiers in Endocrinology volume 13 - 2022 https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.867073 DOI=10.3389/fendo.2022.867073
Quote: “The occurrence of chromosomal anomalies among infertile males strongly suggests the need for routine genetic testing in Algeria.”
Djalila, Chellat-Rezgoune & Mohamed Larbi, Rezgoun & Kherouatou, N. & Abadi, N. & Cherifa, B. & Dalila, Satta. (2015). Chromosomal abnormalities in a population of infertile males from Algeria. International Journal of Pharmaceutical Sciences Review and Research. 32. 95-99. https://www.researchgate.net/publication/282209382_Chromosomal_abnormalities_in_a_population_of_infertile_males_from_Algeria
This has been known about for a long time; here is a study from 1985:
Kohn,, G., Lasch,, E.E., El Shawwa,, R., Litvin,, Y. and Rosler,, A.. "Male Pseudohermaphroditism Due to 17 β-Hydroxysteroid Dehydrogenase Deficiency (17 βHSD) in a Large Arab Kinship. Studies on the Natural History of the Defect" Journal of Pediatric Endocrinology and Metabolism, vol. 1, no. 1, 1985, pp. 29-38. https://doi.org/10.1515/JPEM.1985.1.1.29
Pregnenolone to progesterone - progesterone is involved in embryogenesis as well as the menstrual cycle and pregnancy.
17α-Hydroxypregnenolone to 17α-hydroxyprogesterone - a precursor to other important hormones being developed - not much is known about this one.
DHEA to androstenedione - androstenedione is a precursor to testosterone
Androstenediol to testosterone - testosterone is not only the male hormone, but regulates the development of male reproductive tissues, eg testicles and prostate, while in the womb, as well as promoting secondary sexual characteristics, muscle mass, etc.
Androstadienol to androstadienone - Androstadienol is actually a pheromone present in men and women’s sweat - you didn’t know humans had pheromones, did you?
In Islamic societies, the taboo against closely related people marrying are not so strict as they are in Western society: In Algeria and other Arabic countries, people more frequently marry their close relatives, something that is more likely to result in genetic problems.
This excellent article is the reason why I am subscribed to you
Knowing absolutely nothing about Algerian culture, I have to wonder if cousin marriage is as common there as it is in other Arab Muslim cultures? Certainly such practices increase the mutational load in the associated societies. Could the unusually high incidence of a particular mutation be evidence of this?