Leaked report on Algerian boxer who fought as woman stirs more controversy

A report allegedly containing medical details of the boxer who fought as a woman at the Olympics despite having the male XY chromosomes is stirring more controversy.

The report was obtained by Le Correspondant, an independent French news organization.

The outlet confirmed details of the report to The Lion, including that the boxer, Imane Khelif, who has an endocrine deficiency (called alpha 5 reductase type 2), tested at well above the average testosterone levels for females in 2023.

The boxer tore through the female competition during the summer Paris Olympics, with critics charging that the male chromosome combination created unfair biological advantages against women boxers who had female chromosomes.

But defenders of the boxer said that the simple fact of the male chromosome pair doesn’t give a complete picture.  

The boxing authority that controlled the Olympic qualifications in the Paris competition, however, declined to give specifics about which tests were administered to the boxer to make sure the competition was fair. 

With the release of the details of the boxer’s physical characteristics by Le Correspondant, the complete picture could be coming clearer, with those details pointing to a competition that wasn’t just unfair but could be described by some as one-sided. 

Under “hormonal exploration” Le Correspondant quotes Khelif’s medical report, completed in June 2023, saying, Khelif has “male type testosterone level of 14.7 [nmol/L].” 

The medical site WebMd reports that normal testosterone levels for women are between 0.5-2.4 nanomoles per liter (nmol/L). Male testosterone levels are 10 to 35 nanomoles per liter (nmol/L).  

The report on Khelif was completed by the Kremlin Bicêtre Hospital in Paris and the Mohamed Lamine Debaghine Hospital in Algeria, Khelif’s home country. 

Kremlin Bicêtre Hospital is a public assistance hospital and the largest university hospital in Europe, according to the European Reference Network (ENDO-ERN), which specializes in information about rare endocrine disorders such as alpha 5 reductase type 2 deficiency. 

“[Kremlin Bicêtre Hospital] Endocrinology Department has a strong expertise in rare inherited genetic or acquired disorders affecting the regulation of pituitary hormones, sex development and calcium-phosphate metabolism,” said ENDO-ERN.  

Alpha 5 reductase type 2 deficiency is a rare genetic endocrine disorder that prevents testosterone from converting into dihydrotestosterone (DHT). DHT has a role in producing male sexual organs. 

“Children with a deficiency of 5α-reductase will have decreased production of DHT during fetal development, and this leads to defective external genital development and ambiguous genitalia,” reports the U.S. National Institute of Health (NIH).  

The condition can sometimes result from consanguineous procreation (e.g., close blood relatives). 

Despite the stunting of the development of male genitalia in the disease, the high levels of testosterone lead to high levels of muscle mass, like that seen in males.  

“At puberty, testosterone is responsible for aggressive psychosexual behavior, deepening of the voice, increased muscle mass,” said NIH.   

Le Correspondant reported that in the case of Khelif, “pelvic MRI” shows “an absence of a uterus,” the presence of  “gonads [also called testicles] in the inguinal canals,” “a blind vagina” and a “clitoral hypertrophy.” 

A snippet of the alleged report provided by Le Correspondant said, “On the therapeutic level, surgical correction and hormonal therapy will be indicated for [Khelif] as well as sustained psychological support because a very significant neuropsychiatric impact has been noted in her.” 

In its own summary, the news outlet noted surgical correction meant the removal of gonads, while hormone therapy should be undertaken to reduce testosterone levels.  

The medical report also recommended “a very significant neuropsychological impact” on Khelif from the disease, which “requires permanent monitoring.” 

The French news outlet declined a request by The Lion to review a copy of the report because it said that it will be publishing the report in its next edition.