What is a DSD? The condition at the heart of the Olympic boxing controversy and the Imane Khelif bout

Differences successful activity improvement (DSD) person go a cardinal constituent of controversy astatine this year's Olympics aft 'biological male' Algerian boxer Imane Khelif hit an force successful nan women's boxing event.

Khelif was banned from a erstwhile women's tourney aft failing a 'gender assessment' but was controversially fixed nan greenlight to compete astatine this year's games. 

And facing disconnected against Italy's Angela Carini, Khelif was victorious aft conscionable 2 blows pinch her opponent yelling 'this is unjust' arsenic nan lucifer was abandoned.

Khelif hasn't yet commented connected nan taxable but speculation abounds that she has a DSD, a uncommon information that only affects betwixt 0.05 and 1 percent per cent of nan population. 

Also called 'intersex' conditions, DSDs tin consequence successful outwardly female individuals having antheral chromosomes aliases anatomy.

DSD is an umbrella word for 40-plus individual conditions which create successful nan womb.

For example, a personification tin beryllium calved pinch female genitalia but person nan XY chromosome combinate emblematic of males arsenic good arsenic soul hidden testicles. 

They tin springiness group different combinations of chromosomes and reproductive organs, which successful nan context, of athletics tin boost their performance.

For example, an jock whitethorn beryllium calved pinch female anatomy but person a DSD which boosts her level of testosterone, a hormone captious to building musculus and strength. 

While galore DSDs are spotted astatine birth, immoderate only travel to ray successful puberty aliases arsenic a consequence of a aesculapian operations, trial and moreover autopsies.  

In immoderate cases, athletes person only learned they person a DSD during pre-competition aesculapian tests, which person led to them being disqualified and ending their dreams of representing their country. 

One of nan astir celebrated examples of DSD successful athletics is that of South African runner Caster Semenya.

An Olympic golden medalist, Semenya has a DSD called 5-alpha-reductase deficiency, which intends she has the antheral XY chromosomes and produces higher levels of testosterone than normal for women.

This DSD tin hap successful group pinch female reproductive anatomy and genitalia arsenic in Semenya's case.

She has antecedently elaborate really she has male, but internal, testes, and nary uterus but does person a vagina. 

Semenya, who dominated women's moving events betwixt 2009 and 2019, learnt astatine nan aforesaid clip arsenic nan remainder of nan world that she had a DSD. 

She was controversially forced to return narcotics for illustration nan contraceptive pill to little her testosterone to align pinch caller rules that constricted nan level of nan hormone successful women's events. 

Semenya has previously shared how this gave her 'panic attacks', caused her terrible accent and made her 'want to propulsion up each day'.

The taxable of her DSD, and if she was discriminated against by sporting bodies, person been nan taxable of an extended ineligible battle. 

And she's not nan only jock to beryllium caught up successful nan storm. 

Fellow runners Francine Niyonsaba of Burundi, Kenya's Margaret Nyairera Wambui, and Namibia's Christine Mboma and Beatrice Masilingi person besides been ruled ineligible to compete successful competitions owed to DSDs. 

While astir group pinch DSDs unrecorded perfectly normal and patient lives immoderate conditions tin beryllium terrible and require progressive aesculapian care. 

While immoderate DSDs tin tally successful families, successful astir cases what precisely triggers it hap during improvement successful nan womb is unknown. 

Worldwide, up to 1.7 per cent of group person intersex traits — astir nan aforesaid proportionality of nan organization who person reddish hairsbreadth — according to nan Office of nan United Nations High Commissioner for Human Rights.

The British kindness DSD Families estimates that around 130 babies calved successful nan UK each twelvemonth request investigations for imaginable intersex conditions. 

Historically group pinch DSDs person sometimes been subjected to shocking aesculapian curen and still do truthful successful immoderate parts of nan world. 

For example, alleged 'corrective surgeries' person been sometimes utilized to 'fix' babies' genitalia to amended lucifer 1 sex, without aesculapian need. 

For example, antheral babies calved without a penis, a DSD called aphallia, person sometimes been subjected to 'feminisation surgery' to create an artificial vagina.

But specified surgeries only relationship for quality of genitalia and not really a person's assemblage is really built. 

In nan supra example, this has resulted successful group being raised arsenic girls only to turn facial hairsbreadth and a deeper sound erstwhile their antheral puberty starts which tin origin them unthinkable distress. 

DSD charities person besides criticised this 'corrective 'approach arsenic it usually driven by societal expectations of what a personification should look for illustration alternatively than immoderate aesculapian use for nan patient.

The taxable of DSDs, and nan imaginable advantage women pinch these conditions whitethorn have, has go a taxable of contention astatine this year's Olympics. 

At nan centre of nan large wind is Khelif who was banned from a erstwhile women's world title arena aft tests reportedly recovered she had 'male activity chromosomes' starring to comments she is simply a 'biological male'. 

At nan clip International Boxing Associate president, Umar Kremlev, claimed nan tests had proven Khelif 'had XY chromosomes', which are an parameter personification is male. 

He added that they 'uncovered athletes who were trying to fool their colleagues and dress to beryllium women'. 

However, and to awesome controversy, she was cleared to participate nan Paris games.

In a shocking lucifer coming against Italy's Carini that only lasted 46 seconds Khelif dominated pinch nan conflict abandoned aft she delivered 2 powerful blows.

Sports scientists have told MailOnline that pitting a 'biological male' against a female force was balanced to pitting a 90kg combatant against a 60kg competitor. 

Khelif has yet to remark connected speculation astir her aesculapian history, but has antecedently told Algerian media she has had precocious levels of nan hormone testosterone since birth. 

But up of nan conflict the Algeria's Olympic Committee (COA) condemned what they called 'baseless' attacks connected Khelif.

'COA powerfully condemns nan unethical targeting and maligning of our esteemed athlete, Imane Khelif, pinch baseless propaganda from definite overseas media outlets,' they said. 

'Such attacks connected her characteristic and dignity are profoundly unfair, particularly arsenic she prepares for nan pinnacle of her profession astatine nan Olympics. The COA has taken each basal measures to protect our champion.'