IAAF offers to pay for Caster Semenya’s gender surgery if she fails verification test – Telegraph

IAAF offers to pay for Caster Semenya’s gender surgery if she fails verification test – Telegraph. This article was recently addressed in the Organisation Intersex International (OII) Forum and someone asserted that the reason why doctors remove testicles from women with androgen insensitivity syndrome (AIS) is because we want to prevent women from having them. So, I did a little research and this is what I found out:

There really isn’t a conspiracy to prevent women from having testes. The issue is that mammalian testes need to be cooler than core body temperature; thus testes have evolved to hang outside of the body in scrotums. Internalized testes are a cancer risk for both men and women. And the risk of cancer is greater in women with AIS than in men with undescended testes (UDT).

According to HM Wood (1):

  • The incidence of testicular cancer in men is 0.9 to 7.8 per 100,000 men per year
  • 1.1 to 1.6% of boys have unilateral or bilateral undescended testes
  • Among men with testicular cancer, 5-10% have had a history of UDT
  • Men with a history of UDT have 2.75 to 8 times the risk of testicular cancer compared to men who don’t; the risk is even higher in men with bilateral UDT, associated genitourinary anomalies, or late (after age 10-12 years) or uncorrected UDT
  • Orchiopexy (repositioning testes outside the body) by age 10 to 12 years results in a 2 to 6-fold decrease in relative risk of cancer compared with orchiopexy after age 12 years or no orchiopexy

According to SJ Robboy (2):

  • The incidence of complete AIS is 1 in 20,000 live births
  • There is a risk for malignancy in AIS gonads owing to the occurrence of germ cell tumors. The cumulative risk for a germ cell tumor is greater than 30% by 50 years of age
  • The risk of malignancy in patients with testicular feminisation is only 4% by the age of 25 years, but reaches 33% by 50 years

Thus, women CAN have testes, but they should be removed if they aren’t located in a scrotum.

References:
(1) Wood HM. Elder JS. Cryptorchidism and testicular cancer: separating fact from fiction. Journal of Urology. 181(2):452-61, 2009 Feb.
(2) Robboy SJ. Jaubert F. Neoplasms and pathology of sexual developmental disorders (intersex). Pathology. 39(1):147-63, 2007 Feb.

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