How is the Topic of Intersex Athletes in Elite Sports Positioned in Academic Literature Between January 2000 and July 2022? A Systematic Review

Jensen, Marisa; Schorer, Jörg; Faber, Irene R.

doi:10.1186/s40798-022-00520-0

Sports Medicine - Open

Table 2 Summary of the data synthesis

From: How is the Topic of Intersex Athletes in Elite Sports Positioned in Academic Literature Between January 2000 and July 2022? A Systematic Review

Topic	Theme	Statement	References	Distilled values
Perspectives	The sex construct	Sex is not binary	[5, 26, 32, 46, 58, 78, 93, 107, 83, 49, 67, 66, 50, 47, 57, 73, 74, 76, 80, 89, 96, 99]	Truth-finding Equality Acceptance of sex diversity
		Sex segregation in sporting competition is unjust	[58]	Social Justice Equality
		Binary categories for elite sporting competition are appropriate	[4, 93, 91]	Equity Competition Fairness
	Sex verification in elite sports	Sex verification is ethically indefensible	[6, 28, 44,45,46,47,48, 44, 47, 76]	Social justice Privacy
		Sex verification can cause great harm	[56, 59, 121]	Wel-lbeing Privacy Social Justice
		The athlete’s privacy must be ensured	[25, 28, 56, 52, 61, 51, 54, 88, 72]	Privacy
		Privacy is a sacrifice when competing in elite sports	[62]	Competition Fairness Dedication Compliancy
	Fair play and intersex athletes	The regulations on hyperandrogenism from 2011 are ethically debatable	[5, 7, 23, 70, 85, 71, 70,71,72,73,74,75, 75, 77, 95]	Social justice Equality
		The World Athletics’ 2018 Eligibility Rules are ethically debatable	[92, 94,95,96, 96, 105,106,107, 110,111,112,113, 116, 119,120,121]	Social justice Equality
		The World Athletics’ 2018 Eligibility Rules are currently the best method	[4]	Competition Fairness Equity
		Excluding intersex athletes from elite sporting competition is unfair	[58, 49, 79, 95]	Social Justice Inclusiveness Equality Recognition
		A new rule for intersex athletes in elite sports is necessary	[87, 97, 118, 122]	Recognition Social Justice Inclusiveness
		Diversity is what makes sports interesting	[78, 85]	Acceptance of sex diversity
		High androgen levels are one of many athletic advantages	[23, 78, 51, 85, 60, 83, 68, 73, 95, 101, 105, 111, 115, 117, 118, 121]	Acceptance of sex diversity Equality Recognition
		High androgen levels do not always provide an athletic advantage	[6, 28, 32, 45, 47,48,49, 61, 51, 48, 71, 49, 47, 63]	Education Evidence-based practice Truth-finding
		High androgen levels provide an athletic advantage	[25, 104, 109, 117, 118]	Evidence-based practice Competition Fairness
	Information and knowledge	Information on intersex variations/androgens is lacking	[4, 23, 93, 91, 85, 92, 94, 60, 53, 55, 69, 88, 71, 91,92,93,94, 108, 111, 114, 117, 121]	Evidence-based practice Truth-finding
	Information and knowledge	Information on the treatment set by IOC/World Athletics in 2011 is lacking	[71, 64]	Evidence-based practice Transparency Wel-lbeing
Proposals for solutions	The sex construct	Abolish sex segregation in sporting competition	[26, 28, 58, 52, 79]	Equality Inclusiveness
	The sex construct	Do not abolish sex segregation in sporting competition	[51, 109]	Equity Competition Fairness
	Sex verification	Abolish sex verification	[45, 59, 54, 67]	Social justice Privacy Equality
	Sex verification	Set a clear policy on sex verification	[28, 56, 88]	Transparency Equality
	Fair play and intersex athletes	Abolish the 2011 regulations on hyperandrogenism	[70, 71, 64, 97, 77]	Social Justice Inclusiveness
		Use a third category to separate sporting competition	[100]	Social Justice Competition Fairness
		Do not use a third category to separate sporting competition	[26, 91, 85, 49, 68, 66, 114]	Inclusiveness Social Justice
		Intersex athletes should limit androgens to compete in the female category	[25, 58, 61, 51, 109]	Equity Competition Fairness
		Use an athletic gender to separate sporting competition	[4, 93]	Social Justice Competition Fairness
		Do not use testosterone as a criterion to separate sporting competition	[5, 91]	Acceptance of sex diversity
		Set new criteria to separate sporting competition	[26, 107, 100, 72, 67, 63]	Evidence-based practice Acceptance of sex diversity Inclusiveness Competition Fairness
		Include women in the debate	[72, 102]	Inclusiveness Equality
		Treat all advantages in sporting competition equally	[67]	Equality
		Use categories based on weight and height to separate sporting competition	[107, 90]	Competition Fairness
		Do not use biological parameters as criteria for separating sporting competition	[5]	Equity Inclusiveness
		Use self-identification as a criterion to separate sporting competition	[78, 84, 97, 50]	Autonomy
		Do not use self-identification as a criterion to separate sporting competition	[25, 83, 109]	Competition Fairness
		The decision on a participation permission should be conducted for each case individually	[117]	Social Justice Equity
	Information and knowledge	Educate about sex diversity	[44, 103]	Education Recognition Evidence-based practice
	Information and knowledge	Include other specialists to find a solution	[28, 56, 61, 60, 49, 82, 111]	Evidence-based practice Recognition

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