A report has revealed that Algerian boxer Imane Khelif, who came under fire during the Paris Olympics for boxing in the women’s division and winning gold after previously failing gender eligibility testing at a different international competition, has a disorder of sex development only found in biological males, has XY chromosomes, and has a testosterone level of that typically seen in males. 

The report, drafted in June 2023 through a collaboration between the Paris Kremlin-Bicetre hospital and the Alters Mohammad Lamine Debaghine hospital, was obtained by French journalist Djaffer Ait Aoudia in the end of October. The report was drafted by endocrinologist experts Soumaya Fedala and Jacques Young, and revealed that Khelif has a 5-alpha reductase deficiency. 

This deficiency in sex development is only seen in biological males, and according to the National Library of Medicine, those with this deficiency do not produce enough of a hormone that has a critical role in male sexual development. Those diagnosed with the condition are often incorrectly noted at birth to be female due to deformed external genitalia. 

In puberty, the disorder becomes apparent as adolescents begin to experience signs of masculinization like muscle and hair growth, and the absence of breast tissue development or menstruation, Reduxx reported.

The clinical report revealed that an MRI was conducted on Khelif, with showed the boxer had no uterus, and in its place were internal testicles and a "micropenis" that resembled an enlarged clitoris, Aoudia reported. 

Chromosomal testing showed that Khelif has an XY karyotype, and hormone testing showed that Khelif had a testosterone level that was typical of males. Aoudia added that the report suggested Khelif’s parents may be blood relatives.

The report recommended that Khelif be referred for "surgical corrective and hormone therapy," and that psychological support would be needed as the results of the testing had caused "very significant neuropsychiatric impact."

In an August interview, Khelif’s coach Georges Cazorla said that endocrinologists had said there was a "problem with [Khelif’s] chromosomes." Cazorla said that Khelif should still be allowed to compete in the women’s division. Cazorla also said that Khelif had been placed on testosterone suppressants after testing ordered by the International Boxing Association in 2023 determined that "the boxer’s DNA was that of a male consisting of XY chromosomes."

Khelif won gold in the women’s welterweight division at the Paris Summer Olympics. In a fight earlier in the international competition, Italian boxer Angela Carini forfeited just 46 seconds into the first round after being hit by Khelif. Italian coach Emanuele Renzini told reporters after the fight that Carini didn’t want to continue the fight after being punched hard in the nose by Khelif, saying, "After one punch she feel big pain."

In the wake of the Olympics, Khelif filed a lawsuit against author JK Rowling, X owner Elon Musk, and others alleging "cyber harassment" following controversy that Khelif had previously failed gender testing for the 2023 world championships. Khelif was allowed to compete in the women's division because Khelif's passport states that the athlete was a female.

Former University of Kentucky Swimmer Riley Gaines wrote, "Remember the man who won an Olympic gold medal in women’s boxing? His medical reports show he has XY chromosomes, male testosterone levels, testicles, & a micropenis. But that never mattered—they believe that words & feelings make you woman, not biology."