NEW DELHI : Among various genetic and hormone disorders that cause gender ambiguity is the 5-alpha-reductase type-2 deficiency (5-ARD) which can lead to a genetically male child being brought up as a female.

The topic of `gender verification' has come into focus following the disqualification of Indian medal-winner S. Santhi in the Asian Games in Doha.

The 5-ARD condition is caused by the deficiency of an enzyme that transforms testosterone (male hormone) into dihydrotestosterone (DHT), the most potent androgen, and leads to abnormalities in gender.

The disorder affects only genetically male individuals but can cause confusion about the gender when the child is born. Like in the Androgen Insensitivity Syndrome (AIS), 5-ARD individuals also do not have uterus and fallopian tubes. Endrocrinological tests will confirm the differential diagnosis between AIS and 5-ARD.

There is no mention of the 5-ARD condition in the exceptions given under the gender verification policy of the International Association of Athletics Federations (IAAF). The IAAF allows athletes with certain conditions in which there are chromosomal abnormalities, to compete with other women.

The decision to withdraw the medal from Santhi was taken under the rules of the Olympic Council of Asia (OCA) that state that women athletes must comply with the "prescribed gender test" and a medal could be withdrawn by the order of the OCA Executive on a proposal from the Medical Committee.

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