Algerian Olympic boxer Imane Khelif, who won the gold medal in the women's 66kg boxing category at the 2024 Paris Olympics, has found herself in the middle of a gender-related debate. Reports accessed by French journalist Djaffar Ait Aoudia, as published in Reduxx, brought to light medical findings about Khelif's biological status, revealing that Khelif has "testicles" and an XY chromosome arrangement, thus confirming as 'biologically male'.

According to this report, Khelif has a medical condition known as 5-alpha reductase deficiency (5-ARD), a rare difference in sex development (DSD). Medical documents, allegedly from collaborations between France’s Kremlin-Bicêtre Hospital and Algeria’s Mohamed Lamine Debaghine Hospital, were reportedly compiled in June 2023. These reports outline that Khelif has internal testes and other characteristics atypical for female development.

An MRI and chromosomal tests confirmed the absence of a uterus and the presence of internal male reproductive organs. Furthermore, her testosterone levels were consistent with typical male ranges.

What are DSD?

DSD comprise the group of congenital conditions characterized by lack of typical sex development. In most cases, DSD can be identified in prenatal development due to interactions between complex genetic factors and hormone signals. Sometimes, people use the older term and refer to DSD as "intersex," while at other times they use some precise vocabulary to describe a given condition.

But first, what is 'Sex' and 'Gender'?

The terms "sex" and "gender" tend to be used almost interchangeably; however, they refer to two different things. "Sex" generally relates to the physical qualities determined by genetics and hormone influence, whereas "gender" refers to a human being's identity and social construction. DSD conditions can usually obscure the distinctions that are typical for sex, making talk around these terms particularly tricky.

DSD: Shattering genetic factors, Sex hormones and Genitalia

Genetic Factors

The genetic factors form the core of DSD conditions. Normally, a human being has 46 chromosomes, two of which decide the sex of the individual-the X and Y chromosomes. In most females, two X chromosomes are found, but in most males, an X and a Y chromosome are found. DSD can cause variations in such chromosomal patterns and hence sometimes lead to incongruity between chromosomal sex and physical attributes.

Sex Hormones

Sex hormones, including androgens in males and estrogens in females, determine body development both in fetal life and at puberty. Such hormones are produced in gonads, which could be either testes in a male or ovaries in a female, as prescribed by the genetic pattern. Hormonal pathways may therefore get affected in DSD such that sexual characteristics might appear in an atypical fashion.

Body Parts of Reproduction

DSD may result in the combination of male and female reproductive structures or in reproductive parts not typical male or female. A few have mixed genitals, but others may have typical genitals yet possess an unusual chromosomal setup that reveals itself at puberty or even later.

DSDs are as diverse as are the individuals affected by them. For example, some can be mentioned to be the following:

- In this case, one finds an individual with an XY chromosome yet having female-like external genitals.

- In other words, one has XX chromosomes but with male-like genitals.

- One can still have both ovarian and testicular tissues, meaning in such a case, you are likely to have genitals which might be a mix of a male and female.

- Some individuals have normal sex organs but an atypical arrangement of chromosomes, meaning changes in physical development over time.

The Cleveland Clinic notes that "intersex" has been the term used for decades in describing DSDs; however, terminology may vary among individuals and cultures. Some people with DSD prefer terms like 'differences' instead of 'disorders', arguing that DSD is just a variation in biological development.

According to a report in The Independent, "If I showed you pictures of my patients without any clothes on, you would say, well, these are females that I'm looking at," said Prof Højbjerg Gravholt, professor of genetic endocrinology in Denmark and works with patients who have differences in sex development.

He mentions that physical characteristics, hormonal profiles, or chromosomes cannot determine a person's sex uniquely. DSD in the lives of many presents the message that sex is not a biological category but rather a spectrum molded by genetic and hormonal diversity.

What Causes Disorders of Sex Development?

DSDs are caused by variations in genes that control sexual development or altered response to hormones such as those found in CAH. CAH presents as a result of excess androgen production with the development of male characteristics. Another type of DSD is the AIS where the body system is unable to respond to the presence of androgens thereby modifying physical development.

Is there a Treatment for DSD?

According to Cleveland Clinic, treatment of DSD is given based on the severity of the symptoms. These can vary from:

-Hormonal therapy for puberty and other conditions that may arise in connection with DSD, including osteoporosis.

-Genital reconstruction or modification surgery. Most of the surgeries are irreversible and thus left until the patient is capable of giving consent. For the very mild cases of DSD, no treatment is necessary and the individual may lead an untreated life.

Is It Possible to Prevent DSD?

Currently, DSDs can't be prevented. What is not well understood at present is the complex gene interactions that drive the development of human sex. No method has been developed that can predict or avoid DSDs in future offspring. That unpredictability reflects the normal variation in human biology.

A lace-like pattern appearing on the skin may sometimes point to blocked arteries. Health experts warn that this netted discoloration can, in certain cases, be linked to damage in tissues and organs.

Heart and circulatory diseases remain the leading cause of death worldwide, claiming close to 18 million lives every year. This group includes serious conditions such as stroke, coronary artery disease, and heart failure.

An Unusual Skin Pattern That Could Signal Artery Blockage

In the UK, cardiovascular disease is responsible for around one quarter of all deaths. Because of its scale and severity, recognising warning signs early can save lives.

Most people are familiar with common symptoms like chest pain. What is less widely known is that heart-related problems do not always announce themselves clearly. Some signs are subtle and can appear in unexpected places, including the skin.

What Is Livedo Reticularis?

The American Academy of Dermatology highlights one particular skin pattern that may be linked to heart and blood vessel problems. A blue or purple, net-like discoloration on the skin can sometimes indicate reduced blood flow or a blocked artery.

This condition is known as livedo reticularis. It is believed to occur when small blood vessels near the skin tighten suddenly or when circulation close to the skin becomes uneven.

When the Pattern Is Usually Harmless

In many cases, livedo reticularis is not a cause for concern. Cold temperatures are a common trigger, and the pattern often fades once the skin warms up. Certain medications can also produce this effect without posing a serious health risk.

According to the dermatology body, some people notice the pattern when they feel cold, only for it to disappear as their skin warms. When medication is responsible, it is generally considered harmless.

When It May Point to a Serious Condition

In some situations, the same skin pattern can be linked to a condition known as cholesterol embolisation syndrome. This happens when tiny arteries become blocked by cholesterol particles.

Such blockages can interfere with blood supply and lead to damage in tissues and organs. For this reason, experts stress the importance of medical evaluation to rule out any underlying or undiagnosed disease.

When to See a Doctor

The Mayo Clinic advises seeking medical advice if the mottled skin does not fade with warmth or if it appears alongside other worrying symptoms. You should also consult a doctor if painful lumps or sores develop in the affected area, if you already have a condition that affects blood flow to your limbs, or if you have a connective tissue disorder and notice new skin changes.

Doctors also caution that a similar-looking condition, called livedo racemosa, is more often linked to serious underlying illnesses.

Other Warning Signs of Heart Disease

Skin changes are only one possible clue. Other symptoms linked to heart disease include chest discomfort, pain or weakness in the arms or legs, shortness of breath, irregular heartbeats, dizziness, unusual tiredness, and swelling in the limbs.

If any of these symptoms feel concerning or persistent, it is important to speak to your GP for further advice.

A diagnostic report from Madhya Pradesh’s Satna district has sparked shock and concern after it incorrectly stated that a 47-year-old man had a uterus. The incident has raised serious questions about negligence and accuracy in medical testing.

The report was issued to Niranjan Prajapati, chairman of the Uchehra Nagar Panchayat, who had gone for a sonography after experiencing abdominal pain and swelling. Instead of clarity about his condition, he received a report that appeared to describe female reproductive organs, including an inverted uterus.

How the Error Came to Light

Prajapati underwent the ultrasound at a diagnostic center on Station Road in Satna on January 13. Initially, he did not closely examine the report and followed the prescribed treatment. However, when his condition did not improve, he sought further medical advice.

“I was sick and had stomach pain. I first got treatment in Unchahara and then went for sonography in Satna,” Prajapati said. “I did not pay much attention to the report at first and took medicines, but there was no relief.”

He later visited a doctor in Jabalpur, where the mistake was clearly identified. “The doctor told me straight that this report cannot belong to me,” Prajapati recalled. “I said the report has my name on it, but it mentioned a uterus. That is when I realized something was seriously wrong.”

Questions Over Diagnostic Negligence

The report not only listed a uterus but also described its position, despite the patient being male. Medical experts say such an error goes far beyond a minor clerical mistake.

A senior doctor, speaking on condition of anonymity, said incorrect diagnostic reports can have serious consequences. “A wrong sonography report can mislead treatment, cause unnecessary stress to the patient, and in some cases become life-threatening if doctors act on false findings,” the expert said.

Attempts to seek clarification from the diagnostic center did not yield answers. Dr Arvind Saraf, associated with the facility, declined to comment on the incident, adding to concerns about accountability and quality checks.

Complaint Filed, Health Department Responds

Following the incident, Prajapati filed a formal complaint at the local police station. The matter has also been taken up by the Health Department.

Chief Medical and Health Officer of Satna, Dr Manoj Shukla, confirmed that an investigation is underway. “This complaint has come to my notice. We are examining the report thoroughly. If any irregularity or negligence is found during the investigation, appropriate action will be taken,” he said.

Officials are expected to review how the report was generated and whether standard diagnostic protocols were followed.

What Is Sonography?

Sonography, also known as ultrasound, is a commonly used imaging test that uses sound waves to create images of internal organs. It does not involve radiation and is generally considered safe. However, experts stress that accuracy and proper verification are crucial, as reports directly guide diagnosis and treatment.

The incident has once again highlighted the need for stricter checks and accountability in diagnostic services, especially when errors can directly affect patient health and trust in the medical system.

Josie Gibson, English TV personality, opened up about her secret health disorder and that she is turning to a "last resort" surgery for the same. She revealed that this health challenge has left her with extreme pain. This Morning presenter, 40, appeared on the show and spoke to Cat Deeley and Ben Shephard about being diagnosed and having a "lipodema" body. She said, "A couple of years ago somebody actually said on Instagram, 'you have got a typical lipodema body'. I thought, 'what's lipedema?'"

She said she did not even have a clue, but she knew something was not right. But she did not know what lipedema was. She got diagnosed about a year ago and had a surgery. She told her fans that she has been "constantly fighting" her genetics.

What Did Josie Gibson Reveal About The Surgery?

Speaking on ITV’s This Morning, Gibson said surgery was a “last resort” but described herself as happy with the results after spending around £7,000 on liposuction to treat her calves. She explained that the procedure, which combines liposuction with a technique that tightens the skin, had to be carried out in stages.

“The last thing I want to do is put myself through surgery, but it was my last resort,” she said, adding that she had only treated her calves so far. Gibson said the change in her appearance had been significant, telling viewers: “All my life I have wanted to have ankles. I’ve finally got them.”

What Is Lipedema?

Lipoedema is a condition that mainly affects women and causes an abnormal build-up of fat, most commonly in the legs and sometimes the arms. It can make the lower body appear out of proportion and is often associated with pain, tenderness and a feeling of heaviness.

Gibson said she had always felt something “wasn’t right” with her body but was only diagnosed with lipoedema last September. She said specialists told her that diet and exercise would not remove the affected fat. “They said I could train seven days a week and I wouldn’t get rid of lipoedema fat like that,” she said.

Describing the impact of the condition, Gibson said her legs felt increasingly out of place compared with the rest of her body and that symptoms had worsened over time, now also affecting her arms. “I could train, train and train but really, I’m going down the surgery route now,” she added.

Lipoedema specialist Dr Dennis Wolf, who also appeared on the programme, said the condition is not currently treated on the NHS due to the lack of a formal diagnostic test and limited research. He said doctors often rely on symptoms and patient experiences to identify it and believes some people may have a genetic predisposition.

Dr Wolf explained that lipoedema fat is resistant to weight loss, meaning people can exercise and diet without seeing changes in affected areas. While surgery is the most common way to manage the condition, other treatments include compression garments to help reduce discomfort.

Gibson also shared a light-hearted moment from her surgery, admitting the anaesthetic left her flirtatious and apologetic towards her surgeons.