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The ovarian and testicular tissue may be separate, or the two may be combined in what is called an ovotestis.

Affected individuals have sex chromosomes showing male-female mosaicism (where one individual possesses both the male XY and female XX chromosome pairs).

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Individuals with a 46, XX chromosome complement usually have ambiguous external genitalia with a sizable phallus and are therefore often reared as males.

In 2011, they ruled that any woman whose “functional testosterone” was above a threshold determined to be too masculine would have to have surgery to remove her gonads or take supplements that would chemically lower her testosterone.

This ruling was again challenged in 2015 by the Indian runner Dutee Chand.

So, while Patino would always fail a Barr body test and her body did produce higher than normal levels of testosterone, her body was unable to use the hormone for any competitive advantage.

As a result, the IAAF abandoned chromosome-based testing in 1992, claiming that these tests were no longer necessary because of doping regulations that could monitor athletes sex sufficiently.

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