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In recent years a growing number of sports federations, including World Aquatics and World Athletics, have barred athletes who have undergone male puberty from competing in elite female competition amid concerns over fairness and safety.
Last May the Football Association and England and Wales Cricket Board were among a number of British sports bodies to follow suit after the UK Supreme Court's ruling that the legal definition of a woman was based on biological sex.
The moves have been opposed by trans rights campaigners who argue they could violate human rights, and insist inclusion should be prioritised.
However, this year US President Donald Trump signed an executive order that prevents transgender women from competing in female categories.
He said it would include the 2028 Olympics and that he would deny visas for transgender athletes trying to visit the US to compete at the Games.
New Zealand's Laurel Hubbard became the first openly transgender women to compete at an Olympics after being selected for the women's weightlifting team at Tokyo 2020.
The Paris 2024 Olympics were engulfed in controversy after Algeria's Imane Khelif won the women's welterweight boxing gold medal, a year after being disqualified from the World Championships for reportedly failing a gender eligibility test.
The IOC cleared the 25-year-old to compete, along with Taiwan's Lin Yu-ting, who was also banned by the suspended International Boxing Association (IBA).
The IOC said competitors were eligible for the women's division if their passports said they were female.
Some reports took the IBA saying Khelif has XY chromosomes to speculate that the fighter might have DSD. However, the BBC was not able to confirm whether this was or was not the case.
Last week it was announced that Lin could return to women's sport after passing a sex test.
At the 2016 Olympics in Rio, all three medallists in the women's 800m, including winner Semenya, were DSD athletes, intensifying calls for tighter rules.
World Athletics then insisted that for track events from 400m up to the mile, DSD athletes must reduce their testosterone levels in order to be eligible.
Semenya refused, arguing it was an infringement of her human rights and discriminatory.
Amid a long legal battle, World Athletics' made its rules stricter in 2023.
