The International Olympic Committee is recommending the establishment of special medical centers to deal with cases of athletes with ambiguous sexual characteristics.
The IOC wants rules put into place by sports bodies to determine the eligibility to compete on a "case by case" basis for athletes whose gender is called into question.
The IOC organized a two-day conference with medical specialists in Miami to consider guidelines for handling sex verification cases. The issue gained global attention last year when South African runner Caster Semenya was ordered to undergo gender tests.
The case of Semenya, who won the women's 800 meters at the world championships, was not dealt with directly in the closed meetings Sunday and Monday. But it helped focus the need for clarity on the issue of whether an athlete competes as a man or a woman.
"We did not discuss any particular case," IOC medical commission chairman Arne Ljungqvist told The Associated Press. "We explored the science of all these matters. We established several important points based on up-to-date science and global expertise. Now we have the scientific basis for going further."
The IOC will consult with lawyers and its own athletes' commission to help establish specific guidelines.
Among the key conclusions was a proposal to set up health centers where experts would diagnose and treat athletes with what are known as "disorders of sex development." Most cases, Ljungqvist said, require treatment such as surgery or hormone therapy.
"We cannot expect sports in every country around the world to have the necessary expertise," Ljungqvist said by telephone. "That's not possible, so we recommend strategically located centers where cases could be referred, if necessary. It's for the experts to decide what to do with each individual case. There is no general treatment. There is no general diagnosis."
The Miami symposium — attended by about 15 scientists, medical experts and sports federation doctors — took place amid international scrutiny on Semenya, who was 18 when she won the 800 gold at the championships in Berlin in August. Her dramatic improvement in times and muscular build led the International Association of Athletics Federations to order gender tests.
The IAAF is still reviewing the test results to determine Semenya's future. The IAAF has refused to confirm or deny Australian media reports that the tests indicate Semenya has both male and female sex organs.
Officials from IAAF and FIFA, the world soccer governing body, attended the Miami conference to explain their policies and experiences on gender issues, Ljungqvist said.
While the Semenya controversy has gone on for months, Ljungqvist said the experts in Miami stressed that all cases should be dealt with quickly.
"It is very important to as rapidly as possible establish a diagnosis once you have come across a suspicious case," he said. "It's not something that should be allowed to drag on. If the sport comes across such a case, you have to deal with it in an expeditious manner."
Sports federations should have rules to determine an athlete's eligibility to compete during the gender diagnosis and treatment periods, Ljungqvist said.
"There cannot be a general rule," he said. "The rule needs to allow for a case-by-case evaluation. Each case is unique. They are not many. They are all individual."
The delegates also cited the potential benefit of "pre-participation health examinations" for aspiring athletes. Ljungqvist said some countries, including Italy, require athletes to take medical checks before they are ruled eligible for competition.
"We emphasized that these exams could be a very important and useful tool for identifying athletes with these disorders," he said.
Ljungqvist said more discussions will be needed.
"We have achieved the first step successfully," Ljungqvist said. "There needs to be some legal input. This may require further discussions. Certainly the IOC will take some initiatives to pursue this further."
The IOC used to carry out mandatory gender exams at the Olympics, but they were dropped in 1999 because the screening process — chromosome testing — was deemed unscientific and unethical.
The IOC instead uses a special medical panel on site at the Olympics that can intervene, if necessary.