The available evidence indicates that Khelif is actually male: two blood tests from two independent labs revealing an XY karyotype, a member of Khelif's training team describing problems with hormones and chromosomes and that Khelif has been on medication to adjust testosterone to within the female range, and a leaked medical report which describes Khelif as having the male-specific disorder of sexual development 5-alpha reductase deficiency (5-ARD).

This implies that Khelif is not female but is male, and went through male puberty, therefore having the male physical advantage in sport caused by male sexual development.