> We don't have height categories, we have categories based on sex.
I mean, we do have weight categories in combat sports, right? I don't see why we couldn't come up with similarly neutral categories if we think it's good to segment people out by physical advantages. The parent comment is making a good point, though: it feels like some people care a lot about physical advantages that map onto gender stuff they care about, and not a lot about weird genetic anomalies that provide physical advantages that aren't gendered.
We could do that! I'm just trying to say that given categories based on (biological) sex, we should find some criterion based on biological sex to sort people into said categories, which the OC decision seems to do (at least better than the alternatives I have encountered). I don't have a problem at all with finding different ways of defining categories for competitions.
Re: anomalies - I think this is just unavoidable in any sort of category system, and I don't have a good solution for it except to consider frequency and severity.