Can Transgender Athletes Compete in Sport?

Caster Semenya

The first that many outside the trans community and who are not sports administrators or lawyers heard of this issue was probably in relation to South African middle-distance runner Caster Semenya. The woman from Polokwane is a hugely decorated athlete, as we can see below. But she has now been involved in a long-running and potentially historic controversy.

Semenya was subject to some terrible treatment by some sections of the media and some people within her sport when, in the early stages of her career, she made huge improvements. There were questions about doping before people questioned her sex, with varying degrees of sensitivity. In 2009, in response to her rapid improvements the International Association of Athletics Federations (IAAF, now World Athletics) called for her to take a test to confirm her sex.

It was felt that Semenya’s improvement and dominance were so great that she must be “biologically male”, although there was no doubt that she had been assigned the female sex at birth and raised as a girl and woman. She is actually cisgender in that she was raised and identifies as the same sex she was given at birth but lots of aspects about her case are relevant to the issue of transgender people and sport.

The results of her tests were not published but leaks suggested she had some intersex characteristics. The term intersex covers a wide range of conditions and variations, some of which would historically have been described as hermaphroditism.

The full history of both the specific language used in relation to the issues discussed and a detailed assessment of Semenya’s case are beyond the scope of this article. However, irrespective of what the exact nature of her body and development is, it is now accepted that – for whatever reason – she has “hyperandrogenism” and differences of sex development (DSD). The BBC explains that this means her “hormones, genes, reproductive organs may be a mix of male and female characteristics” and that she has levels of testosterone far beyond those typically found in women.

Trans Athletes & Testosterone

The core issue that links intersex athletes, such as Semenya and others who have unusually high levels of testosterone, with transgender women, is the debate about what it means to be a woman and how and where that line is drawn in terms of sporting competition. Regulations that the IAAF want to use “are based on the idea that testosterone levels are the prime indicator of biological sex”.

Many feel this is neither accurate nor fair. In days gone by, far cruder methods were used, with little more than a humiliating physical assessment used to decide who was a man and who was a woman. Thankfully, we have moved on from that, but there are still so many complex questions to answer.

Brilliant marathon runner, Paula Radcliffe, is against trans women competing in women’s events, saying it makes “a mockery of the definitions of male and female sports categories”. Just as intersex women with high testosterone levels are perceived to have an advantage, so too are trans women. Trans women usually take drugs to reduce their testosterone levels anyway. The IOC has suggested that they can compete as long as their levels are reduced for a defined period of time but Martina Navratilova has been one of many people to have questioned this logic.

Several top athletes, including Dame Kelly Holmes, Radcliffe and Sharron Davies wrote to the IOC to say that far more research was needed into what benefits being a trans woman may confer. It may be that science will find a way to guide the ethics on this matter and as we learn more about biochemistry and athletic performance a clearer path becomes apparent. Right now though, there seems to be little agreement, with no solution coming close to appeasing all parties.

The Olympics

The 2004 games in Athens were the first at which transgender athletes were allowed to compete at all. However, only those who had undertaken genital surgery were permitted. In 2015 the IOC held a meeting to discuss the issue of transgender athletes and decided that they should not be excluded from the chance to compete.

Following this, at the 2016 Rio Games, as we have already said, trans men were free to compete without any restrictions but trans women had to prove they had reduced their testosterone levels to under 10 nmol/L for a minimum of 12 months.

That level is considerably higher than the upper typical range for women, around three times higher, and about the same as the bottom range typical in adult men. This was controversial for various reasons. Firstly, forcing trans women to take drugs to alter their bodies is opposed by some. Other people suggest that permitting a level three times above what is common still gives trans women a huge advantage. It was argued that even with reduced levels of testosterone, many trans women would still have an advantage over their cisgender rivals in various events. Doubts and disagreements aside, this is the current position with regards the Olympics though, for now at least.

Cycling

Cycling at the highest level is one of the most physically demanding sports around, especially when it comes to extended and gruelling road races, such as the Tour De France. This has led, especially in the past, to a culture of doping, as athletes do anything to obtain an edge in a sport of fine margins.

Because of this the issue of trans athletes in a hot topic. Veronica Ivy, until recently known as Rachel McKinnon and born as Rhys McKinnon, is a transgender activist and made history in 2018 by becoming the first trans world track champion. She won the Masters title for the 35-44 age bracket but this caused a great deal of controversy.

She began transitioning in her late 20s, having developed an interest in cycling relatively late in life, only switching from the road to the track in 2017. She says her physical development as a man does not put her at an advantage, arguing that her power stats were “dead centre average for women”. Jen Wagner-Assali, who won the bronze medal behind Ivy (then Rachel McKinnon) disagreed, saying it was not fair, and that view was supported by several athletes.

None the less, Ivy defended her title and according to a report in the NY Post she “keeps dominating women’s cycling”. The criticism keeps coming though, with a former champion Victoria Hood saying that, “The science is there and it says that it is unfair. The male body, which has been through male puberty, still retains its advantage; that doesn’t go away. I have sympathy with them. They have the right to do sport but not a right to go into any category they want.”

Cycling’s governing body, the Union Cycliste Internationale (UCI) is said to be considering a rule change, along with athletics’ IAAF. A meeting of the latter said that, “Testosterone is the primary known driver of the performance gap between males and females and serum Testosterone is regarded as an acceptable proxy to distinguish male from female athletes.” It also proposed that the testosterone threshold should be halved to “at or below 5nmol/L for eligibility for the female category”.

Rugby

Rugby has been in the news a lot in recent weeks with regards to the involvement of trans women. It was reported that rugby union’s governing body, World Rugby, had banned trans women from “elite women’s rugby”. This ban was said to be for the “foreseeable future” and that after great examination of the available evidence they had “concluded that safety and fairness cannot presently be assured for women competing against trans women in contact rugby”.

However, just a few days after that decision by World Rugby, the RFU, English rugby’s governing body, the Rugby Football Union, took the opposite point of view. The Guardian reported that “Transgender women will still be allowed to play women’s rugby at all non-international levels of the game in England for the foreseeable future, the Guardian can reveal, after the Rugby Football Union decided that more evidence was needed before implementing any ban.” So, that clears that up!

Other Sports

When World Rugby banned trans women they were reported to be the first major international sports governing body or federation to take such a step. From that, we can deduce that other sports do permit trans women to compete. The exact rules vary and as we have said, will change, quite possibly many times. In general, the same sorts of guidelines are used in terms of testosterone, although precise details vary depending on the requirements of the sport and the approach of the federation in question.

To use the world’s most popular sport, football, as an example, the Football Association (FA) has published a seven-page document entitled, unimaginatively but certainly accurately, The Football Association Policy on Trans People in Football Policy Document. This details precisely how the FA will consider trans footballers. For full information you can access the document here.

In summary, up to the age of 16 children can more or less play in whatever team they want to, men’s, women’s or mixed. After that, assessment is typically on a case-by-case basis to ensure: “(1) the safety of the applicant and fellow players, and (2) the need to ensure fair play and fair competition.” For a female trans player, the requirements are rather stricter and the FA state that either hormone therapy or a gonadectomy is needed with evidence of “blood testosterone within natal female range for an appropriate length of time so as to minimise any potential advantage”.