The modern world has thrown up solutions to problems that have existed for thousands of years and modern medicine and science has saved millions of lives. It is not all iPhone 12s and self-tying shoelaces though (or even laces that can be tightened by an app!) and there is no denying that many dilemmas exist now that pose new challenges.
Greater education and understanding of transgender issues has improved life for many people in many ways. However, there are still lots of grey areas and matters that with all the best will in the world, politicians, administrators and businesses are struggling to resolve. That is also the case when it comes to sport. Balancing the rights, wishes and freedoms of transgender athletes with those of the larger cisgender (someone whose gender and personal identity are the same as their birth sex) community is a tricky feat and one that may ultimately prove impossible.
So, as we look at what some of these issues are we will attempt to answer the question: can transgender athletes compete in sport? If they can, how does it currently work and who do transgender athletes compete against? If they cannot, what does the future hold and where and how can they compete?
Before we do that, a slight disclaimer: our expertise is in sports and betting, not transgender issues. Therefore if you feel we have misrepresented any issue or used incorrect language please let us know so we can improve this article.
Transgender Athletes & Sport
Over the past few years, there have been several high profile cases concerning transgender athletes. In very simple terms, the primary issue is that a trans woman who was assigned the male sex at birth will typically have considerable physical advantages over an athlete who was assigned the female sex at birth. This may be due to elevated testosterone levels, or advantages in height, weight or muscle mass.
The trickiest question is balancing a transgender athlete’s right to take part in and enjoy sport with the rights of cisgender women to be able to compete on a level playing field. In many sports, the issue for cisgender women is even more serious and is not about whether or not they can win but about the real possibility they may be injured competing against opponents who in general are bigger, stronger and more powerful.
Of course, that is not to say that all trans women are bigger than all cis women in a given sport or event. But it is hard to argue that in sports, such as rugby, boxing and other combat sports (although these typically have weight divisions anyway), and a range of other pursuits, some participants would be at an increased risk of injury competing against trans athletes.
It is also not to say that there are only issues with how trans women should compete. Male-to-female athletes have been able to compete without restriction in the Olympics since the 2016 games in Rio. There have also been similar rules in other spheres but that is not to say there is not a lot still to resolve beyond the mere ability to participate.
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.
Why Is Testosterone So Important?
The issue of testosterone itself is far from an easy one to unravel. Its role in sporting performance is complex and not entirely clear. Although widely regarded as performance-enhancing, it is a belief that is not fully supported by scientific evidence.
The piece to which we link above states: “Despite all the debate, though, there hasn’t been much of any conclusion about what the science actually says about testosterone’s effect on women’s athletic performance. And that’s for a good reason: there isn’t much conclusive evidence at all.”
Testosterone is considered to be the major sex hormone for men, though it is naturally occurring in women too. It plays a big role in muscle and bone mass and men have levels of the hormone around eight times higher than that typically found in women. A man who naturally has high levels of testosterone is widely thought to be at an advantage as he will be stronger and more powerful. This is considered fair and proper in the same way that nobody questions a basketballer’s height or a swimmer’s foot size.
In contrast, a woman with unusually high testosterone is thought to have an unfair advantage. Some sporting bodies, such as the International Olympic Committee (IOC) and World Sport, have set limits for female testosterone. They require that an athlete must unnaturally and chemically alter their body to reduce their testosterone levels to compete against other women.
This is despite serious questions about the science behind this. But what does this have to do with trans athletes?
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.
What Are the Rules with Trans Athletes & Sport?
Hopefully you now have an understanding of some of the key issues in the debate, but what are the actual rules? In short, can transgender athletes compete in sports? Well, once again we must include a minor disclaimer in that these rules and regulations are being updated very frequently. We have tried to make them as accurate as possible but rules vary from sport to sport and from region to region, as well as being altered and contested regularly.
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 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 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!
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”.
We have said this many times but we will say it again: this is a hugely complex question with lots of competing views and problems that at best are difficult to reconcile and at worst might be impossible to solve. Let us remember as well that in this piece we have only considered participation from a safety and fairness perspective. There are other issues to resolve, especially beneath the elite tier, where matters of logistics, including changing facilities, may create concerns or dilemmas.
However, in the vast majority of sports, transgender athletes can compete against members of the sex with which they identify. When it comes to trans men the restrictions, if there are any at all, are fewer and less severe.
Trans women will usually have to satisfy various criteria in order to compete against natal women. This is to ensure the safety of those involved and to protect the integrity and fairness of the sport. These criteria often focus on testosterone levels but also include other assessments and measures.