Transgender Athletes: Overview

Introduction

For years, many international sports organizations prohibited transgender women athletes from participating in the women’s divisions of elite athletic competitions. Then, in 2004 the International Olympic Committee (IOC) changed its rules to allow transgender women to compete in women’s divisions for the first time. Initially, the rules required athletes to complete full surgical transition, which raised significant human rights concerns. In 2015 the IOC lifted the surgery requirement in favor of allowing hormone-only transition, which further intensified the controversy. In 2021 the IOC further lifted restrictions for trans athletes, revising its guidelines to remove hormone level limits completely.

Some welcomed the IOC’s new policy for being more inclusive of athletes across the gender spectrum, while others criticized the change on the grounds that it is unfair to cisgender women, as trans women often have higher levels of testosterone, which can affect strength and endurance. Both sides agreed that more research is needed to understand the impact of transition on athletic performance. However, some people believe transgender athletes should be allowed to compete until it is proven that they have an unfair competitive advantage, while others feel they should be barred from competition until it is proven they do not have such an advantage.

Understanding the Discussion

Cisgender: Having a gender identity corresponding to the sex one was assigned at birth; may be shortened to “cis.”

Gender identity: One’s inner conception of their own gender, whether female, male, or something else.

International Association of Athletics Federation (IAAF): The organization that sets rules and regulations for international track-and-field events.

International Olympic Committee (IOC): The organization that sets the rules and regulations that govern, among other things, the criteria for participation in the Olympic Games.

Intersex: A broad term used to describe natural variations in which individuals have sex characteristics that are not typically male or female; intersex variations may be caused by chromosomal differences or unusual hormone levels.

Sex: Refers to a person’s reproductive characteristics, including chromosomes, hormones, and internal and external organs.

Testosterone: A sex hormone, a type of androgen, an anabolic steroid that affects sexual characteristics and physical strength. Typically produced in greater quantities by male bodies, testosterone can be used for both hormone therapy and as a performance-enhancing drug.

Transgender: Having a gender identity that differs from the sex one was assigned at birth; often shortened to “trans.”

History

Historically, professional athletics associations and elite sporting events prohibited transgender athletes from competition, particularly in women’s sport divisions. The organizations’ stated goals were to ensure that men disguised as women did not gain an unfair advantage, but instead the rules prevented transgender athletes from competing as their identified gender and caused traumatic situations for intersex athletes or those with hormonal differences.

Enforcing these rules frequently involved invasive practices such as genital inspection and chromosome testing. Olympic officials at the 1936 Berlin Games requested that US runner Helen Stephens be physically examined after her record-setting performance in the 100-meter race aroused suspicion. Following World War II, the International Association of Athletics Federation (IAAF) instituted a policy requiring a physician’s letter confirming the sex of all female track-and-field athletes, and the International Olympic Committee (IOC) followed suit in 1948. Later, anatomical checks were required to avoid the possibility of forged doctors’ notes, and chromosome tests were instituted starting in the 1960s. Protests from both athletes and the medical community, based on the difficulty of clearly identifying sex in all cases, led to the discontinuation of mandatory sex testing by the end of the twentieth century; however, both the IAAF and the IOC still allowed testing in cases of reasonable suspicion.

The IOC updated its regulations in 2003 to allow transgender athletes to compete in the 2004 Olympics in Athens, Greece. However, athletes needed to have undergone genital surgery, two years of postoperative hormone therapy, and changed their gender legally to qualify. The surgical requirement in particular generated human rights concerns, which led the IOC to revise its policy in 2015. The new rule eliminated the legal and surgical requirements, allowing athletes to compete in women’s divisions as long as their testosterone level was under a threshold value of 10 nanomoles per liter (nmol/L), near the low end of what is considered normal for a man. In theory, this allowed for more representation of transgender women in the 2016 Summer Olympics in Rio de Janeiro; in practice, no out transgender women competed that year. The IOC decision to remove the surgical requirement was motivated in part by the case of Chris Mosier, an American transgender man who qualified for a place on the men’s national duathlon (running/biking) team in 2015.

The IOC’s new policy generated mixed reactions. Many felt the change was a step in the right direction for elite transgender athletes, while some advocated for an even more inclusive policy by noting that testosterone concentration limits still exclude many athletes who identify as women. By contrast, those who criticized the new policy argued that physiological differences gave transgender women an unfair advantage, particularly for those who transitioned later and spent years training at an elite level as men, with high testosterone levels.

Perhaps the biggest criticism of the IOC’s policy, however, was the lack of scientific support for the 10 nmol/L threshold. A 2017 British Journal of Sports Medicine study conducted by Dr. Stephane Bermon and Dr. Pierre-Yves Garnier suggested that higher testosterone levels can provide performance advantages in certain sports, particularly those involving speed and strength. Such studies bolstered the argument of those who wanted the IOC to reduce its testosterone threshold for women still further, to 5 nmol/L.

Very few studies existed that compare the performance of elite athletes before and after transition. IOC-affiliated researcher Dr. Joanna Harper noted that the most significant study up to the 2010s found that the race times of trans women runners slowed significantly after transitioning. However, the study only reviewed data for eight runners and did not address any strength-related sports such as weightlifting. She believed further study was needed before making any definitive rulings.

Meanwhile, as athletes entered the qualification period for the 2020 Summer Olympics in Tokyo, Japan, debate continued over the IOC’s existing and proposed rules for inclusion. The IOC rules stated that male-to-female transgender athletes must undergo hormone therapy and have testosterone levels below 10 nmol/L in the year prior to, and throughout the duration of, the competition, as well as have declared their gender identity at least four years before the start of the competition. While the IOC had begun reviewing this policy, the organization ultimately kept its existing rules in place due to a lack of clear scientific support for lowering the limit and the sensitive nature of the issue. At the Tokyo Summer Olympics, which were postponed until the summer of 2021 due to the COVID-19 pandemic, Laurel Hubbard, a weightlifter from New Zealand, and Quinn, a Canadian soccer player, became the first openly trans athletes to compete at the Olympics.

Transgender Athletes Today

On the national, state, and local levels, each sport’s governing body has the power to establish its own rules as long as they do not run afoul of anti-discrimination laws. However, many follow the IOC’s lead, so experts felt that the IOC’s policy change could impact even those transgender athletes who do not compete at the elite or international level.

The highly publicized story of transgender woman Lia Thomas's achievements in collegiate swimming, particularly her reception as a member of the University of Pennsylvania women's team which won a first-place trophy in the National Collegiate Athletic Association (NCAA) swimming championship in 2022, further spurred the debate around transgender athletes. Her victory led World Aquatics, the international group that governs the sport of swimming, to impose a ban on trans athletes in women's events. Thomas subsequently filed a lawsuit challenging the legality of that ban. Similarly, a new rule from World Athletics, which governs the sport of track and field, went into effect in March 2023 that prohibited any athletes who had gone through male puberty from taking part in women's international competitions. The sport of cycling likewise imposed a ban against trans athletes in elite women's competitions in July 2023.

Meanwhile, following the announcement of Title IX sex discrimination amendment proposals in 2022 that were based on years of stakeholder consultation, in early 2023 the administration of President Joe Biden released a proposed rule prohibiting blanket school policies banning transgender athletes from competing on teams aligned with their gender identity. The regulation changes received both praise, including support from several states' attorneys general, and criticism; however, after several delays the Biden administration ended up leaving out mention of trans athletes in its rewrite of Title IX when the ruling was ultimately finalized in April 2024, though it did add sexual orientation and gender identity to the list of protected groups under the amendment.

The sport of long-distance running was notable for its inclusion of trans and nonbinary athletes in such prestigious events as the Boston Marathon. The April 2023 running of that event was the first time the race included a nonbinary division for runners, considered a major milestone among transgender activists. Other major marathons, such as the Chicago and New York City Marathons, also included nonbinary divisions. In late 2023, Cal Calamia, a nonbinary trans masculine runner, made headlines when he received a therapeutic use exemption from the US Anti-Doping Agency allowing him to compete in male and nonbinary events run by USA Track and Field, despite his use of testosterone as part of his gender-affirming treatment, which previously had been prohibited for use by runners competing in such events. The exemption—believed to be the first of its kind—allowed Calamia to compete without running the risk of violating anti-doping regulations.

Bans against transgender youth participating in school sports also continued into the 2020s. By May 2024, twenty-five states had enacted laws or regulations prohibiting trans athletes from competing in sports consistent with their gender identity, according to the Movement Advancement Project, an LGBTQ advocacy group that tracks such legislation. Furthermore, the National Association of Intercollegiate Athletics announced in April 2024 that transgender athletes participating in women's sports must be assigned female at birth and not have received any hormone therapy in order to compete on teams that fall under its governance (mostly at smaller-sized colleges).

Critics of such legislation pointed to a 2024 report funded by the IOC comparing transgender and cisgender men and women athletes that revealed that fundamental physiological differences existed between trans women and biological men. The study further showed that trans female athletes actually had lower lung function and jumping ability than those athletes assigned female at birth. The study helped to refute the argument that trans women should be banned from women's sports because they hold advantages over cisgender women.

These essays and any opinions, information, or representations contained therein are the creation of the particular author and do not necessarily reflect the opinion of EBSCO Information Services.

Bibliography

Barnes, Katie. "Former University of Pennsylvania Swimmer Lia Thomas Responds to Critics: 'Trans Women Competing in Women's Sports Does Not Threaten Women's Sports.'" ESPN, 31 May 2022, www.espn.com/college-sports/story/‗/id/34013007/trans-women-competing-women-sports-does-not-threaten-women-sports. Accessed 6 June 2023.

Carpenter, Les. "IOC No Longer Will Determine Transgender Athlete Eligibility by Testosterone Levels." The Washington Post, 16 Nov. 2021, www.washingtonpost.com/sports/olympics/2021/11/16/ioc-transgender-athlete-policy-changes/. Accessed 6 June 2023.

Cole, Devan. "Federal Appeals Court Throws Out Case Brought by Connecticut High School Girls Challenging Trans-Inclusive Sports Policy." CNN, 16 Dec. 2022, www.cnn.com/2022/12/16/politics/connecticut-transgender-sports-lawsuit-appeal/index.html. Accessed 6 June 2023.

Downey, Caroline. "Biden Admin Adds 'Gender Identity' as Protected Class in New Title IX Rules, but Sidesteps Trans-Athlete Policy." National Review, 19 Apr. 2024, www.nationalreview.com/news/biden-administration-sidesteps-trans-athlete-policy-in-new-title-ix-rules/. Accessed 20 May 2024.

Fessler, Leah. “The First Transgender Athlete on Team USA Reveals How He Combats Sexism in Sports.” Quartz, 30 Oct. 2018, qz.com/work/1408533/the-first-transgender-athlete-on-team-usa-reveals-how-he-combats-sexism-in-sports/. Accessed 27 Nov. 2019.

Harper, Joanna. “Transgender Olympians.” HuffPost, 1 Sept. 2016, www.huffpost.com/entry/transgender-olympians‗b‗57c5c596e4b004ff0420e1af. Accessed 27 Nov. 2019.

Longman, Jeré. "New Study Bolsters Idea of Athletic Differences Between Men and Trans Women." The New York Times, 23 Apr. 2024, www.nytimes.com/2024/04/23/world/europe/paris-olympics-transgender-athletes.html. Accessed 20 May 2024.

Megan, Kathleen. “Transgender Sports Debate Polarizes Women’s Advocates.” The CT Mirror, 22 July 2019, ctmirror.org/2019/07/22/transgender-issues-polarizes-womens-advocates-a-conundrum/. Accessed 27 Nov. 2019.

“Naturally Produced Testosterone Gives Female Athletes ‘Significant’ Competitive Edge.” BMJ, 7 July 2018, www.bmj.com/company/newsroom/naturally-produced-testosterone-gives-female-athletes-significant-competitive-edge. Accessed 21 Nov. 2019.

Ortega, Rodrigo Pérez. "World Athletics Banned Transgender Women from Competing. Does Science Support the Rule?" Science, 4 Apr. 2023, www.science.org/content/article/world-athletics-banned-transgender-women-competing-does-science-support-rule. Accessed 6 June 2023.

Rogol, Alan D., and Lindsay Parks Pieper. “Genes, Gender, Hormones, and Doping in Sport: A Convoluted Tale.” Frontiers in Endocrinology, 12 Oct. 2017, doi:10.3389/fendo.2017.00251. Accessed 27 Nov. 2019.

Soong, Kelyn. "A Transgender Runner's Push for Inclusion May Have Changed the Sport." The Washington Post, 27 Oct. 2023, www.washingtonpost.com/wellness/2023/10/06/trans-nonbinary-runner-testosterone-exemption/. Accessed 20 May 2024.

Tumin, Remy. "Title IX and the New Rule on Transgender Athletes Explained." The New York Times, 7 Apr. 2023, www.nytimes.com/article/title-ix-transgender-athletes-school-sports.html. Accessed 6 June 2023.

Valle, Jay. "Transgender Athlete Wins Discrimination Case against USA Powerlifting." NBC News, 2 Mar. 2023, www.nbcnews.com/nbc-out/out-news/transgender-athlete-wins-discrimination-case-usa-powerlifting-rcna72879. Accessed 6 June 2023.