transgender athletes essay

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Sport and Transgender People: A Systematic Review of the Literature Relating to Sport Participation and Competitive Sport Policies

Bethany alice jones.

1 Nottingham Centre for Gender Dysphoria, 3 Oxford Street, Nottingham, NG1 5BH UK

2 School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK

Jon Arcelus

3 Division of Psychiatry and Applied Psychology, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK

Walter Pierre Bouman

Emma haycraft.

Whether transgender people should be able to compete in sport in accordance with their gender identity is a widely contested question within the literature and among sport organisations, fellow competitors and spectators. Owing to concerns surrounding transgender people (especially transgender female individuals) having an athletic advantage, several sport organisations place restrictions on transgender competitors (e.g. must have undergone gender-confirming surgery). In addition, some transgender people who engage in sport, both competitively and for leisure, report discrimination and victimisation.

To the authors’ knowledge, there has been no systematic review of the literature pertaining to sport participation or competitive sport policies in transgender people. Therefore, this review aimed to address this gap in the literature.

Eight research articles and 31 sport policies were reviewed.

In relation to sport-related physical activity, this review found the lack of inclusive and comfortable environments to be the primary barrier to participation for transgender people. This review also found transgender people had a mostly negative experience in competitive sports because of the restrictions the sport’s policy placed on them. The majority of transgender competitive sport policies that were reviewed were not evidence based.

Currently, there is no direct or consistent research suggesting transgender female individuals (or male individuals) have an athletic advantage at any stage of their transition (e.g. cross-sex hormones, gender-confirming surgery) and, therefore, competitive sport policies that place restrictions on transgender people need to be considered and potentially revised.

Introduction

Transgender people are those who experience incongruence between the gender that they were assigned at birth (based on the appearance of their genitals) and their gender identity/experienced gender. Gender identity, or experienced gender, can be defined as a person’s internal sense of gender, whether this be male, female, neither or somewhere along the gender continuum. Some transgender people, but not all, will choose to affirm their gender identity by socially transitioning (i.e. living as their experienced gender socially, at work or at an educational institution, with friends and family, outside the home) and some, in addition, will choose to medically transition with cross-sex hormones and gender-confirming surgeries [ 1 , 2 ]. Although over time various different terms have been used, the term ‘transgender female individual’ will be used to describe individuals assigned male at birth, based on their genital appearance, but who later identify as female. ‘Transgender male individual’ will be used to describe people who are assigned female at birth, based on their genital appearance, but later identify as male. ‘Cisgender’ will be used to describe people who do not experience incongruence between their gender assigned at birth and their gender identity.

Recent reports indicate that the number of transgender individuals who attend transgender health services has increased substantially over the years in many European countries [ 3 – 5 ]. There has also been a significant increase in the number of people who self-identify as transgender and do not necessarily attend transgender health services [ 6 ]. For example, Kuyper and Wijsen [ 6 ] found that 4.6 % of people who were assigned male at birth and 3.2 % of people who were assigned female at birth in their Dutch population sample reported an ambivalent gender identity (equal identification with the other gender as with the gender they were assigned at birth). The authors also reported that 1.1 % of the people who were assigned male at birth and 0.8 % of the people who were assigned female at birth identified as transgender. It remains unknown how many of these people will seek treatment through a transgender health service. The increase in people who identify as transgender may be at least partly explained by the increase in visibility of transgender people within Western society [ 4 , 5 ]. For example, Caitlin Jenner, a former athlete and current television personality, recently came out as transgender during a television interview that was viewed all over the world [ 7 ]. Increases in visibility may have prompted some people to reflect and question their gender identity [ 8 ].

Some transgender people experience stigma, transphobia, prejudice, discrimination and violence as a consequence of their gender identity [ 9 – 11 ]. Ellis et al. [ 12 ] found that transgender people were more likely to avoid situations when they were afraid of being harassed, identified as transgender or ‘outed’, such as in clothes shops, public toilets and gyms. Gyms are a popular outlet to engage in sport-related physical activities (i.e. gym fitness exercises) and therefore it is important to create an inclusive environment given the established mental and physical health benefits of physical activity and sport [ 13 , 14 ]. This is particularly important for transgender people as they have been found to report a high prevalence of depression and anxiety [ 15 , 16 ], which could be managed with physical activity. Furthermore, physical activity and sport can also contribute towards maintaining the appropriate weight necessary to undergo gender-confirming surgery, acknowledging that not every transgender person will wish to do so [ 1 , 2 , 17 ].

The premise of competitive sport is fairness (i.e. inclusion in the absence of advantage) and, owing to fears surrounding the perceived athletic advantage of transgender people, the question of whether transgender people should be permitted to compete in accordance with their gender identity has been raised and greatly contested within the literature, among sport organisations, fellow competitors and spectators. It is a commonly held belief that androgenic hormones (especially testosterone) confer an athletic advantage in competitive sport. Therefore transgender female individuals, because of high endogenous testosterone levels, are perceived to hold an advantage in sport (when testosterone has not been blocked to a cisgender female level). Transgender men are not thought to possess an athletic advantage, despite being injected with testosterone if they chose to medically transition with cross-sex hormones. However, there has been a paucity of research that has directly explored how androgenic hormone levels are associated with athletic competence in both cisgender and transgender populations (e.g. running time).

To facilitate the inclusion of transgender competitors, in 2004, the International Olympic Committee (IOC) [ 18 ] announced that transgender people could participate in all future Olympic games providing they had fully medically transitioned (i.e. had been prescribed cross-sex hormone treatment for 2 years and undergone gender-confirming surgery). Although the requirements of this policy appear to concur with the commonly held belief that transgender people hold an athletic advantage, they have been criticised for not being underpinned by an evidence-based rationale [ 19 ]. The IOC [ 20 ] has recently updated its policy to be more inclusive of transgender athletes (i.e. fewer restrictions); however, the 2004 policy has been extremely influential on other sport organisations’ policy development. The new (2016) IOC policy will be considered in Sect. 3 .

In an attempt to draw a consensus as to whether transgender people should be able to compete in accordance with their gender identity, in 2005 Reeser [ 21 ] conducted a review of the literature pertaining to gender identity issues in competitive (elite) sport. Reeser paid particular attention to the evolution of gender verification in competitive sport and whether current competitive sport policies for transgender people are fair. He concluded that, while gender verification has made significant advances, there is a lack of physiological performance-related data in transgender people. This is preventing an overall consensus from being made as to whether transgender sport policies are fair or not (i.e. fairness in the absence of advantage). Reeser’s review, although important, has some limitations. He did not adopt a systematic methodology and therefore did not include the majority of transgender sport policies. Additionally, Reeser only considered the implications of such policies in relation to elite competitive sport and did not consider the experiences of transgender people who engage in sport or sport-related physical activity for leisure or fitness (e.g. gym fitness activities, jogging).

With the intention of addressing the limitations of the previous literature review, this systematic review has two aims. First, to systematically analyse and critically review the available literature regarding transgender people’s experiences in relation to competitive sport (elite and recreational) and sport-related physical activity participation (e.g. jogging, gym fitness activities). Second, to systematically review the available transgender competitive sport policies with regard to their fairness (i.e. competition in the absence of advantage). It is hoped that this systematic review will further enhance the understanding of sport participation and competition amongst transgender people. It may be expected that as more people define themselves as transgender, the issues that transgender people experience in competitive sport and sport-related physical activity will become more pronounced. It is therefore important that those who work to facilitate and promote sport and develop policies for their own sport organisations (e.g. sport medicine specialists, sport policymakers) are informed about the issues that this vulnerable population face. This will allow for a non-discriminatory atmosphere in sport, whilst ensuring a fair system for all participants and competitors (regardless of their gender identity).

Search Strategy

Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to undertake this systematic review [ 22 ]. To obtain relevant peer-reviewed articles, an electronic search of literature published between January 1966 and August 2015 was conducted using the following search engines: ScienceDirect, Web of Science, Scopus and PubMed. Within each search engine, the following search terms were entered: gender dysphoria, gender identity disorder, trans people, trans individual, transgender and transsexual. These terms were combined with three terms relating to sport (physical activity, exercise and sport) using the “AND” operator. The reference lists of eligible papers were searched for potentially relevant publications. Sport policies were obtained through a Google search using the above search terms with the addition of “policy” at the end of all sport-related terms.

Inclusion and Exclusion Criteria

To address the first aim, articles that were selected were concerned with the experiences and issues surrounding physical activity and sport participation for transgender people. This systematic review only considered articles eligible if they were research articles, as opposed to discussion papers. Case studies were also considered eligible, as research articles were limited. Peer-reviewed articles that were written in English only were included. For the second aim, all available national and international policies on competitive sport in transgender people were selected and reviewed.

Study Selection

Thirty-one research articles were considered potentially relevant to the remit of this review. The search also identified 31 competitive sport policies for transgender people. After screening the abstracts, ten research articles were excluded as six were concerned with lesbian, gay, bisexual and transgender sport, one was a Scottish non-academic survey, one was a book chapter, one was concerned with an irrelevant topic and another focused on cisgender participants. The remaining 21 articles were downloaded for full-text review and 13 papers were excluded as they were discussion papers, as opposed to research articles. Therefore, eight research articles fulfilled the inclusion criteria and were consequently included within this systematic review (Fig. 1 ). All 31 competitive sport policies for transgender people were reviewed and included within this systematic review.

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Process of identifying eligible research articles. LGBT : lesbian, gay, bisexual, transgender

This section presents the findings from the research articles and sport policies included within this systematic review. First, the findings from the research articles that explored participation in sports (both elite and recreational standards) and sport-related physical activities (i.e. gym fitness activities, jogging) are provided. Second, findings from the reviewed competitive sport policies relating to transgender inclusion are given.

Transgender People and Sport Participation

Characteristics of the eligible research studies.

The oldest research article included was published in 2004 [ 23 ] and the most recent publication was from 2015 [ 24 ]. The majority of the studies were qualitative in nature, all of which employed interviews [ 24 – 29 ]. The remaining two research articles included an experimental study [ 23 ] and a cross-sectional survey [ 30 ]. Most of the studies were concerned with transgender people who participated in sport competitively, at an elite or recreational level [ 21 , 23 , 25 – 29 ]. Some authors focused on a specific sport; ice hockey, netball and softball [ 26 , 28 , 29 ] while others were concerned with transgender people engaging in any sport [ 25 , 27 , 29 ]. Broadly, across all sports, Gooren and Bunck [ 23 ] explored whether transgender athletes have a physiological advantage in competitive sport. One study explored participation in competitive sports and sport-related physical activity [ 24 ] and another study discussed participation in sport-related physical activity only [ 30 ]. Details of all of the research articles included within this systematic review can be found in Table 1 .

Table 1

Study characteristics of research articles included within the review

Review of Transgender People and Competitive Sport Participation (Elite and Recreational): Research Articles

The same data were extracted from all research articles reviewed (Table 1 ). Below, we provide the most prominent findings in relation to competitive sport participation from each of these articles. Six research articles were concerned with competitive sport participation within this systematic review [ 23 , 25 – 29 ]. The only experimental study was by Gooren and Bunck [ 23 ] who aimed to explore whether transgender people taking cross-sex hormone treatment can fairly compete in sport. The authors measured transgender people’s muscle mass (via magnetic resonance imaging) and hormone levels (via urine and blood analyses) before and 1 year after cross-sex hormone treatment. They found that 1 year after transgender male individuals had been administered cross-sex hormone treatment, testosterone levels significantly increased and these levels were within a cisgender male range. They also found that 1 year after cross-sex hormone treatment, transgender male individuals’ muscle mass had increased and was within the same range as transgender female individuals (assigned male at birth) who had not been prescribed cross-sex hormone treatment. In relation to transgender female individuals, Gooren and Bunck found testosterone levels had significantly reduced to castration levels after 1 year of cross-sex hormone treatment. Muscle mass had also reduced after 1 year of cross-sex hormone treatment. However, muscle mass remained significantly greater than in transgender male individuals (assigned female at birth) who had not been prescribed cross-sex hormone treatment.

Therefore, Gooren and Bunck concluded that transgender male individuals are likely to be able to compete without an athletic advantage 1-year post-cross-sex hormone treatment. To a certain extent this also applies to transgender female individuals; however, there still remains a level of uncertainty owing to a large muscle mass 1-year post-cross-sex hormones. While this study was the first to explore, experimentally, whether transgender people can compete fairly, the sample size was relatively small ( n = 36). Additionally, they did not explore the role of testosterone blockers and did not directly measure the effect cross-sex hormones had on athletic performance (e.g. running time). Many, but not all, transgender female individuals are prescribed testosterone blockers to help them to reach cisgender female testosterone levels, when administration of oestrogen alone is not enough to reduce testosterone levels. This is particularly important if the person aims to undergo gender-confirming surgery, as 6 months of testosterone suppression is a requirement for such procedures. However, if a transgender woman does not wish to undergo surgery or does not wish to have their testosterone blocked to cisgender female levels (e.g. as they wish to use their penis), their testosterone levels will be above cisgender female levels. Differentiating not only between those taking cross-sex hormones and not taking cross-sex hormones, but also transgender female individuals taking testosterone blockers, may be necessary when discussing an athletic advantage.

The remaining studies considered within this section are qualitative, and although they have provided insight into the experiences of transgender people participating in competitive sport, the findings cannot be generalised. Semerjian and Cohen’s [ 27 ] narrative account provides a good overview of how diverse and individual the issues and experiences of transgender people participating in competitive sport can be. Some participants felt anxious when engaging in sport because they felt their genitals may be revealed (e.g. when changing). In contrast, one participant used sport as a safe space to escape from the harassment he received at school. It must be considered though, that participants within the study engaged in different sports and their experiences could therefore be associated with the specific sport (i.e. some sports could be more inclusive then others).

Three qualitative studies described the implications that sport policies had on the experiences of transgender people who engaged in sport [ 26 , 28 , 29 ]. Cohen and Semerjian [ 26 ] published a case study about a transgender woman (pre-gender-confirming surgery) who was playing in the women’s national ice hockey tournament, but who was eventually banned from playing in the tournament because it was felt she had an athletic advantage. She described how she felt under constant surveillance when she was playing and at times felt ambivalent about what gendered team she should play on. It was apparent that although teammates were supportive, the issues she experienced in relation to inclusion in the tournament were primarily related to constraints put in place by competitive sport policies. Similarly, the discussions held by two former New Zealand transgender female netball players in Tagg’s [ 28 ] study gave the impression that although transgender sport policies were supposedly implemented to increase the inclusivity of transgender people, this was not always the case. They discussed how policy would allow a pre-gender-confirming surgery transgender woman to compete in a male or mixed-gender netball team only and they must obey male dress codes. However, the participants in this study were former netball players and therefore their discussions may not have been based on the current state of netball in relation to transgender participation. In contrast to the previously mentioned studies, the majority of participants ( n = 12) in Travers and Deri’s [ 29 ] study discussed the positive experiences they had in relation to transgender participation in competitive sport. However, some of the transgender men did discuss how they had hostile experiences (e.g. incorrect pronoun use). Several of the participants in this study also felt that testosterone gave transgender women (endogenous) and men (when injected) an athletic advantage.

For the two young transgender male individuals in Caudwell’s [ 25 ] study, the stage of transition appeared to be instrumental in disengagement from participation in competitive sport. The discussion held by the participants highlighted how accessing sport during their transitional period was difficult as they would not be accepted or feel comfortable on either a male or female team during this period. However, this study again discussed sport very broadly and therefore it is unknown whether the participants’ experiences were associated with specific sports or whether they are generalisable across other sports.

In summary, there is limited research from which to draw any conclusion about whether transgender people have an athletic advantage in competitive sport or not. The limited physiological research conducted to date has informed the development of transgender sport policies that are implemented by sporting organisations all over the world. It is these sport policies that appear to be instrumental in transgender people’s experiences with competitive sport, most of which are negative.

Review of Transgender People and Sport-Related Physical Activities: Research Articles

Within this systematic review, only two studies explored sport-related physical activities [ 24 , 30 ]. Muchicko et al. [ 30 ] set out to quantitatively explore the relationship between gender identity and physical activity. They compared levels of physical activity between cisgender and transgender people. The study found that self-identified transgender participants ( n = 33) reported engaging in less physical activity than cisgender participants ( n = 47). Social support and self-perception were found to mediate the relationship between gender identity and physical activity. The authors suggested that their study highlights how leisure centres need to be more inclusive, and transgender people need to be given more social support to encourage physical activity. However, this study was limited by the sampling methods employed. The cisgender participants were recruited from a university campus where they potentially had more opportunity to walk around campus, and opportunity for discounted gym memberships, whereas the transgender participants were recruited from a support group for transgender people and were not associated with the university.

As with transgender people who engage in sport at a competitive level, transgender people who engage in sport-related physical activity also appear to experience a range of different barriers. Hargie et al. [ 24 ] found in their qualitative study that transgender people prefer to engage in individual, as opposed to group, sport-related physical activities. This was reportedly owing to their fear of being ‘outed’. Regardless of whether sport-related physical activities are engaged in individually or in a group, changing rooms appeared to be a significant barrier. Being excluded from sport-related physical activities was distressing for participants, as they could not maintain physical fitness, which they felt was important in preparation for gender-confirming surgery. Despite these interesting findings, the study is limited by the lack of sociodemographic information provided about participants. Within qualitative research, because of the small sample size, it is often desirable to provide a large amount of sociodemographic detail about participants so that the findings can be interpreted in relation to this information. For instance, in the context of sport-related physical activities, the stage of transition may be an important factor when interpreting the individuals’ current experiences of sport-related physical activities.

The limited research studies concerned with sport-related physical activities suggest that inclusive environments are not created for transgender people engaging in such activities, which may deter engagement.

Transgender-Inclusive Sport Policies

Characteristics of the eligible sport policies.

Of the 31 transgender inclusive policies reviewed, 13 were from the USA [ 31 – 43 ]. Ten of the policies reviewed were from the UK [ 44 – 53 ]. One policy was from Australia [ 54 ]. The rest of the policies ( n = 7) were international [ 18 , 20 , 55 – 59 ]. Details of all of the sport policies included within this review can be found in Table 2 .

Table 2

Transgender-inclusive sport policies included within this systematic review

GCS gender-confirming surgery, CHT cross-sex hormone therapy, IOC International Olympic Committee, TUE therapeutic use exemption, n.d. no date

a Gender dysphoria is the diagnostic name included within the Diagnostic and Statistical Manual for Mental Disorders , Fifth Edition, for people who experience an incongruence between their gender assigned at birth and gender identity [ 60 ]

Review of the Sport Policies

Policies within this section were systematically reviewed in relation to their inclusiveness of transgender competitors (i.e. maintaining fairness in the absence of advantage for all competitors). The fairness of the policy requirements was judged against the available physiological research that has explored athletic advantage. The time restrictions associated with each requirement were also reviewed (e.g. cross-sex hormones must have been administered for at least 2 years prior to competition). The requirements from each policy are summarised within Table 2 and the most salient points of these policies are then presented in the section that follows.

In 2004, the IOC [ 18 ] announced that transgender people who transition after puberty are permitted to compete in sport in line with their experienced gender identity providing they have had gender-confirming surgery, can provide legal recognition of their gender, have been prescribed cross-sex hormone treatment for at least 2 years and have lived in their experienced gender for the same amount of time [ 18 ]. Additionally, transgender people who had undergone gender-confirming surgery pre-puberty are eligible to compete in sport in line with their experienced gender identity [ 18 ]. This is an international policy and has been adopted by sport organisations all over the world.

While the 2004 IOC [ 18 ] policy has been praised for its efforts to address the inclusion of transgender athletes [ 61 ], several flaws have been identified [ 61 ]. First, the policy excludes transgender people who choose not to have gender-confirming surgery owing to a lack of genital dysphoria (distress), medical reasons, fears about risk during operations, and/or because of other personal reasons [ 28 , 62 , 63 ]. The 2004 IOC [ 18 ] policy also excludes transgender people who are in the process of transitioning. For instance, a transgender athlete may be prescribed cross-sex hormone treatment, but be yet to undergo gender-confirming surgery. The 2004 IOC policy [ 18 ] therefore adopts a very narrow definition and excludes a large proportion of transgender people [ 19 ]. In addition to this, the policy appears to have been developed with only transgender female individuals in mind, possibly as transgender male individuals are not thought to possess athletic advantages in the majority of sports, and therefore the policy discriminates against transgender male individuals [ 21 ]. Moreover, the 2004 IOC [ 18 ] policy fails to take into consideration the regional, national and international differences in accessing cross-sex hormone treatment and gender-confirming surgery [ 18 , 63 – 65 ]. Within this policy, there also appears a lack of an evidence-based rationale as to why a period of 2 years was chosen as the length of time cross-sex hormone treatment must be administered prior to sport competition and why individual differences in blood hormone levels are not considered [ 66 ]. As mentioned previously, the role of testosterone blockers in transgender women is also not considered. Although the rationale for the 2-year time period is not made explicit, it may be related to the fact that this time period was imposed by the IOC in 2004, when banning athletes from competitive sport to discipline them for doping violations. The evidence-based rationale for gender-confirming surgery is also not clear [ 61 ]; whether an athlete has a penis or vagina appears irrelevant, as this will not change the physiology of the body or the physiological advantage of the person [ 63 ].

Approximately 200 days before the 2016 Rio Olympic Games, the IOC announced changes to their competitive sport policy for transgender people. The new 2016 IOC [ 20 ] policy suggests that transgender male athletes are able to compete in a male category without any restrictions. Transgender female athletes may compete in a female category if they have declared their gender as female for at least 4 years and their blood testosterone levels are below 10 nmol/L for at least 12 months prior to competition. However, the latter requirement is a general guideline, and each case will be reviewed individually to determine whether 12 months is a sufficient amount of time to suppress testosterone levels to an appropriate level. If transgender female athletes do not meet these requirements, they will be able to compete in a male category. This is a great improvement in sport policy, which considers gender assigned at birth and individual difference in relation to bloody hormone levels and moves away from the requirement of surgery to compete in their experienced gender category. However, we could not find any evidence to support the requirement for testosterone levels to be below 10 nmol/L for at least 12 months.

Despite its flaws, the 2004 IOC policy [ 18 ] has been adopted by several other sport organisations. Within this systematic review, 11 sport organisations adopted the policy outlined by the IOC in 2004 [ 33 , 36 , 38 – 40 , 45 , 46 , 48 , 49 , 51 , 57 ]. All but one (the International Tennis Federation) of these sport organisation policies are employed at a national level. Not only is it problematic that other sport organisations adopted the 2004 IOC policy, but elements of the 2004 IOC policy concerning children pre-puberty are not applicable to sport organisations in the UK and many other countries. Within the UK (and many other countries), children presenting with gender incongruence cannot undergo gender-confirming surgery before the age of 18 years, by which time puberty has usually started.

Three policies stated that it is only necessary to provide legal recognition of gender and to be prescribed cross-sex hormone treatment for a ‘sufficient amount of time’ (international policy) [ 56 ] or so that hormone blood levels are within cisgender female or male ranges (national policy) [ 44 , 52 ]. Policies from the National Collegiate Athletic Association [ 32 ] and British Rowing [ 50 ] also state that only cross-sex hormone treatment is required; however, the specifics of this requirement differ for both transgender male and female individuals. With both of these policies, transgender female individuals have to provide more evidence of cross-sex hormone treatment and their blood hormone levels in comparison to transgender male individuals. Similarly, the Association of Boxing Commissions [ 31 ] in its national policy has different cross-sex hormone treatment requirements depending on gender assigned at birth and how the athlete identifies themselves (transgender or transsexual). The language used within the Association of Boxing Commissions’ policy [ 31 ] may be seen as offensive by some transgender people and the difference between “transsexuals” and “transgender” people remains unclear. Policies held by the Ladies Professional Golf Association (international policy) [ 43 ] and the International Association of Athletics Federations [ 55 ] differ dramatically in relation to gender and gender-confirming surgery as a requirement. In both cases, it is necessary for transgender female individuals to have undergone this procedure, but not for transgender male individuals. Although some of the requirements of these policies are unreasonable and not evidence based (e.g. gender-confirming surgery), the gender difference in relation to the amount of evidence that is required about their gender change seems acceptable considering that only transgender female individuals (and not transgender male individuals) are currently seen to potentially have an athletic advantage [ 23 ].

The more inclusive sport policies reviewed here only required legal or medical recognition or do not ask for any evidence of gender; thus they encourage competition in line with the experienced gender (five were national policies and two were international) [ 34 , 35 , 41 , 42 , 53 , 54 , 59 ]. The Fédération Internationale de Volleyball [ 58 ] had the most invasive policy considered within this systematic review; they ask players to provide a birth certificate to verify gender. Additionally, female players may be asked to provide a gender certificate or submit themselves to a medical examination if the medical evidence is not sufficient. Both British Universities & Colleges Sport [ 47 ] and USA Triathlon [ 37 ] do not have their own policies, but suggest the adoption of other policies (i.e. those relevant to the sport in question or guidelines of the US Anti-Doping Agency, respectively).

Currently, the majority of sport policies unfairly exclude transgender people from competitive sport, as the requirements they place on them are not underpinned by evidence-based medicine. Until (and if) there is consistent and direct evidence to demonstrate transgender people have an athletic advantage, it seems unreasonable to exclude them on any basis.

The first aim of this systematic review was to explore the experiences of transgender people in relation to competitive sport participation (elite and recreational) and sport-related physical activity. The majority of the studies within this body of literature are qualitative in nature, which may be at least partly a reflection of the low numbers of transgender people in the general population. It is therefore difficult to draw any definite conclusions because of the lack of quantitative research. By its very nature, the findings from qualitative research cannot be generalised but the findings can be used to form a platform from which generalisations can be made. The research articles reviewed here described a generally negative experience of sport participation and sport-related physical activity for transgender individuals. It was evident from these studies that transgender people are facing barriers when engaging in competitive sport and sport-related physical activity. In relation to sport-related physical activity, lack of accessibility to an inclusive and comfortable environment appeared to be the primary barrier to participation. Charities and support organisations working with transgender people should consider developing campaigns to raise awareness about different gender identities. Leisure centres should also be made more aware of potential gender differences (i.e. via training and greater information provision) and be given advice on how to make such environments more inclusive of transgender people (e.g. gender neutral changing facilities with cubicles). In relation to competitive sport participation, the findings from this systematic review suggest that the requirements that transgender competitive sport policies place on competitors were instrumental in transgender athletes’ negative experiences.

While a distinction needs to be made between the issues and experiences transgender people have with regard to participation in sport and competitive sport, it also needs to be acknowledged that there is an overlap. Transgender male and female individuals have anecdotally discussed that access to sport participation (such as becoming part of the local football team) is restricted as even community and local sport organisations who play at a recreational level implement transgender competitive sport policies.

The second aim was to review the available sport policies regarding the fairness for transgender people in competitive sport (i.e. fairness in the absence of advantage). Owing to overinterpretation and fear of the athletic advantage in transgender athletes, the majority of the policies reviewed were discriminatory against transgender people, especially transgender male individuals (i.e. exclusion in the absence of advantage). Although the updated IOC policy may be perceived as more inclusive then the 2004 version, there are still flaws. The requirement for a transgender female individual to have declared their gender as female for at least 4 years is excessive. In the UK and many other countries, once a transgender person has accessed a transgender health service, it is likely to be less than 4 years before a person legally changes their name, undergoes irreversible treatments and, hence, fully commits to their experienced gender. There appears to be a lack of rationale regarding the 4-year time period for transgender athletes, although this time restriction is consistent with the current disciplinary action for cisgender athletes when a doping incident occurs [ 67 ]. The 2016 IOC policy [ 20 ] also states that to avoid discrimination against transgender female individuals, they are allowed to complete in a male category if they do not meet the requirements for transgender female athletes. For most transgender female individuals, competing in a male category, when their experienced gender is female, would be distressing and may deter engagement in competitive sport altogether. This particular requirement may be promoting exclusion of transgender female individuals in competitive sport, rather than avoiding discrimination.

Several sport policies, including the recently updated IOC 2016 [ 20 ] policy, have based their requirements for transgender competitors on indirect, inconsistent and unambiguous evidence. Physiological research involving cisgender people has shown that testosterone deficiency in young men is associated with a decrease in muscle strength [ 68 ] and testosterone injections in cisgender men are associated with an increase in some aspects of muscle strength [ 69 ]. However, this research did not determine whether these decreases and increases in muscle mass are within ranges for cisgender female and male individuals and the time required to reach cisgender male or female levels. Elbers et al. [ 70 ] expanded on this research by exploring the effects of oestrogen supplements and androgen deprivation on fat distribution and thigh muscle mass (by using magnetic resonance imaging) in 20 transgender female individuals. They found that 12 months after cross-sex hormone treatment, transgender female individuals had a more feminine pattern of adiposity and their thigh muscles had decreased. Other research has found that transgender female athletes who have hormonally and surgically transitioned have reported feeling weaker and their testosterone levels tend to be lower than average compared with cisgender women [ 19 , 71 ]. However, this research does not tell us anything about the relationship between androgenic hormones and athletic ability.

To date, Harper’s study [ 72 ] is the only one to directly explore androgenic hormones and athletic ability. The aim of the study was to explore the long-distance (5–42 km) running times of eight transgender female individuals pre- and post-testosterone suppression. It was found that post-testosterone suppression running times were significantly slower in comparison to pre-testosterone suppression. Harper stated that owing to reductions in testosterone and haemoglobin, transgender female individuals post-transition would have the same endurance capabilities as a cisgender female individual. However, the sample size was very small ( n = 8) and participants were asked to self-report their race times, which might have been subject to recall or social desirability bias.

On average, men perform better than women in sport; however, no empirical research has identified the specific reason(s) why. Based mainly on indirect research with cisgender people, it is commonly believed that androgenic hormones (specifically high testosterone levels) confer an advantage in competitive sports (i.e. enhance endurance, increase muscle mass) and, while this belief has informed several sporting policies, testosterone may not be the primary, or even a helpful, marker in determining athletic advantage [ 73 ]. Karkazis et al. [ 73 ] have argued that there is no evidence to suggest that endogenous testosterone levels are predictive of athletic performance (apart from doping), as there is variation in how bodies make and respond to the hormone. Testosterone is only one part of a person’s physiology and there are other important factors (both biological and environmental) that should be considered if fairness (the absence of advantage) is the aim in competitive sport. For instance, having large hands is key for manipulation in some sports (e.g. basketball), but this is not seen as an unfair advantage. Establishing what an athletic advantage is in competitive sport would facilitate inclusion of all athletes (regardless of their gender identity) on the premise of fairness.

The Canadian Centre for Ethics in Sport [ 74 ] recently released a document offering guidance to sport organisations on how to develop inclusive competitive sport policies for transgender people. An expert panel maintained the viewpoint that everyone has the right to compete in accordance with their gender identity at a recreational and elite level. Cross-sex hormones and gender-confirming surgeries should not be a requirement at any level of sport. If any sport organisation requires transgender competitors to take cross-sex hormones for a specified time, they will have to provide evidence to support that this is reasonable. The panel suggests that when sporting organisations are concerned about safety, based on the size or strength of competitors, such organisations should develop skill and size categories, such as in wrestling.

The issues and challenges that transgender people experience when engaging in competitive sport and sport-related physical activity will undoubtedly become more prominent as the visibility and prevalence of transgender people become more pronounced. Consequently, health professionals working in sport will need to become more familiar with the specific issues and challenges that a transgender person may experience when engaging in sport. By doing this, these professionals will be able to ensure transgender people can start or continue to engage in sport in a safe and inclusive manner. The most common question of people working within the sport domain will likely be: When it is safe and fair to permit a transgender person to compete in sport in line with their experienced gender? At the current time, this is a difficult issue to address considering that there is a lack of direct and consistent physiological performance-related data with transgender people, which is preventing a consensus from being made as to whether transgender people (especially transgender female individuals) do or do not have an athletic advantage. It may be sensible to suggest that until there are direct and consistent scientific data to suggest that transgender competitors have an advantage, transgender people should be allowed to compete in accordance with their gender identity with no restrictions (e.g. no requirement to have cross-sex hormones, gender-confirming surgery). The athletic advantage transgender female individuals are perceived to have (based on indirect and ambiguous evidence) may be no greater than widely accepted physiological (e.g. large hands) and financial (e.g. training opportunities) advantages that some cisgender people possess in competitive sport. Sport organisations wanting to exclude a transgender person from competing in their experienced gender category would need to demonstrate that the sport is gender affected and that exclusion is necessary for fair and safe competition [ 74 , 75 ]. At the current time, this would be difficult considering there is no evidence to suggest that androgenic hormone levels consistently confer a competitive advantage [ 74 , 75 ].

Limitations of the Area and Directions for Future Research

Within the area of sport, physical activity and transgender individuals, research is limited and mainly qualitative. More quantitative research needs to be conducted to increase the applicability and generalisability of the research findings and so that conclusions about transgender people and sport can be drawn. At a medical level, more physiological research is needed with the transgender population to accurately determine whether transgender people have an advantage in competitive sport or not. Future studies should investigate when a person can be considered physiologically as their experienced gender. This in turn should aid more inclusive (i.e. inclusion in the absence of advantage) sport policies for transgender individuals and a fair system for all. To date, the few studies exploring the experiences of transgender people have mainly been concerned with exploring experiences in relation to competitive sport. This research now needs to be extended to those who participate in sport-related physical activity for leisure and fitness. It is also important to understand transgender people’s experiences in the context of different sports. The barriers to, and facilitators of, football participation, for example, may greatly differ to those experienced when engaging in gymnastics, athletics, swimming or aquatic activities. For the latter four sports, clothing may be revealing and an indication of one’s gender. For example, feeling comfortable in swimwear may be an issue for transgender people, especially when they are in the process of transitioning, as the body is often more exposed than in other sportswear (e.g. a football kit) and swimwear is heavily gendered (i.e. swimming trunks are worn by male individuals and swimming costumes by female individuals). In light of this, it would be interesting to explore the experiences of transgender people who have previously participated, or are currently participating, in aquatic activates, gymnastics and/or athletics.

Overall, it appears that the majority of transgender people have a negative experience of competitive sport and sport-related physical activities. Accessibility to sport-related physical activity needs to be improved. Within competitive sport, the athletic advantage transgender athletes are perceived to have appears to have been overinterpreted by many sport organisations around the world, which has had a negative effect on the experiences of this population. When the indirect and ambiguous physiological evidence is dissected, it is only transgender female individuals who are perceived to potentially have an advantage as a result of androgenic hormones. Within the literature, it has been questioned as to whether androgenic hormones should be the only marker of athletic advantage or, indeed, if they are even a useful marker of athletic advantage. Given the established mental and physical health benefits of engaging in physical activity and sport [ 13 , 14 ], the barriers transgender people experience are a significant limitation to the promotion of healthy behaviours in transgender individuals. There are several areas of future research required to significantly improve our knowledge of transgender people’s experiences in sport, inform the development of more inclusive sport policies, and most importantly, enhance the lives of transgender people, both physically and psychosocially.

Acknowledgments

We sincerely thank Prof. Barrie Houlihan for his helpful advice and feedback on an early draft of this systematic review.

Compliance with Ethical Standards

Bethany Jones was supported by a PhD studentship co-funded by Leicestershire Partnership NHS Trust and Loughborough University. No other sources of funding were used to assist in the preparation of this article.

Bethany Jones, Jon Arcelus, Walter Bouman and Emma Haycraft declare that they have no conflicts of interest relevant to the content of this review.

clock This article was published more than 2 years ago

The fight for the future of transgender athletes

A group of influential women’s sports advocates say their proposals are about fairness. but lgbt activists say their plans would endanger transgender rights — and transgender lives..

The women timed their announcement carefully, holding it the day before National Girls and Women in Sports Day, created three decades ago to promote female athletes.

Among them were trailblazers: Donna de Varona, the Olympic swimmer who lobbied for Title IX’s passage in 1972; Donna Lopiano, the former chief executive of the Women’s Sports Foundation; and Nancy Hogshead-Makar, Olympic swimmer and law professor who wrote a book on Title IX.

Before that day in early February, they were universally respected as pioneers in the long fight for women’s equality in sports. Then they unveiled their project: changing the way transgender girls and women participate in women’s sports. Almost immediately, their proposal drew bitter criticism in the fraught debate over transgender rights.

For starters, they said, they planned to lobby for federal legislation requiring transgender girls and women, in high school sports and above, to suppress testosterone for at least one year before competing against other girls and women, making universal a policy already in place in some states and some higher levels of sports. For transgender girls in high school who do not suppress testosterone, they suggested “accommodations,” such as separate races, podiums or teams.

They called themselves the Women’s Sports Policy Working Group .

“To give girls and women an equal opportunity to participate in sports, they need their own team. Why? Because of the biological differences between males and females,” said Hogshead-Makar, CEO of Champion Women, a women’s sports advocacy organization.

They portrayed their proposals as a science-based compromise between two extremes: right-wing politicians seeking wholesale bans of transgender athletes and transgender activists who argue for full inclusion — and who even dispute what some view as settled science about the relationship between testosterone and athleticism. They quickly drew fierce backlash, illustrating how the issue of transgender athletes has become the most vexing, emotionally charged debate in global sports and why it may prove impossible for schools and sports organizations to craft policies that are both fair to all female athletes and fully inclusive of transgender girls and women.

Transgender and women’s equality activists denounced their proposals as transphobic and accused the women of having a myopic focus on sports at a critical time for the transgender equality movement — as the Biden administration fights to expand federal anti-discrimination protections for transgender people and as conservative lawmakers push bills in more than 20 states seeking to ban transgender athletes and criminalize gender-affirming hormone therapy for transgender youth.

Critics also pointed to members of the working group with reputations of engaging in anti-trans rhetoric, including Martina Navratilova, the tennis champion whose commentary on transgender athletes has stoked outrage, and a Duke law professor whose work calling transgender girls and women “biological males” is cited in anti-transgender legislation.

Inside the world of sports — where careers are built on split-second wins and governed by rules that measure testosterone by the nanomole — these women’s proposals have gained some surprising voices of support. They have drawn endorsements from the first openly transgender Division I cross-country runner in NCAA history as well as a leading transgender scientist researching the effects of hormone therapy on athleticism. With enduring credibility in the sports world and on Capitol Hill, they have begun meeting with state and federal lawmakers grappling with this issue.

But even advocates who view their proposed policies as sensible for collegiate and professional athletes wonder whether these women have truly grappled with the impact their policies would have on the lives of hundreds, perhaps thousands of transgender girls across the country.

“The folks who are pushing these anti-trans bills … they don’t believe transgender people exist. They think they’re faking it for an advantage in sports,” said Cathryn Oakley, state legislative director at the Human Rights Campaign. “I don’t know how you find a middle ground between a hate group and people pushing for equality.”

A patchwork of policies

Before 2010, few college or high school athletic associations had policies on transgender athletes, according to a report published that year by the Women’s Sports Foundation and the National Center for Lesbian Rights.

Noting that “an increasing number of high school and college-aged young people are identifying as transgender,” the report proposed a set of policies: In college sports, transgender women should undergo one year of hormone therapy before competing against other women, a rule rooted in scientific research that suggested such an approach would mitigate any athletic benefits. The NCAA quickly adopted the policy.

For high schools, the report recommended letting transgender girls compete in sports as soon as they transition socially and begin dressing and acting in accordance with their gender identity. Requiring hormone therapy for adolescents is potentially harmful, experts said in interviews, because not all transgender teens have supportive families or access to gender clinics. Ones who do may not want to undergo hormone therapy, which for transgender girls typically involves puberty blockers that pause developmental changes followed by a combination of testosterone suppressors and estrogen.

According to information compiled by transathlete.com and the ACLU , 10 states let transgender girls compete in high school sports after undergoing some treatment. Twelve states prohibit them entirely, including four that passed new laws and executive orders this year. Nine states have no policies at all. And 19 states, as well as the District of Columbia, let them compete regardless of testosterone level.

For the past decade, this policy patchwork has developed largely without controversy. Transgender youth are a very small minority of the U.S. population — 1.8 percent of high school students, according to a 2019 CDC report — and the number of those transgender girls likely to play sports and compete at an elite level is even smaller.

But then, a few years ago, a transgender runner took the Connecticut track scene by storm, catching the attention of politicians, pundits and advocates — including Lopiano, a Connecticut resident and Title IX champion.

Running on the boys’ team as a ninth-grader in suburban Hartford, Terry Miller was an average track athlete, online records show, failing to qualify for any postseason events. But in 2018, Miller came out as a transgender girl. In her first season running against other girls, as a sophomore, Miller dominated. She won five state championships and two titles at the New England championships, beating the fastest girls from six states.

The next fall, as a junior, Miller won another four state titles and two more all-New England titles. In several races, she was followed closely by Andraya Yearwood, another transgender girl who had also won three state titles.

In interviews, Miller and her supporters discussed how important track was for her confidence and stability as she transitioned.

“Track helps me forget about everything, and I love it,” Miller said in a 2019 story on DyeStat, a website that covers high school track and field. (Miller and her parents declined an interview request for this story.)

Support for Miller, however, was not unanimous. Girls who lost to her and their coaches complained that she had an unfair advantage. Parents of other girls started online petitions demanding state high school officials add a testosterone suppression requirement for transgender girls.

I’m not saying transgender girls are going to take over women’s sports. I’m saying that the law protects girls and women, and they shouldn’t have to compete against someone who has an immutable testosterone-based advantage. — Donna Lopiano, Title IX advocate

A lawyer representing a few mothers contacted Lopiano and asked for help. Believing Connecticut’s policy violated Title IX, Lopiano met with state officials and attempted to broker a compromise that would allow the results of transgender runners not to affect the results of cisgender girls.

Title IX doesn’t define what it means to be a girl or a woman. But Lopiano argues Congress intended to restrict female sports to girls and women who haven’t gone through male puberty, when testosterone in boys surges to between four and 10 times the levels found in girls and women.

She points to the 1975 testimony of Bernice Sandler, an activist known as “the godmother of Title IX,” who told Congress that, because of physical advantages men acquire during puberty, any effort to integrate sports between the sexes “would effectively eliminate opportunities for women.”

“I’m not saying transgender girls are going to take over women’s sports,” Lopiano said. “I’m saying that the law protects girls and women and they shouldn’t have to compete against someone who has an immutable testosterone-based advantage.”

Lopiano’s compromise never materialized. The mothers decided instead to work with the Alliance Defending Freedom, an Arizona-based conservative Christian advocacy organization that supports anti-trans lawsuits and legislation across the country. The Alliance helped three girls who lost races to Miller and Yearwood sue Connecticut high school authorities, arguing their policy on transgender athletes violated Title IX. The case is pending in U.S. District Court in Connecticut.

The ACLU has intervened on behalf of the transgender runners. In an interview, Chase Strangio, deputy director for transgender justice at the ACLU, said courts already have found Title IX protections apply to transgender girls and women in cases involving access to women’s restrooms. He views restrictions on transgender athletes in high school, such as hormone requirements, as discriminatory and probably a violation of the law.

Miller did not begin suppressing testosterone until her junior year, Strangio acknowledged, but Yearwood was on hormone therapy throughout high school. Regardless, Strangio emphasized that his clients didn’t win every race they competed in and they quit the sport after high school.

“Their careers were sabotaged by the rhetoric and the attacks on them,” Strangio said.

In early 2019, Lopiano began meeting regularly with de Varona and Hogshead-Makar to discuss what they believe are looming collisions between the transgender equality movement and Title IX. To them, the Connecticut controversy illustrated what they view as the two extreme positions between which they are trying to navigate.

The Alliance Defending Freedom argues that transgender girls and women always have physiological advantages in sports, even if they have suppressed testosterone. Their advocacy has inspired a wave of legislation across the country targeting transgender athletes since 2019.

“You can’t change a person’s biological sex,” said Christiana Holcomb, an Alliance lawyer working on the Connecticut case. “Nothing can undo the physiological advantages that come from being born biologically male.”

Strangio and the ACLU dispute whether transgender girls and women have advantages in sports, even if they’re not suppressing testosterone. Other prominent transgender activists, making this same argument, have called for the NCAA to remove its testosterone suppression requirement.

“The truth is, transgender women and girls have been competing in sports at all levels for years, and there is no research supporting the claim that they maintain a competitive advantage,” a 2019 ACLU article noted.

“Athleticism is complex,” Strangio said. Referring to Lopiano and her colleagues, he added, “I’m not a scientist, and neither are any of them.”

A growing research field

Benjamin Levine, a professor of cardiology at the University of Texas Southwestern Medical Center, is one of the world’s leading experts on the science of athletic performance. The founder and director of the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, one of the largest institutes of its kind in the world, Levine has published hundreds of peer-reviewed papers and consulted for the NCAA, the NFL, World Athletics and NASA.

In an interview, Levine said he understands why this topic stirs intense emotions. But, he said, there is no debate over whether post-pubescent transgender teenage girls and women have advantages in sports until they suppress testosterone.

Regardless of gender identity, Levine said, people who go through puberty with male levels of testosterone, on average, will grow taller and stronger than cisgender girls and women, with more muscle mass, larger hearts and advantages in several other physiological factors that affect athleticism. Puberty in boys typically begins by 12 and ends by 18.

“This is why, for every single record that you see in athletic competitions, boys and girls before puberty are about the same, and then everything diverges afterward,” said Levine, whose scientific research is cited by the women’s policy group.

Transgender advocates dismiss Levine’s research as irrelevant because he studies cisgender athletes. But several small-scale studies have found transgender women do have physiological advantages until they suppress their testosterone for at least one year.

The first was published in 2004 by Louis Gooren , a Dutch endocrinologist and founder of the Center of Expertise on Gender Dysphoria in Amsterdam, one of the largest transgender health clinics in the world. “Testosterone exposure has profound effects on muscle mass and strength,” wrote Gooren, who reported that as he gave more testosterone to 19 transgender men, they saw marked increases in muscle growth, as well as hemoglobin and insulinlike growth factor levels, both relevant in athletic performance. As he suppressed testosterone in 17 transgender women, the opposite occurred: Their muscles shrank, and their hemoglobin and IGF levels dropped.

Gooren’s findings were essentially replicated in November by a study published in the British Journal of Sports Medicine examining how 29 transgender men and 46 transgender women in the Air Force performed on routine fitness tests — push-ups, sit-ups and a 1½-mile run — as they transitioned hormonally.

After a year of treatment, transgender men were performing better and the transgender women worse. The transgender women were still running slightly faster than cisgender women, however, so the authors concluded elite sports organizations might need to lengthen testosterone suppression requirements beyond one year. In interviews, two of the study’s authors cautioned against drawing conclusions about high school athletes because their research subjects were all 18 or older.

Other recent research has been conducted by a transgender athlete herself: Joanna Harper, a medical physicist and runner. In 2015, Harper published an analysis of what happened to her and seven other transgender women runners as they transitioned hormonally. Seven of the eight women, including Harper, saw their times slow considerably.

After that, Harper left her job in Portland, Ore., and moved to England to research the effects of hormone treatment on transgender athletes at Loughborough University.

In February, she published a systematic review of 24 studies of the effects of hormone treatment on transgender women. Harper found some athletic benefits — such as higher hemoglobin levels, vital in endurance sports — dissipated after only four months of suppressing testosterone. But other advantages, such as increased muscle area and strength, remained even after 36 months.

Harper has consulted for the International Olympic Committee, World Athletics and other elite sports organizations, where she advocates for allowing transgender girls and women to compete after one year of hormone therapy. She also has signed on as a public supporter of the women’s policy group.

In a recent interview, Harper said she has been called both “the destroyer of women’s sport” and “a traitor to transgender people.”

“My agenda is to pull people toward the middle,” Harper said. “The science leads me there.”

My agenda is to pull people toward the middle. The science leads me there. — Joanna Harper, transgender athlete and researcher

When asked for experts to support his belief that it’s unclear whether transgender girls and women have competitive advantages in sports, the ACLU’s Strangio mentioned two people: Katrina Karkazis and Joshua Safer.

Karkazis is a cultural anthropologist and bioethicist. She has not conducted original research on testosterone and athleticism, but she has written extensively on the subject, including the book, “Testosterone: An Unauthorized Biography.”

In an interview, Karkazis emphasized many complexities in scientific research of testosterone and athleticism — testosterone alone doesn’t build a better athlete, researchers have found — but did not dispute that transgender girls and women who do not suppress testosterone have advantages in sports.

“Yes, on average … there will be performance differences that will be better,” she said when pressed on this point. “Whether that’s an advantage or not … I actually think that’s a normative statement that involves a value judgment about what is advantaged.”

Safer is an endocrinologist and the director of a transgender health clinic who has served as an expert witness for the ACLU. In court filings, Safer has acknowledged transgender girls and women with higher levels of testosterone will have advantages in sports. But, he has noted, these advantages are less pronounced in high school.

“Testosterone begins to affect athletic performance at the start of puberty, and those effects increase each year until about age 18,” Safer wrote in a statement challenging a law barring transgender athletes in Idaho. “As a result, testosterone provides less of an impact for a 14-, 15- or 16-year-old than it does for a 17- or 18-year-old.”

In an interview, Safer emphasized that, despite the advantages conferred by testosterone, the list of known examples of transgender girls and women succeeding in sports, at any level, is vanishingly short.

There has never been an openly transgender athlete in the Olympics ; the first three, all women, could compete this summer in Tokyo. There has been one openly transgender woman champion in the history of NCAA: CeCe Telfer, a Franklin Pierce University runner who won the Division II 400-meter hurdles in 2019. On the high school level, there are just Miller and Yearwood in Connecticut.

Said Safer, “The important thing to consider here, as it relates to high school sports and teenagers, is are we addressing a problem that actually exists, or are we simply addressing a fear?”

‘Sports does discriminate’

At their opening news conference, Lopiano spoke first and stressed that the group’s proposals represented “respectful inclusion” of transgender athletes.

“These are our kids. And we have to take care of all of them,” she said.

A few minutes later, the women turned the news conference over to one of their lesser-known colleagues: Doriane Lambelet Coleman, a Duke law professor and former elite runner who, in the late 1970s, was one of the first women to receive a track scholarship to Villanova University.

Over the past few years, Coleman has published law review articles and essays defending the preservation of girls’ and women’s sports for athletes with female levels of testosterone.

“I’ve tried to make clear that I support a science-based approach to inclusion, not categorical exclusion,” she said.

But as the debate moves beyond sports and into mainstream politics, more people have begun to see “science-based inclusion” as a form of exclusion. Which is why, to her dismay, her writings are routinely cited by right-wing politicians promoting wholesale bans of transgender athletes. It’s also why some transgender advocates say her and her colleague’s proposals are not only unfair but dangerous.

Research shows that transgender youth struggle with alarmingly high rates of anxiety, depression and suicidality. Emerging research has suggested affirmative transgender care — letting children transition socially for a period of time and then, if prescribed, start hormone therapy — can significantly reduce those mental health problems. A key to affirmative care, experts said, is to avoid situations where a transgender child is treated in any way that invalidates their gender identity.

When briefed on the women’s policy group’s proposals, several experts sharply criticized the idea of transgender-specific sports teams or events as stigmatizing.

“They have to go through so many obstacles just to recognize they are transgender, and for a lot of them, sports is the turning point. … You’d just end up exiling transgender girls from sports,” said Helen Carroll, former director of the Sports Project of the National Center for Lesbian Rights, who co-wrote the NCAA’s policy on transgender athletes.

And even if they do have physiological advantages, some experts argued, transgender teens face a minefield of challenges, including higher rates of bullying, rejection by their families and homelessness.

“The deck is stacked against them in every single way, so, to me, it seems silly to … look at this physiological advantage but not consider all the other substantial disadvantages these kids face,” said Jack Turban, fellow in child and adolescent psychiatry at Stanford University School of Medicine.

De Varona and her peers conceded that their concerns about high school sports are mostly hypothetical. As the legal and social climate for transgender people improves, they believe, more situations similar to what happened in Connecticut may arise.

But when asked to describe the harms that occurred to the girls who lost to the transgender athletes in Connecticut, they struggled to come up with anything concrete. Neither Miller nor Yearwood, the transgender girls, received track scholarships to college, and the women concede they are unaware of any cisgender girls who missed out on a scholarship opportunity as a result of Miller’s and Yearwood’s success.

There was other harm, the women argued, pointing to dozens of girls who lost races or opportunities to advance to postseason meets because they finished behind the transgender girls. Research has shown, they emphasized, that when girls succeed in sports, they’re more likely to go to college and have successful careers.

“Everybody here … has worked their entire lives to make sure that girls and women have equal opportunities in competitive sports,” Hogshead-Makar said.

And in those moments, these women tacitly conceded that, despite their talk of inclusion, they view transgender girls and women as different from the girls and women to whom they have devoted their careers — at least when they’re on the playing field.

“Yes, it’s important for everyone to have that opportunity in athletics,” de Varona said. “But sports does discriminate.”

From the field to the courts

The IOC is revising its guidelines on transgender athletes and is expected to announce them after this summer’s Tokyo Games. The NCAA also is examining its guidelines after hearing concerns from transgender advocates last fall.

The battle over transgender athletes in America’s high schools is likely to be settled, at least in part, in the courts. The ACLU is challenging an Idaho law that banned transgender athletes from competing in any public school, including colleges. The Connecticut lawsuit challenging that state’s policy also must be resolved.

Since its February news conference, the women’s policy group has had conversations with several members of the House and Senate, on both Judiciary Committees, according to Coleman, but they declined to specify whom or how many.

They also acquired a prominent supporter: Juniper Eastwood, one of the first openly transgender women to compete in NCAA Division I sports and the first cross-country runner.

There’s no way it would have been fair. My testosterone levels were so much higher than any of the girls I would’ve been running against. — Juniper Eastwood, the first openly transgender cross-country athlete in NCAA Division I history

In an interview, Eastwood said she never would have competed against girls or women without suppressing her testosterone. In high school, she set a Montana state record in the 800 meters that, had she been running on the girls’ team, would have broken the women’s world record.

“There’s no way it would have been fair,” she said. “My testosterone levels were so much higher than any of the girls I would’ve been running against.”

A closer examination of Eastwood’s personal story, however, spotlights the ramifications of policies that would separate transgender youth from sports.

Eastwood always planned to transition after she finished her track career because she knew she would attract unwanted attention as a transgender runner. But in her sophomore year at the University of Montana, Eastwood got hurt and had to sit out the season. Running had always been her way of coping with gender dysphoria. Without it, Eastwood began drinking excessively and struggled with depression.

Eastwood decided to transition and then continue running track on the women’s team. As she had expected, she got considerably slower as she suppressed her testosterone. And, as she had dreaded, her performances were closely analyzed by right-wing news sites, track and field obsessives and transgender activists.

Eastwood’s senior track season ended abruptly because of the coronavirus . She’s in graduate school at Montana, studying environmental philosophy, and would like to work somewhere outdoors. Even though she feels a little out of shape lately, Eastwood said, she enjoys running now more than she ever did in high school or college.

She lives not far from several secluded trails where she can run for miles without seeing another person. When she runs now, she said, she feels free from the worry about what someone will write online the next day about her performance.

“It’s just me, the trails and no one else,” Eastwood said. “And I can just run.”

Correction: An earlier version of this article described Juniper Eastwood as the first openly transgender athlete in NCAA Division I sports history. Eastwood is o ne of the first openly transgender women to compete in Division I sports and the first to run cross-country. The story has been corrected.

I’m Transgender. Here’s How Playing Sports Saved My Life

By Shane Diamond

Image may contain Face Human Person Glasses Accessories Accessory Photo Photography and Portrait

It would not be an exaggeration to say that sports saved my life.

I grew up in a small town in the American Southwest known as an offbeat refuge for artists and skiers. Locally, the area had a reputation for heroin overdoses, drunk driving fatalities, and high school drop-outs. But after school and on the weekends, my friends and I all played youth sports like soccer and basketball together. Athletics kept us occupied, supervised, and generally out of trouble. We also learned lifelong lessons about accountability, hard work, and time management.

When soccer season ended and the boys started playing ice hockey, I was one of the only girls who was eager to join them; I wanted to do what my friends did. Throughout my youth and into high school, I was often the only girl on the ice, and one of only a handful statewide, but I was welcomed and accepted by both my team and the league. Looking back, it makes sense that I was “one of the boys” because I was a boy, but we didn’t have language or resources to support transgender youth in the early ’90s the way we do today.

After high school, I played varsity women’s ice hockey at Bowdoin College in Maine. I can’t tell you what our record was during my four years of playing college hockey, which team won the league championship, or how many goals I scored, but I can say with absolute assurance that my hockey teammates are still some of my best friends. And that didn’t change after I came out as transgender in 2016 and started transitioning.

We’ve supported each other during marriage and divorce, while caring for ill parents and starting families, and through experiences of racism and discrimination. During the pandemic, we have remained connected online and debated whether or not we’re going to wear pants with elastic waists forever. We share a bond that can only be forged through long hours at the rink and grueling lifting schedules at the gym. We all remember the collective joy of celebrating a win and the shared grief after a loss.

As a kid who didn’t quite fit in, I always found safety and stability among my teammates. When the weight of the outside world felt like it was too heavy for a teenager struggling with identity, I knew that for an hour each day, I could leave it all outside the rink and just play hockey. Then in my 30s, while fighting for sobriety and battling depression, outreach from my college teammates saved my life: They made overt gestures, like flying to Maine when I was approaching rock bottom just so we could lie in a hotel bed, eat Thai food, and watch trashy reality TV. They messaged me on the daily group text where we offer support and accountability.

Only a person who has spent years working out with you can call you up and say, “I love you but you’re being an idiot,” with the sort of bluntness that you know comes from a place of love.

I’m not alone in my experiences. For transgender youth, having access to sports is quite literally life-saving; according to a study recently published by the Center for American Progress, the mere existence of transgender-insluive sports policies lowers the risk of poor mental health and suicidality for trans youth. Even if trans youth don’t participate in sports, the fact that they are able to reduces their risk of depression and attempted suicide. As a community, we need the mental health benefits that sport can offer. The largest survey of transgender people, the 2015 U.S. Transgender Survey conducted by the National Center for Transgender Equality, reports that transgender people are nine times more likely to attempt suicide over our lifetime than our cisgender peers. And almost 75% of transgender people who attempt suicide are under the age of 18. Even without harmful and invasive laws, it is dangerous to be a young trans person .

But lawmakers in 31 states are preying on this already vulnerable population by trying to pass laws to ban trans kids from playing sports . Politicians are targeting young children who are already coping with trauma after a year of wearing masks and only seeing their classmates on Zoom. They are going after teenagers who, like each of us, miss spending time with their friends without being afraid for the future. They are harming college students who are preparing to enter an economy grappling with unemployment and low wages.

It’s important to note that the majority of these attacks are not coming from cisgender athletes. They overwhelmingly welcome their transgender teammates. Earlier this month, over 550 current student athletes from over 85 U.S. colleges and universities recently — and for the second time — sent a letter to the NCAA in support of transgender student athletes. They know that trans athletes just want to be included. I played hockey as a kid because that’s what my friends were doing and I didn’t want to be left out. These laws and policies don’t just leave out trans kids, they intentionally exclude us.

Transgender athletes are not a new trend: the NCAA has allowed transgender athletes to participate since 2011 and the International Olympic Committee since 2004. But trans kids are still facing pushback. In 2018, transgender Texas wrestler Mack Beggs was forced to compete against girls despite wishing he could wrestle with other boys. The story of his fight to participate and show up as himself, along with the stories of Connecticut runner Andraya Yearwood and New Hampshire skier Sarah Huckman, are featured in the documentary film Changing the Game , for which I am the Impact Change Coordinator. Their stories are powerful examples of what happens when we let kids be themselves, participate fully as students, athletes, friends, and family members. Trans athletes aren’t asking for special treatment, nor do we want to be stigmatized for our transness. We simply want the opportunity to play.

Canadian cyclist Rachel McKinnon prepares her bike before competing.

Because of the wave of anti-transgender legislation sweeping the country, trans youth are hearing consistently false and harmful messages about themselves: that our inherent identities are deceptive and unfair, that there’s not enough room for us, that we don’t belong. But I am living proof that there is no better lifeline for trans kids than ensuring they are able to play sports with their peers. We owe it to kids, transgender and cisgender alike, to make sure they have the same opportunities to participate in, fall in love with, and be saved by sports the way so many of us have.

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Call your local schools’ athletic directors and demand that athletic policies allow trans youth to participate as themselves, contact legislators in these 31 states — many of whom have never met a trans person — and tell them why this matters to you and your family. Every young person deserves the chance to learn and grow through the transformative power of sports. Many of these bills and laws will likely make their way to the Supreme Court and hopefully be ruled unconstitutional, but the damage being caused to trans kids in the process will have lasting effects.

When I say that I don’t know where I’d be without sports, I mean it quite literally; without the support networks that have lasted well beyond my time on the ice, I would likely have joined too many of my transgender siblings who felt isolated and excluded enough to end their lives. Trans youth need our support now, loud and proud and in unison, before it’s too late to fight for them.

Shane Diamond is a media and communications maverick. Previously the communications manager at TLDEF, he is now the impact campaign coordinator for the film Changing the Game, a transgender advocate, and former college athlete.

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Transgender athletes are having a moment. At all levels of sport, they’re stepping onto the podium and into the headlines. New Zealand weightlifter Laurel Hubbard won two gold medals at the Pacific Games, and college senior CeCé Telfer became the NCAA Division II national champion in the 400-meter run. Another senior, June Eastwood, has been instrumental to her cross-country team’s success . At the high school level, Terry Miller won the girls’ 200-meter dash at Connecticut’s state open championship track meet .

These recent performances are inherently praiseworthy—shining examples of what humans can accomplish with training and effort. But as more transgender athletes rise to the top of their fields, some vocal opponents are also expressing outrage at what they see as transgender athletes ruining sports for cisgendered girls and women.

These issues have come to a head in Connecticut, where a conservative Christian group called Alliance Defending Freedom has filed a legal complaint on behalf of three high school athletes who are seeking to bar transgender girls from competing in the girls category. In Connecticut, as in more than a dozen other states, high school athletes are allowed to compete in the category that matches their gender identity. According to ADF legal counsel Christiana Holcomb, two transgender athletes—Miller and another runner, Andraya Yearwood—“have amassed 15 different state championship titles that were once held by nine different girls across the state.” The US Department of Education’s office for civil rights is now investigating the group’s complaint.

Nowhere are the debates around transgender rights as stark as they are in sports, where the temptation to draw a hard biological line has run up against the limits of what science can offer . The outcome, at least so far, is an inconsistent mix of rules that leaves almost nothing resolved.

In the NCAA, for example, transgender women can compete on women’s teams after they’ve completed one year of testosterone suppression treatment. But the organization doesn’t place limits on what a transgender athlete’s testosterone levels can be. The International Olympic Committee has more granular rules: Transgender women can compete in the women’s category as long as their blood testosterone levels have been maintained below 10 nano moles per liter for a minimum of 12 months. Cisgender men typically have testosterone levels of 7.7 to 29.4 nano moles per liter , while premenopausal cis women are generally 1.7 nmol/L or less. Meanwhile, the governing body of track and field just adopted a 5nmol/L limit .

So which approach is most fair? “Fair is a very subjective word,” says Joanna Harper, a transgender woman, distance runner, and researcher who served on the IOC committee that developed that organization’s current rules. It boils down to whom you’re trying to be fair to, Harper says. “To billions of typical women who cannot compete with men at high levels of sport?” Or “a very repressed minority in transgender people who only want to enjoy the same things that everybody else does, including participation in sports?”

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Transgender women’s performances generally decline as their testosterone does. But not every male advantage dissipates when testosterone drops. Some advantages, such as their bigger bone structure, greater lung capacity, and larger heart size remain, says Alison Heather, a physiologist at the University of Otago in New Zealand. Testosterone also promotes muscle memory—an ability to regain muscle mass after a period of detraining—by increasing the number of nuclei in muscles, and these added nuclei don’t go away. So transgender women have a heightened ability to build strength even after they transition , Heather says.

One way to address these issues, Heather and her colleagues wrote in an essay published in the Journal of Medical Ethics , would be to create a handicap system that uses an algorithm to account for physiological parameters such as testosterone, hemoglobin levels, height, and endurance capacity, as well as social factors like gender identity and socioeconomic status. “Such an algorithm would be analogous to the divisions in the Paralympics, and may also include paralympians,” they write. Instead of two divisions, male and female, there would be multiple ones and “athletes would be placed into a division which best mitigates unfair physical and social parameters.” The algorithm would need to be sport-specific, and Heather and her colleagues acknowledge that producing it would be a difficult task.

Another approach would be to create a third category for people who don’t fit neatly into the male/female dichotomy (including intersex people, who are born with a mix of male and female traits). Although this might sound like a simple solution, Harper says that “As a transgender person myself, I don’t want to compete in a third category, which many people would see as a freak category.” It could also limit opportunities for transgender athletes if there are not enough of them to fill out a team or category.

For all the hand-wringing about transgender women ruining women’s sport, so far there’s little evidence of that happening. Although CeCé Telfer and June Eastwood garnered attention for their outstanding performances on women’s collegiate running teams, they are hardly the only transgender athletes in the NCAA. Helen Carroll is a LGBTQ sports advocate who worked on the NCAA transgender handbook . Through her advocacy work, she has interacted extensively with transgender athletes and she estimates there are somewhere in the neighborhood of 150 to 200 transgender athletes currently competing in NCAA sports. Most of them “you don’t hear a thing about,” she says, because their participation hasn’t caused controversy.

Sport can be a life-saver for transgender people, who are at high risk of suicide , Carroll says. “They’ve been fighting themselves and feeling like they were in the wrong body, and sport gives them a place to be happy about their body and what it can do.”

Where to draw the line between inclusiveness for transgender athletes and fairness for cis ones is an ethical question that ultimately requires value judgements that can only be informed, not decided, by science. Even basic notions of a level playing field aren’t easy to codify. Which means that at some point the question of who is a woman becomes a cultural inquiry: How athletically outstanding can a girl or woman be before we no longer see her as female?

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Striking a balance between fairness in competition and the rights of transgender athletes

Professor of Ethics, Strategy, and Public Policy, University of New Orleans

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Chris W. Surprenant does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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In a majority of U.S. states , bills aiming to restrict who can compete in women’s sports at public institutions have either been signed into law or are working their way through state legislatures.

Caught up in this political point-scoring are real people – both trans athletes who want to participate in competitive sports and those competing against them.

As a professor of ethics and public policy , I spend much of my time thinking about the role of the law in protecting the rights of individuals, especially when the rights of some people appear to conflict with the rights of others.

How to accommodate transgender athletes in competitive sports – or whether they should be accommodated at all – has become one of these conflicts.

On one side are transgender athletes who want to compete in the gender division with which they identify. On the other are political activists and athletes – especially biologically female athletes – who believe that allowing trans athletes to compete in women’s divisions is inherently unfair .

So why is this issue so fraught? What’s so special about women’s sports? Why do women’s divisions even exist? And is it possible to protect women’s sports while still finding a way to allow transgender athletes to compete in a meaningful way?

Winners elicit outcry

Let’s be clear: Few Americans would care about how to best accommodate transgender athletes if they were not winning events.

But that’s exactly what has happened. In 2017 and 2018, Terry Miller, a trans woman, won the Connecticut women’s high school track championships in the 55-meter, 100-meter, 200-meter and 300-meter events. Her closest and only real competitor those two years was Andraya Yearwood , who is also a trans woman.

In 2017 and 2018, Mack Beggs, a trans man, dominated the Texas 6A 110-pound girls wrestling division, capturing two state championships while compiling a record of 89 wins and 0 losses. Unlike in Connecticut, where athletes may compete as they identify , athletes in Texas must compete in the gender listed on their birth certificate .

While Miller, Yearwood, Beggs and others have triumphed in their respective sports, the number of transgender high school athletes is very low . Nor is there any evidence that athletes have transitioned for the purpose of gaining a competitive advantage.

Four sprinters run at an indoor track meet.

Yet some legislators have latched onto these examples, using them as a basis for bills that ban all transgender teens from participating in gendered divisions that differ from their birth sex. But these bills don’t solve the competitive imbalances that can occur with athletes like Beggs. Worse, they might prevent transgender teens from competing altogether.

Sports matter – with meaningful participation

Since studies have shown that kids who participate meaningfully in athletics have better mental and physical health than their peers who don’t – and teens who identify as transgender are at a significantly greater mental health risk than their peers – it’s a worthy goal to try to accommodate their desire to compete.

The phrase “participate meaningfully” is important. Someone who, for example, is nominally on a team but does not take the sport seriously does not participate meaningfully in competitive sports. Similarly, someone who takes a sport seriously but easily dominates all competition also does not participate meaningfully in competition.

Youth sports organizations exist because we don’t believe kids should compete against adults, and kids are further separated by age because age, for children, is a reasonably good proxy for skill and ability. Organizations like the Special Olympics and Paralympics exist to provide opportunities for people with physical and mental disabilities to participate meaningfully and compete against people with similar skill sets.

Male and female athletes are separated for the same reason.

[ The Conversation’s science, health and technology editors pick their favorite stories. Weekly on Wednesdays .]

The rise of women’s sports

In 1972, the U.S. Congress extended Title IX of the Educational Amendments to the 1964 Civil Rights Act to prohibit discrimination in all federally funded education programs, including their associated athletics programs .

Title IX’s impact on athletics for women and girls – and, as a result, U.S. culture – has been nothing short of dramatic . In 1970, fewer than 5% of U.S. girls participated in high school sports. Now 43% of high school girls participate in competitive sports.

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Separating athletes by biological sex is necessary because the gap between the best male and female athletes – at all levels – is dramatic.

Serena Williams is not only one of the best female tennis players in history, she’s one of the best female athletes in history. In 1998, both Serena and her sister Venus famously claimed that no male ranked outside of the ATP Top 200 could beat them. Karsten Braasch, the 203rd-ranked player ATP player at the time, challenged each to a set. Braasch beat Serena 6-1 and Venus 6-2.

“I didn’t know it would be that difficult,” Serena said after the match . “I played shots that would have been winners on the women’s circuit, and he got to them very easily.”

At the 2019 New Balance Nationals Outdoor, the national track championship for U.S. high school students, Joseph Fahnbulleh of Minnesota won the men’s 100-meter with a time of 10.35 seconds . That same year, Olympic Gold Medal winner Shelly-Ann Fraser-Pryce ran the fastest 100-meter time of any female in the world – 10.71 seconds . Her time would have tied for 19th at that U.S. boys high school event.

One more example that’s a bit different: In 2012, Keeling Pilaro , a 4-foot-8, 80-pound seventh grade boy, petitioned the New York State Public High School Athletic Association to play field hockey on his school’s all-female team. It approved his petition.

As a seventh grader, Pilaro made the school’s JV team. As an eighth grader, he made the varsity team. But players and coaches from other schools argued he had a significant advantage because he was a boy. During the summer before his ninth grade year, the league agreed. It ruled Pilaro could no longer participate because his “advanced field hockey skills” had “adversely affected the opportunities of females.”

I point to these examples because, put together, they show that no fitness regimen, no amount of practice, and no reallocation of financial resources could allow the best female athletes at any level to compete against the best male athletes at that same level.

This advantage isn’t simply a difference in degree – it’s not just that male athletes are bigger, faster and stronger – but it’s a difference in kind. Pound for pound, male bodies are more athletic .

Evaluating trans athletes on a case-by-case basis

So, how can we allow trans athletes to compete without giving them an unfair advantage over their competitors?

One proposed solution, as if taken from the pages of novelist Kurt Vonnegut’s “ Harrison Bergeron ,” is testosterone-based handicapping for events . Competitors would have their testosterone levels measured and then algorithms would determine their advantage. Then, competitors would be fitted with weighted clothes, compete on a different track or otherwise receive an appropriate handicap before competing.

But having a higher level of testosterone does not automatically make you a better athlete . Beyond this, while handicapping may be fine for a golf outing with friends, it isn’t appropriate for serious athletic contests. The point of athletic competitions is to determine who is actually the best, not who is the best relative to handicaps.

Another proposed solution entails replacing gender divisions entirely with ability-level divisions . Yet this could hinder women’s participation in sports. In a world with no female-only divisions, Serena Williams would still win some tennis tournaments, but they likely wouldn’t be tournaments you’ve heard of.

Serena and Venus Williams laugh on the tennis court.

So what’s the most viable solution to this debate?

Since there is no typical transgender athlete, broad rules for transgender athletes don’t seem appropriate.

Instead, language similar to the Equal Employment Opportunity Commission’s disability accommodation policy could be used for transgender athletes: “ The decision as to the appropriate accommodation must be based on the particular facts of each case .”

“Men’s” divisions could be eliminated and replaced with “open” divisions. Any athlete could be allowed to compete in that division.

Then, transgender athletes could be evaluated on a case-by-case basis. Based on their athletic ability, a tournament organizer could determine which division is most fair for them to compete in, “women’s” or “open.”

For trans women athletes, at issue is their athletic ability, not their womanhood. If a tournament organizer determines that a trans woman athlete is too good to compete against other women because of her biological advantage, requiring her to compete in an “open” division does not undermine her humanity.

Instead, this acknowledges – and takes seriously – that she identifies as a woman, but that respect for the principles of fair competition requires that she not be allowed to compete in the women’s division.

While whatever decision is made is unlikely to make all competitors happy, this approach seems to be the most fair and feasible given the relatively small number of transgender athletes and the unique circumstances of each athlete.

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Opinion article, transgender athletes in sports competitions: how policy measures can be more inclusive and fairer to all.

1 Princeton University, Princeton, NJ, United States
2 Plastic and Reconstructive Surgery Department, Rush University Medical Center, Chicago, IL, United States

Introduction

Recently, there has been much debate over the inclusion of transgender athletes in elite athletic competitions. Since the transgender population in the United States and worldwide is increasing every year ( Meerwijk and Sevelius, 2017 ) and with it the transgender athletic population, it's important to establish athletic policies that are both inclusive and fair to avoid future conflicts. In this article, environmental and social barriers to transgender athlete participants as well as biological differences related to athletic performance are examined. A review of the current athletic policies and suggestions for potential policy updates are provided. We acknowledge that this is a relatively under-researched field and that there is no clear-cut solution. However, we believe this topic is important and we hope to contribute to the ongoing discussion.

Barriers to Participation

It's important to first address some of the barriers transgender athletes face to participate in sports competitions before examining the current policies behind their participation. A recent study showed that transgender men (TGM) are significantly more likely to participate in team sports than transgender women (TGW) but that this difference is not apparent for individual sports ( López-Cañada et al., 2020 ). Transgender women have previously stated that the primary barrier to their participation is the lack of an environment that is both inclusive and comfortable ( Jones et al., 2017 ), and this could contribute to their decreased participation in team sports. More specifically, TGW perceive their voices to be a contributing barrier in their lack of participation ( Stewart et al., 2020 ). Sports that are strongly gendered create an environment for these athletes that makes them feel anxious that speaking out or cheering for their teammates could result in them not being identified as women ( Stewart et al., 2020 ). Similarly, sports clothing may serve as a barrier to participation because it can be physically revealing. For example, a TGW who has not had bottom surgery might use a “tucking” technique to hide the bulge of the penis and testicles. Sports bras can relatedly impact transgender athletes: TGW might add padding to their bras and TGM might bind their chests. Any of these actions could be uncomfortable to the athlete and/or hinder performance in sports competitions. Additionally, locker rooms and other team spaces are often strongly segregated by gender and transgender athletes may be excluded from areas that match their gender identity. Restricting athletes from such areas, regardless of whether they are allowed to participate, may have the effect of causing athletes feeling separated from their teammates and their gender identity invalidated ( Cunningham et al., 2018 ).

There is certainly an additive effect of the numerous barriers to participation discussed, but one of the most important and in some cases least understood barriers is stigma. Although stigma is not a novel concept, stigma in how it impacts transgender athletes is more of a recent phenomenon. The numerous roles of stigma are often under-recognized ( Hatzenbuehler, 2017 ), and acknowledging it prior to developing new policies could help to combat some of its negative effects. Transgender stigma, in general, limits opportunities and can have extremely negative effects on mental and physical health ( Hughto et al., 2015 ). Stigma acts at numerous levels (e.g., structural, interpersonal, and individual), and adopting interventions to address and combat the negative effects of stigma at all of these levels is an important aspect of developing any new policy ( Hughto et al., 2015 ), especially when this policy aims to include transgender athletes. This is especially significant in developing sports policy that addresses youth athletes, as transgender stigma can be heightened when geared toward transgender youth and adolescence is a critical point to target interventions ( Hatzenbuehler and Pachankis, 2016 ; Hatzenbuehler, 2017 ).

To add to these social and environmental barriers, athletic policy restrictions have also contributed to a decrease in participation of the transgender individuals in competitive sports ( Jones et al., 2017 ). The lack of consensus among the various athletic governing bodies makes it even more difficult to determine the exact policies to include transgender athletes in sports competitions. Acknowledging these barriers to participation is an extra element that should be included in the adoption of new athletic policies regarding transgender athletes.

Biological Differences Related to Athletic Performance

The current debate over including transgender athletes in sports competitions (in their current state) is centered on biological differences, most notably those between transgender and cisgender women. Performance disparities based on “assigned sex at birth” vary across sports—they are known to be the lowest for swimming and highest for track and field events ( Bassett et al., 2020 ). These differences in athletic performance don't appear until after puberty and are thought to be most likely due to increased circulating testosterone levels in the “male” assigned sex at birth athletes when compared to the “female” assigned sex at birth athletes ( Handelsman et al., 2018 ). However, there is a general lack of data showing that higher testosterone levels are correlated with improved athletic performance ( Karkazis, 2019 ).

Despite the lack of evidence, hormone therapies are currently being employed by TGW to suppress their testosterone levels to those more similar to cisgender women to comply with competition regulations. Interestingly, the muscular advantage of TGW over cis-gender women is only minimally reduced after testosterone suppression ( Hilton and Lundberg, 2021 ). This suggests that in certain athletic competitions which rely on muscles mass and explosive strength, TGW will still have a physical advantage even if they are able to lower their testosterone levels to the officially requested threshold. Other hormone therapies have been successful at decreasing hemoglobin levels in TGW after only 4 months, but remain unsuccessful at decreasing strength, lean body mass, and muscle area even if undergone for 36 months ( Harper et al., 2021 ). Although only slight changes are seen in TGW after hormone therapies, this is not the case for TGM. After only 1 year of gender-affirming hormone treatment, TGM were able to significantly increase muscle mass and strength ( Wilk et al., 2020 ). Without a scientific evidence that testosterone levels are mainly responsible for athletic performance discrepancies between transgender and cisgender women, TGW could be undergoing unnecessary treatments. More research is needed to show this link before athletic governing bodies can enforce decreased testosterone policies as a requirement for TGW to attend competitions.

While proposed methods for categorization may be considered as a “commonsense and clear-cut assessment” by many, they have all failed as they were not scientifically driven ( Karkazis, 2019 ). Authorities have used physical examination in 1960's, chromosomal testing in 1970's, and testosterone measurements in 2010's and 2020's for “sex testing” athletes to allow them to participate in competitions ( Karkazis, 2019 ). “Physical examination of genitals,” “chromosomes,” “gonads,” and more recently “hormones” have all been used in “sex testing” and as evidence for categorization in sports through the history albeit without success; mostly due to the fact that they were not scientifically based and only considered “common sense.”

Current Athletic Policies

A fundamental issue regarding the current sports policies on transgender athletes is that the governing bodies of different athletic organizations have very different policies these athletes must follow to be included in sports competitions. In 2019, the International Olympic Committee (IOC) restricted all athletes from competing in the female category unless they lowered their natural testosterone levels below 5 nmol/L ( Harper et al., 2018a ). This level was recently increased in 2021 to 10 nmol/L and the additional requirement of these levels being maintained for at least 12 months prior to competition was added ( Hilton and Lundberg, 2021 ). Unlike the IOC, the National Collegiate Athletic Association (NCAA) has much less explicit guidelines for the inclusion of transgender athletes. They only require that TGW must complete at least one year of hormonal suppressive therapy to participate on a women's team, but do not require natural testosterone levels to be below a specific level ( NCAA Office of Inclusion, 2011 ). The NCAA's policies have not been updated since 2011, suggesting that there could be room for improvement based on new and more updated research.

As touched upon previously, the center of the debate over the inclusion of transgender athletes in sports competitions is the physical advantages that TGW could have. However, the “female” category for sports in general is ambiguous and not established in the same manner universally ( Ingram and Thomas, 2019 ). In order for competitions to remain fair, universal rules need to be created regarding the inclusion or exclusion of transgender athletes. Currently, policies and perceived fairness of inclusion vary immensely at the level of sporting competition ( Tanimoto and Miwa, 2021 ), meaning that there is a large difference in how transgender athletes are perceived at professional and non-professional levels. Setting the standards for their inclusion at the professional level, may result in other levels of sporting competitions (e.g., recreation leagues, high school athletics, sports clubs, etc.) following suit. However, it has also been argued that the aim of athletics at these non-professional levels is mass participation, and therefore more restrictive guidelines should be avoided ( Cunningham et al., 2018 ; Buzuvis, 2019 , 2021 ; Tanimoto and Miwa, 2021 ).

Both the medical and the scientific communities need to provide input to help guide the creation of such rules ( Ingram and Thomas, 2019 ), especially with hormone therapy expansions as well as increased research into the link between testosterone levels and increased athletic performance. While physicians will play an influential role in developing new sports policy, it is important to also acknowledge the roles of sports managers and others who have experience in sport governance and development. Opening conversations among all of these individuals is the first step to ensuring the success and implementation of new policies at all levels of sporting competitions.

Proposed Solutions

Numerous solutions have been proposed to include transgender athletes in sports competitions while being fair to all athletes. Since numerous nations around the world already allow a “third legal gender,” some have proposed extending this idea to elite sports as a separate category for athletes who identify as this gender ( Harper et al., 2018b ). A problem with this idea that it still excludes athletes who don't identify as the third legal gender, leaving some athletes without a category in which they can compete. Others suggest employing an algorithm that includes all athletes and divides them into categories based on both physiological and social parameters ( Anderson et al., 2019 ). This idea is still relatively new, and more research is needed to determine how inclusive this approach is and how effective it would be to enact.

Others suggest reforming sports policies to favor participation based on gender identity and not on biological sex ( Buzuvis, 2019 , 2021 ). This solution argues that in general, U.S. policies are on the side of inclusion and that this can readily extend into athletic policies, especially for youth athletes ( Buzuvis, 2019 , 2021 ). While there are certainly merits to this argument in terms of inclusion, it is difficult to completely ignore the biological arguments discussed previously. Thus, a solution that balances both inclusivity and fairness is the best approach to this problem in particular.

The most important parameters when assessing methods to improve current sports policies are determining how inclusive a policy is to transgender athletes and how fair it is to all athletes involved in competitions. Many suggest adding more categories under which athletes can compete ( Knox et al., 2019 ), upholding inclusivity without compromising fairness. However, it is unclear how many categories would need to be added to accomplish this feat and if athletic organizations can financially support a large number of athletic categories competing under each sport. For this reason, we suggest adding a third category to elite sports similar to that suggested above, but without the legal third gender requirement. This category would be considered “open,” meaning that any athlete can compete regardless of their gender identity. Male and female sports categories would still be included in this idea but adding an “open” category is more inclusive to all athletes who wish to participate. As we believe that gender is a no longer a binary concept, having an open category supports the inclusion of non-binary, transgender, and genderqueer groups of individuals in sports competitions. While this idea has its advantages and disadvantages, we believe that the language used in naming a third category is especially important and the term “open” is more inclusive than previous suggestions.

The population in the United States, similar to the rest of the world, is constantly changing and it's imperative that elite athletics mirrors these changes. This is especially relevant for the community of transgender athletes as they should be included in sports competitions in a fair and inclusive manner. It is clear that more research is needed to determine what advantages transgender athletes, particularly TGW, could have in athletic competitions. This needs to be accomplished prior to making definitive policy statements regarding the inclusion or exclusion of transgender athletes ( Johnston, 2020 ). In the meantime, current policies need to be careful in the language used in order to promote inclusivity.

Author Contributions

AH conceptualized the paper and AR wrote the first edition of the manuscript. AR and AH contributed to the manuscript with their expertise, read, edited, and approved the submitted version. Both authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Harper, J., O'Donnell, E., Sorouri Khorashad, B., McDermott, H., and Witcomb, G. L. (2021). How does hormone transition in transgender women change body composition, muscle strength, and haemoglobin? Systemic review with a focus on the implications for sport participation. Br. J. Sports Med. 2021, 1–9. doi: 10.1136/bjsports-2020-103106

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Keywords: transgender athletes, athletics, sports policy, inclusivity, fairness

Citation: Reynolds A and Hamidian Jahromi A (2021) Transgender Athletes in Sports Competitions: How Policy Measures Can Be More Inclusive and Fairer to All. Front. Sports Act. Living 3:704178. doi: 10.3389/fspor.2021.704178

Received: 01 May 2021; Accepted: 22 June 2021; Published: 14 July 2021.

Reviewed by:

Copyright © 2021 Reynolds and Hamidian Jahromi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Alireza Hamidian Jahromi, alirezahamidian@yahoo.com

This article is part of the Research Topic

Highlights in The History, Culture and Sociology of Sports: 2021/22

All the Arguments You Need: To Prove It’s Fair for Trans, Intersex Athletes to Compete in Consistence With Their Gender Identity

Bodies and gender identities aren’t binary, so why are sporting competitions?

trans athletes winning in women's sports

Nowhere is the struggle between maintaining the traditional status quo of the gender binary, and moving forward toward greater inclusivity, more pronounced than in competitive sports, due to the differences in male and female physiology. But, there is enough science and data out there to suggest these differences aren’t nearly as stark as we’ve been led to believe — which means any argument against allowing trans and intersex people and people with differences in sex development (DSD) to compete against ciswomen is queerphobic at best. Here are all the arguments you need to fight for greater gender inclusivity in sport.

“Biological males have physical advantages over women such as more stamina, larger bones, and more muscle, so it’s unfair for trans women to compete with ciswomen.”

The science on what women’s bodies can do is flimsy at best. But consider what the female body can do better than a male body: “Women’s bodies have a lower center of gravity and therefore better balance; they tend to be more flexible, and their bodies more efficiently convert calories into energy giving them greater endurance,” Liesl Goeker writes for The Swaddle , while arguing for equal pay in sports. This gives women the upper hand in ultra-endurance running and gymnastics — just as male bodies have the upper hand when it comes to sports such as the shotput and 100m sprint that require speed and brute strength. But zero trans women who are gymnasts are complaining about the advantage cis women have, or saying they want to compete in the men’s category for endurance running or gymnastics — because they just want to participate in the sports category congruent with their gender identity.

Besides, sports isn’t ‘fair.’ It never was. Genetics isn’t either. Many elite athletes are genetically blessed in a way the average person isn’t. Basketball players have the advantage of height, and Michel Phelps’s very peculiar anatomy gives him the upper handin swimming. Privilege isn’t fair either — athletes of color are at a disadvantage when it comes to exposure, opportunities, and resources to even begin pursuing sports competitively, compared to Caucasian athletes. So, what is this “level playing field” argument but a myth spun by those allowed to play and win in the field, to maintain the status quo?

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“Biological males have the advantage of testosterone that enhances performance so it’s unfair for trans women to compete with ciswomen.”

The science on physiological advantages male athletes have over female athletes is in a nascent stage. It’s important to preface this argument by pointing out that very little research and conversation is around, say, the advantages of estrogen (the hormone responsible for many physical characteristics of a typical female) or prolactin (the breastfeeding hormone) on athletic ability. The obsession is entirely with testosterone (T) — the hormone responsible for many glorified physical characteristics of a typical male — and the absurd question of at what level of testosterone does a female athlete become too good to be a woman.

For every credible study and statement out there that proves greater testosterone is linked to greater athletic ability in men and women, there are equally credible studies that prove testosterone is just one of the many factors that affect sporting ability — sometimes even negatively. Take the International Association for Athletics Federation’s data on elite women athletes. Its initial analysis of two world championships showed that women with higher T levels performed better in only five out of 21 events.

After an independent group of researchers took an issue with the research methodology to reach even this finding, the sports body was forced to issue a correction. In the corrected results, in three of 11 running events, the group with the lowest levels of T did better. Across all events, the association between T and performance was the strongest (and the most surprising) in the 100m sprint: athletes with lower T ran 5.4% faster than those with the highest levels of T. The independent group of researchers who objected to the results earlier concluded it’s “impossible” to discern the real relationship, if any, between T and performance. Clearly, though, neither this study nor the broader sports science literature supports the IAAF’s claim that targeted trans, intersex athletes “have the same advantages over [other] women as men do over women.”

Then there’s the stuff outside of the binary that science is nowhere close to explaining clearly, like Chand’s and Semenya’s hyperandrogenism (a medical condition where a typical female body produces higher testosterone than usual). Or, as Faryal Mirza, a clinical endocrinologist at the University of Connecticut Medical Center, tells Scientific American , sometimes high T simply means that a person isn’t very efficient at using T: the body is producing more precisely to arrive at “typical” function of someone producing T in the “typical range.”

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A review of 31 national and international transgender sporting policies, including those of the International Olympic Committee, the Football Association, Rugby Football Union and the Lawn Tennis Association by researchers at the Scool of Sports Exercise and Health Sciences, Loughborough University concluded : “After considering the very limited and indirect physiological research that has explored athletic advantage in transgender people, we concluded that the majority of these policies were unfairly discriminating against transgender people, especially transgender females” by overinterpreting the “unsubstantiated belief” that testosterone improves athletic performance.

Thousands of trans athletes have been competing at national and international competitions who you just don’t hear about simply because they don’t all win or qualify for the Olympics even with all their apparent unfair advantages. This also proves the non-cisgender athletes who do go ahead and win medals owe their success more to their training, skill, perseverance, resilience, and a host of other reasons apart from their gender or sex, and especially from the myth of testosterone.

“Letting trans and intersex women compete in women’s sports will lead to many male athletes pretending to be women just so they can easily win.”

Yikes. Are we really suggesting there are numerous male athletes who will declare they identify as women, go through exhausting transition processes such as hormone replacement, gather the required medical and psychological proof of their fake gender dysmorphia (prolonged distress caused a mismatch between their biological sex and gender identity), go through their entire lives living under the pretense of being female, all while facing prejudice that trans people face on a daily basis — only for a few gold medals and some cash? Notwithstanding the paranoia (looking at you Martina Navratilova ), this argument is the literal definition of transphobia . This idea — that we should ban all innocent and real trans and intersex women based solely on the fantastic hypothetical of the fraudulent cis man — has roots in an irrational fear of the other (in this case, non-cisgender people) based on prejudice or ignorance.

Laws and rules can always be misused, irrespective of gender. But, we can’t deny people’s rights simply because a few could, in theory, game the system. Look at it this way: are some people falsely framed for murder? Yes. Does that mean we don’t have any rules to punish the crime? Of course not.

This debate doesn’t even have to be esoteric; there is actual data to prove male athletes aren’t queuing up to declare a new gender identity. In 2003, the International Olympic Committee adopted the Stockholm Consensus (SC) allowing the inclusion of trans athletes who had undergone sex reassignment, making it possible for trans athletes to compete in the Olympics from 2004. The IOC modified these guidelines in 2015 to put a cap on testosterone levels for trans womenathletes. And yet, despite the fact that more than 50,000 athletes have participated in the Olympics since 2004, no trans athlete has ever been a part of the Olympics until now, real or fake. So, clearly including trans athletes in sports won’t make the sky fall.

Explaining the Vocabulary of the Gender Spectrum

“If not men’s and women’s sports categories, then how do we organize sports fairly?”

Creating a third, mixed category for trans, non-binary, cis men and women to compete against each other can be an earnest, motivating place to start making sports more inclusive. Mixed-gender sports teams are a widely debated topic and have been for many years, just not in relation to opportunities for transgender people. But, introducing more mixed-gender sports teams would also facilitate accessibility for transgender people. The IOC did well, when in June 2017, it added mixed-sex events in athletics, swimming, table tennis, and triathlon to the upcoming Summer Olympics schedule in Tokyo 2020 , in addition to the traditional categories. This not only allows trans and intersex athletes to compete in the sports category congruent with their gender identity based on their athletic ability alone, Tokyo 2020’s milestone mixed-sex events are a concrete step towards ungendering sports. (It is important here to note this will all be moot unless the IOC allows trans and intersex athletes to compete — in these mixed events at least — without having to meet any criteria other than being a human adult who’s good enough to qualify.)

Another way to organize sports, as suggested by Alison Heather, a physiologist at the University of Otago in New Zealand, and her colleagues in an essay published in the Journal of Medical Ethics , would be to create a system that uses an algorithm to account for physiological factors such as testosterone, height, and endurance, and social factors like gender identity and socioeconomic status. Sure it’s a Herculean task, but international sports bodies have enough money to at least begin research into the idea if it means a more inclusive world.

Apart from this, sports can also be organized on the basis of other factors such as weight class, professional/amateur status, and size. The idea is that through a mixture of formats, we redesign sports to make them more inclusive.

It’s going to take fresh thinking and self-awareness that what we believe to be facts about sex and gender are not unquestionable. But every individual must have the possibility of practicing sport, without discrimination of any kind, and in the spirit which requires mutual understanding, with a spirit of friendship, solidarity and fair play. Those are not my words, that’s the Olympic charter.

Pallavi Prasad is The Swaddle's Features Editor. When she isn't fighting for gender justice and being righteous, you can find her dabbling in street and sports photography, reading philosophy, drowning in green tea, and procrastinating on doing the dishes.

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A fair and inclusive solution for transgender women in sports.

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University of Pennsylvania swimmer Lia Thomas congratulates Princeton's Ellie Marquardt after a ... [+] qualifying heat of the 500 yard freestyle event at the Ivy League Women's Swimming and Diving Championships in February.

By Donna Lopiano and Mariah Burton Nelson

To include or to exclude? That’s the question at the core of the debate about transgender women in sports. But that’s a binary way of thinking about a nonbinary situation. It presumes only two types of people: men and women. People are more diverse than that.

We propose a third option since trans women themselves transcend our traditional way of thinking about how individuals fit in either female or male biological categories. The fact that trans girls and women were born with biologically male bodies means that even after taking hormones or undergoing surgery or both, they don’t fit neatly into female or male categories, biologically speaking. In sports, those categories matter.

So, our policies should not be binary either. We need a creative solution.

Fair competition is why separate women’s sports were created. Competitive sport (which does not include recreational sports, physical education, or intramurals) is ultimately a physical test in which post-puberty males possess significant advantages. During puberty, boys generally develop longer and denser bones, more muscle tissue, more strength, more speed, greater height, and greater lung capacity than girls. These differences provide men with a performance advantage that ranges from 8 to 50 percent. This is why men and women have different tee boxes in golf; different three-point arcs in basketball; different net heights in volleyball; and different hurdle heights in track.

Performance advantages (including musculoskeletal features and lung capacity) persist even after transgender women suppress testosterone levels or surgically change their bodies.

“What’s fair is fair!” tweeted trans activist Caitlin Jenner, praising the recent decision by swimming’s world governing body (FINA) to ban from women’s competitions people who have gone through male puberty. “If you go through male puberty you should not be able to take medals away from females. Period,” wrote Jenner, who won a gold medal in the 1976 Olympic men’s decathlon.

Yet trans girls and women must not be relegated to the sidelines. These brave athletes, who come out as trans despite widespread discrimination and even threats of violence against them, must be welcomed onto women’s teams. Considering their grace and determination under pressure, who wouldn’t want trans women as teammates?

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On one side of the binary debate are those who believe trans women should be excluded to be fair to cisgender women. When signing Florida’s Fairness in Women’s Sports Act, Governor Ron DeSantis said, “I want… every girl in Florida to compete on an even playing field.” Seventeen other states also ban transgender women athletes from competing on girls’ and women’s sports teams.

On the other side are those who believe trans women must be allowed to compete without conditions. They argue that there are relatively few trans women athletes, so their inclusion on women’s teams won’t have an appreciable impact. They argue that trans girls are a vulnerable minority, as illustrated by a higher-than-average suicide rate. Anti-trans sports bills “represent a cruel effort to further stigmatize and discriminate against LGBTQ+ people across the country,” according to the Human Rights Campaign.

But including performance-advantaged trans women at the expense of cisgender women (who also face persistent discrimination) would violate the core reason for separate women’s competitions.

So, the question is: How can we include trans women without hurting cisgender women, both of whom deserve fair and safe competition?

Our nonbinary solution is called the Women’s Sports Umbrella. Under this umbrella, all people who identify as female would be invited to try out for women’s sports teams, with one caveat: Competition.

The vast majority of team experience revolves around such things as practice, meetings, weightlifting, team travel, and social activities. There is no reason why this environment should not include all who identify as female.

Trans women who transitioned before male puberty do not have a performance advantage; they would be allowed to compete on women’s teams without any restrictions if they so choose. However, in individual sports, trans women who have gone through male puberty would be allowed to practice, travel, and socialize with women’s teams if they want to, but they would be scored separately. For example, the University of Pennsylvania swimmer Lia Thomas would still swim in team meets and postseason women’s championships, but her times would be recorded in a separate, trans category.

In team sports, trans women who possess the post-puberty performance advantage could also practice, travel, and socialize with their female teammates – then would compete in a trans category. If there are insufficient numbers of trans women to field teams, all-district or all-conference teams could be formed. In contact sports such as basketball and rugby, this model would also prevent cisgender women from being injured by larger, denser, post-male-puberty bodies.

Under the Women’s Sports Umbrella, the legal justification for a separate female sports category – relevant physical and physiological differences between the biological sexes – would be preserved.

An essential aspect would be training coaches, administrators, and athletes in diversity, equity, and inclusion so that separate scoring results would be equally respected and valued by all team members, just as they currently are for lightweight rowers; different weight classes of wrestlers; junior varsity and varsity teams; athletes with disabilities; and athletes in different age groups.

Achievements of transgender and other athletes would be equally celebrated. Biological differences – along with differences in gender-identity, race, culture, religion, and sexual orientation – would be accepted as natural human variations.

The Women’s Sports Umbrella also provides solutions for others who fall outside the female/male binary: intersex, nonbinary, and gender-fluid people. These athletes would compete in the transgender scoring category only if they choose to join a women’s team and possess the male-puberty performance advantage.

Like any compromise, the Women’s Sports Umbrella will not make everyone happy. Open-minded administrators, coaches, and trans and non-trans athletes would need to work together to fine-tune the best possible options for each sport to modify the specifics over time. But this model offers a starting point. It transcends the misguided either/or binary. It welcomes everyone to the greatest extent possible and requires non-identical treatment of the fewest possible number of people. It helps us envision a sporting arena where all who identify as women would experience an equitable, safe, and appropriate playing field. It’s both inclusive and fair.

Mariah Burton Nelson is a former Stanford and professional basketball player and the author of The Stronger Women Get, The More Men Love Football and six other books. She also co-authored Staying in Bounds: An NCAA Model Policy to Prevent Inappropriate Relationships Between Student-Athletes and Athletics Department Personnel . She can be reached on Facebook or Instagram @MariahBurtonNelson or her website, MariahBurtonNelson.com.

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Arguments that trans athletes have an unfair advantage lack evidence to support

NPR's Scott Detrow speaks with geneticist Dr. Eric Vilain about a spate of laws targeting trans athletes.

SCOTT DETROW, HOST:

Last week saw a flurry of activity in the ongoing debate about transgender athletes competing in school sports.

(SOUNDBITE OF MONTAGE)

UNIDENTIFIED REPORTER #1: Breaking news - transgender athletes will soon be banned from playing in women's sports in Kansas schools.

UNIDENTIFIED REPORTER #2: The Biden administration has proposed a new rule. This plan essentially bars blanket bans of trans athletes, but it leaves wiggle room for schools to place some restrictions at more elite levels.

UNIDENTIFIED REPORTER #3: The U.S. Supreme Court has denied West Virginia's request to let it fully enforce a state law that bans women who are transgender and girls from participating on public school sports teams consistent with their gender identity.

DETROW: The debate is heated, highly politicized, and it's taking place all across the country. According to the ACLU, 19 other states have enacted similar bans over the past three years. They generally state that only those who are assigned biologically female at birth will be allowed to compete on girls' and women's sports teams within the state. In Kansas and elsewhere, supporters say these bans are all about fairness, ensuring an even playing field for girls in particular.

So what does fairness mean really, and what is the extent that it can be measured? What do we know? We decided to ask a doctor to speak with us, an MD PhD who advises sports organizations on the issue of transgender athletes. Dr. Eric Vilain is a pediatrician and geneticist at the University of California, Irvine. Dr. Vilain, thanks for joining us again on ALL THINGS CONSIDERED.

ERIC VILAIN: Always a pleasure to be here.

DETROW: Let's start just a little bit with those headlines. There was that new law in Kansas, then the Biden administration's proposed rule change to Title IX, which would outlaw broad bans against transgender athletes but give schools discretion to ban specific athletes. Do you think that strikes the right balance?

VILAIN: Well, on one hand, not having an indiscriminate ban suggests that the baseline for eligibility for all athletes, including trans athletes, should be inclusion. And I think that's a good thing. And that's actually what the International Olympic Committee has done in creating a framework for inclusion and fairness that's based on the principle of no presumption of advantage. And if a category is going to be excluded, it needs to be based on evidence. The problem here with the exclusion on a case-by-case basis is that it is likely not to be based on evidence. Who's going to undertake all the necessary research to demonstrate a disproportionate advantage, sport by sport, at so many different ages? Who will fund this? Likely not the school systems.

And the other problem is that the proposed rule will likely create a quite inequitable patchwork of inclusion and exclusion throughout the country, with some states or some cities more likely to include and others not. And the same trans athlete may be eligible in one school and, if they move, may not be in another school, which doesn't make much sense. And finally, all the schools that will ban participation will also prevent the collection of any data on trans athletes, which will further even more the inability to make policy supported by data.

DETROW: Is there a way - I mean, if you put the politics out of it, which, at this point, is a naive view and increasingly impossible because it's an incredibly political issue, but is there a balance that could take people and assess them on an individual basis, like you're saying is important, but also be equitable? Because if we're making different policies for specific people and specific places, it feels hard to have a broader policy in place.

VILAIN: The issue is we lack a lot of data, so we, in fact, know very little about advantages of trans girls and women athletes over their cisgender peers. That's true in elite competitions. That's true in school sports. What we know is that boys and men have an advantage in performance over girls and women, and that disadvantage increases after puberty. So the answer of competitive advantage will vary by class level, and the difference will be much smaller, of course, in elementary school, before puberty, than in high school. So it's a complicated debate. Some are making the argument that the difference between boys and girls should translate directly into concluding that there will be the same difference between trans and cisgender girl athletes. But there is no good evidence for this, in part because many cases are going to be different, some having undergone blocking of puberty at different ages.

I'll end by saying that the larger question really goes beyond a simple competitive advantage. It's whether there is a disproportionate competitive advantage between trans and cis athletes. So there are all sorts of advantages coming into play for athletic abilities - their genetic advantages, metabolic differences, physical characteristics, height, for example, and all the socioeconomic access to better nutrition, better coaching, better training equipment. Does all of these differences that provide some advantage are dwarfed by the fact of being trans athlete? We simply don't know.

DETROW: A lot of people say they're worried about inclusion. A lot of other people say they're worried about protecting female athletes. You're an expert in this field. What are you worried about?

VILAIN: I'm worried that outright bans will prevent inclusion. And it's especially worrying at the school level because there are already so much inequity of sports participation that comes from all sorts of other issues, such as socioeconomic status, access to sports, which are not addressed. So adding layers of exclusion is just not helpful.

DETROW: Dr. Eric Vilain is a pediatrician and a geneticist at the University of California, Irvine. Thanks so much for coming on ALL THINGS CONSIDERED.

VILAIN: Thank you.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Is there really a competitive advantage? Debate over trans athletes tests science and inclusion

Legislation on trans policies in alberta expected in the fall.

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Aria McGowan picks up a football and gingerly takes a couple of steps back before throwing it to a teammate down the field.

It's a Saturday morning and the Edmonton Storm, a women's tackle football team, is holding a practice at Commonwealth Community Recreation Centre.

McGowan, 46, is their quarterback.

She loves playing football, and it's clear the football field is a place McGowan feels safe. But she and other trans athletes in the province could potentially see their athletic pursuits curtailed.

In late January, Alberta Premier Danielle Smith proposed a slew of policies that could affect trans youth and adults , ranging from restrictions on gender-affirming health care to classroom pronoun policies. Among the proposed policies is a ban on transgender girls and women competing against cisgender girls and women in athletic competitions.

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"There are some sports where the physical differences make a difference," Smith said at a press conference on Feb. 1.

"In those cases, we do want to have biological women — women who are born biologically female — have the choice of being able to participate in a biological-female-only category while still preserving the gender-neutral categories and co-ed opportunities so that everyone has the ability to participate."

Details on these proposed policies are slim. Legislation for the suite of policies is expected to be introduced in the fall. If passed, Alberta would be the first province in the country to implement this type of ban.

"Being told I'm not allowed to [play] would really suck," McGowan said, holding back tears. "It's just a lot of emotions."

In the last few years, debate has been raging in North America over who should be allowed to compete in sports. While the discussion revolves around concepts of fairness and inclusion, researchers say the science around whether trans athletes have a competitive advantage is unsettled.

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The Edmonton Storm is part of the Western Women's Canadian Football League and often plays in other Prairie provinces.

Storm president Laura Hayne said the team is fully behind McGowan, but acknowledges the political situation could complicate their season.

"If this legislation moves forward in the way that we think it will, it will very much affect our ability to compete," Hayne said.

'Life of hiding'

McGowan said she had questioned her gender identity ever since she was a child.

"My family's background is religious…. It was a life of hiding and, I guess, trying to be normal, according to society," she said.

After her gender-affirming surgery in June 2009, she said she felt "whole."

"It was the greatest feeling ever. It was just like a weight was lifted off my shoulders," McGowan said. "That I could just move forward and start living life the way I wanted to, not the way everybody else wanted me to."

A woman wearing black shorts and a blue shirt holds a football in the air.

McGowan played football as a teenager and said she enjoys how it is a team sport where trust is pivotal.

She joined the Edmonton Storm the year after her surgery and has been on the team ever since. McGowan said she's not aware of any teammate or member of an opposing team expressing concern with her presence on the field.

"I'm not the biggest person, not the smallest. I'm not the fastest. I don't see where an issue would lie with me playing. I'm not taking up anybody's spot," she said.

When it comes to the issue of physical advantages, McGowan says she worked in a warehouse before her surgery and used to move tires that weighed between 250 and 300 pounds. Now, she says she struggles to move 50 pounds.

"My strength has decreased significantly," she said. "When I first started running again after having surgery, I fell on my face a couple of times because, in my head, my legs could move that fast, but my body was telling me it couldn't. I kind of had to retrain myself."

McGowan fundamentally disagrees with Alberta's proposed sports policy.

"Being told you can't do something makes you think there's something wrong with you, when there's not," she said.

U.S. lawsuit

While an Alberta sports ban would be novel in Canada, such restrictions aren't new south of the border.

According to the Movement Advancement Project , a U.S. non-profit think-tank, 24 states have passed laws banning transgender students from playing sports, while one, Alaska, has regulations that ban these students from competition. However, several states are facing injunctions that block the enforcement of these bans.

Selina Soule, 21, used to compete in track and field as a high school student in Connecticut, a state that allows transgender athletes to compete in a category that aligns with their gender identity.

Soule started in track and field when she was eight years old and competed in the 55-metre dash, the 4x200-metre relay and long jump, among others.

A woman with long red hair sits in front of a wall with several medals and awards.

But her passion for track and field was dealt a blow when she began to compete against transgender athletes.

"Over the years, I raced against those athletes dozens of times … and I never won a single time. I was never close to beating them," she said.

Soule said she lost out on medals and qualifying competitions for certain events, saying they were never fair contests.

She is now a plaintiff in a lawsuit against the Connecticut Interscholastic Athletic Conference. First filed in 2020, the case is still working its way through the U.S. court system.

According to court filings, Soule finished in eighth place at the 2019 state open indoor 55-metre preliminary race, while two transgender athletes finished first and second. The complaint alleges Soule would have qualified for the regional championship if the two transgender athletes had not competed in the race.

Trans athlete responds to proposed Alberta policy

"I was quite literally forced on the sidelines in my own event, knowing that I should have been there on that track, competing and showing off my talents to college scouts," she said.

"It was a very frustrating and demoralizing thing to have to go through, because we elite female athletes train so hard to shave fractions of a second off our times to win…. It's heartbreaking knowing that no matter what you do, how many hours you spend in practice, that you will never be able to get that gold medal."

Soule pointed to physical differences between men and women to explain why athletes should compete in categories that align with their sex.

"Everybody has the right to participate in sports. It just needs to be done where it's most fair to everybody involved. And that means that we need to protect the female category and ensure that only women can participate in women's sports," Soule said.

Debate over competitive advantages

Doctors say more research is needed to determine whether trans athletes truly have a competitive physical advantage.

Dr. Brad Anawalt, a professor of medicine and an endocrinologist at the University of Washington in Seattle, said there is a negligible difference in power, speed and strength between boys and girls pre-puberty.

But he said that it is clear that post-puberty, men have an advantage over women when it comes to power, strength and speed, and in elite sports, minuscule differences can mean the difference between winning and losing.

Where it gets muddy, he said, is when an individual begins hormone therapy to transition to a woman.

"In that particular setting, we don't have a lot of data to tell us that that person has a competitive advantage over cis[gender] women. We have some examples and we have this inferential knowledge that strength and power and speed will be different, but we don't know that for certain," he said.

A man with black hair and a blue sweater sits in a room.

Anawalt said that based on limited data, after one or two years of hormone therapy, a trans woman has muscle mass and strength that is somewhere between that of a cisgender woman and a cisgender man, on average.

"Other important things that really will never change are things like hand size or feet size, and that's important in sports like swimming," he said, adding that "height can't be changed with hormone therapy."

In Anawalt's opinion, policies could vary by sport, but he notes there is more to it than that.

This issue "can't be resolved by science. It has to be resolved by society and recognizing that there's a tension in values," he said. "By trying to include everybody, we inevitably have to exclude somebody. It's just the simple math of highly competitive elite sports."

Dr. Joshua Safer, executive director at Mount Sinai's Center for Transgender Medicine and Surgery in New York City, agrees the science about competitive advantage is inconclusive.

"One hundred per cent there needs to be more research and it has to be sport-specific…. The question that's going to get posed then to society is, in the absence of research, what's your default situation?"

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Until there is clear evidence of advantages, Safer recommends inclusivity over fear.

For example, he said, "we don't worry that, at international levels, the Dutch basketball team is taller than the Guatemalan basketball team."

Inconsistency among sports organizations

Around the world, sporting organizations and federations are grappling with the question of who should be allowed to compete in athletic competitions. The policies are piecemeal and there is little consistency.

For example, USPORTS , which oversees Canadian university sports, and Volleyball Canada have released policies stating athletes can compete on a team that corresponds with their gender identity. The NCAA in the United States and the International Olympic Committee state transgender athletes must meet certain testosterone levels. World Rugby recommends trans women do not play women's contact rugby, citing safety concerns, while World Athletics has banned trans women from competition if they have gone through puberty .

"The council agreed it must be guided by our overarching principle, which is to protect the female category," said World Athletics president Sebastian Coe during a World Athletics Council press conference on March 23, 2023 , adding that the decision was open to review based on developing science.

A woman with brown hair and a blazer stands on a sidewalk in Toronto.

For Allison Sandmeyer-Graves, the CEO of Canadian Women and Sport, there is no debate — trans girls and women should be allowed to compete against cisgender girls and women.

Sandmeyer-Graves said the number of trans girls and women athletes is "very, very small" and notes that Alberta's proposed policy will actually have more of a negative impact on all girls and women in sport, as it will place the onus on a woman to prove she is a woman.

She also points to the need to make sports a welcoming and inclusive space for all, pointing to the benefits of sport on an individual's well-being.

"Until the sports system … moves beyond having these two categories — male and female — in sport, women's sport is going to be the best place, we believe, for transgender girls and women to play," she said.

Policing gender

While many believe the sex of an individual is the most important aspect in this debate, J.J. Wright, a sociologist at MacEwan University in Edmonton, said the tension is over the definition of woman.

"When babies are born, they're labelled either male or female," Wright said.

"These issues that we're talking about around this ban of trans girls and women in sports is so much about reinforcing a conservative vision of what gender is and how we understand sexed bodies."

A person wearing a white shirt and with short blonde hair sits in an office.

Wright said individuals often base their lives on this bifurcation, from marriage to having children, and that the category of who is a woman is important to define for some people.

"Because when they see people who don't fit into this category and the way that they envision it, the way they've been taught in society to envision it, it makes them deeply uncomfortable," Wright said.

"It's really simply that we're socialized in a particular way to imagine that … there's parameters to womanhood and some people don't fit into that. When they don't, they are policed."

While the Alberta government is poised to limit who can compete in sports, the Edmonton Storm said it will be business as usual until legislation is introduced in the fall.

Hayne, the team's president, said it seems as if this moment could be a defining one.

"The world of sport is just reflecting society," she said, "and society overall, right now, isn't sure where it wants to go."

ABOUT THE AUTHOR

Senior reporter

Julia Wong is a senior reporter based in Edmonton.

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The Case of Transgender Athletes. Why Sports Aren't Fair and That's OK | Opinion

Between the growing number of states passing legislation to prevent transgender and intersex athletes from competing as women and the opportunity presented by a new administration, the debate about who gets to play and how in the United States is heating up.

Montana joined Idaho and 14 other states with legislation passed or pending to prevent transgender and intersex athletes from competing as women . Recently, the Women's Sports Policy Working Group—a new collection of scholars and elite athletes absent of transgender members—presented a controversial plan that would allow transgender women to compete as women only if they take hormones or medically transition, a policy which poses problems for intersex women as well as transgender women who do not take hormones or pursue medical transition.

In the cases of both transgender and intersex athletes, supporters of gender testing and medical intervention argue that these policies are needed in order to make sports fair for women . But the hard truth is that sports aren't fair.

They aren't fair for a broad range of reasons, many of which have nothing to do with anatomy or hormones. No one can excel at a sport to which they've never been exposed, and categories of inequality like social class, race and nationality dictate who has the opportunity to pick up a golf club, a soccer ball or a baseball bat.

Social class is an especially important determinant of both access to and success in sports because, put simply, playing sports costs money. Typically, American families spend $700 per year on their child's sports activities, but for some families the costs climb as high as $35,000. Among families earning less than $50,000 a year, cost was cited as the main reason for their child opting out of sports. At the elite level of any sport, the majority of athletes who are still on the field are there because of an invisible accumulation of unfair monetary advantages.

In addition to social class, there's the leg-up that comes with knowing the right people, still an important component of sporting success. NFL quarterbacks and brothers Peyton and Eli Manning benefitted from having a father who played in the NFL, providing insight, knowledge and connections . In fact, in many men's professional leagues participation is passed down like an inheritance.

Is it fair that Ken Griffey Jr., a Hall of Fame baseball player, was able to learn to play from his father, a three-time All-Star? Or that NBA star Stephen Curry benefited from his father, Dell Curry's experiences during his own extensive NBA career?

Sports aren't fair for physiological reasons too, not only because of differences that have to do with gender alone. Men and women—whether cisgender or transgender—exist along a continuum of size, speed and ability and there are only a handful of sports which account for these natural physical differences in the interest of "fairness."

Weight classes exist in boxing, mixed martial arts, wrestling and ultimate fighting because it's deemed unfair for a 126 pound featherweight to compete against a 200-plus pound heavyweight. Most other sports have no size or weight restrictions on athletes, accepting these physical inequalities as a normal part of competition.

Athletes do bring genetic advantages to the field, but we are blind to those advantages that have nothing to do with gender. Studies show that some elite runners and cyclists have rare conditions that give them extraordinary advantages when it comes to their muscles' ability to absorb oxygen and their resistance against fatigue.

Some basketball players have acromegaly, a hormonal condition that results in very large hands and feet. This condition is surely a genetic advantage in the sport, but players with acromegaly are not banned .

Some doctors speculate that Olympic swimmer Michael Phelps has Marfan syndrome , a genetic condition that results in the long, flexible arms and legs that made Phelps such a force in the pool. Major league baseball players tend to have extraordinary eyesight, which allows them to see the seams on a tiny ball hurtling toward them at high speeds and hit it with greater success than those with poorer vision.

In all these ways, sports aren't fair and yet, these types of inequalities are not just acceptable, but mostly unnoticed. For those like Republican legislators in Montana and other states, the real reason for clinging to the necessity of gender testing isn't about fairness, but the need to protect and reinforce the idea of gender itself.

In a world that is increasingly gender integrated and where the strict roles laid out for men and women are loosening, sports remain one of the last strongholds for the cult of gender differences. Preventing transgender and intersex women from competing has nothing to do with fairness, but with the ways in which their inclusion calls into question the meaningfulness of gender as a category in the first place.

Sports aren't fair in all these ways, but there are more important values than fairness at stake in the debates about transgender and intersex athletes—values like equality, teamwork, access and inclusion.

High school sports are an important way for athletes to build self-esteem and develop connections to both their schools and communities. The American Psychological Association is one among many organizations that recommend allowing transgender kids to compete in sports in ways consistent with their gender identity. Their studies have shown no signs that doing so impacts the sport.

Transgender children and teens are already at risk from higher rates of bullying and harassment. Almost half of all teenage transgender boys and 30 percent of teenage transgender girls have attempted suicide at some point in their lives.

How can we justify depriving this vulnerable group from the potential benefits of sports? In the end, it's that cruelty that truly isn't fair.

Robyn Ryle is a professor of sociology and gender studies and the author of "Throw Like a Girl, Cheer Like a Boy: The Evolution of Gender, Race, and Identity in Sports" and "She/He/They/Me: For the Sisters, Misters and Binary Resisters."

The views expressed in this article are the writer's own.

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Four Myths About Trans Athletes, Debunked

A crowd of marchers with one holding a sign with the text " Trans Athletes Belong in Sport."

For years state lawmakers have pushed legislation attempting to shut trans people out of public spaces. In 2020, lawmakers zeroed in on sports and introduced 20 bills seeking to ban trans people from participating in athletics. These statewide efforts have been supported through a coordinated campaign led by anti-LGBTQ groups that have long worked to attack our communities.

Before the COVID-19 pandemic shut down most state legislatures, Idaho became the first state to pass a sweeping ban on trans people’s participation in athletics from kindergarten through college. We, along with our partners, immediately sued . Advocates across the country are gearing up to continue the fight against these harmful bills in legislatures when they reconvene. In Connecticut, the ACLU is defending the rights of transgender athletes in a lawsuit brought by cisgender athletes seeking to strike down the state’s inclusive policy.

Though we are fighting every day in the courts and in legislatures, upholding trans rights will take more than judicial and legislative action. It will require rooting out the inaccurate and harmful beliefs underlying these policies. Below, we debunk four myths about trans athletes using the expertise of doctors, academics, and sports psychologists serving as experts in our litigation in Idaho .

FACT: Including trans athletes will benefit everyone.

Myth: the participation of trans athletes hurts cis women..

Many who oppose the inclusion of trans athletes erroneously claim that allowing trans athletes to compete will harm cisgender women. This divide and conquer tactic gets it exactly wrong. Excluding women who are trans hurts all women. It invites gender policing that could subject any woman to invasive tests or accusations of being “too masculine” or “too good” at their sport to be a “real” woman. In Idaho, the ACLU represents two young women, one trans and one cis, both of whom are hurt by the law that was passed targeting trans athletes.

Further, this myth reinforces stereotypes that women are weak and in need of protection. Politicians have used the “protection” trope time and time again, including in 2016 when they tried banning trans people from public restrooms by creating the debunked “bathroom predator” myth. The real motive is never about protection — it’s about excluding trans people from yet another public space. The arena of sports is no different.

On the other hand, including trans athletes will promote values of non-discrimination and inclusion among all student athletes. As longtime coach and sports policy expert Helen Carroll explains, efforts to exclude subsets of girls from sports, “can undermine team unity and also encourage divisiveness by policing who is ‘really’ a girl.” Dr. Mary Fry adds that youth derive the most benefits from athletics when they are exposed to caring environments where teammates are supported by each other and by coaches. Banning some girls from athletics because they are transgender undermines this cohesion and compromises the wide-ranging benefits that youth get from sports.

FACT: Trans athletes do not have an unfair advantage in sports.

Myth: trans athletes’ physiological characteristics provide an unfair advantage over cis athletes..

Women and girls who are trans face discrimination and violence that makes it difficult to even stay in school. According to the U.S. Trans Survey , 22 percent of trans women who were perceived as trans in school were harassed so badly they had to leave school because of it. Another 10 percent were kicked out of school. The idea that women and girls have an advantage because they are trans ignores the actual conditions of their lives.

Trans athletes vary in athletic ability just like cisgender athletes. “One high jumper could be taller and have longer legs than another, but the other could have perfect form, and then do better,” explains Andraya Yearwood , a student track athlete and ACLU client . “One sprinter could have parents who spend so much money on personal training for their child, which in turn, would cause that child to run faster,” she adds. In Connecticut, where cisgender girl runners have tried to block Andraya from participating in the sport she loves, the very same cis girls who have claimed that trans athletes have an “unfair” advantage have consistently performed as well as or better than transgender competitors.

“A person’s genetic make-up and internal and external reproductive anatomy are not useful indicators of athletic performance,”according to Dr. Joshua D. Safer. “For a trans woman athlete who meets NCAA standards , “there is no inherent reason why her physiological characteristics related to athletic performance should be treated differently from the physiological characteristics of a non-transgender woman.”

FACT: Trans girls are girls.

Myth: sex is binary, apparent at birth, and identifiable through singular biological characteristics. .

Girls who are trans are told repeatedly that they are not “real” girls and boys who are trans are told they are not “real” boys. Non-binary people are told that their gender is not real and that they must be either boys or girls. None of these statements are true. Trans people are exactly who we say we are.

There is no one way for women’s bodies to be. Women, including women who are transgender, intersex, or disabled, have a range of different physical characteristics.

“A person’s sex is made up of multiple biological characteristics and they may not all align as typically male or female in a given person,” says Dr. Safer. Further, many people who are not trans can have hormones levels outside of the range considered typical of a cis person of their assigned sex.

When a person does not identify with the sex they were assigned at birth, they must be able to transition socially — and that includes participating in sports consistent with their gender identity. According to Dr. Deanna Adkins, excluding trans athletes can be deeply harmful and disruptive to treatment. “I know from experience with my patients that it can be extremely harmful for a transgender young person to be excluded from the team consistent with their gender identity.”

FACT: Trans people belong on the same teams as other students.

Myth: trans students need separate teams..

Trans people have the same right to play sports as anybody else. “For the past nine years,” explains Carroll , “transgender athletes have been able to compete on teams at NCAA member collegiates and universities consistent with their gender identity like all other student-athletes with no disruption to women’s collegiate sports.”

Excluding trans people from any space or activity is harmful, particularly for trans youth. A trans high school student, for example, may experience detrimental effects to their physical and emotional wellbeing when they are pushed out of affirming spaces and communities. As Lindsay Hecox says, “I just want to run.”

According to Dr. Adkins, “When a school or athletic organization denies transgender students the ability to participate equally in athletics because they are transgender, that condones, reinforces, and affirms the transgender students’ social status as outsiders or misfits who deserve the hostility they experience from peers.”

Believing and perpetuating myths and misconceptions about trans athletes is harmful. Denying trans people the right to participate is discrimination and it doesn’t just hurt trans people, it hurts all of us.

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Transgender athlete laws by state: Legislation, science, more

Recently, North Carolina became the 23rd state to pass a law limiting transgender athletes from participating in competitive sports. Katie Barnes reports on the history of this type of legislation and its impact on one family in Missouri. (6:41)

Since 2020, 23 states have passed laws restricting transgender athletes' ability to participate in school sports in accordance with their gender identity. The laws vary from state to state, creating a patchwork legal landscape for transgender student-athletes wanting to participate in school sports.

In April, the U.S. House of Representatives passed HR 734 , a federal bill that mirrored legislation that had already been adopted by nearly half of the U.S. states. The bill declared that it was a "violation of Title IX" to "allow individuals of the male sex to participate in programs or activities that are designated for women or girls." It further stated that "sex shall be recognized based solely on a person's reproductive biology and genetics at birth." HR 734 passed the House on a party-line vote but has not been taken up by the Senate and is unlikely to become law. President Joe Biden has said that he would veto the bill.

The issue has spawned litigation in multiple states, and it is expected that the Supreme Court will eventually hear one of the cases.

The roots of the legislation can be traced to Idaho. In February 2020, Idaho Rep. Barbara Ehardt introduced HB 500. The bill sought to regulate eligibility for girls and women's sports at publicly funded schools and institutions of higher education by barring transgender girls and women from participating in the women's category. Ehardt was alarmed by transgender girls competing in girls' sports in other states. Over the course of two years, she consulted with Matt Sharp at the conservative legal firm Alliance Defending Freedom. Citing testimonials and studies, the bill states the "evidence is unequivocal" that there is a gender gap in sports and that claims to the contrary are a "denial of science." HB 500 was signed into law by Idaho Gov. Brad Little in March 2020, making it the first state to enact such a law, though it was later blocked by a federal court.

Laws such as HB 500 fit into a global climate of restrictive policies for transgender athletes, particularly transgender women seeking to compete in women's sports. In 2021, the International Olympic Committee turned the policy decisions over to the international federations, and many have adopted more restrictive policies. World Athletics , World Aquatics and the International Cycling Union have enacted policies that bar transgender women from women's elite competition if they did not medically transition before puberty. The NCAA -- just months before Lia Thomas won a 2022 NCAA title in swimming -- announced that it would move to a sport-by-sport approach , deciding to use the policies of each sport's national governing body.

Before the passage of the various state laws, high school associations set their own eligibility policies. For the states that have not passed legislation for transgender athlete participation, the high school association still sets the eligibility criteria for school sports, though individual school districts have increasingly begun to set their own policies. Consequently, a transgender athlete's ability to participate in sports in accordance with their gender identity depends on where the athlete lives, which sport they want to play and at what level.

Here is a state-by-state look at the rules governing transgender athlete participation.

On April 23, 2021, Gov. Kay Ivey signed into law HB 391 , which establishes sports categories fixed by sex in K-12 public schools and bars athletes assigned male at birth from participating in the girls' category. It also bars athletes assigned female at birth from participating in the boys' category unless there is no comparable girls' opportunity (such as football). On May 30, 2023, Ivey, a Republican, signed into law HB 261 , which extended the rule to public two- and four-year colleges.

There is no state law that bans transgender athletes in Alaska, leaving eligibility decisions up to schools. In July 2023, the state board of education delayed action on a proposal that would restrict transgender girls from playing on girls' and women's sports teams across the state. At least one school district, the Matanuska-Susitna Borough district, has a policy in place that restricts transgender girls from competing on girls' sports teams.

On March 30, 2022, then- Gov. Doug Ducey signed into law SB 1165 , which bans athletes assigned male at birth from participating in girls' interscholastic and intramural sports starting in kindergarten and running through college. On July 20, 2023, a federal judge blocked enforcement of the law pending a lawsuit filed on behalf of two transgender girls in the state.

In March 2021, then- Gov. Asa Hutchinson signed SB 354 . The law prohibits transgender girls and women from participating in girls' and women's sports in elementary school through college.

AB 1266, which was signed into law in 2013, requires public schools to allow transgender students to access bathrooms and sports teams in accordance with their gender identity. The California Interscholastic Federation policy echoes the law, but has an appeals process in case there is a dispute. No medical or legal requirements are stated.

Students in Colorado must inform their school in writing that their gender identity differs from their sex assigned at birth, and the Colorado High School Activities Association requires the school to perform a confidential evaluation. All forms of documentation are voluntary, and there are no medical or legal requirements stated.

Connecticut

School districts in Connecticut determine the proper placement for each athlete, but the Connecticut Interscholastic Athletic Conference gives guidance that the districts should make those decisions based on the gender identity reflected in school records and the students' daily activities. There are no medical or legal requirements.

The Delaware Interscholastic Athletic Association allows transgender students to participate in accordance with their gender identity under any of the following conditions: a student provides an updated birth certificate, passport or driver's license that recognizes the student's identity; or a physician certifies that a student has "had appropriate clinical treatment" for medical transition or has begun a medical transition. Each school determines a student's eligibility, and any school can challenge the participation of a transgender student if there are concerns about safety and competitive equity.

On June 1, 2021, Republican Gov. Ron DeSantis signed SB 1028 , which has a provision that states that sex for athletic participation in interscholastic, intercollegiate, intramural and club public school settings will be established by "official birth certificate," which was filed at or near birth. Those assigned female at birth may participate in boys' and men's sports, but those assigned male at birth may not participate in girls' and women's sports.

On April 28, 2022, Republican Gov. Brian Kemp signed HB 1084 , which established a committee with the authority to bar transgender girls and women from competing on sports teams consistent with their gender identity. A bill that proposed a blanket ban failed to make it through the House. In May 2022, the Georgia High School Association passed a rule that states a student-athlete's gender will be determined by birth certificate. It states, with the exception of wrestling, students assigned female at birth may participate on boys' teams when there is no girls' team offered in that sport or activity and bars students assigned male at birth from all girls' teams.

The Hawaii High School Athletic Association has no discernible policy, and the state has no law. Bills that would prohibit transgender girls from participating in girls' and women's sports have been filed, but none has passed.

Idaho became the first state to enact a law restricting transgender students' access to sports in March 2020. Republican Gov. Brad Little signed HB 500 , which says that students assigned male at birth may not participate in girls' sports in public elementary, middle, high school or college. It includes club and intramural sports. A preliminary injunction was granted by a federal judge in August 2020, so the law has not gone into effect. On Aug. 17, 2023, the 9th Circuit Court of Appeals upheld that ruling . The Idaho High School Activities Association policy mirrors the language of HB 500.

The Illinois High School Association determines eligibility for student-athletes. A student must notify the school that their gender identity differs from their sex assigned at birth and provide medical documentation. The IHSA then convenes a group, which includes medical personnel acting in an advisory role, to issue a ruling. Legislation aimed at restricting the ability of transgender girls to play on girls' and women's teams has been introduced in Illinois but not passed.

On May 24, 2022, the Indiana General Assembly overturned Republican Gov. Eric Holcomb's veto of HB 1041 and made it illegal for athletes assigned male at birth to participate in girls' sports from kindergarten through high school graduation. A lawsuit challenging the ban was dismissed in January 2023 after the plaintiff transferred to a charter school.

On March 3, 2022, Republican Gov. Kim Reynolds signed into law House File 2416 , which prohibits transgender girls and women from participating in girls' sports, starting in kindergarten, and women's college athletics. The law went into effect immediately.

On April 5, 2023, the Kansas legislature overrode Democratic Gov. Laura Kelly's veto of HB 2238 , barring athletes assigned male at birth from playing in girls' and women's sports at the interscholastic, intercollegiate, intramural and club levels at public schools. The law affects athletes from kindergarten through college.

On April 13, 2022, the Kentucky legislature overrode Democratic Gov. Andy Beshear's veto of SB 83 , enacting a law that bans athletes assigned male at birth from competing in women's and girls' athletics starting in sixth grade and running through college. It applies to public and private colleges as well as public and private schools with interscholastic athletics managed by the state board.

On June 6, 2022, Democratic Gov. John Bel Edwards declined to veto SB 44 , which bans transgender women and girls from competing on sports teams consistent with their gender identity at all public and some private elementary and secondary schools and colleges. Edwards had vetoed a similar bill in 2021. The law went into effect Aug. 1, 2022.

The Maine Principals' Association policy outlines procedures for student-athletes to compete in a category consistent with their gender identity. A student must notify their school, and the school requests a hearing with the Gender Identity Equity Committee. The student must provide school records, medical documentation, documentation that establishes the validity of the student's gender identity, a list of athletic activities in which the student wishes to participate, and documentation of the student's prior athletic history and achievements. The committee will grant the request unless it does not believe the student's identity is valid or if the committee believes the student will have an athletic advantage. Bills that would restrict transgender girls' ability to participate in girls' and women's sports have been filed but not passed.

The Maryland Public Secondary Schools Athletic Association provides guidance for local school districts to determine eligibility for transgender students. The recommendations are that each student should be allowed to participate in accordance with their gender identity regardless of what is listed on the student's records. Should there be a concern about a student's gender identity, it should be reviewed on a case-by-case basis by establishing an appeal review committee. There are no medical and legal requirements stated.

Massachusetts

The Massachusetts Interscholastic Athletic Association cites existing state law that requires students to be "accepted by their schools as the gender with which they identify across all school programs." Local schools make eligibility determinations, but MIAA focuses on gender identity, rather than sex, when separating sports. The regulation states "a student shall not be excluded from participation on a gender-specific sports team that is consistent with the student's bona fide gender identity."

The Michigan High School Athletic Association allows transgender boys to participate in boys' sports without restriction. For transgender girls, the MHSAA executive director makes determinations on a case-by-case basis, considering the sex indicated on legal documents, and what medical steps have been taken, if any. Bills that would bar transgender athletes from participating on teams consistent with their gender identity have been introduced but have not become law.

The Minnesota State High School League allows transgender students to participate in accordance with their gender identity. There are no medical or legal requirements. The Minnesota State High School League hears appeals if a school should deem a student-athlete ineligible. Bills that would restrict the ability of transgender athletes to participate in sports have been introduced in the Minnesota legislature but have not passed.

Mississippi

Republican Gov. Tate Reeves signed SB 2536 in March 2021, limiting transgender athletes' ability to participate in sports. The law states that student-athletes assigned male at birth may not participate in girls' sports in public elementary, middle, high school or college. It includes club and intramural sports.

On June 7, 2023, Republican Gov. Mike Parson signed into law SB 39 , which requires all athletes to compete on sports teams consistent with the gender they were assigned at birth or on a government record. The law affects public and private schools, elementary through college. Athletes assigned female at birth can participate in sports designated for males if the sport is not offered for girls and women.

In May 2021, Republican Gov. Greg Gianforte signed into law HB 112, which states that students assigned male at birth may not participate in girls' sports in public elementary school, middle school, high school or college. It includes club and intramural sports.

Legislation to restrict transgender girls from participating in girls' and women's sports has been introduced but not passed. The Nebraska School Activities Association uses students' birth certificates to determine eligibility for sex-segregated sports. To participate in a manner consistent with their gender identity, transgender students must meet the following criteria: the student living as their gender identity; testimony provided by parents, friends, and/or teachers attesting to the validity of the student's gender identity; and verification from a health-care professional. Additionally, transgender girls must have completed one year of hormone therapy or had surgery, and demonstrate through a "medical examination and physiological testing" that they do not have any additional advantages. There are no requirements stated for transgender boys. To become eligible, a student's school must determine that they meet the requirements set by the NSAA and file an application with the association. The NSAA will convene a committee to review applications. There is an appeal process should a student's request be denied. In April 2023, the Kearney school district instituted a rule that a student-athlete's sex, as written on a birth certificate, would be the determination for participation in grades 6-12.

The Nevada Interscholastic Activities Association provides a position statement and policy guidance, but it is not regulatory. The guidance stipulates that schools should make the initial determination of a student's eligibility as reflected in the student's school records and daily life activities in school and the community. Schools may also consider additional documentation provided by the student. No medical or legal requirements are stated.

New Hampshire

Individual schools in New Hampshire determine the best placement for student-athletes. The New Hampshire Interscholastic Athletic Association instructs that the determination of a student's eligibility to participate in gender-specific sports should be made based on the gender identity of that student as reflected in school records and daily life activities in school and the community. No medical or legal requirements are stated. Bills aimed to prevent transgender girls from participating in girls' and women's sports have been introduced to the New Hampshire legislature, but none has passed.

New Jersey State Interscholastic Athletic Association policy states that transgender students may participate either according to their sex assigned at birth or in a manner consistent with their gender identity, but not both. There are no medical or legal requirements stated. Any member school may appeal the eligibility of a transgender student, and that appeal will be heard by a committee. Bills that would restrict transgender girls from participating in girls' and women's sports have been filed but not passed.

There is no state law in New Mexico. Eligibility for sex-segregated sports in New Mexico is determined by birth certificate, original or amended. No additional guidance is provided by the New Mexico Activities Association . Bills that would prohibit transgender girls from participating in girls' and women's sports have been filed in New Mexico but not passed.

The New York State Public High School Athletic Association policy is that all students should be able to participate in accordance with their gender identity. A student must notify their superintendent that they would like to participate in a manner consistent with their gender identity. The student's school determines eligibility, which is confirmed by the superintendent using documentation provided by the student. Any appeal of a transgender student-athlete's eligibility goes to the commissioner of education.

North Carolina

On Aug. 16, 2023, North Carolina's legislature overrode Democratic Gov. Roy Cooper's veto and enacted HB 574 , which bans transgender girls and women from participating on girls' and women's sports teams at most middle schools, high schools and colleges. It went into effect for the 2023-24 school year. "Sex shall be recognized based solely on a person's reproductive biology and genetics at birth," it states.

North Dakota

On April 11, 2023, Republican Gov. Doug Burgum signed into law HB1249 and HB1489 , which together place bans on athletes assigned male at birth from competing in girls' and women's sports at intramural and interscholastic levels, kindergarten through college.

The Ohio High School Athletic Association uses a policy based on hormone therapy. A transgender boy who has not begun hormone therapy may participate in girls' or boys' sports. To be eligible to participate in boys' sports after beginning hormone therapy, medical evidence must be submitted that demonstrates that increased muscle mass from testosterone does not exceed that of a cisgender boy. Additionally, testosterone levels must be monitored every three to six months. To be eligible for participation in girls' sports, a transgender girl must have completed one year of hormone therapy or provide medical evidence that she does not possess physical (bone structure, muscle mass, testosterone, hormonal, etc.) or physiological advantages. Hormone treatments must be monitored by a physician, with regular reports sent to the OHSAA executive director's office. In June 2023, the House approved H.B. 68, which would ban transgender girls and women from participating in girls' and women's sports from kindergarten through college. It has not yet been sent to the Senate.

As the debate around transgender athletes continues, researchers focus their studies on testosterone and the athletic benefits it can provide.

On March 30, 2022, Republican Gov. Kevin Stitt signed into law SB 2 , which prevents transgender girls and women from competing on girls' and women's sports teams. The law, which applies to athletes from kindergarten to college, took effect immediately.

Once a student, parent or guardian notifies the student's school of their desire to participate in a sporting category that differs from their sex assigned at birth, the Oregon School Activities Association will recognize that decision and hear no appeals from member schools on the issue. No medical or legal requirements are stated.

Pennsylvania

The Pennsylvania Interscholastic Athletic Association gives power to individual principals to decide when "a student's gender is questioned or uncertain." No other detail is given. Bills that would restrict transgender girls from participating in girls' and women's sports have been filed but not passed. At least one Pennsylvania school district, Hempfield School District in Lancaster County, enacted a policy in 2022 that requires student-athletes to compete on a team that matches the gender they were assigned at birth.

Rhode Island

There is no Rhode Island state law that bans transgender athletes from participating in sports consistent with their gender identity. Individual schools in Rhode Island determine students' eligibility for sex-segregated sports. The Rhode Island Interscholastic League provides instruction to those schools that gender identity should be based on current school records and the daily life activities of the student at school and in the community. If a student's gender identity differs from that listed on their records, the student must notify the school, and the principal makes the determination based on documentation from a parent, guidance counselor or doctor, psychologist or other medical professional. Bills restricting transgender athletes' participation have been introduced but not passed.

South Carolina

On May 16, 2022, Republican Gov. Henry McMaster signed into law H4608 , which prohibits transgender boys and girls from competing on sports teams consistent with their gender identity. The law affects athletes from elementary school through college.

South Dakota

On Feb. 3, 2022, Republican Gov. Kristi Noem signed into law SB 46 , which bans transgender girls and college-age women from playing in school sports leagues that match their gender identity.

In March 2021, Republican Gov. Bill Lee signed a law requiring student-athletes' "gender for purposes of participation" in athletic events to be determined by their original birth certificate. The law affects public high school and middle schools but excludes grades K-4. In May 2022, Lee signed into law a bill that bans transgender athletes from participating in women's college sports at public and private universities and includes both intercollegiate or intramural sports. It went into effect July 1, 2022.

On Oct. 25, 2021, Republican Gov. Greg Abbott signed into law HB 25 , which allows student-athletes participating in interscholastic sports to participate only in the sports that correspond with the sex listed on their "official birth certificate," which is defined as the document issued "at or near the time of the student's birth." On June 15, 2023, Abbott signed SB 15 , which extends the restriction to colleges and includes all NCAA, club and intramural sports.

On March 25, 2022, lawmakers voted to override Republican Gov. Spencer Cox's veto of H.B. 11, which bans transgender girls from participating on interscholastic sports teams consistent with their gender identity. In August 2022, District Court Judge Keith Kelly issued a preliminary injunction while he considered a lawsuit filed by three transgender student-athletes. While the lawsuit is pending, the state has convened a commission to make eligibility decisions about athletes on a case-by-case basis.

There is no state law that bans transgender athletes from participating in sports consistent with their gender identity in Vermont. The state has been home to recent controversies in basketball and volleyball . Students are required by the Vermont Principals' Association to notify their superintendent that they wish to participate in athletics consistent with their gender identity, and the home school will make the eligibility determination. The student must give the superintendent documentation from parents/guardians, guidance counselor and/or medical professional, though a medical diagnosis is not required. There are no medical or legal requirements stated.

Republican Gov. Glenn Youngkin issued new policies for transgender students this past July, but the Virginia High School League told its member schools it plans to retain its policy, which uses a multilevel review process to determine eligibility. The student or parent/guardian must contact the principal of the student's school and provide the following documentation: a personal statement from the student; one or two support letters from parents, friends or teachers; a list of medications; and verification from a physician. The principal forwards the student's case to the district committee. The district committee summarizes its review and escalates it to the VHSL executive director and/or compliance officer. If the decision does not grant the student eligibility, they may appeal.

Washington (State)

The Washington Interscholastic Activities Association policy states that each athlete will participate in programs "consistent with their gender identity or the gender most consistently expressed." There are no medical or legal requirements. If there is a question about eligibility, a student may appeal. Bills that would prohibit transgender girls from participating in girls' and women's sports have been introduced but not passed.

Washington, D.C.

Each school in Washington, D.C., determines the best placement of students when it comes to sex-segregated sports, but the District of Columbia State Athletic Association and the District of Columbia Interscholastic Athletics Association give clear guidance that schools must allow students to participate in a manner that is consistent with their gender identity. The association also has both an appeals and mediation process should a school deny a transgender student's eligibility. There are no medical or legal requirements stated.

West Virginia

On April 28, 2021, Republican Gov. Jim Justice signed into law HB 3293 , which mandates that student-athletes assigned male at birth may not participate in girls' sports in public elementary school, middle school, high school or college. It includes club and intramural sports. A lawsuit filed on behalf of a 12-year-old track athlete is pending, and the Supreme Court ruled in April that she can continue competing while the lawsuit continues.

Several bills restricting transgender athlete participation have been introduced in Wisconsin, but none has passed. If a transgender student-athlete wishes to compete on a team consistent with their gender identity, they must notify their school in writing, and then submit medical documentation, a personal statement, verification from a health-care professional of their gender identity and additional written testimony from their parents, friends and/or teachers. The Wisconsin Interscholastic Athletic Association provides additional guidance around hormone therapy: a transgender boy must participate in the boys' category if he's started hormone therapy but can participate in the girls' category "if desired" if he hasn't; a transgender girl may participate in the girls' category after completing one year of hormone therapy but can participate in the boys' category "if desired" before that time. These regulations apply even if a student has transitioned socially. There is an appeals process.

SF133 bans transgender girls and women in grades 7 through 12 from competing on sports teams consistent with their gender identity. The law, which went into effect July 1, also created a five-member school-activity-eligibility commission to hear eligibility appeals on a case-by-case basis. Republican Gov. Mark Gordon called the ban "draconian" and withheld his signature .

Transgender athletes face growing hostility: four tell their stories in their own words

USA TODAY’S “In Their Own Words” is a video project that interviewed four transgender athletes who told their own stories about living in an America that is increasingly hostile to gender diverse people. We’re using a video format so you can hear from the athletes directly.

This project is needed now more than ever. Increasing numbers of states are attempting to prohibit transgender athletes from participating on teams that align with their gender identities.

One of the main goals of supporters of these bills, the trans athletes interviewed for this project say, is to both demonize and spread misinformation about the trans community. They’ve identified sports as a vehicle to attack trans people, the athletes said.

These athletes tell a different story. It is a story of hope, self-expression, and sports competition. It’s their story…told in their own words.

Olympic medalist slams transgender track athlete for competing in women's event: 'Simply cheating'

S harron Davies, a former Olympic swimmer who won a silver in the 400 medley for Britain in 1980, was among those to call out the unfairness in allowing transgender athletes to compete in women’s sports on Sunday.

A picture of transgender track athlete CeCe Telfer circulated across social media from an event earlier this year. Telfer was competing in a meet a few years after winning an NCAA Division II championship with Franklin Pierce University in 2019.

CLICK HERE FOR MORE SPORTS COVERAGE ON FOXNEWS.COM

"Spot the male athlete in the women’s race! It’s simply Cheating," Davies wrote on X.

VIEW THE POST ON X.

Davies was far from the only critic. Others criticized the NCAA for allowing Telfer to compete in the championships about five years ago.

READ ON THE FOX NEWS APP

Currently, the NCAA takes a sport-by-sport approach when it comes to its transgender participation rules and takes its rules from the sport’s national governing body. USA Track and Field takes its policy from the International Olympic Committee, which says that "robust and peer-reviewed research" should determine eligibility.

MAGIC'S JONATHAN ISAAC CRITICIZES WHITE HOUSE OVER TRANSGENDER DAY OF VISIBILITY

"This Framework recognizes both the need to ensure that everyone, irrespective of their gender identity or sex variations, can practice sport in a safe, harassment-free environment that recognizes and respects their needs and identities," the IOC said in January.

World Athletics said last March it would prohibit transgender women from competing against biological females. The organization added it "decided to prioritize fairness and the integrity of the female competition before inclusion."

Telfer still expressed hope last year in competing for a spot on Team USA.

Follow Fox News Digital’s sports coverage on X and subscribe to the Fox News Sports Huddle newsletter .

Original article source: Olympic medalist slams transgender track athlete for competing in women's event: 'Simply cheating'

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His Brownstone Is Worth $5.4 Million. Why Is His Tax Bill So Low?

Housing advocates and even some homeowners in wealthier neighborhoods say New York’s property tax system is unfair. A court case could force the city to make changes.

Richard Erde, 83, stands in the doorway of his home. The door is made of glass covered in decorative iron, and is flanked by large planters. Columns rise on either side.

By Mihir Zaveri and Camille Baker

New York City is known for its pricey real estate, but some homeowners get an unexpected bargain: Property taxes on some of the fanciest, most coveted properties are often very low — at least relatively.

The flip side? Renters and homeowners in lower-income neighborhoods end up carrying a lot of the burden.

Take, for example, a $5.4 million brownstone in Brooklyn’s Park Slope. Its annual property tax bill is around $12,000 — about 0.2 percent of the home’s overall worth. Now compare that with the $7,500 tax bill for a $780,000 home in the Bronx. The cheaper home has an effective property tax rate almost four times higher.

Both bills are lower than in much of the suburbs, where property taxes for less valuable homes routinely top $25,000.

“I don’t think it’s fair,” said Mark Young, 60, who owns the brownstone.

Nearly everyone in New York agrees with him . Under the city’s property tax system, which is broadly criticized as opaque and unjust, lower-income homeowners and owners of big apartment buildings pay more relative to the value of their properties. Several mayors have unsuccessfully pledged to mend the resulting racial and economic disparities.

Now, a decision from the state’s highest court has made it much more likely that the city will be forced to make changes. The decision was procedural, essentially allowing the case to move forward. But the court rejected some of the city’s methods that have led to the unevenness.

In response to questions about the case, a spokesman for the city’s Law Department said the city was still figuring out its next steps, adding that the best way to improve the tax system was through the State Legislature. But Liz Garcia, a City Hall spokeswoman, said in a statement that “the city’s property tax system has been unfair, particularly for Black and Brown homeowners.”

“Mayor Adams has been clear that it needs reform,” she said.

Revenue from property taxes is extremely important to New York: The city draws in about $32 billion each year in property tax revenue, according to recent figures, amounting to about 30 percent of the overall $110 billion budget.

How the city raises that money, however, frustrates Carmen Daniels, 74, a retired teacher and administrator who bought a three-bedroom home in East New York in 1998.

Ms. Daniels noted that she pays considerably higher taxes relative to people in wealthier parts of Brooklyn, like Park Slope and Prospect Heights. She asked, “Why is it our taxes in the lower-income neighborhoods, people of color, why are the taxes more” than theirs?

A Deal on a Brooklyn Brownstone?

Richard Erde, 83, bought his home in Park Slope in 1980 for about $140,000. He said he had “watched the house appreciate tremendously” — his home today is valued by the city at nearly $6.5 million.

His roughly $15,000 property tax bill, however, doesn’t reflect that growth.

“It’s much less than, for instance, it would be if I lived in the Hamptons,” he said.

Officials in New York City follow a familiar formula to determine a tax bill. First, the city estimates a home’s market value. Then, it comes up with an “assessed value,” which is a smaller portion of the overall market value. Finally, it applies a tax rate to the assessed value to calculate how much the owner owes.

But the state sets limits on how quickly assessed values can go up. This benefits people like Mr. Erde in neighborhoods like Park Slope, where market values have skyrocketed, because it essentially means their tax bills won’t rise as fast as the market value of their homes.

A change in that system could be a hardship for Mr. Erde, who lives on a fixed income.

A higher tax bill would “cause us to adjust in some way our weekly, monthly budgeting for things,” he said.

People like Ms. Daniels are in a different situation. Home values in neighborhoods like hers have grown at a slower rate, meaning that even though assessed values are increasing, they rarely hit the limit.

Over time, that creates gaps between neighborhoods: Homeowners in Staten Island, much of the Bronx and parts of Brooklyn and Queens end up paying much more relative to the value of their homes compared with those in well-to-do neighborhoods.

Ms. Daniels’s $3,000 to $4,000 annual property tax bill may appear low. But it is effectively three times higher than Mr. Erde’s.

Condo vs. Rental

The gulfs can seem even more staggering when comparing co-op and condo buildings with rentals.

For example: A penthouse condo in Central Park Tower, advertised as the “tallest residential tower in the world,” sold in January for around $115 million. But the city valued the unit at only about $10 million in 2024, and valued the entire 179-unit building at $308 million.

The reason is a state rule that forces the city to value co-op and condo buildings as if they were rentals. But the city often uses rent-stabilized buildings in those comparisons, which means the condos and co-ops are valued too low, according to the court ruling. The court said the city should compare those buildings to market-rate apartments.

Rose Ricci-Mullen, 54, who owns a co-op apartment in Park Slope, is aware that her taxes are relatively low. She pays 30 percent of the roughly $11,000 in property taxes owed for her entire three-unit building, which was valued at close to $1.9 million.

Ms. Ricci-Mullen, a school librarian, said she would not have a problem with making the system more equitable. She said it was important to have a “tax base that makes it so everybody gets services.”

But if her taxes were to go up, she added, “I would need advanced warning, just because we’d have to budget around it.”

Compared with the owners of co-ops and condos, the owners of rental buildings pay much higher taxes. Damon Pazzaglini, chief operating officer of Fetner Properties, a real estate company, said taxes are the biggest component of a building’s expenses. As they rise, building owners typically pass on the cost to renters.

“This is one of the biggest drivers of high rents in New York that exists,” Mr. Pazzaglini said.

In many cases, apartments might not be built at all because the taxes are so high, Mr. Pazzaglini said. For example, he said that none of three developments Fetner is constructing — two in Long Island City and one on the Upper West Side, totaling almost 700 rental apartments — would have been built without a tax break to reduce some of the property tax costs.

“Simply, that land would be sitting fallow right now,” he said.

State lawmakers let such a tax break, known as 421a, expire in 2022 and the pace of rental construction has plummeted.

Flee for the Suburbs? Good Luck.

New Yorkers in search of affordable housing often cast their eyes on the suburbs . Many housing advocates would agree that the tax system is simpler in some suburbs. But that doesn’t necessarily mean that homeowners pay less.

Rachel Goldberg, 47, and her husband left New York City for South Orange, N.J., in search of “beauty and peace” and a place to raise their children, she said.

Their annual tax bill, however, is more than $25,000, she said. Her home was valued at close to $834,000 in 2023, according to county records. Ms. Goldberg, a school superintendent, said the couple may need to move again if the taxes keep growing, “which is sad.”

“I would love to say we’d be here for the next 20 years,” she said.

Mihir Zaveri covers housing in the New York City region for The Times. More about Mihir Zaveri

Camille Baker is a news assistant working for The Times’s Data team, which analyzes important data related to weather and elections. More about Camille Baker

Politics in the New York Region

A Jail Project: The demolition of a Manhattan jail complex in Chinatown to make way for a bigger one has damaged a neighboring building and raised concerns about years of dust and disruption.

Adultery as Crime: An antiquated but seldom-enforced state law categorizes adultery as a crime, and past efforts to repeal it have gone nowhere . But that seems poised to change.

Limiting Social Media’s Hold: New York’s governor and attorney general joined forces to pass a law trying to restrict social media companies’ ability to use algorithms to shape content for children. Big Tech is putting up a battle with a high-stakes lobbying effort.

Targeting Trans Athletes: A proposed ban on transgender women playing on women’s sports teams has turned a Long Island county into the latest battleground for conservatives who have put cultural issues at the center of a nationwide political strategy.

Illegal Donations: A Chinese business titan pleaded guilty to federal charges that he made more than $10,000 in straw donor contributions to political candidates — including, a person familiar with the case said, to a New York congressman and Mayor Eric Adams.

A Cannabis Mess: Gov. Kathy Hochul has ordered officials to come up with a fix for the way New York licenses cannabis businesses amid widespread frustration over the plodding pace of the state’s legal cannabis rollout.

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Sport and Transgender People: A Systematic Review of the Literature Relating to Sport Participation and Competitive Sport Policies

Jon Arcelus

Walter Pierre Bouman

Introduction

Search Strategy

Inclusion and Exclusion Criteria

Study Selection

Transgender People and Sport Participation

Table 1

Review of Transgender People and Competitive Sport Participation (Elite and Recreational): Research Articles

Review of Transgender People and Sport-Related Physical Activities: Research Articles

Transgender-Inclusive Sport Policies

Table 2

Review of the Sport Policies

Limitations of the Area and Directions for Future Research

Acknowledgments

Compliance with Ethical Standards

The fight for the future of transgender athletes

A patchwork of policies

A growing research field

‘Sports does discriminate’

From the field to the courts

Read more about sports and social issues

I’m Transgender. Here’s How Playing Sports Saved My Life

Trans Athletes Are Posting Victories and Shaking Up Sports

Striking a balance between fairness in competition and the rights of transgender athletes

Disclosure statement

Winners elicit outcry

Sports matter – with meaningful participation

The rise of women’s sports

Evaluating trans athletes on a case-by-case basis

Events Officer

Lecturer (Hindi-Urdu)

Director, Defence and Security

Opportunities with the new CIEHF

School of Social Sciences – Public Policy and International Relations opportunities

People also looked at

Introduction

Barriers to Participation

Biological Differences Related to Athletic Performance

Current Athletic Policies

Proposed Solutions

Author Contributions

Conflict of Interest

This article is part of the Research Topic

All the Arguments You Need: To Prove It’s Fair for Trans, Intersex Athletes to Compete in Consistence With Their Gender Identity

“Biological males have physical advantages over women such as more stamina, larger bones, and more muscle, so it’s unfair for trans women to compete with ciswomen.”

“Biological males have the advantage of testosterone that enhances performance so it’s unfair for trans women to compete with ciswomen.”

“Letting trans and intersex women compete in women’s sports will lead to many male athletes pretending to be women just so they can easily win.”

“If not men’s and women’s sports categories, then how do we organize sports fairly?”

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Four Myths About Trans Athletes, Debunked

FACT: Including trans athletes will benefit everyone.

FACT: Trans athletes do not have an unfair advantage in sports.

FACT: Trans girls are girls.

FACT: Trans people belong on the same teams as other students.

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