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Wednesday, May 7, 2025

Male to female transgender athletes in sport

The exclusion criteria

by

752 days ago
20230416

The in­clu­sion of trans­gen­der ath­letes in sports has be­come a top­ic of much de­bate and con­tro­ver­sy in re­cent years. While there is a grow­ing ac­cep­tance of gen­der flu­id­i­ty, the phys­i­cal dif­fer­ences be­tween males and fe­males are still a sig­nif­i­cant con­cern, es­pe­cial­ly in sports. I will dis­cuss the is­sue of male-to-fe­male (MTF) trans­gen­der ath­letes com­pet­ing in fe­male sports and jus­ti­fy the World Ath­let­ics’ move to ban such ath­letes from com­pet­ing in women’s events.

One of the most sig­nif­i­cant dif­fer­ences be­tween males and fe­males re­gard­ing ath­let­ic per­for­mance is the lev­el of testos­terone present in the body. Testos­terone is a hor­mone that is pri­mar­i­ly pro­duced in the testes in males and ovaries in fe­males. It plays a cru­cial role in the de­vel­op­ment of male sex­u­al char­ac­ter­is­tics, such as mus­cle mass, bone den­si­ty and body hair. The nor­mal testos­terone con­cen­tra­tion for males is ap­prox­i­mate­ly 10-35 nanomoles per litre, while the nor­mal range for fe­males is ap­prox­i­mate­ly 0.5-2.5 nanomoles per litre.

Testos­terone lev­els peak in males dur­ing ado­les­cence and ear­ly adult­hood, and it is dur­ing this time that males ex­pe­ri­ence the most sig­nif­i­cant gains in strength, speed, and en­durance. This hor­mone acts on var­i­ous tis­sues in the body, in­clud­ing mus­cles and the brain, to en­hance male sex­u­al de­vel­op­ment and sec­ondary sex­u­al char­ac­ter­is­tics. It reg­u­lates mus­cle mass, fat dis­tri­b­u­tion, bone den­si­ty and even cog­ni­tive traits such as ag­gres­sion. As a re­sult, males have a clear ath­let­ic ad­van­tage over fe­males.

The World An­ti-Dop­ing Agency (WA­DA) has es­tab­lished poli­cies to ad­dress the in­clu­sion of trans­gen­der ath­letes in sports. The pol­i­cy al­lows each sport­ing fed­er­a­tion to make de­ci­sions re­gard­ing the in­clu­sion of male-to-fe­male trans­gen­der ath­letes in fe­male sports. If a trans­gen­der ath­lete wish­es to com­pete with cis-gen­dered fe­males, they must med­ical­ly low­er their testos­terone lev­els be­fore com­pet­ing. This is done to en­sure that the play­ing field is fair and that there is no gen­der-based ad­van­tage.

How­ev­er, low­er­ing testos­terone lev­els does not com­plete­ly re­verse the per­for­mance ad­van­tage that males have over fe­males. Old­er stud­ies such as Bhasin et al., 1996 and Singh et al., 2003 do demon­strate a de­crease in mus­cle mass and strength. More re­cent stud­ies do sup­port the pre­vi­ous find­ings but al­so made new dis­cov­er­ies which are more rel­e­vant to sports. Hew-But­ler et al., 2008 and Gal­vao et al., 2008 found that the meta­bol­ic rate is not de­creased, and phys­i­cal per­for­mance is of­ten not sig­nif­i­cant­ly de­creased. This means that a trans­gen­der MTF ath­lete may still have some ath­let­ic ad­van­tage over cis-gen­dered fe­males, even af­ter un­der­go­ing testos­terone sup­pres­sion ther­a­py. The on­ly way to en­sure that there is no gen­der-based ad­van­tage is to use testos­terone sup­pres­sion ther­a­py be­fore the on­set of pu­ber­ty. How­ev­er, this rais­es sig­nif­i­cant eth­i­cal is­sues re­gard­ing con­sent and the long-term ef­fects of hor­mone ther­a­py.

Re­cent­ly, World Ath­let­ics an­nounced that it would ban trans­gen­der ath­letes from com­pet­ing in women’s events. The move was based on the un­der­stand­ing that the sup­pres­sion of testos­terone lev­els does not elim­i­nate the phys­i­cal ad­van­tages that males have over fe­males. The de­ci­sion was not made light­ly and was based on sci­en­tif­ic ev­i­dence and con­sul­ta­tion with ex­perts in the field. I sup­port the move by World Ath­let­ics based on the da­ta we cur­rent­ly have avail­able.

The ban ap­plies to all events that are re­strict­ed to fe­male ath­letes, in­clud­ing track and field, road run­ning and cross-coun­try. How­ev­er, it does not ap­ply to events that are open to all gen­ders, such as mixed re­lays. The move by World Ath­let­ics is not a dis­crim­i­na­to­ry move but rather a nec­es­sary one to en­sure that the spir­it of sport is sup­port­ed and that the play­ing field is fair.

The in­clu­sion of trans­gen­der ath­letes in sports is a com­plex is­sue that re­quires care­ful con­sid­er­a­tion. While there is grow­ing ac­cep­tance of gen­der flu­id­i­ty, the phys­i­cal dif­fer­ences be­tween males and fe­males can­not be ig­nored, es­pe­cial­ly in sports. I be­lieve that very soon oth­er sport­ing dis­ci­plines will fol­low this move to al­low for a fair space for cis-gen­dered fe­male ath­letes to com­pete.

In Ja­maica, we have not had a case of a trans­gen­der ath­lete try­ing to com­pete at the na­tion­al lev­el, but we must pre­pare for such pos­si­bil­i­ties and be guid­ed by sci­ence. Un­til we can be con­fi­dent, with sci­en­tif­ic ev­i­dence, that trans­gen­der MTF ath­letes do not have a sig­nif­i­cant ad­van­tage, fol­low­ing what­ev­er new ther­a­py is de­vel­oped, we can­not con­tin­ue to place fe­male ath­letes at a dis­ad­van­tage.

Dr Aldeam Facey is a lec­tur­er in the Fac­ul­ty of Sport, Mona Cam­pus, UWI. He re­ceived the Prime Min­is­ter’s Youth Award for Ex­cel­lence for In­no­va­tion in Sci­ence 2018.


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