Transgender people in sports
The participation of transgender people in competitive sports is a controversial issue, particularly where trans women athletes who went through male puberty are successful in women's sports, or may cause injury to cisgender women competitors while competing. Resistance to trans women competing in women's sports generally focuses on physiological attributes such as height and weight, or performance metrics such as speed and strength, arguing that testosterone suppression and estrogen does not adequately reduce advantages gained in male puberty within a given women's sport. Supporters of transgender athletes argue that medically prescribed puberty blockers  and estrogen suppresses testosterone levels and reduces muscle mass of transgender women, potentially reducing possible competitive advantages. Supporters also argue that sport, particularly youth sports, is also about belonging, well-being, and socialization of young people. Supporters, such as the American Medical Association, contend that anti-transgender legislation, including in sports, harms the mental health of transgender people. Access regulations requiring that trans athletes compete against athletes of the same assigned sex at birth and requiring sex verification testing have been used. Proponents of such regulations regard them as necessary to ensure fair competition, while opponents regard them as unfounded  and discriminatory. History of transgender athletes in competition. Historically, sport has been seen as a male domain. The masculine perception of sport was first moderated with the rise of women's sports and further challenged with the gradual acceptance of gay sportsmen. A third departure from tradition occurred with the emergence of trans athletes, many of whom challenge the culturally accepted binary gender norms of male and female. Renée Richards. One of the earliest high-profile transgender athlete was tennis player Renée Richards. Already a promising tennis player in the men's circuit, Richards underwent gender reassignment therapy in 1975  and started playing in women's tournaments a year later. Her discovery and the resulting media frenzy sparked protests. After she accepted an invitation to a warm-up tournament for the US Open, the Women's Tennis Association (WTA) and the United States Tennis Association (USTA) withdrew their support and 25 of the 32 women pulled out of the tournament. As a result the USTA and WTA introduced the Barr body test, which identifies a person's sex chromosomes. Richards refused to take the test and was banned from the US Open. She filed a lawsuit in 1977 claiming that  her civil rights were violated and that the policy was unfair. The New York Supreme Court ruled in her favor, saying that the Barr body test as the sole determinant of sex was "grossly unfair" and ruled Richards legally female. She then competed in the 1977 US Open at the age of 43, lost in the first round and retired four years later. At the time, the ruling in Richards's case did not lead to major changes outside of tennis. Olympics. In 2003, a committee convened by the International Olympic Committee (IOC) Medical Commission drew up new guidelines for  participation of athletes who had undergone gender reassignment. The report listed three conditions for participation. First, athletes must have undergone sex reassignment surgery, including changes in the external genitalia and gonadectomy. Second, athletes must show legal recognition of their gender. Third, athletes must have undergone hormone therapy for an appropriate time before participation, with two years being the suggested time. It was not until 2004 that the IOC allowed transgender athletes to participate in the Olympic Games. In 2015, the IOC modified these guidelines in recognition that legal recognition of gender could be difficult in countries where gender transition is  not legal, and that requiring surgery in otherwise healthy individuals "may be inconsistent with developing legislation and notions of human rights". The new guidelines require only that trans woman athletes declare their gender and not change that assertion for four years, as well as demonstrate a testosterone level of less than 10 nanomoles per liter for at least one year prior to competition and throughout the period of eligibility. Athletes who transitioned from female to male were allowed to compete without restriction. These guidelines were in effect for the 2016 Rio Olympics, although no openly transgender athletes competed. In 2021 , the IOC approved Laurel Hubbard, a trans woman, to compete in the 2020 Summer Olympics in weightlifting. Hubbard became the first out trans woman to compete at the Olympics; she did not complete her lifts and won no medals. Katelyn Burns, an MSNBC Opinion Columnist, suggested Hubbard's performance demonstrates that transgender athletes do not always win. Hubbard competed with the support of her fellow Olympian competitors. Australian weightlifter Charisma Amoe-Tarrant said "I have so much respect for her and wish her and the other lifters the best and hope we can all come together and enjoy the Olympics , because this Olympics right now is quite different compared to others. I’ve competed with her previously and always had good chats with her, I just wish her well." On 21 July 2021, at the same Games, Canadian non-binary soccer player Quinn became the first transgender person to compete at the Olympics, playing for the Canadian women's soccer team. At the 2020 Summer Olympics, they became the first out, transgender Olympian to medal and win a gold medal. Alana Smith, a non-binary skateboarder, represented the United States in the women's skateboarding semifinals of the 2020 Summer  Olympics. In November 2021 the IOC issued a non-legally binding framework that focuses on ten principles of inclusion: prevention of harm, non-discrimination, fairness, no presumption of advantage, evidence-based approach, primacy of health and bodily autonomy, stakeholder-centered approach, right to privacy and periodic reviews. The new guidelines have been described as loosening the rules that restrict the participation of transgender and intersex athletes in Olympic sports, with enforcement of sport-specific rules governing inclusion. On February 18, 2022, Timothy LeDuc became the first openly non-binary athlete to compete in a Winter Olympics in Beijing. They competed  in pairs figure skating alongside their skating partner Ashley Cain-Gribble for Team USA. World Athletics. In October 2019, World Athletics changed the testosterone limit for transgender competitors, setting it at 5 nmol/L, from the previous 10 nmol/L, in order to bring it in line with the DSD (intersex) regulations. According to regulations from October 2019, in order for a trans woman to compete in the women's category: "3.2.1 she must provide a written and signed declaration, in a form satisfactory to the Medical Manager, that her gender identity is female; 3.2.2 she must demonstrate to the  satisfaction of the Expert Panel (on the balance of probabilities), in accordance with clause 4, that the concentration of testosterone in her serum has been less than 5 nmol/L continuously for a period of at least 12 months; and 3.2.3 she must keep her serum testosterone concentration below 5 nmol/L for so long as she wishes to maintain her eligibility to compete in the female category of competition." World Athletics also has rules for intersex/differences of sex development (DSD) athletes. DSD athletes will be subjected to specific rules if they have XY male chromosomes, testes rather than  ovaries, have circulating testosterone within the typical male range (7.7 to 29.4 nmol/L), and are androgen-sensitive so that their body makes use of that testosterone. World Athletics requires that any such athlete must reduce their blood testosterone level to 5 nmol/L or lower for a six-month period before becoming eligible for track running events from 400 metres to the mile run in international competition, though World Athletics publicly remains open to extending this to other events based on new scientific study. World Athletics created these rules as a way to ensure fair competition in the women 's category. Others. In 1996, the Iron Ladies, a men's volleyball team made up of gay men and transgender women from Thailand, won the national championship. The Iron Ladies were not allowed to join Thailand's national volleyball team because of the way they dressed. The first out transgender person to make a US national team was Chris Mosier, who in 2016 qualified for Team USA in duathlon. Mosier is considered the catalyst for the change in the IOC policy on transgender athletes in 2015, when he challenged the policy after initially being banned from the world championship race . Mosier also became the first known transgender athlete to compete in the Olympic Trials in the gender with which they identify, and the first trans man to make a men's Olympic Trials, when he competed in January 2020 in the US Olympic Team Trials in the 50k Racewalking event. In 2017, Mack Beggs, a teenager from Texas, was required to wrestle against girls throughout the season of his transition from female to male up through the state championship, despite wanting to wrestle against boys. This was due to state sport regulations requiring athletes to compete alongside athletes of their  assigned sex. Some opponents say the testosterone prescribed as part of his transition gives him an unfair advantage and made it unsafe for the other wrestlers. (He finished the regular season at 52–0 and won the state championship.) In October 2018, Veronica Ivy (then known as Rachel McKinnon) won a gold medal at the cycling Masters World Track Championship in Los Angeles. Since 2021, media has widely covered University of Pennsylvania student Lia Thomas, who swam for the men's team in 2018–2019, and for the women's team in 2021. "The Washington Post" wrote that Thomas was "shattering records . In December 2021, USA Swimming official Cynthia Millen resigned in protest, because of her belief that Thomas has an unfair advantage over her competitors. In February 2022, CNN called Thomas the face of the debate on transgender women in sports". In March 2022, she became the first openly transgender athlete to win an NCAA Division I national championship in any sport after winning the women's 500-yard freestyle event. Thomas lost muscle mass and strength through testosterone suppression and hormone replacement therapy. Her time for the 500 freestyle is over 15 seconds slower than her personal bests before medically  transitioning. Thomas’s winning time of 4:33.24 was 9.18 seconds short of Katie Ledecky’s NCAA record of 4:24.06. In other races, Thomas has been beaten by multiple cisgender women as well as by Iszac Henig, a transgender man not on hormones. Testing. Sports organizations have sought a test for sex verification to ensure fairness across all sports. This began in the 1940s with "femininity certificates" provided by a physician. In the 1960s, visual genital inspections were used to confirm gender, followed by chromosomal analysis to detect the presence of the SRY and DYZ1 genes, normally found on the Y  chromosome. These tests were all designed to ensure that athletes were only allowed to compete as their sex, but mostly resulted in the exclusion of intersex athletes. More recently, testosterone levels have become the focus and, at the same time, new guidelines have been sought that would allow successfully-transitioned athletes to compete. Since the proposition in 2003 to use testosterone levels, reputable organizations such as the IOC have adopted strict policies that employ testosterone as a metric to allow successfully transitioned female athletes to compete. More recent guidelines have focused entirely on testosterone levels, such as the IOC's  current guidelines, originally set in November 2015, which set limits on transgender athletes' testosterone levels for them to be permitted in women's competition categories. Controversy surrounding the 2020 Tokyo Olympics also centered around testosterone levels, specifically over whether the IOC's guidelines should be amended to set stricter testosterone limits, although this proposed change has been strongly debated. The testing of testosterone alone as a marker for athleticism has been debated. The increased visibility of trans women in professional sports has led to debates on the IOC policies. Many scientists criticize the policies because of published papers showing that  people who went through male puberty retain significant advantages even after a year of testosterone suppression. In July 2021, the IOC's medical and science director, Richard Budgett, stated that the 2015 guidelines were outdated and that new ones would be coming in a few months. He stated that the new guidelines would help each individual sport to balance between safety, fairness, and inclusion. Testosterone, athletic ability and injury risks. Biological sex differences in humans impact performance in sports. Debate over whether and how transgender women should compete in female sports often has to do with whether they have an  unfair advantage over cisgender women due to higher testosterone levels and skeletal, muscle and fat distribution differences. Testosterone regulates many different functions in the body, including the maintenance of bone and muscle mass. A 2021 literature review concluded that for trans women, even with testosterone suppression, "the data show that strength, lean body mass, muscle size and bone density are only trivially affected. The reductions observed in muscle mass, size, and strength are very small compared to the baseline differences between males and females in these variables, and thus, there are major performance and safety implications in sports where these  attributes are competitively significant." After 24 months of testosterone suppression, bone mass is generally preserved. The review states that no study has reported muscle loss greater than 12% with testosterone suppression even after three years of hormone therapy. It found that trans women are in the top 10% of females regarding lean body mass and possess a grip 25% stronger than most females. They suggest that instead of universal guidelines, each individual sport federation decide how to "balance between inclusion, safety and fairness" due to differences between sports. A 2021 systematic review found that significant decreases in measures of strength , lean body mass and muscle area were observed after 12 months of hormone therapy, while the values remained above those observed in cisgender women, even after 36 months, suggesting that trans women "may retain strength advantages over cisgender women." Effects of longer duration therapy were unclear due to scarcity of data. A 2017 systematic review of literature relating to sport participation and competitive sports policies reported that there is no direct or comprehensive evidence of transgender women having an athletic advantage over their cisgender counterparts at any stage of transition (e.g. cross-sex hormones or sex reassignment surgery), due to  the lack of quantitative research on the subject; this made it "difficult to draw any definite conclusions". Only one of the papers in the systematic review took any physical attributes into account. A 2018 extended essay analyzed the current IOC rule set in 2015 (testosterone below 10 nmol/L for trans women) and found that "the advantage to transwomen afforded by the IOC guidelines is an intolerable unfairness", while they propose to abandon male/female categories in favor of a more nuanced division. A 38-page draft document from World Rugby's transgender working group in 2020 acknowledged that rugby  players who are cisgender women, when tackled by a player who has gone through male puberty, are at a significantly greater risk of injury. The working group calculated that increased injury risk for typical players with female characteristics when tackled by a typical player with male characteristics was between 20 and 30%, and potentially reaching "levels twice as large" in extreme cases where the players are unusually small and large, respectively. Consequently, the document proposes that in the absence of persuasive evidence to the contrary, International Olympic Committee (IOC) guidelines regarding a minimum 12-month lowering of testosterone are "not  fit for purpose" in the context of rugby. This move was criticized because there were "no examples of transgender women causing serious injuries to cisgender women". In secondary education. Australia. In July 2019, Sport Australia published guidelines on making sport more inclusive for transgender and gender-diverse people. Canada. Provincial governing bodies for high school sports have independent policies on the participation of transgender or non-binary athletes on sex-segregated teams. Organizations such as the Alberta Schools' Athletic Association, the Manitoba High Schools Athletics Association and BC School Sports each have policies that allow the participation of transgender student -athletes in accordance with their gender identity. Transgender or non-binary student-athletes looking to compete in a team consistent with their gender identity in British Columbia must submit an application to the BC School Sports Executive Director, and are required to have a written statement from both the student-athlete and the principal of their high school confirming their gender identity. United States. There are no rules federally to regulate inclusion of transgender children. States vary widely on participation of transgender children in sports and which locker room those students should use. Opponents of including transgender athletes emphasize the  argument that there may be an unfair advantage of larger size and strength in trans women, and trans athletes could threaten the safety of cisgender children, both in competition and in the locker room. Advocates in favor of allowing transgender children to participate in sports based on their preferred gender point out the known benefits of participating in sports and the psychological well-being of the transgender children. Many states have tried to mimic the NCAA and IOC rules that rely on testosterone level tests to determine when a trans woman can participate in women's sports competitions. These kinds  of rules are more difficult to enforce in secondary education because of the lack of resources to test testosterone levels, and medical professionals are often hesitant to prescribe minors hormones. States have individually come up with rules to regulate trans athlete participation through restricting transgender athletes to teams of their assigned sex at birth, matching NCAA/IOC guidelines, allowing school districts to decide, or allowing complete inclusion. Section::::"Hecox v. Little". In March 2020, Idaho Governor Brad Little signed into law the "Fairness in Women's Sports Act", also known as House Bill 500. This legislation, the first of its kind  in the United States, prohibits transgender athletes from competing in sports against athletes of the other biological sex. In April 2020, the ACLU and the Legal Voice filed a lawsuit, "Hecox v. Little", arguing that this law violates the US Constitution and Title IX. ADF Legal Counsel Christiana Holcomb, representing two female athletes, said: "Both of our clients agree: Putting male athletes up against females is simply not fair because it changes the nature and dynamics of sport for young women ... In one year, 275 high school boys ran faster times than the lifetime best of World Champion sprinter Allyson  Felix." On August 17, 2020, the United States District Court for the District of Idaho issued a preliminary injunction against the law pending trial, issuing an opinion that the plaintiffs were "likely to succeed in establishing [that] the Act is unconstitutional as currently written". the case is before the Ninth Circuit Court of Appeals. Section::::"Soule v. Connecticut Association of Schools". After women's high school competitions were won by transgender student Andraya Yearwood in Connecticut, a lawsuit was filed against the Connecticut Association of Schools-Connecticut Interscholastic Athletic Conference (CIAC) and several school boards in federal court to try to  stop the participation of transgender athletes. Christiana Holcomb, ADF Legal Counsel in the case, said that Yearwood and Terry Miller (another transgender student athlete in Connecticut) between them "amassed 15 different state championship titles that were once held by nine different girls across the state." The lawsuit was dismissed in April 2021 by the district court as moot. In October 2021, women's sports icons Billie Jean King, World Cup Champion and United States women's national soccer team Co-Captain Megan Rapinoe, WNBA stars Brianna Turner, Layshia Clarendon, and over 150 athletes in women's sports filed an amicus  brief in an appeal of the "Soule v. CIAC" trial court dismissal, along with the Women's National Basketball Players Association (WNBPA), Athlete Ally, and the Women's Sports Foundation, in support of CIAC and affirming the dismissal. Post-secondary education. Canada. In September 2018, U Sports, the governing body of intercollegiate and varsity athletics in Canada, released a policy addressing eligibility and best practices for the inclusion of transgender student-athletes at their member institutions. Under this new policy, U Sports student-athletes are able to compete according to their gender identity or sex assigned at birth provided they  meet requirements of the Canadian Anti-Doping Program. Transgender student-athletes, like other U Sports athletes, are given five years of eligibility to compete and may only represent one gender of sports team per school year. United Kingdom. Under the Equality Act 2010, discrimination based on sex or gender reassignment is illegal, however certain sporting activities are exempt if transgender athletes competing would put non-transgender athletes at an unfair disadvantage. It does not apply to those who consider themselves trans or non-binary, but have not undergone gender reassignment officially. In April 2022, the Prime Minister Boris Johnson said  he believed that transgender women should not compete in women's sport. United States. In August 2011, the National Collegiate Athletic Association Office of Inclusion published the NCAA Inclusion of Transgender Student-Athletes resource outlining their best practices and policies for the inclusion for transgender student-athletes. This policy permits transgender athletes who are not using hormone therapy to continue to participate on the team that corresponds to their assigned sex at birth. A trans man student-athlete may participate on either a men's or women's team, unless receiving testosterone, in which case he may only compete on  a men's team; athletes receiving doses of testosterone as a part of their transition must apply for a medical exemption through the league, as testosterone is considered a banned substance in the NCAA. A trans woman student-athlete is not permitted to compete on a women's team until after one year of testosterone suppression treatment. Ongoing monitoring of treatment and written documentation is required for student-athletes undergoing testosterone suppression. A 2021 Gallup poll showed that 62% of Americans opposed people playing on teams that matched their gender identity rather than their birth sex. However, a 2021 PBS /NPR/Marist poll found 67% of Americans, including 66% of Republicans, oppose legislation that would prohibit transgender student athletes from joining sports teams that match their gender identity. Public opinion. A March 2022 Harvard CAPS-Harris Poll found that 63% of Americans were against gender-transitioning athletes competing in opposite-sex sporting events, while 37% of Americans were in favour of them competing. 60% of Democrats, 32% of Independents, and 20% of Republicans were in favour of gender-transitioning athletes competing in opposite-sex sporting events, while 80% of Republicans, 68% of Independents, and 40% of Democrats were against them  competing. In 2022, Australian Olympic swimmer Emma McKeon publicly stated that she is against transgender athletes competing in women's sport, saying "it's just not fair". Emily Seebohm supported McKeon the following day saying "Biological males are always going to be faster and stronger than I will ever be in my life".