The author, a medical expert who transitioned in her 20s and has advised the IOC, believes science and sporting studies show a route to respecting the rights of all athletes
The participation of transgender athletes in womens sports continues to be one of the most contentious issues in all of sports. One side claim that it is unfair to allow anyone who has been through male puberty to compete in the womens division, while the other argues that anyone who identifies as female should be allowed to compete in womens sport.
I believe in a middle ground, one that respects the rights of all female athletes to enjoy meaningful competition, while also allowing those transgender women who have undergone medical transition a pathway to eligibility.
My personal journey and my research have influenced my opinions. While in my 20s, I ran a marathon in 2:23, and later transitioned to female. Within nine months of starting hormone therapy in 2004, I was running 12% slower; serious male runners are 10-12% faster than equally serious female ones. In 2015, I published a study of eight trans women distance runners who competed at a similar level as men before transition and as women after transition. To be clear, this is a small study of only one sport.
Before initiation of hormone therapy, trans women have all of the advantages of male athletes, so I do not believe that gender identity alone should be the gateway to allowing transgender athletes into elite level competition.
However, hormone therapy consisting of an anti-androgen agent plus oestrogen causes trans women to lose many components of athleticism. There are not yet any published data on strength sports analogous to my study and it is certainly true that even after hormone therapy, trans women will be, on average, taller, bigger and stronger than other women. Yet the larger frames of trans women when combined with reduced muscle mass and reduced aerobic capacity lead to disadvantages. The advantages and disadvantages held by trans women play out differently in different sports.
Lets look at the fortunes of one of the biggest and strongest trans women ever to compete against other female athletes. The Australian Hannah Mouncey stands 1.88m (6ft 2in) tall, weighs 100kg (15st 10lb), played for the Australian mens handball team, and is still in her 20s. If there ever was a trans woman who would dominate her sport, then Mouncey is she.
Mouncey played for the Australian womens handball team in the December 2018 Asian championships. Look online and several pictures of Mouncey show her towering over opponents. But optics dont always tell the full story. Clearly, Mounceys size and strength are advantages, but she was only the third-leading scorer for a team placed fifth in a 10-team tournament. Neither Mouncey nor her team dominated.
Beyond individuals, it is useful to look at population studies. The largest and longest of these would be collegiate sports in America. Each year more than 200,000 women compete in NCAA sports and the system has allowed trans women to compete after hormone therapy since 2011. Trans people make up between 0.5% and 1.0% of the population, and so there should be more than 1,000 trans women competing in the NCAA every year. Yet, eight years after the hormonebased rules were implemented, there are only a handful of trans women in American collegiate sports and they have won nothing of importance.
Paula Radcliffe and others have suggested that the current limit of 10 nanomoles per litre of testosterone (T) for trans women is too high cisgender (or typical) women are usually under 2nmol/L and I agree. In 2017, I was on a committee that recommended to the International Olympic Committee that it should reduce the limit to 5nmol/L, and I believe this change will be implemented for next years Tokyo Games.
It is important to note that 5nmol/L is an upper limit. Most trans women carry less than 1nmol/L of T after hormone therapy, and will likely have lower T levels than the women they compete against. Additionally, cisgender women with polycystic ovary syndrome can approach 5nmol/L and are still allowed to compete.
Lastly, I have been one of many to call for more transgender athletic research, especially into the area of muscle memory. Scientists at both Loughborough and Brighton Universities (along with a handful of other institutions worldwide) are initiating studies, and the IOC is offering research grants of up to $100,000.
Lord Coe, the chancellor of Loughborough University as well as president of track and fields governing body, the International Association of Athletics Federations, has said that transgender athletic research is among the most important research areas of the next 20 years. I think that, data permitting, we should eventually have sport-specific rules for transgender athletes, but that for now, imposing a limit of 5nmol/L of testosterone on trans women is the best condition we have to allow equitable competition for all athletes.
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