A shorter version of the article appears in the printed version of Youth Hong Kong on pages 24-26.
Transgender participation in sport has drawn increasing attention as more and more transgendered athletes are entering competitions. The Olympic Games welcomed its first openly transgendered women to compete in the women’s weightlifting competition this year in Tokyo. The discussion on this issue has been polarized, as it touches on gender identity concerns. Some fear that competition may no longer be fair, particularly in women’s sports, if a former biological man competes against biological women, taking podium positions, athletic scholarships, and replacing girls’ records. Others advocate inclusivity in sports and respect for all athletes irrespective of identity.
Sports should be for all. There is no doubt about the importance and benefits of sports participation.i Further, trans rights are equal to men’s and women’s rights, and none of these rights is less than human rights, including the right to participate in the cultural life of the community.ii Everyone should enjoy the opportunity to compete. That said, the controversy lies in competitive sports, where athletes train to compete against one another in a regulated environment, and where winning or losing matter greatly for careers.
The debate on transgender inclusion in sports is centered particularly on transwomen (individuals who transitioned from being a male). Opponents to inclusivity frequently cite the fairness argument, which can be represented in the following premises:
Premise 1: Competition should be as fair as possible.
Premise 2: Biological males have an unfair physical advantage over biological females and transwomen are biological males.
Logically speaking, the conclusion that follows is that it is unfair for competitive sports to pit transwomen against ciswomen. Are the premises valid and sound? Can we avoid the conclusion?
Two questions arise from premise 1:
According to UNESCO, fairness is one of the values of sport,iv which means fairness is a widely endorsed quality to be expected in any sporting environment. It is counterintuitive if sport is all about being the absolute bestin this sense, it would be logically permissible to put anyone who wish to compete in one large pool of competitors, and it would be permissible for anyone to pursue any means to improve their performance.
If fairness is something that we expect in sport, then how do we draw the line between fair and unfair? Some argue that no competition is fair because some people are gifted with genetic advantages. For example, Michael Phelps is nearly 2m tall, has an arm span of 2m, unusually flexible ankles and muscles that produce half the lactic acid as normal, v all of which are advantageous features for a swimmer. Because no competition is truly fair, fairness is arbitrary and hence does not matter. However, this argument is not constructive to the discussion and unrealistic in terms of how sports operate.
There are reasons why competition is segregated by age, sex, abilities, and sometimes by weight. Kids, youths, adults, and older adults don’t compete against each other, nor do males or females. We have the Olympics for the able-bodied, Paralympics for people with physical disabilities, Special Olympics for people with intellectual disabilities and the World Masters Games for older adults. There are also different weight classes in weightlifting and combat sports and categories of disabilities in the Paralympics. While there are inherent advantages that some possess, we still consider such competition to be fair. Indeed, fairness does not, and cannot mean being equal in every single aspect imaginable.
It is therefore more constructive to ponder at what point the advantage crosses the line from inevitable and acceptable to avoidable and unacceptable. Unfairness is where an advantage is intolerable and sufficiently morally troublesome to warrant elimination.vi It is sensible to say that competition should not be unfair, such that athletes would consider the pursuit to win is worthwhile, and that the pursuit is far from hopeless. This should keep the athlete motivated to dedicate time and effort in their sports despite some differences between the competitors. With this in mind, let’s evaluate premise 2.
Three questions arise from premise 2:
Let’s explore these questions one by one.
(I) Consider an example in sprinting, a sport which pure physicality determines success. E. Thompson-Herah, a 29-year-old Jamaican professional athlete, won the gold medal and broke the Olympic record in the women’s 100m sprint with 10.61s at the Tokyo Olympics.vii However, this was slower than a record set by a Hong Kong secondary school boy, aged under 19, who ran 100m in 10.60s in 2017-18. Not only did the boy break the 100m record of the Hong Kong Inter-school Athletics Competition, he would also have broken the Olympic record if he had run the women’s 100m in the Olympics.viii But, these times wouldn’t even qualify for the finals in the boy’s 100m sprint in the 2017 New Balance Nationals, a competition for US high school students.ix The performance gap between biological males and females in various sports is undeniable: 11-13% in rowing, swimming, and running, 16-22% in track cycling and jumping, >20% in sports that involve extensive upper body contributions, 31-37% in weightlifting and >50% in baseball pitch.x
Why are there such performance gaps that give males superior strength, power and endurance? Males and females are different in terms of hormonal, musculoskeletal, and cardiovascular respiratory physiology. Hormonally, a male’s testosterone level is >15-fold that of a female at any age. This provides a significant, continuous and cumulative physical advantage by forming larger and stronger bones, greater and denser muscle mass, greater strength and increased erythropoietin production, hence increased red blood cell count and 12% higher circulating haemoglobin on average.xi In contrast, increased estrogen levels in females lead to increased fat mass and shorter bone growth. Biological males are taller, with a larger fulcrum that provides greater leverage for exerting power in jumping, throwing, and other explosive activities.xii Being tall is also advantageous in sports like basketball, volleyball, swimming and rowing. Cardiovascular respiratory features also set males apart. Their larger lung volume and greater tracheal cross-sectional area lead to greater exercising ventilation potential.xiii Larger blood volume, larger heart size, larger stroke volume, more red blood cells and higher haemoglobin concentrationxiv lead to overall superior cardiac outputxv and aerobic capacity.xvi Taken together, these features show that no amount of training nor fitness regimen could allow the best female athletes to compete meaningfully with males at the same level and that’s why we have men’s sport and women’s sport.
(II) Are transwomen biological males? The biological sex of a person is defined by genetic, chromosomal, gonadal, hormonal and phenotypic (including genital) characteristics,xvii all of which are, by definition, binary: either male or female.xviii Gender is a self-identified social construct that expresses a person’s experience and feelings about their gender role,xix although it is inherently related to biology.xx Transgender people are those who experience a different gender from that assigned at birth.xxi Transwomen, especially those who transitioned after puberty, possess male biological characteristics. Although testosterone can be suppressed with ongoing hormonal therapy, the biological traits (genetics) and the male physique that come from going through male puberty do not disappear with transition. The fact that transwomen are biological males cannot be interpreted otherwise.xxii
(III) Do transwomen have an unfair physical advantage against ciswomen? Joanna Harper, a transwoman athlete, scholar and advocate advisor to the Olympic Committee on Gender and Sport attested, “There’s absolutely no question in my mind that transwomen will maintain strength advantages over cis women, even after hormone therapy,”xxiii “It is certainly true that as a population group, trans women do have athletic advantages over [cisgender] women.”xxiv There is no doubt that transwomen will lose some physical advantage after going through transition. Yet, a study found that mean muscle mass in transwomen after a year of cross-sexual treatment remained significantly higher compared to transmen.xxv While testosterone suppression typically reduces the physical advantage enjoyed pre-transition, studies have established that the muscular advantage of transwomen is minimally reduced.xxvi Bone density remains the same for about 12.5 years post-transitionxxvii and the male skeletal parameters remains unaltered in transwomen.
Do we see transwomen’s advantage manifest in competitions? Consider the following examples. From 1998-2012, Laurel Hubbard did not qualify for any international tournament as a male weightlifter. In 2013, Hubbard transitioned at the age of 35. Between 2014 and 2021, Hubbard qualified for 11 international tournaments as a women weightlifter, including the Tokyo Olympics. Laurel also won two gold medals at the Pacific Games. In 2017, Cece Telfer ranked 390th in the men’s NCAA Division II 400m hurdles. Telfer transitioned in 2018 and championed the 2019 NCAA Division II women’s 400m hurdles. From 2013-2015, Hannah Mouncey made 22 appearances for the Australian men’s handball team but scored no goals. Mouncey transitioned in 2018 and played 6 times in the Australian women’s handball team, scoring 23 goals. From 2017 to 2019, Terry Miller and Andraya Yearwood, two transwomen athletes, won 15 different US state championship titles that were once held by 9 different girls. Note that only examples of transwomen winning over women can be found, because little would report on those who are not taking up podium positions. Nevertheless, these are just a few of the examples of transwomen winning in women’s sport.
Would this kind of athletic advantage that transwomen have over ciswomen be considered unfair and intolerable, or fair and tolerable? This is a question for you to consider. Opinion on this question is diverse, as are proposed ways to mitigate what is considered an unfair advantage. Through finding ways to maintain the fairness of competition between transwomen and ciswomen, the logical conclusion of the argument may be avoided and transwomen could be included in competitive sports without being questioned.
One option is strict segregation according to biological sex so that women don’t have to worry about competing against the physical advantage of transwomen. But, if they cannot identify with their competitors, this may discourage some transwomen from competing at all. Furthermore, this creates another controversytransmen are biological women, but some may have taken hormone therapy to increase their testosterone level so that they can develop masculine characteristics. Mack Beggs is a teenager from Texas. In 2017, Beggs was required to wrestle against girls, despite being a transman and wanting to wrestle against boys because Texas required athletes to compete according to their biological sex. Opponents complained that the testosterone prescribed as part of Beggs’ transition offered Beggs an unfair advantage and made the competition unsafe for the other girl wrestlers. Beggs finished the regular season undefeated and won the state championship.xxix But Begg’s victory wasn’t celebrated by all because the transition Begg went through was considered unfair. Apparently, requiring athletes to compete according to their biological sex does not solve the problem.
A second option is a separate category for trans athletes. However, there would be a small number of entries and meaningful competition would be difficult. Moreover, it is hard to find enough athletes to form a trans-only team so opportunities for trans athletes to compete in team sports would be limited.xxx There could also be safety concerns in certain countries for openly transgendered persons.
A third option is to have sport-specific regulations for trans athletes based on the sport-specific performance gaps between male and female summarized by Hilton and Lundberg.xxxi Different degrees of biological difference between males and females in different sports impact the fairness of transgender inclusion differentially. Thus, some sports may benefit from stricter regulations regarding trans athlete participation while others don’t. However, evidence-based regulations for each sport are needed to ensure fairness for both transgender and cisgender athletes and these would depend on further scientific research.
A fourth option is to replace the men’s division with an “open division” for which a transgender athlete could qualify if they are not able to participate in the women’s division due to unfair biological advantages. The distinction of categories would rest on abilities rather than gender identity. However, where to draw the line for qualification for such a division would be tricky.
In conclusion, while transwomen possess biological advantages, questions regarding the nature of fairness and the point at which a physical advantage becomes unfair need further exploration. There should be more honest and civil conversations on how to include trans athletes meaningfully in competitive sports. Like all other controversial topics, there won’t be one satisfactory answer for all. But hopefully, with more research and empathy with trans athletes, the entire sports community will be able to welcome their participation in competitive sports meaningfully and fairly.
Tiffany Tiu is a graduate in kinesiology and sports science from the University of Toronto.
i Tiu, Tiffany (2021). Sports: a must have for youth. Youth Hong Kong, 13(3), 36-37.
iii This is a philosophical question that warrants discussion in itself. The discussion of fairness in this article is by no means exhaustive.
v Cooper, E. J. (2010). Gender testing in athletic competitions-human rights violations: why Michael Phelps is praised and Caster Semenya is chastised. J. Gender Race & Just., 14, 233.
vi Devine, J. W. (2019). Gender, steroids, and fairness in sport. Sport, Ethics and Philosophy, 13(2), 161-169.
x Hilton, E. N., & Lundberg, T. R. (2021). Transgender women in the female category of sport: perspectives on testosterone suppression and performance advantage. Sports Medicine, 51(2), 199-214.
xi Handelsman, D. J., Hirschberg, A. L., & Bermon, S. (2018). Circulating testosterone as the hormonal basis of sex differences in athletic performance. Endocrine reviews, 39(5), 803-829.
xii Handelsman, D. J., Hirschberg, A. L., & Bermon, S. (2018). Circulating testosterone as the hormonal basis of sex differences in athletic performance. Endocrine reviews, 39(5), 803-829.
xiii Åstrand, P. O., Cuddy, T. E., Saltin, B., & Stenberg, J. (1964). Cardiac output during submaximal and maximal work. Journal of Applied Physiology, 19(2), 268-274.
xiv Tong, E., Murphy, W. G., Kinsella, A., Darragh, E., Woods, J., Murphy, C., & McSweeney, E. (2010). Capillary and venous haemoglobin levels in blood donors: a 42‐month study of 36 258 paired samples. Vox sanguinis, 98(4), 547-553.
xv Best, S. A., Okada, Y., Galbreath, M. M., Jarvis, S. S., Bivens, T. B., Adams‐Huet, B., & Fu, Q. (2014). Age and sex differences in muscle sympathetic nerve activity in relation to haemodynamics, blood volume and left ventricular size. Experimental physiology, 99(6), 839-848.
xvi Pate, R. R., & Kriska, A. (1984). Physiological basis of the sex difference in cardiorespiratory endurance. Sports Medicine, 1(2), 87-89.
xvii Handelsman, D. J., Hirschberg, A. L., & Bermon, S. (2018). Circulating testosterone as the hormonal basis of sex differences in athletic performance. Endocrine reviews, 39(5), 803-829.
xviii The existence of rare genetic cases such as the Klinefelter Syndrome, in which individuals has two X and a Y chromosomes, or individuals with Disorders of Sex Development (DSD), do not negate the binary nature of sex and the basis of human reproduction in sexual dimorphism, nor suggest that biological sex is therefore a spectrum.
xix Handelsman, D. J., Hirschberg, A. L., & Bermon, S. (2018). Circulating testosterone as the hormonal basis of sex differences in athletic performance. Endocrine reviews, 39(5), 803-829.
xx The role of testosterone in gender development is well-established in research studies. See Hines, M. (2006). Prenatal testosterone and gender-related behaviour. European Journal of Endocrinology, 155(suppl_1), S115-S121.
xxi Jones, B. A., Arcelus, J., Bouman, W. P., & Haycraft, E. (2017). Sport and transgender people: a systematic review of the literature relating to sport participation and competitive sport policies. Sports Medicine, 47(4), 701-716.
xxii A person’s belief about themselves does not negate their biology. If a person believes they are a dragon that does not actually make them a dragon. Similarly, a person who believes that they are a member of the opposite sex does not change their biological sex.
xxv Gooren, L. J., & Bunck, M. C. (2004). Transsexuals and competitive sports. European Journal of Endocrinology, 151(4), 425-430.
xxvi Hilton, E. N., & Lundberg, T. R. (2021). Transgender women in the female category of sport: perspectives on testosterone suppression and performance advantage. Sports Medicine, 51(2), 199-214.
xxvii Ruetsche, A. G., Kneubuehl, R., Birkhaeuser, M. H., & Lippuner, K. (2005). Cortical and trabecular bone mineral density in transsexuals after long-term cross-sex hormonal treatment: a cross-sectional study. Osteoporosis international, 16(7), 791-798.
xxviii Space limitations means this is not an exhaustive discussion of all possible ways to include trans athletes in competitive sport. Nevertheless, the intention of this section is to present some possible solutions.
xxxi Hilton, E. N., & Lundberg, T. R. (2021). Transgender women in the female category of sport: perspectives on testosterone suppression and performance advantage. Sports Medicine, 51(2), 199-214.