Right: Olympic Games swimming champion Michael Phelps is pointed to as having natural advantages that could be compared to those of transgender athletes. In Phelps' case, however, his body's production of lactic acid is half that of the swimmers he competes against. This gives Phelps an edge in competition, allowing proponents of transgender participation in women's events to argue that Phelps' "legal" advantage is no more so than any advantage a transgender athlete may have.
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Arguments supporting transgender women athletes taking part in sporting competition against cisgendered women
1. Removing or excessively limiting transgender women athletes' access to sporting competitions is discriminatory
Those who oppose significant limitations being imposed on transgender athletes' access to competitive sport claim that such restrictions are discriminatory. They argue that a particular class of athletes, transgender women athletes, are being restricted or excluded from competitive sport on unjust grounds. They argue that the claim that these transgender athletes are being excluded or restricted because they have an unfair advantage is false. Their supporters claim that their exclusion is based on their gender and so is discrimination.
The claim of discrimination is based on the fact that many forms of relative advantage are allowed in sport. Some athletes are naturally taller than others, have better hand-eye co-ordination or greater musculature and, though these attributes give them an advantage over others, they are not excluded because of them. Gregg Bloche, a professor of law at Georgetown University and co-director of the Georgetown-Johns Hopkins joint degree program in law and public health, has stated, 'We allow some differences in capability to affect sports outcomes without calling out those with an edge as cheaters. Indeed, we admire many of these advantages, whether we believe they're bestowed by God or good fortune: we praise competitors for their strength, speed, endurance, agility, toughness, discipline, resolve, and more.'
An editorial published in The Duquesne Duke, the magazine of Duquesne University, similarly stated, 'It is...important to realize that advantages already exist in sports among cisgender athletes, and they are not banned. Michael Phelps, for example, produces half of the lactic acid of his competition [giving him a large competitive advantage], and he is a celebrated Olympic champion.'
It has further been noted that such relative advantages as exist between competitors only add to the interest and entertainment value of the sport. Professor Bloche has noted, 'Myriad influences - environmental, genetic, and mixtures of both - produce differences in athletic capability and performance. Without these differences, sports would be insufferably dull. Every competition would yield a tie - or, worse, a winner decided by dumb luck.'
Joanna Harper, a PhD researcher at Loughborough University, England, and the author of the book 'Sporting Gender', has stated, 'Advantages are allowed in sport. What is not allowed is overwhelming advantage. For instance, left-handed tennis players are allowed to compete against right-handed tennis players despite their advantages. On the other hand, heavyweight boxers are not allowed into the ring against flyweight boxers. The important difference is that meaningful competition exists between left- and right-handed tennis players but not between big boxers and small boxers. I think it is important to examine the question of trans women athletes within this framework.
It is claimed that any residual advantage that transgender women athletes may have will not be an overwhelming one. Supporters of transgender inclusion argue the process of transitioning into their new gender identity decreases any innate advantage among transgender athletes considerably, while physical differences between all athletes mean there is never a truly level playing field in sport.
Therefore, it is argued, any move to exclude them on the basis of unfair advantage is really an attempt to disguise prejudice against transgender athletes. The editorial writers of the Duquesne Duke have stated, 'There is no conclusive evidence that suggests transgender athletes create an unfair playing field for cisgender athletes, so it is wrong to exclude them from sports at any level.' Finally, it is argued that such discrimination in sport only consolidates the discrimination transgender people experience in all areas of life. Chris Mosier, a triathlete and the first trans man to represent the United States internationally, has noted that the current debate over the exclusion of transgender athletes was damaging for all trans people. He claimed that such debates 'serve as an entry point to larger scale discrimination'.
2. Transgender athletes suffer discrimination in many other areas of their lives
Those who support transgender athletes being able to compete within the gender classification with which they identify argue that this is an important measure to help redress the disadvantage suffered by a group which already faces much discrimination.
The prevalence of discrimination faced by transgender individuals appears to be a worldwide phenomenon. The United Nations Human Rights Office of the High Commissioner (OHCHR) has stated, 'Gender-diverse and trans people around the world are subjected to levels of violence and discrimination that offend the human conscience: they are caught in a spiral of exclusion and marginalization; often bullied at school, rejected by their family, pushed out onto the streets, and denied access to employment.'
The OHCHR has further noted that where transgender people are part of other marginalised groups, their position becomes even worse. They have stated, 'When they are persons of colour, belong to ethnic minorities or are migrants, living with HIV, or sex workers, they are particularly at risk of violence, including of killing, beatings, mutilation, rape and other forms of abuse and maltreatment.' Additionally, the OHCHR has noted that they often have highly damaging and discriminatory 'interventions' forced upon them. The OHCHR states, 'In order to practice their right to recognition before the law, gender-diverse and trans persons are often victim to violence in health-care settings such as forced psychiatric evaluations, unwanted surgeries, sterilization or other coercive medical procedures, often justified by discriminatory medical classifications.'
Discrimination against transgender people is a significant problem in Australia. In 2014, Curtin University released the results of 'The First Australian National Trans Mental Health Study'. Among the study's findings was that 'Experiences of discrimination and harassment were common. Nearly two thirds of participants (64.8 percent) reported at least one instance, with experiences ranging from social exclusion to violence and assault. Many participants reported changing their behaviour for fear of being subject to further instances. Participants also reported discrimination when accessing healthcare, and that the healthcare system generally failed to meet their needs.'
An Australian study released in March 2021, conducted by Dr Ada Cheung and Sav Zwickl, of the University of Melbourne, found that transgender Australians are arguably among the most marginalised and socioeconomically disadvantaged groups in the Australian community - a disadvantage that has been magnified by the COVID-19 pandemic. 35 per cent of those surveyed reported discrimination from employment as a result of being trans, and the unemployment rate of 19 percent is more than three times the national rate. The study further noted that discrimination when accessing healthcare results in nearly a third of transgender people avoiding medically necessary care.
There are those who claim that there is a probable connection between the mental health problems transgender people suffer and the level of social discrimination they encounter.
A report published in Medical News Today on May 20, 2021, concluded, 'People who identify as transgender have higher rates of mental health complications than those in the general population due to stigma and discrimination.'
Dr Wang and her colleagues from the department of psychiatry at the Second Xiangya Hospital of Central South University in China have noted regarding the impact of discrimination within schools, 'Within the school environment, transgender adolescents are vulnerable to harassment and bullying... findings indicate the need for researchers, practitioners and policy makers to address these mental health risks...School-level intervention is recommended to support the well-being and equity of gender minority youth.' It has been argued that as a high profile, socially valued activity, sport can lead the way in addressing the problems of discrimination that transgender people face. Sport Australia chief executive officer Kate Palmer, when releasing the 'National guidelines for the inclusion of transgender and gender diverse people in sport', stated sport 'must be safe and inclusive for all.' She has further argued, 'It must take strong, proactive leadership to stand up against any attitudes or behaviours that lead to discrimination in sport, so I urge every sporting organisation...to make your sport more inclusive... Every single person involved in Australian sport can play an important part in being more inclusive.'
3. Competitive sporting participation can assist transgender people with mental health issues
There is a high incidence of mental health issues among transgender people. Sporting competition, it is claimed, can help transgender athletes maintain their mental wellbeing.
It has been repeatedly indicated that transgender or gender-nonconforming adolescents may be at greater risk of a range of mental health issues. Dr Yuanyuan Wang, of the department of psychiatry at the Second Xiangya Hospital of Central South University in China, and colleagues have recently written, 'There are...a number of studies reporting a high percentage of suicidal ideation, self-harm and suicide attempts in adolescents with gender dysphoria.' Dr Wang noted that these young people appeared to be at greater risk 'compared with their cisgender peers' of 'mental health problems such as anxiety, depression and suicidal ideation'.
Australian data released in April 2021 replicates the results of Chinese research. LGBTQA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Asexual, Ally + Other Identities) young people aged 16 to 17 were almost three times more likely to have attempted
suicide in the past 12 months. These young people were almost five times more likely to have attempted suicide in their lifetimes, while transgender people aged 14-25 are fifteen times more likely. 48.1 percent of transgender and gender diverse people aged 14 to 25 reported that they had attempted suicide in their lifetime. 35 percent of transgender people aged 18 and over reported that they had attempted suicide in their lifetime and 28 percent of gender questioning young people between 14 and 21 years reported that they had attempted
suicide.
Among LGBTQA+ Australians who have had suicidal thoughts research figures are similarly high. LGBTQA+ young people aged 16 to 17 were over five times more likely to have experienced suicidal ideation in the past 12 months. 59.1 percent of these young people aged 16 to 17 reported having experienced suicidal ideation in the past 12 months and 58.2 percent aged 14 to 21 had seriously considered attempting suicide in the past 12 months. 24.4 percent of LGBTQA+ young people aged 14 to 21 had made a suicide plan in the past 12 months and 41percent of transgender people and non-binary people aged 18 years and over reported thoughts of suicide or self-harm in the last two weeks.
Australian research further shows that mental conditions, including depression, are also high among transgender adolescents and young adults. 44.5 percent of LGBTQA+ young people aged 14 to 21 reported receiving treatment or support for a mental health condition in the past 12 months. 73.2 percent of people in this group aged 18 and over reported having at some time in their lives having been diagnosed with a mental health condition; 51.9 percent reported being diagnosed or treated for a mental health condition in the past 12 months. Referring specifically to depression, Australia data shows transgender, and gender diverse people aged 14 to 25 are over seven times more likely than those in the same age group in the general population to suffer with depression. Transgender and gender diverse people aged 18 and over are five and a half times more likely.
It is claimed that findings such as these have a direct bearing on how transgender athletes should be treated. Participating meaningfully in sporting competitions has been found to promote the mental well-being of trans individuals, while being excluded from these competitions intensifies the damaging sense of rejection that trans people frequently suffer.
The United Kingdom's Mental Health Foundation has noted, 'Participation in regular physical activity can increase our self-esteem and can reduce stress and anxiety. It also plays a role in preventing the development of mental health problems and in improving the quality of life of people experiencing mental health problems.'
These findings suggest regular physical activity has both a preventative and a curative role in regard to the development of mental issues. It can boost self-esteem and help develop resilience, thus forestalling the development of depression and other disorders. It can also help those suffering the effects of mental ill-health overcome these problems. The value of competitive sport in helping to manage conditions such as depression has been suggested by a 2017 study of the effect of high-level sporting competition on Paralympians. The study concluded, 'The findings suggest that Paralympians benefited from exposure to highly demanding situations in a supportive environment and this helped develop mentally tough characteristics and behaviors and individualized cognitive coping strategies.' Supporters of transgender athletes being able to compete at the highest levels that they are able suggest that the same mental health benefits are available to them.4. The competitive advantage of transgender women athletes has been exaggerated
Those who support transgender athletes being given either full or relatively unrestricted access to sporting competitions argue that the degree of advantage these transgender athletes have been claimed to have has been exaggerated.
One of the points noted regarding the supposed advantage of transgender women over ciswomen in sporting competition is that on average transgender women, even before gender realignment or affirming treatments, are not as physically able as the average cisman. Cisgender men are as much as 50 percent stronger in the upper body than cisgender women. However, trans women are not cisgender men. Measured hand-grip strength in non-athletic trans women was 10-14 per cent lower than in cisgender men even before gender affirming hormone therapy (GAHT).
Looking at a subset of the trans population who were already physically fit and trained prior to receiving hormone therapy, a study of changes in fitness test results of transgender American service personnel indicated that the trans women in the study were able to do 31 per cent more push-ups per minute than cisgender women prior to GAHT but this difference was entirely resolved with GAHT.
Supporters of transgender athletes being allowed either free or relatively unrestricted access to sporting competitions argue that trans women athletes experience a range of potential disadvantages as well as some potential advantages. In July 2021, WebMD/Medscape interviewed sports physicist Joanna Harper, who has advised the International Olympic Committee (IOC) and other sporting bodies on gender and sports. Dr Harper stated, 'Trans women have larger frames, which are now being powered by reduced muscle mass and reduced aerobic capacity, and that can lead to disadvantages in things like quickness, recovery endurance, and things that might not be quite as obvious as seeing somebody bigger...The idea that trans women only have advantages just isn't true. The analogy I've used is that it's like a big car with a small engine competing against a small car with a small engine.'
Harper's comments are borne out by the experience of Idaho cross-country runner Lindsay Hecox, who has seen her competitiveness decline since transitioning. Hecox stated that after the therapy, 'I could feel myself getting slower.' Ultimately she became uncompetitive with ciswomen cross-country runners despite having been a successful high school competitor before transitioning. Despite a rigorous training schedule provided by the school she attends, she was not fast enough to make Boise State's women's track team in 2020.
It has further been noted that some of the physical advantages that transgender women athletes have been claimed to retain after gender reassignment of affirmation therapy do not make the crucial difference they are said to. Volleyball is a sport where the height of a player has been claimed to confer a decisive advantage. Therefore, it is a sport where it would appear that a transgender woman player with a height advantage conferred by her former physiological gender would have a competitive edge. However, a 2005 study was conducted of Olympic volleyball terms to assess the importance of the height of its players in giving a team victory. The study found the gold medal winning women's team in every Olympic Games since 1968 had (with one exception) not been the tallest team in the tournament. The study also found the final ranking of the men's volleyball teams participating in the medal round of the Athens 2004 Summer Games was inversely related to average team height. This suggests that an often gender-linked characteristic, commonly assumed to give a crucial competitive advantage may not be as significant as many have claimed. The study concluded, 'Insofar as team success in [Olympic] volleyball is concerned, there would appear to be factors more critical to individual performance and team success than average player height.'
5. Most competitive advantages some transgender women athletes have can be removed
Those who support transgender athletes taking part in sporting competitions argue that most competitive advantages they may have because of their transgender status can be removed. It is also argued that any advantages that may remain will not be competitively significant, that is, they will not give the transgender athlete a competition-winning degree of assistance. This means that cisgender athletes competing against them are not being unfairly penalised.
It is claimed that one of the principal reasons that transgender women should be able to take part in competitive sport is that gender affirming hormone therapy (GAHT) removes the physiological advantages that these competitors might otherwise possess. GAHT is taken by transgender people to allow them to exhibit the secondary sexual characteristics of the gender with which they identify. This hormone treatment typically removes most of their potentially advantageous sports-related attributes.
Joanna Harper, a PhD researcher at Loughborough University, England, and the author of the book 'Sporting Gender', has stated, 'Trans women on GAHT achieve the same testosterone levels as cisgender women and this includes the high-level athletes studied at Loughborough University in England.' She concluded, 'I think that in most sports testosterone suppression alone will mitigate...the physiological advantages held by trans women to the point that trans women and cisgender women can enjoy meaningful competition.'
In a July 2021 interview given to WebMD/Medscape, Harper further stated, '95 percent of cisgender women have testosterone below 2 nanomoles per liter. And in a recent study of nearly 250 trans women, 94 percent of them had testosterone below 2 nanomoles per liter.' Testosterone levels affect haemoglobin levels and haemoglobin determines the blood's oxygen carrying capacity and has a major impact on endurance. Haemoglobin (Hb) is a protein found in the red blood cells that carries oxygen and gives blood its red colour. Haemoglobin levels vary from person to person; however, men usually have higher levels than women. Haematocrit levels show the ratio of the volume of red blood cells to the total volume of blood, they are, therefore, a measure of the blood's oxygen-carrying capacity. The blood's oxygen-carrying capacity is important in most sports as it affects energy levels.
Harper explains that as transgender women taking hormone therapy lose testosterone their haemoglobin levels similarly decline. She has stated, 'Haemoglobin levels follow the testosterone. Within weeks of starting testosterone suppression, testosterone levels will be within female norms, but it takes a little longer for haemoglobin to get the female norms, probably in the 3- to 4-month range. That's roughly the life cycle of red blood cells. As trans women replace their red blood cells, with their new lower testosterone levels, they will have fewer red blood cells and lower haemoglobin, but it does take three to four months.'
Harper further noted, 'After four months of hormone therapy haemoglobin and haematocrit levels of trans women will shift from typical male to typical female levels. Haemoglobin is the single most important factor influencing performance in endurance sports.' Levels of the male hormone testosterone also affect lean muscle mass which can, it has been argued, give a transgender woman athlete a competitive advantage in many sports. Studies have found that lean body mass and muscle strength decline but remain above cis female levels up to three years after hormone transition. Harper, however, has claimed that while transgender women may retain a muscle mass advantage after a year of hormone therapy, it is possible that residual advantage may ultimately disappear. She has stated, 'The greatest changes in the strength of trans women on hormone therapy occur in the first 12 months, but there aren't enough data to make a definitive statement. It is possible that there are further declines in strength after 36 months, and a recent small study out of Brazil suggests that the entire strength advantage might go away.'
Despite some lean muscle mass advantage that transwomen athletes may retain, it is argued that high-level ciswomen athletes are competing at such accelerated levels of performance, that any lingering advantage gained by a trans athlete is not likely to be significant. Dr. Timothy Roberts, a pediatrician and associate professor at the University of Missouri-Kansas City, has argued that though lean muscle mass may continue to give transwomen athletes an advantage it was within the competitive range. Referring to trans- and ciswomen runners, Roberts noted, '[Transwomen retain] a 12 percent advantage after two years in run times. But to be in the top 10 percent of female runners, you have to be 29 percent faster than the average woman. And to be an elite runner, you've got to be 59 percent faster than the average cis woman.'
What Harper and others argue is that though some transgender athletes may retain residual advantages in some sports this will not be at a level which will make the contest unfair or so skewed that competition has been removed. Harper claims that what she refers to as 'meaningful competition' will remain.