Transgender Athletes, Fair Competition, and Public Policy: Can policymakers support cisgender-transgender competition and still be champions of women?

• Author: Weisman, Dennis L.

The issue of transgender women competing against cisgender women in individual athletic competition is provocative and promises to become even more so in the coming years. Proponents of this type of competition believe that athletes should be able to compete against the gender with which they identify rather than the sex they were born into. Those opposed to this type of competition believe this "comingling" is a direct assault on landmark Title IX (prohibiting sex-based discrimination in any school or educational program receiving funding from the federal government) of the 1972 federal Education Amendments and marks the beginning of the end of women sports as we know it. Appealing to the principle of fair competition, more than 15 states are either considering or are in the process of passing legislation that prohibits transgender women from competing against cisgender women.

The public face of transgender athletes today is college swimmer Lia Thomas, a transgender woman who is in the process of transitioning from male to female. Thomas previously competed for the men's swimming team at the University of Pennsylvania, posting the 32nd fastest 1,650-yard freestyle time in the nation for men in 2018-2019 and ranking 65th and 554th in the 500-yard and 200-yard freestyle, respectively. Thomas has dominated many, but not all, of the swimming races in which she has competed against cisgender women. She recently set four school records in a single meet and won the 500-yard freestyle competition in March, becoming the first Division I transgender NCAA champion.

The argument against Thomas competing against cisgender women swimmers is that nature endowed her with certain post-pubescent physical attributes that provide a competitive advantage. These attributes include larger heart size, more hemoglobin, leaner body mass, and larger lung capacity. These physiological factors underpin the strength, speed, and recovery required to be competitive in most sports. Post-pubescent males have 15 times the amount of circulating testosterone as post-pubescent females. This translates into a 10%--12% performance advantage in running and swimming and a 20% advantage in jumping events, according to a 2018 Endocrine Review article by David Handelsman et al. Hormonal therapies that decrease testosterone and increase estrogen can significantly reduce this advantage. Nonetheless, natural male advantages, including bone structure, heart size, and lung capacity, are not eliminated by hormonal therapy, especially if the transition is post-pubescent.

This controversy has reached the high school level, where some cisgender women are discovering that they are at a physical disadvantage in contests they once dominated. This has resulted in their school records being eclipsed as well as the loss of scholarships and state championships. The rewards women believe they had earned on the merits from years of intense training and personal sacrifice are being lost because of a unilateral change in the terms of the competition. Coaches and club sponsors may now have strong incentives to actively recruit transgender women athletes. An outstanding question that has divided the sports world is whether policymakers can support this type of competition and still claim to be champions of women.

WHAT IS FAIR COMPETITION?

The question of what constitutes fair competition in individual sports is surprisingly complex. It is standard practice to partition individual sport competition into age and biological sex categories. Biological men typically do not compete against biological women (equestrian competition being an exception) nor do the young compete against the old. Wrestlers, boxers, rowers, and weightlifters are partitioned into different weight classes. The Paralympics recognize that the able-bodied should not compete against those that have suffered a disabling injury. The Special Olympics constitute yet another partition of athletic competition. Does this logic suggest there should be a separate category for transgender athletes?

The rationale...