Participation of transgender athletes in elite sport makes its way onto the agenda

There needs to be a well-coordinated multidisciplinary international research program –backed by appropriate research grant funding and athlete participation – to generate the evidence to inform future policy decisions related to transgender athletes in sports.

This is the conclusion of Prof. Yannis Pitsiladis, Professor and Head of Department of Sport, Physical Education and Health (SPEH) at Hong Kong Baptist University. He was one of the panellists speaking about “Integrity in Sport” at the International Forum on Elite Sport produced by the Association of Sport Performance Centres in Hong Kong.

“Such decisions should be based on the best available scientific evidence from the best available scientific practice and the decisions made will also require a firm political resolve to fairly integrate transwomen and DSD (Differences in Sexual Development) women athletes into elite female sport,” Pitsiladis recently wrote.

The final day of the forum touched on some interesting topics. For example, on the topic of “Athlete Health Care and Illness/Injury Prevention,” we learned the average injury rate for all athletes at the Olympics is 12%, while the average illness rate is 8%. We also learned that if you travel more than five time zones from your home country, you have a two- to three-fold chance of getting sick.

We learned about the multitude of new technologies now available to the sport system. While there were too many to mention, a couple stood out. The FITguard from Force Impact Technologies is a mouthguard that lights up different colours depending on the force of the impact received to the wearer’s head. And the Kamleon Smart Urinal, automatically measures your hydration level while you urinate, showing your results in seconds on a screen installed above.

But it was the issue of transgender women competing in female sports at the elite level that stirred the most conversation. Pitsiladis pointed out that the transgender conversation is not a new one, as it’s been going on for over 20 years now. He says it’s just become more politicized and amplified through social media.

“We should always remember why we have male and female categories: it’s to protect the female athletes,” Pitsiladis said.

But he also points to a paper he co-authored just two months ago that acknowledges that the conversation is a difficult one. “The issue is that the performance-enhancing effect of testosterone, which is widely accepted in the literature, and the exposure to higher concentrations of testosterone in trans women and DSD women athletes is expected to provide a competitive performance advantage,” Pitsiladis wrote.

“This expectation has led to an ever-increasing number of international federations banning participation of trans female athletes in elite sports, and the same expected for DSD athletes. While these policy rules and their backing assumptions to primarily ban these athletes from competing may, in time, be proven correct, until data from longitudinal transgender and DSD athlete case comparison studies that control for variations in hormonal exposure and involve numerous indices of performance become available, there is just as much circumstantial evidence to support the policy to ban these athletes than there is to oppose it.”

Pitsiladis noted that because the International Olympic Committee (IOC) three years ago decided to allow the various sport federations around the world to make their own decisions regarding the eligibility of transwomen in female sports, it has become a political football. And, as a result, he says everyone is suffering.

“The amount of hate mail we get daily is horrendous,” Pitsiladis said of the scientists who are working with him. “Why would anyone want to work in that space when you must deal with that every day? I worry the situation is only getting worse, not better. The most common message we receive is, ‘I hope you get cancer and die.’ The biggest problem right now is social media.”

But Pitsiladis admits that no matter where the decision on transgender participation in elite sport lands, it will never please everyone. “Yes, having just male and female categories is problematic,” he says. “It’s an imperfect system.

“But creating a third category also is problematic. It was tried recently at an international event and not a single athlete registered in that category. I really can’t think of another way to do it. There will always be some level of discrimination, because trying to make athletic competition 100% fair, safe, and inclusive for everyone is impossible.”

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