The Truth About Trans Athletes
Evelyn Sifton felt uneasy as she stepped onto the podium. The year was 2017, and the Canadian cyclist had just scooped third place at her debut fixed gear crit in Montreal. There were only six competitors in the entire race, and she’d been lapped – twice – by the first and second place winners, but it was still a proud moment for Sifton. Yet any initial elation had been swiftly replaced by stomach-churning dread.
At a recent triathlon, a fellow competitor had made transphobic comments towards her, and the same voice was ringing in her ears. “When someone is outwardly hateful towards you, it comes as a shock,” says Sifton. “I was worried that someone would say, ‘You don't deserve to be there.’”
This time was different – when the winner, Raphaele Lemieux, climbed the podium, she took the hands of both runners up and raised them in celebration – but transgender athletes are scrutinised regardless of where they place, says Sifton. “If we win a race, we have an ‘unfair advantage’; if we lose a race, we didn’t train hard enough,” she says. “No matter what, people will find a reason to discriminate against us in sport. It doesn’t matter that I’ve put more hours in, it doesn’t matter that I’ve cross-trained and worked on my bike handling. No, if I win a race, there will be people who chalk it up to: ‘she’s a trans woman – that’s totally unfair.'”
Opinions like these are no longer locker room whispers. They’re tabloid headlines. “It’s insane and cheating” Martina Navratilova wrote in the Sunday Times last year. After criticism from athletes and activists the former Wimbledon champion apologised for the phrasing, which she said referred to “a notional case in which someone cynically changes gender, perhaps temporarily, to gain a competitive advantage.”
Speaking on BBC Radio 4, Paula Radcliffe, the fastest female marathoner of all time, said trans women have “certain advantages that women will not ever get.” When Olympic swimmer Sharron Davies called for transgender women to be banned from women’s tournaments in order to “protect women's sport” she was backed by Olympic gold medallist Dame Kelly Holmes, who Tweeted in support: “nothing to do with being transphobic and nothing to do with hatred or stopping people leading their lives as they wish. But in sport it’s a different matter for obvious reasons.” Davies told the BBC she had spoken to other female athletes who share her views but find themselves “in a very difficult predicament where they can't speak out.”
Those embroiled in the furore have also overlooked the achievements of an entire subset of athletes: transgender men. People like Chris Mosier, the first trans athlete to make Team USA ever.
“Nike ran an advertising campaign about him during the 2016 Rio Olympics,” says Rachel McKinnon, who also made sporting history when she became the first transgender athlete to win a World Cycling Championship back in October 2018. “The highest profile corporate-sponsored trans athlete is a trans man, and yet everyone thinks that they don’t exist.”
Competing in the sprint duathlon at the World Duathlon Championships back in 2016, Mosier placed 142nd among 432 men of all ages, and 26th among the 47 men in the 35-39 age group. He was the second American in his age group to finish the event. An achievement made all the more remarkable because of the legal battle he faced to get there. Before Mosier, the International Olympic Committee policy required transgender athletes to undergo both sex reassignment surgery (SRS) and hormone therapy. In January 2016, the SRS requirement was dropped and hormone guidelines relaxed.
The very same year Mosier made history, Aydian Dowling became the first trans man to appear on the cover of Men’s Health, an achievement that he says “Helped kickstart a lot of transmasculine people into getting into fitness.”
Though he played sports his entire life, Dowling really started to put hours in at the gym after discovering he was transgender at the age of 21 – partly to feel good, but also for safety. “I was fearful that if somebody didn’t like the choices I was making, maybe if they saw that I had some muscle they would think twice about wanting to beat me up,” he explains. “It wasn’t to be intimidating, but just to look like I could stand up for myself.”
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Separating Fact from Fiction
“What you really need – and we're working on this at the moment– is real data,” says Dr James Barrett, president of the British Association of Gender Identity Specialists and lead clinician at the Tavistock and Portman Charing Cross Gender Identity Clinic in London. “Then you can have what you might actually call a debate. At the moment, it’s just an awful lot of opinion.”
The small amount of evidence that does exist, he says, indicates that opinions held by Davies, Navratilova and Radcliffe may not be as ‘common sense’ as they suggest. “The assumption is that trans women are operating at some sort of advantage, and that seems to have been taken as given – but actually it’s not at all clear whether that’s true,” Dr Barrett continues. “There are a few real-life examples that make it very questionable.” He points to professional cyclist McKinnon. When she won the World Cycling Championship in California, bronze medalist Jen Wagner-Assali branded the race “unfair” and pressed the governing body to change its rules – even though she’d beaten McKinnon in 10 of 12 previous events.
Since taking home the gold at the UCI Masters Track, McKinnon estimates she has received “well over” 100,000 hateful messages on social media. How does she cope? “In short, lots and lots of therapy,” says McKinnon, who suffers from PTSD due to workplace and sports-related harassment. “It’s taken years of work to be able to withstand the onslaught that just keeps getting bigger and bigger over time.” The recent discourse, she says, has simply perpetuated further misinformation and myths about the transgender community. “It was already bad enough, and in a way it’s worse now,” McKinnon says. “No trans person is trying to transition for personal gain. We just want to participate. We just want to be healthy.”
Identifying Gender and Transitioning
Sifton was 12 when she first realised she didn’t identify with the gender she was assigned at birth. Growing up in small conservative Canadian hometown meant she spent most of her teenage years repressing and burying her feelings. "At university I found myself fighting the internalised transphobia I had,” says Sifton. “There was a lot of inward self-hate and that manifested as really bad depression. By the summer of first year I realised I’d barely left my dorm.”
There was a long road ahead, and a few years passed before Sifton was emotionally and financially ready to come out to her family. “I didn't know how they would react, and to be fair I was right on that,” she says. “They did not react well. I really had to wait until I was in a place where I could risk getting completely cut off.”
Once hormone therapy is underway, transgender athletes find themselves stuck in limbo. “You can’t compete in your gender assigned at birth category, because your body is undergoing massive changes,” says Sifton, “and you can’t compete in your gender identity category because you’re not allowed to yet.”
Transgender swimmer James Wilson, whose name has been changed to protect his identity, has challenged the Amateur Swimming Association to create an optional third category, so athletes who are in the process of transitioning are still recognised on the scoreboards. “Transitioning doesn't happen from one second to the other,” Wilson says. “It’s a very long, slow process, and everybody is different. Sport is very binary, men and women. It’s black and white, but I want to be grey. I don’t care about medals – I just want to have my time recorded.”
A Collection of Mutants
What makes an elite athlete? Training, recovery, and nutrition, sure. Access to good coaching and quality equipment, too. Where you live can also make a difference – training at altitude or in extreme cold or heat can influence an athlete’s performance. But Olympic athletes aren’t segregated by height, or reach, or haemoglobin, or lung volume, or muscle fibre type, says Dr Barrett. “The ethos being that we celebrate difference and what you are looking for is differences in people.” Instead, competitors are stratified by sex. “The Olympics – and any other high-ranking sporting event – is a collection of mutants. And when you’re collecting mutants, it starts to get a bit difficult to say what sex they are. Do you work by chromosomes? If you did, that would have Belgian supermodel Hanne Gaby Odiele as male. Do you use testosterone levels? Well, you can – except that Caster Semeya's testosterone level might be the same as mine.”
Considering it’s a such huge talking point, science has surprisingly little data on the relationship between athletic performance and testosterone – at least, the naturally occurring stuff (steroids are a different story, as you know). The general consensus is that the higher your T levels, the greater your competitive advantage.
A Naturally T-level Playing Field
Under current Olympic guidelines, trans women can enter female categories so long as their testosterone remains below 10 nanomoles per litre (nmol/L) for at least one year, while transgender men may compete in male categories without restriction. Transgender athletes have been allowed to compete in the Olympics since 2003, and not one has ever qualified, but critics believe the hormone threshold for trans women should be lowered further.
The connection between naturally occurring testosterone and athletic performance appears to be overstated. When researchers measured the T levels of elite athletes from 15 Olympic sports, more than 25 per cent of the men were below 10 nmol/L, according to a study from Clinical Diabetes and Endocrinology. Almost 7 per cent had less than 5 nmol/L. There was a “complete overlap” between male and female athletes, the authors wrote. Male powerlifters, of all people, had “remarkably low testosterone” while male track and field athletes had “high oestradiol” levels, which is the most common oestrogen found in women.
“When people talk about men being stronger than women, or men having more testosterone, or men being taller, they’re really talking about averages,” says McKinnon. “This completely ignores the massive ranges within a given sex. The difference between the shortest woman and the tallest woman is much, much larger than the average difference between men and women. And this is true for every natural physical trait.” Dr Barrett agrees. “The differences between men and women are a lot slighter than everybody thinks they are, and training can easily overtake them,” he says. “Take the running races at sports day. Before puberty, it really is truly equality of the sexes. You’re just as likely to have a girl win as a boy. After Mr Puberty comes in, the boys begin to pull ahead.” However, if you were to put the girls through training at this stage, he says, they would likely run faster.
What about transgender men? After hormone therapy, their testosterone levels are equivalent to that of cisgender men, says Dr Barrett. “Trans men have been through a female puberty – if you superimpose a male puberty on top of that, it doesn’t confer any more advantages than going through a male puberty in the first place,” he explains.
When it comes to T, the dosage varies from person to person, depending on weight, height, lifestyle factors and other medication, to bring each person into a “plausible male range,” says Dr Barrett. “You’d only end up looking like Arnold Schwarzenegger if you abuse steroids, and you’d only end up looking like Usain Bolt if you undertook a prodigious quantity of exercise,” says Dr Barrett.
Even so, the myth that trans men are ‘on steroids’ persists. Bodybuilder Ajay Holbrook says he felt pressure to be “a little more intense” in the gym when he first started hormone therapy. “I would lift a lot heavier, pushing myself past barriers that I knew I probably shouldn’t, just going all out,” says Holbrook, who has his sights set on Mr Olympia. “Still to this day I feel like I have to go crazy when I’m in the gym. I feel like I have to be the hardest worker in there.”
The Legacy Effect
Pressure group Fair Play For Women argues that testosterone has a “legacy effect” and confers sizeable strength and stamina advantages even after levels have been reduced – the result of experiencing puberty in a male body.
Whether there is or not remains to be seen, but it shouldn’t be assumed that a potential legacy effect would confer an advantage, says Dr Barrett. “Lung volume, for example, will remain the same,” he says, “but if you haven’t got the muscles to do the work, does that make any difference? The skeleton doesn't significantly alter, so it will remain heavier – it’s hard to see how that would ever be an advantage.” Dr Barrett uses the rapid arm movement skills (known as ‘economy of movement’) required in professional tennis as an example. “The more weight in the limb, the harder that will be to do. It's going to be a very marginal effect – but at top level sport, everything is marginal. There are no substantial advantages or disadvantages.”
When you get down to the minute details of different sports, sometimes the things that matter are the least expected. “When climbing mountains, the assumption is that reach would be useful, but actually small hand size is,” says Dr Barrett. “In tennis, it’s helpful to be tall, but it’s also helpful to be left-handed. If you look at the upper flights of Wimbledon, there's a vast over-representation of left-handed players.” Major league baseball players in the US are far more likely to have been born in August, because of the school year. “When you’re nine, one year is a big chunk of your life. So they do better just because they’re older. So they get picked for the team. So they get more practice. And the advantage just continues through to professional life,” he continues. “What constitutes cheating in sport becomes very complicated,” he says.
For some people, no variable matters as much as gender assigned at birth, Joanna Harper, a medical physicist at Providence Portland Medical Center in Oregon, told The Washington Post. “They can’t get past the idea that I’m a man trying to profit in a woman’s sport.”
If Fair Play For Women and its famous supporters are to succeed in blocking trans women from competing in women’s tournaments, it sends an uncomfortable message: trans women are not women, and trans men are not men. This has deadly implications. Torn between transitioning and surrendering their eligibility to compete, athletes might opt to delay treatment for their gender dysphoria. For your average gym-goer, it could be yet another reason to avoid working out. “There are heavy stigmas and stereotypes about trans women being big, bulky men in a dress,” says McKinnon. “Many trans people already shy away from public group-based fitness activities, and instead gravitate towards solo activities like running, cycling and triathlon.”
At the moment, there’s no data-based evidence that guidelines are failing cisgender athletes – after all, you can’t have fewer than zero transgender Olympians – but the media circus will continue until scientists know more about the biomechanics of athletic performance. Less considered is the impact it will have on the lives of the wider transgender community and their approach to health and fitness.
“I feel like people have a really messed up vision or idea of who we are and what we’re trying to do,” says Holbrook, “when in reality, we’re just trying to be accepted and live our lives in society.” It’s clear that the health and fitness industry needs to do better by the transgender community. But the solution is simpler than you think. “People believe there has to be some huge step you need to make to include trans people,” Dowling says, “but in reality, if you treat us like the regular people that we are, then you don't have to make any exceptions. You don't have to make any changes.”
