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Just 18 months after transgender athletes competed for the first time at the Olympics, international sporting federations are reconsidering whether transgender women should be allowed to keep participating in elite women's competitions, as debate rages in sports and politics circles over who has the right to play.
Some sports organizations introduced bans this week, citing a need to ensure fairness in women's competition — even though experts say the science is far from decisive on whether athletes who have transitioned from male to female have any competitive advantage over their cisgender female competitors.
The International Swimming Federation (FINA) will now only allow transgender women who began transitioning before the age of 12 to compete in high-level international competitions, including swimming, diving and water polo. FINA's rule also affects athletes with a condition known as 46 XY DSD (also referred to as intersex), who have genitalia that is not clearly male or female, but who identify as female.
A day after FINA's rule came into effect, the International Rugby League went even further, banning all transgender women from international matches while it reviews and updates its rules on participation. A spokesperson told CBC News there are no transgender players at the international level.
World Athletics, which oversees track and field, race walking and other athletics events, has hinted it may follow suit when it reviews its own rules later this year.
"If there is a conflict between fairness and inclusion in the female category, we will always choose fairness," a spokesperson for World Athletics told CBC News, adding that FINA's decision was "in the best interests of its sport."
The new policies come after the International Olympic Committee last year announced it would not set a blanket rule for all sports — telling federations they should come up with their own policies.
Until now, most organizations, including FINA and World Athletics, have allowed transgender and intersex women to compete as long as they meet rules for suppressing testosterone levels.
The fight over who competes
The decision to ban many transgender women athletes has drawn a mixed response in Canada and around the world.
"The new FINA gender inclusion policy perpetuates the harmful and marginalizing practice of gender policing in women's sport. This harms all women," Canadian Women & Sport said in a statement on Monday.
Some female athletes have expressed concerns that transgender and intersex women have a physiological advantage in competition and say banning them from elite sports will level the playing field.
Australian Olympic swimming champion Cate Campbell on Sunday told FINA's congress that she believed its decision would "uphold the cornerstone of fairness in elite women's competition."
Critics, however, believe bans like FINA's are motivated more by ideology than science, coming amid a political push in the United States and U.K. to block trans women athletes from competing (18 U.S. states have banned trans girls and women from participating in female school sports).
"Transgender athletes are not dominating, nor have they ever dominated in sports," Chris Mosier, a Team U.S.A. triathlete and trans advocate, told CBC News via email.
U.S. college swimmer Lia Thomas is a rare exception. In March, she became the first known transgender athlete to win a National Collegiate Athletic Association swimming championship — and faced an immediate backlash over her success.
"It is very obvious [FINA's] policy is a reaction to public pressure because of one swimmer who worked hard, followed all the rules and had moderate success for one season," Mosier said.
FINA confirmed there are no transgender women athletes currently competing at the elite level.
"We're talking about maybe a handful, less than five, male-to-female trans athletes that have become the centre of attention [in the U.S.] — and so what's happening politically, and also in the media, outstrips the numeric consideration of what constitutes a threat on women's sport," said Carole Oglesby, a board member of research-based advocacy organization WomenSport International.
The science so far
FINA's decision to ban trans women who transitioned after the age of 12 is based on changes that male bodies undergo during puberty, when a surge of testosterone causes a growth spurt and greater muscle mass.
In its new policy, FINA said its scientific advisers "reported that there are sex-linked biological differences in aquatics, especially among elite athletes, that are largely the result of the substantially higher levels of testosterone to which males are exposed from puberty onwards."
FINA has not made its scientific advice public.
Experts who spoke with CBC News said there is limited research to show what, if any, advantage a transgender woman athlete might have over a cisgender woman athlete — in large part because studies to date have not used athletes as research subjects.
"What is needed is actual science on how trans athletes perform, and that science is in its infancy," said Joanna Harper, a medical physicist and expert in transgender athletic performance at Loughborough University in England.
Harper is leading multiple current studies looking at transgender women athletes' performance at different stages of their transition, as well as comparing the performance of trans and cis-women athletes.
"The advantages that trans women have are significantly mitigated — not eliminated — but mitigated by hormone therapy, and this process introduces disadvantages for trans female athletes, too," she told CBC News.
"Their larger frames are now being powered by reduced muscle mass, reduced aerobic capacity, and that can lead to disadvantages in things like quickness, recovery and endurance."
WomenSport International has a new task force collating scientific evidence that it hopes will help sports organizations as they ponder the future of trans women's participation.
"I just throw my hands up at the idea that the science is clear," said board member Oglesby, a former professional softball player and retired professor of kinesiology, formerly of California State University.
"I don't know where this is going to end up — that's why I say I'm on the fence. I'm not sure what the best solution is, but I know that we are not at the place of determining what should happen."
Critics of FINA's policy also point out that all women athletes — not just those who are transgender or intersex — can be subject to invasive and humiliating sex testing to prove they're eligible to compete.
"FINA has opened up yet another opportunity for the abuse of women athletes by mandating testing to decide who is a woman and who is not. This policy does nothing to protect women's sports or protect cisgender women in sports," Mosier said.
Three sports, three approaches
Days before FINA made its decision public, the Union Cycliste Internationale (UCI) — which oversees international cycling events, including road, track, mountain and BMX — changed its policy for trans women athletes.
Rather than banning them from competing, UCI halved the maximum permitted testosterone level from 5 nmol/L — the limit currently in place for a number of other sports, including athletics — to 2.5 nmol/L, and it doubled the amount of time athletes must maintain low testosterone before they can compete, to 24 months.
Soccer's governing body, FIFA, is also reviewing its rules this year but has said it will review any athletes' eligibility on a case-by-case basis until its new regulations are in effect.
FINA is also proposing a new "open" competition category that transgender women — barred from elite female competition — could participate in.
It's unclear what the event would look like, whether other sports might follow suit or if it would feature in events like the Olympics, said Sarah Teetzel, a professor of kinesiology at the University of Manitoba in Winnipeg, who is researching barriers that transgender athletes face to inclusion in sport.
"They say that a working group is looking at that right now, but will they truly invest equal prize money, promotion, opportunity, access? It would be very surprising if they did."
Angela Schneider, director of the International Centre for Olympic Studies at Western University in London, Ont., suggests that sporting federations should be working together to come up with a framework for trans women's participation across sports.
"It does require minds that have the ability to be open but at the same time critical, and to take a step back and look at this, and allow people to actually have open dialogue," Schneider, a former Canadian Olympic rower, said.
"It has to be a process that allows for the representation of women athletes. And it has to be a process that really does talk about fairness fundamentally."