Confronting a New Threat to Female Athletics

On 17 February, tennis legend Martina Navratilova published an article in the The Sunday Times wherein she voiced her concerns about men who “decide to be female” participating in women’s sports. The followup to this publication was met with Navratilova being subsequently dropped as an ambassador by Athlete Ally, an organisation which supports LGBT athletes, and she was removed from the advisory board of Trans Actualy, a non-profit U.S. organization. Here’s the back story.

In December, Navratilova responded to a tweet from one of her followers about female-identified biological males participating in women’s sport: “Clearly that can’t be right. You can’t just proclaim yourself a female and be able to compete against women. There must be some standards, and having a penis and competing as a woman would not fit that standard.” Rachel McKinnon, a male-born Canadian philosophy professor who competes against women as a transgender athlete, weighed in with a lengthy social-media dissertation, in which McKinnon informed Navratilova that “people’s genitals are irrelevant to sports performance,” and called her comments “transphobic.”

In recent days, this fight has entered a new phase, with Navratilova’s article being reported in other media outlets as if what she were saying was not just unreasonable but bigoted. CNN’s coverage, for instance, declared: “Martina Navratilova criticized for comments about trans women in sport.” At the BBC, meanwhile, producers allegedly rescinded an invitation to a guest who sought to defend Navratilova, and instead gave the air time to McKinnon, who declared that having a debate on the issue was tantamount to “a black person [debating] a KKK member on civil rights.”

Navratilova’s flip claim that “there must be some standards, and having a penis and competing as a woman would not fit that standard” stood out not just because she is a tennis legend, but because she represents the constituency most significantly affected by these recent developments (even as activists seek to quash such voices through harassment and mobbing): female-born, female-identified athletes.

Amazingly, the International Olympic Committee (IOC), the governing body for the Olympic Games, seems more disposed toward McKinnon’s position than Navratilova’s. As far as the IOC is concerned, it is indeed permissible for male-born athletes to compete against women. In 2016, the organization relaxed its guidelines for the inclusion of trans-identified athletes, removing the requirement that they undergo surgically administered anatomical changes. Under the new policy, female-to-male athletes can compete against males “without restriction,” while male-to-female athletes must demonstrate that their testosterone levels have been below a specified level for at least a year—at which point it is (falsely) assumed that any male physical advantages will have been suppressed.

On the Issue of Female Athletics, the IOC Has Shirked Its Duty to Lead

Sydney. London. Toronto.

QuilletteDoriane Coleman and Martina Navratilova

The movement for trans inclusion now begins in youth sports, where many leagues have no restrictions beyond self-identification. Transathlete, a website founded by female-identified transgender athlete Chris Mosier, campaigns for “trans inclusion in athletics.” Mosier’s goal is to implement a universal policy across all public high schools in the United States allowing transgender-identified students to participate in sports under their affirmed gender in the name of “respect for personal dignity.” In 2016, Nattaphon “Ice” Wangyot, born a biological male, competed for a high school state track championship in Alaska, beating out almost every female in a 100m race. More recently, Terry Miller and Andraya Yearwood, both natal males who identify as female, dominated the 2018 field in Connecticut’s all-state high-school tournaments. Bianca Stanescu, the mother of a female runner, learned about the participation of the pair when her daughter competed against them at a track meet, at which Miller and Yearwood ultimately placed first and second respectively:

One of them switched [gender] right before high school…and it was a shocker…We watched the kids lining up at the start[ing] line and all of a sudden there is a one at the finish line and all the girls halfway down the track. All of the parents looked at each other and said, “What just happened?” So we went home and looked online at the stats on Terry Miller and there was no Terry Miller. So, we went through the male athletes list and there was his name on the boys’ events, for three seasons, where he had competed as a male.

One reason all this has happened is that protections contained in Title IX of the Education Amendments Act of 1972 (a U.S. federal law known colloquially simply as “Tittle IX”) have been interpreted so as to prohibit disclosure of who is trans and who is not. And the states are pressured to take their cues from the federal standard. Legally, boys cannot compete with girls according to CIAC (Connecticut InterScholastic Conference) rules. But self-identified trans girls are allowed to compete with females simply by filling out a form.

High-school sports present a particularly charged environment when it comes to gender issues, because children’s bodies typically are undergoing rapid changes. Once male bodies begin puberty, they gain physical advantages that female bodies can never attain, no matter how much training girls do. Testosterone affects the body permanently during puberty, increasing height, augmenting the oxygen-carrying capacity of blood, making male bones denser and organs (including heart and lungs) larger than those of females. So it is no surprise that top high-school male sprinters fare better than almost every top-ranked Olympic female athlete. The top 10 times of New York state’s male high-school 100-meter dash runners since 2006, for instance, range from 10.48 to 10.79 seconds. For the world’s top females, on the other hand, the top three times at the last 10 Olympics ranged from 10.54 to 11.19 seconds.

Kate Hansen, a Canadian roller derby competitor, offers her own story as an illustration of what’s at risk for women who challenge the inclusion of natal men in women’s sport. In 2017, she received a number of friend requests on Facebook from a local transgender-identified skater named Kather Anne Bickford. When the two got into a disagreement over whether Bickford should be competing in a woman’s league, Bickford circulated Hansen’s message on social media. As a result, Hansen was targeted by a campaign of threats and harassment—which included people circulating her home address and the name of her children’s school. Even some of her former friends joined in the mob attack, she tells me.

Hansen’s strong reaction to Bickford did not come out of thin air. Hansen had only competed against one trans-identified natal male, who was around Hansen’s size. Then in 2013, she competed against two trans-identified natal male players whom she reports as being much larger—tall even by male standards. The players’ obvious size and strength advantage put her and the other women at increased physical risk. But Hansen says that she didn’t feel free to complain about these obvious facts, even if many women were complaining in private.

“I don’t have a problem with trans people in the sport of roller derby, if they play for co-ed teams,” she tells me. “I also feel that trans female-to-male players don’t have an appropriate venue. They’re officially unwelcome in women’s leagues even though they’re usually small, and they can’t really hold their own on men’s teams either. I’ve played with both trans-identified males and females, and the bio females are still built like women. Some consideration for biology and physical reality needs to be taken.”

After the social-media attacks, several women from the larger roller-derby community contacted Hansen to lend their support. Locally, however, Hansen was shunned by members of her own team. “While I am welcome to skate with any team, including the Rink Minx [Hansen’s former team], you are not welcome anywhere,” Katherine reportedly gloated in a message to Hansen.

We don’t know how many women are in Hansen’s position, because many simply keep their mouths shut, lest they be accused of contradicting the “correct” opinion about trans athletes. When women were fighting for the right to win inclusion in the sports world, their activism was celebrated by progressives. Now, ironically, those same progressives remain silent (or even partake in the mobbing) when women seek to protect the safe sporting spaces they have created.

Of course, roller derby isn’t regulated at the same level of professionalism as many more established sports. And, as noted above, the IOC has set guidelines for testosterone limits as a proxy for eligibility for competition as a female. However, the research supporting these guidelines is dubious, and recent moves have done little to quell controversy. Last year, for instance, the IOC came under fire due to New Zealand weightlifter Laurel Hubbard—who’d been competing internationally as a man under the name Gavin Hubbard until the age of 35. Hubbard’s inclusion in women’s competitions caused outrage among both male and female athletes, who called for a separate division for transgender athletes. (In January, USA Powerlifting, the American organization in charge of powerlifting competitions in the United States, finally had enough, and announced it would not permit transgender women to compete as women. This decision has been challenged by Congresswoman Ilhan Omar, who described USA Powerlifting’s policy as “discriminatory” and “unscientific.”)

Alison Heather, a professor of physiology at Otago University in New Zealand who has researched the science of transgender physiological changes, has concluded that professional male athletes who trained and competed before receiving gender-related medical interventions will always retain certain advantages, regardless of their testosterone levels or subsequent gender identification. Heather notes, for instance, that Hubbard’s years competing as a man served to increase the quantity of muscle fibres, which in turn allowed Hubbard‘s muscles to develop more effectively, even after transitioning. Heather also notes that questions remain as to how hormone therapy may or may not reduce muscle fibres. Available studies already suggest that most changes associated with male puberty present irreversible advantages vis-à-vis biological women, regardless of subsequent hormone regimens.

In part as a result of the Hubbard case (and others like it), the IOC issued new guidelines last year, aimed at 55 different sports, halving the maximum allowable testosterone level (from 10nmol/L to 5nmol/L) for women in certain competitions. But ironically, in setting lower testosterone limits for transgender women, the guidelines also made it harder for some natal women to establish their eligibility.

A little history is in order here. After a controversy in 2009 surrounding Caster Semenya, an athlete with a rare condition producing extremely high levels of testosterone, the IOC departed from the sex-determining DNA tests it had implemented in 1991 as its standard for sex-segregated competition. That standard was replaced with a physical exam and testosterone test. Athletes would be permitted to compete in women’s competition provided they physically resembled their claimed sex and had testosterone levels deemed appropriate for that sex.

The case of Semenya prompted the IAAF (International Association of Athletics Federations) to introduce a policy regarding hyperandrogenism (high natural levels of testosterone for females) in 2011. The new rule limited the testosterone of female athletes to 10nmol/L. But the rule was subsequently suspended by the Court of Arbitration for Sport (CAS) in July, 2015 after an appeal by the Indian sprinter Dutee Chand, and remains a topic of active debate.

The IOC modified its policies again in November, 2015, at a Consensus Meeting on Sex Reassignment and Hyperandrogenism, which dropped the requirement for athletes to physically resemble the claimed sex, instead permitting transgender athletes to compete without having to undergo sex reassignment surgery. The only remaining requirement under IOC rules was the testosterone limit of 5nmol/L.

In a way, this standard is worse than no standard at all—because it can create both false negatives and false positives: The 5nmol/L limit prevents certain women from competing because of their naturally high testosterone levels, while also green-lighting trans women who pass the test despite enjoying locked-in physical advantages accrued over many years in a male body. (The IAAF’s rules on this are currently being challenged by Semenya at the Court of Arbitration for Sport in Switzerland.)

And it gets worse. In 2017, Stéphane Bermon and Pierre-Yves Garnier examined serum androgen levels in track and field performances of males and females in the 400m, 400m hurdles, 800m, hammer throw, and pole vault competitions. They found that altering testosterone levels had a much stronger effect on female performance levels than they did for males. So by lowering the maximum allowable levels of testosterone from 10nmol/L to 5nmol/L, the IAAF disproportionately penalizes women with naturally occurring hyperandrogenism (i.e. excessive hormone levels) versus trans-identifying biological males who are required to reduce their own testosterone levels. (Moreover, even at their reduced level, trans athletes’ levels would still be higher than those for the average female athlete, which is about 0.7 nmol/L).

While I know of no single comprehensive study in this area that examines all components of strength (including bone density, muscle mass and muscle endurance), several published studies show how the bodies of male-born transgender-identified athletes retain physical advantages later in life. In 2015, for instance, researchers studied 49 “normally active” trans-identified natal males (with an average age of 33) over two years of testosterone suppression, before and after one- and two-year periods of cross-sex hormonal therapy. The results were compared to an age-matched control group of males. Evaluation consisted of measuring such indexes as grip strength, bone density, body fat and lean mass, and bone geometry. The study concluded that a man’s skeletal status is well preserved during hormonal treatment, despite substantial muscle loss.

With regard to the impact of muscle loss on athletic performance, a 2004 study found that even the reduced muscle mass contained in trans-identifying natal males after one year of hormones remained significantly higher than in natal females. Researchers noted that trans-identifying males who have transitioned have no competitive advantage over other women in regard to androgen hormone levels, “but the effects of prior androgen exposure on muscle mass and strength do carry over, at least for a certain time period, while previous effects on height and the size of feet and hands are irreversible, and this may be a relevant consideration.” Which is to say: Even if the short-term effects of testosterone evaporate, it is impossible to negate the many long-term effects of testosterone that provide male bodies with myriad physical advantages from puberty onward.

Unfortunately, where science and politics meet, the former does not always get a fair hearing, as shown at an open lecture held at the University of Brighton last Spring under the title “Beyond Fairness: The biology of inclusion for transgender and intersex athletes.” Joanna Harper, a medical physicist at the Providence Portland Medical Center, and Professor Yannis Pitsiladis, Professor of Sport and Exercise Science at the University of Brighton and a member of the International Olympic Committee (IOC), were brought in to discuss “the implications of a third gender for elite sport, and present a roadmap to guide the implementation of rules for the inclusion for transgender and intersex athletes.” In reality, only Pitsiladis considered the option of a third category in sports. According to several audience members who attended the discussion, Harper seemed less interested in discussing the weight of evidence than in promoting the notion of “gender identity,” which Harper treated as settled science. Channeling a theme that has become strangely popular on social media of late, Harper suggested that it was physical biology—not gender identity—that is a social construct. Specifically, Harper suggested that it is stodgy “traditionalists” who push for biological categorization in sport competition, while “progressive” factions embrace the idea that one can simply self-identify out of one’s physical advantage.

Siddhartha Angadi, a cardiovascular physiologist at Arizona State, has been emphasizing a potentially more important aspect of research in this field—whose implications extend well beyond sport, and into the domain of life-and-death health considerations. Studies have long shown that hormone replacement therapy trials in post-menopausal women are associated with higher morbidity and mortality outcomes—as was the case with the 1970s-era estrogen-supplementation trials conducted under the long-term Coronary Drug Project (CDP). Under the auspices of the CDP, more than 8,000 men were given estrogen to lower their risk of cardiovascular disease. But the trials were shut down because patients were dying so fast. “So it’s plausible that transgender individuals could have worse health outcomes,” Angadi tells me. “But follow-up and phenotyping is currently lacking and urgently needed.” (Angadi and Harper are among a group of authors who recently published an article in Current Sports Medicine Reports in regard to the possibility of a new category for athletes who exhibit “specific differences of sex development,” which could provide unique opportunities for certain trans athletes to compete against one another without unfairly putting women’s sports at risk.)

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Last October, Rachel McKinnon won the gold medal at the UCI Masters Track Cycling World Championship in Los Angeles, where, controversially, McKinnon competed in the women’s 35-44 age bracket. Following the victory, one of McKinnon’s most important critics was Jennifer Wagner-Assali, an orthopedic hand surgeon from Houston, Texas, who came in third that day. A racing specialist who has been competing since 2010, Wagner-Assali responded to one of the many tweets criticizing McKinnon for “cheating,” writing, “I was the third place rider. It’s definitely NOT fair.” But three days later, she tweeted, “After having some time to reflect, I realize my twitter comments earlier this week unintentionally fanned the flames on a controversial situation, and that I regret. I made the comments out of a feeling of frustration, but they weren’t productive or positive.”

“I felt really guilty,” Wagner-Assali told me when I asked her about the follow-up post. “I felt like I had to make some kinds of amends to show that I am not a bigot. In my mind, my second string of tweets was to show, ‘no hard feelings,’ and to start a conversation instead of a fight.”

McKinnon, on the other hand, took to Twitter daily to celebrate the victory, which McKinnon describes as one of historic proportions. As for the critics, McKinnon compared them to Nazis: “’Joseph Goebbels, the Nazi propaganda minister, looking at Jesse Owens, and he says, you know, quite openly, I think it’s unfair, to have people like Jesse Owens competing, because you might as well have deer or gazelle on your team.’ Sound familiar, transphobes? Not a good look.”

Wagner-Assali and some other competitors from her circuit now are joining together to suggest a separate trans category as a fair solution. “We know that males who have gone through puberty do have a physical advantage to females,” she tells me. “So why are female athletes made to correspond to testosterone levels that would exclude actual females like Semenya and Chand?”

Along with six other cyclists, Wagner-Assali is in the process of drafting a letter to the IOC. “We understand and sympathize with the IOC having to create rules that deal with this issue that avoid discrimination on both sides,” she writes. “We feel like they have not heard this voice of female competitors and we want to make sure that our voices are heard. We are thinking of the future of the sport and the girls who come after.”

“We even toyed with the idea of having our own competition,” Wagner-Assali tells me. “When women weren’t allowed in the Olympics, one way they gained entry was to hold their own Olympics and the men saw that, ‘Hey, they can do sports too!’ [But] these days, people get fired for things they say. Everyone is afraid to lose their livelihood…I want to be inclusive, but this issue is one place where I [now] can’t shut up.”