Transwomen in elite women’s sport – clarifying the nuances of our approach

By Taryn Knox, Lynley Anderson, and Alison Heather

Our paper in the Journal of Medical Ethics entitled Transwomen in elite sport: scientific and ethical considerations, along with the related posts on the Journal of Medical Ethics and British Journal of Sports Medicine blogs, have generated widespread debate around New Zealand and the rest of the world from the UK to the USA. In this post, we clarify some misinterpretations and respond to a small number of objections. We plan on providing a thorough analysis of the objections in a future paper in the Journal of Medical Ethics.

Our paper argues that there is a problem in elite women’s sport. The International Olympic Committee (IOC) regulations (2015) permit transwomen to compete in the women’s division if (a) she has declared her gender, for sporting purposes to be female for at least four years, and (b) her blood testosterone levels have been below 10nmol/L for at least a year prior to competition (IOC 2015). As explained in our article, these requirements do not ensure fair competition for two reasons – the testosterone limit of an elite transwomen athlete is significantly higher than the average for elite ciswomen athletes, and hormone therapy will not eliminate all the performance advantages of a prior male physiology. We want to encourage trans-communities to participate in sport. Hence, our solution is not to exclude transwomen but to raise the idea that attempting to squeeze everyone into a gender binary is the problem. We seek a solution that fairly includes transwomen (and transmen) in elite sport.

Our paper has been welcomed by some, but not others. Critiques have been wide-ranging. Some reject the science, arguing that transwomen do not have an advantage. Others accept the science but reject the ethical arguments. Others accept the science and the ethical arguments, but don’t like our solution.

To clarify, we support the inclusion of transwomen in elite sport that meet the current IOC standards.  Moreover, they should be able to compete without heckling or criticism from her competitors or the crowd because of her trans-status. This doesn’t mean that we should accept the regulations without criticism. The regulations can, and should, be subject to debate. Instead of criticising those that do not fit neatly into the gender binary of elite sport, we need to criticise the way sport is currently structured.

Our article is strictly limited to elite athletes. (By elite athletes, we mean those athletes competing at national, professional or university (in USA) levels, either paid or unpaid (Swann, Moran, and Piggott 2015).  At the non-elite level of sport, we think the principle of inclusion is likely more important than fairness.

It has been claimed on social media that we are Trans-Exclusionary Radical Feminists (TERFs). The term TERF is generally seen as derogatory and being a TERF is viewed by many as an unacceptable position.  A less derogatory term is gender critical feminist (GCF). A GCF might claim that transwomen should not be included in the category ‘women’. GCFs may accept parts of our argument. For example, they are likely to accept the science showing that elite transwomen athletes have a performance advantage over their cis-counterparts, and that this performance advantage is an intolerable unfairness. However, some might reject our solution that the gender binary in elite sport be replaced with a more nuanced system of categorisation. Some GCFs want to retain the category ‘women’ – arguing that sex and gender have political significance and using a different classificatory system makes it harder to address that political significance.  Given that we are in favour of rejecting the gender binary within elite sport, it is difficult to see how we are trans-exclusionary. We are primarily interested in upholding fairness in elite sport. Our view is broadly egalitarian as fairness increases in importance at the elite level.

We propose replacing the gender binary in elite sport with a more nuanced approach – an algorithm to be applied to all elite athletes (cisgender and transgender) that accounts for a range of physiological factors (including, but not limited to, testosterone levels), and gender identity.  In addition to providing fairness to elite ciswomen athletes, an algorithm could also provide fairness to elite transmen athletes. Although not discussed in the paper, elite transmen athletes are highly likely to be physiologically disadvantaged in comparison to elite cismen athletes. Even if (via hormone therapy) a transman’s testosterone level reached that of an elite cismen athlete, some of his previous female physiology is unlikely to change (e.g. bone structure and lung size) meaning that, in this respect, they are disadvantaged in elite sport.  This is elegantly demonstrated by the widespread doping of female athletes in East Germany whereby even the highest levels of doping did not see female athletes able to approach the world records set by male athletes (Franke and Berendonk 1997). It is difficult to see how our algorithm is transphobic given that it will also provide fairness to all, including elite transmen athletes. That is, while many critics focus on the effect our algorithm may have for elite transwomen athletes, they neglect the impact on elite transmen athletes.

It has been put to us that having a more nuanced system of categorisation through an algorithm will have the effect of preventing transwomen from competing against ciswomen. While the categories generated by the algorithm may be largely consistent with the current gendered categories, there will be instances of transwomen competing against ciswomen. How often this will occur will depend on the precise configuration of the algorithm and be dependent on the sport in question. The algorithm clearly requires serious consideration and input from a range of sources including scientists, ethicists, various sporting bodies and advocacy groups.

Debate on these issues is important. However, in order for debate to lead to progress, both sides need to be open to views and arguments that do not align with their own position. We encourage such debate.


Franke, Werner W., and Brigitte Berendonk. 1997. “Hormonal Doping and Androgenization of Athletes: A Secret Program of the German Democratic Republic Government.” Clinical Chemistry 43 (7): 1262.

IOC. IOC consensus meeting on sex reassignment and hyperandrogenism. 2015

Swann, Christian, Aidan Moran, and David Piggott. 2015. “Defining Elite Athletes: Issues in the Study of Expert Performance in Sport Psychology.” The Development of Expertise and Excellence in Sport Psychology 16 (January): 3–14.


Paper title: Transwomen in elite sport: scientific and ethical considerations

Author(s): Taryn Knox1, Lynley Anderson1, Alison Heather2


  1. Bioethics Centre, University of Otago, Dunedin, New Zealand
  2. Department of Physiology, University of Otago, Dunedin, New Zealand

Competing interests: None

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