Author: Hadia Zainab, DPT

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The debate on transgender athletes has reached the very core of discussions about fairness and inclusivity in sports. This is an increasingly topical issue, with news that a victorious Algerian boxer, Imane Khelif, won her first Olympic boxing match when her opponent, Angela Carini from Italy, quit after just 46 seconds.

Even though, according to publicly available data, Imane Khelif is not transgender and was assigned female at birth, her disqualification from the 2023 world championships raises some questions. The disqualification occurred due to her failing a gender eligibility test, the details of which have been kept confidential. Her participation in the Paris Olympics has been controversial and has drawn attention to the issues surrounding transgender athletes, even though it appears that Imane Khelif's situation may not fall into this category.

The Olympics and other major sporting events have brought these issues to the forefront; therefore, making it necessary to address moral dilemmas thoughtfully and justly.

Understanding transgender athletes in sports

As the number of transgender people in the U.S. and around the world is growing each year, it's important to understand who transgender people are and what it means to be a transgender athlete. This topic is widely discussed on social media under the hashtag #transgender.

Definition and overview

A transgender (or simply 'trans') athlete is someone whose gender identity is different from the sex they were assigned at birth. Being a transgender athlete means competing under one's current gender identity and working one's way through policies or issues regarding inclusion and fair competition in sports.

Transgender athletes gained significant recognition in 1977 when Dr. Renee Richards, a postoperative transgender woman, was allowed to participate in the U.S. Women's Open Tennis Tournament by the Supreme Court. It wasn't until 2004 that transgender athletes could compete in the Olympics due to the enactment of a 2003 International Olympics Committee (IOC) policy.

The IOC's 2003 policy stated that to compete, transgender athletes must have undergone genital surgery, must have had legal recognition of their gender, and must have had hormone therapy for a sufficient period. By doing so, the IOC followed this very approach and thus set requirements for a transgender athlete to compete in the Olympics.

Contrary to the 2003 policy by the IOC, the 2015 IOC policy removed the requirement for sex reassignment surgery for transgender women, focusing instead on maintaining low testosterone levels (below 10 nmol/L) and undergoing hormone therapy for at least 12 months prior to competition. It also removed restrictions for transgender men, who did not have to declare or meet a specific limit of testosterone.

Current regulations and guidelines

In 2021, a new policy for the protection of transgender athletes was passed at a time when anti-transgender sports bills were on the rise. The policy has no universal criteria for all sports but rather defers them to the sporting authorities.

The International Olympic Committee states in its framework on gender identity and sex variations that everyone should be able to participate in sports safely and without prejudice.

The framework emphasizes that mechanisms to prevent harassment and abuse in sports should be further developed, considering the particular needs and vulnerabilities of transgender people and those with sex variations.

The current policy clearly states that every transgender athlete shall participate in their sport as their preferred gender and shall not be required to undergo unnecessary medical procedures.

However, there are still restrictions by sports organizations on participation by transgender athletes. The World Athletics Council banned transgender women who began transitioning after puberty from participating in high-level female events. World Aquatics only allows people to compete if they transitioned before the age of 12. Similarly, the International Cycling Union restricts trans women who began transitioning after puberty, offering them a 'men/open' category for competing instead.

The impact on boxing and other contact sports

Much of the debate about transgender athletes competing in sports focuses on biological differences, which is likely due to differences in hormonal levels and other structural changes between transgender and cisgender individuals.

Physical advantages and disadvantages

Although most biological changes are established after puberty, performance advantages are believed to be the result of higher testosterone levels in those assigned male at birth, compared to people assigned female at birth. However, there's very little evidence to show that high testosterone actually improves athletic performance.

One study compared transgender male and female athletes to their cisgender counterparts. It was found that transgender women reportedly had decreased lung function compared to cisgender women, making breathing more difficult. Despite similar fat-free mass, transgender women performed worse on the countermovement jump than cisgender women and cisgender men.

Some studies, however, indicate that transgender women still have the competitive edge coming from their previous male physiology. Since the data is limited, more research needs to be conducted to reach any firm conclusion.

Safety concerns

If there is a mismatch in strength and other physical abilities, there can be a risk to the safety of both cisgender and transgender athletes. Therefore, matching by skill level, experience, and weight class can ensure more well-matched and safer competitions.

In matches like boxing, where it involves some sort of potential contact, mouthguards, hand wraps, and gloves should be put on as obligatory for competitors in an effort to lower the risk of injury.

It may also affect the mental well-being and confidence of cisgender women athletes who feel they are competing in an environment not safe or fair. Therefore, the mental health of the athletes should also be prioritized.

The moral and ethical debate

An anonymous survey of elite British sportswomen has found that more than 70% are unhappy for transgender athletes to compete in female sports categories. In addition, 67% are uncomfortable speaking publicly about the issue.

This survey of 615 athletes returned 143 responses: 104 who are uncomfortable about transgender athletes competing in the female category versus 11 who are comfortable. In terms of public discussion, responses included unease at being labeled as abusive or discriminatory.

Data from another previous poll results revealed sharp splits among Americans on how transgender athletes should compete in the 2020 Tokyo Olympics. Nearly 39% thought they should compete based on the gender they were born, 20% supported competing based on the gender with which one identifies, 14% thought they shouldn't compete at all, and 23% were unsure.

Recent news sparking the debate

Recently, an Italian boxer Angela Carini came to the Paris Olympics for a medal in memory of her late father and coach, but her bout lasted 46 seconds as she quit with blood on her trunks. This decision reopened the debate about her opponent, Imane Khelif, who had been previously disqualified from championships over gender eligibility issues.

Carini's swift exit triggered an argument as to whether the officials should have allowed the bout to proceed with Khelif. Meanwhile, global media has mostly referred to Khelif as a ‘biological male’ or ‘transgender.’ However, this description seems to be inaccurate, as she is identified as biologically female on her passport.

According to Carini, the quitting was due to the reason that she could not bear the physical pain; also, she added that her act wasn't pre-planned. She is apologetic for the controversy, stating that she doesn't have any personal problem with Khelif.

“We have seen in reports misleading information about two female athletes competing at the Olympic Games Paris 2024. The two athletes have been competing in international boxing competitions for many years in the women’s category, including the Olympic Games Tokyo 2020, International Boxing Association (IBA) World Championships and IBA-sanctioned tournaments,” said the International Olympic Committee, referring to Iman Khelif and the Taiwanese boxer Lin Yu-ting.

The Taiwanese boxer Lin failed a gender eligibility test last year, similar to Khelif, who participated in the 2024 Olympics. On August 2, Lin won against Sitora Turdibekova from Uzbekistan, which has fueled the ongoing debate. The IBA did not explain why the boxers failed their gender eligibility tests but clarified that neither had undergone testosterone tests. Both Lin and Khelif do not identify as transgender or intersex and have been cleared to compete by the IOC.

The IOC further stated that they are dedicated to protecting athletes' human rights and expressed sadness over the abuse the two athletes are facing.

The future of transgender athletes in sports

The right of transgender people to fully participate in society is often restricted by the belief that biological differences between males and females give men and boys an athletic edge. The debate about including transgender women in sports focuses on whether hormone therapy can change the male athletic advantages associated with testosterone.

Transgender athletes are already competing in major sports events like the Olympics. For example, Hergie Bacyadan, a boxer, participated in the 2024 Olympics, and Quinn, a trans footballer, won a gold medal at the 2020 Tokyo Olympics. While the future remains uncertain, there is hope that an increase in transgender athletes may lead to clearer regulations, greater equity, and fairness in sports.

Right now, only a few school sports organizations have rules about including transgender student athletes. However, many are starting to look into this and see the need for these rules.

Public opinion has a strong impact on how policies are formed and implemented. If the greater part of the population would like to include transgender athletes, then policymakers will more likely make and enforce inclusive policies. In turn, very opposite sentiments can bring about increased restrictions. As such, changes to the regulation and practice of sports are responsive to public attitudes and advocacy.

Final word

As more transgender people join sports, it's becoming more important to have clear and fair rules. Some people believe biological differences might give certain athletes an edge, while others focus on the need to include and respect everyone's identity.

Transgender students are seeking increased recognition and support in school sports programs. Advocates want rules that are fair to all and ensure everyone’s rights are respected. This ongoing conversation highlights the need for more discussions and research to make sure sports stay fair and respectful for everyone.

12 resources

American Journal of Public Health. Transgender population size in the United States.
History of Skiing & Snowsports. Transforming the Olympic games: the increased inclusion of transgender athletes from 2003 through the present.
International Olympic Committee. IOC framework on fairness, inclusion, and non-discrimination on the basis of gender identity and sex variations.
Inside the Games. Restrictions on transgender athletes at Paris 2024.
Frontiers in Sports and Active Living. Transgender athletes in sports competitions.
British Journal of Sports Medicine. Strength, power and aerobic capacity of transgender athletes: a cross-sectional study.
International Journal of Environmental Research and Public Health. Transwoman elite athletes: their extra percentage relative to female physiology.
BBC Sport. BBC elite British sportswomen's study 2024 results.
Axios. Exclusive poll: the deep divide over trans athletes in Olympics.
AP News. Why did Italian boxer Angela Carini quit against Imane Khelif?
Uniland. First ever trans athlete at Olympic games loses historic boxing match in Paris.
Women's Sports Foundation. Participation of transgender athletes in women's sports.

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