Women in Sport, as a charity with limited resources, has been working hard to understand how we can add value to the sports organisations that must ultimately take the decisions about transgender inclusion. These sports organisations are often working under considerable pressure, are understandably cautious, and are usually operating in the context of international rules. We are therefore very pleased that the UK Sports Councils have come together to commission this research to assist the governing bodies of sport across the UK when updating their guidance.
Women in Sport is passionately behind the need for society to be inclusive. We believe sport transforms lives, and no-one should be excluded from it. We also understand that exclusion takes many forms – from active exclusion by an organiser, to gender stereotyping, to self-exclusion due to personal reasons, and everything in between. As an organisation we are particularly well informed about the long history of active exclusion of women and girls from sport. We also recognise that the term inclusion is complex as, unfortunately, what allows for inclusion for some may unintentionally lead to exclusion for others.
Women in Sport was formed in 1984, the same year that women were first allowed to run in the Olympic Marathon after many years of campaigning. Whilst change is happening now, for centuries women faced exclusion from sport and even now, the value of sport and exercise for women and girls is not fully appreciated by society. Women in Sport has worked for nearly 40 years to understand the lives of women and girls as they relate to sport and exercise, and to make the case for change. We know that, for women, barriers to participation in sport and exercise can be both cultural and biological and that the two are linked. We have insights into the experiences of women and girls at each life stage based on high quality research, and within this puberty and menopause are key issues. For natal women and girls their biological sex continues to have a significant impact on sport and exercise.
All these issues should be considered in parallel, rightly, with the aim to ensure the inclusion of transgender women in sport as a whole. We believe there is more work to do to find the right solutions for the inclusion of transgender women in sport. In view of the Sports Councils’ research, we believe the decision makers need to invest time and effort into finding those solutions.
In almost all its forms, sport is predominantly about physicality, and male and female bodies are significantly different. Post-puberty, men have different and larger skeletons on average, larger and denser muscle mass, bigger lungs, hearts, and coronary vessels than women. As the Sports Council guidance indicates, the difference in the times run / weights lifted between males and females becomes significant at puberty and amounts to 10-35% depending on the sport. These are key reasons why provision has been made in sport for female-only categories.
It is important to appreciate that while some transgender women may have undergone medical treatments or surgery as part of their gender transition, others may not have. Even after 36 months of hormone therapy, when haemoglobin levels have reduced to levels we see in natal women, strength, lean body mass and muscle area in transgender women remain above those of natal women. This has implications both for health and safety in collision sports and opportunity to win in competitive sports. There is growing evidence that these differences are only slightly reduced even after full surgical transition. When discussing transgender inclusion in women’s sport it therefore is impossible to ignore the evidence that the average transgender woman will continue to have significant size, strength, and cardio-vascular advantages over the average natal women.
At Women in Sport, we understand the value of competitive sport: trying to win, learning to lose, taking risks, and pushing yourself. We believe this builds resilience in individuals and in society. So, in addition to minimising risk of injury in collision sports, we are keen to ensure that the integrity of competition is sustained at all levels, and that no one self-excludes due to a sense of competitive injustice or fear of injury.
For those organising sport, difficult decisions lie ahead, but they must not avoid them, because they matter. For a long time, the complexities of this issue and the implications for women’s sport seem not to have been properly considered. The evidence is increasingly suggesting that the approach of simply measuring testosterone levels in the blood is not taking into account the full breadth of biological differences between people who have gone through male versus female puberty.
Debate, whether within organisations, in the media or on social media, does have a place in sport and in wider society. Unfortunately, the debate on transgender women’s inclusion in sport has not always been based on science, it has often excluded women – whether natal or transgender – and on occasion it has been far from respectful. Women in Sport firmly believe that this debate should be well evidenced, respectful and involve the people most affected. Global sporting organisations and national governing bodies must listen to the voices of both natal and transgender women and map out a path, based on science, that better appreciates the complexities involved.
 How does hormone transition in transgender women change body composition, muscle strength and haemoglobin? Systematic review with a focus on the implications for sport participation | British Journal of Sports Medicine (bmj.com)
 Transgender Research_Summary of data_ENGLISH 09.10.2020 (world.rugby): “Females have 20-30% higher risk factors for head injury when playing against transgender women”.