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World Athletics banned transgender women from competing. Does science support the rule? | Science

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World Athletics (WA), the governing body for track and field and other running competitions, announced last month that transgender women who went through male puberty can no longer compete in women’s events at international competitions. The policy took effect on 31 March.

WA also ruled that to compete as a woman, athletes with differences of sexual development (DSD), who have congenital conditions that cause atypical sex development, must have a testosterone level below 2.5 nanomoles per liter (nmol/L) for at least 24 months before an international competition.

WA said its rules prioritized fairness and “integrity of female competition.” The organization’s president, Sebastian Coe, said, “We will be guided in this by the science around physical performance and male advantage which will inevitably develop over the coming years.”

But Joanna Harper, a Ph.D. student at Loughborough University who studies transgender athletes’ performance, questions whether the WA fully considered the scientific evidence. “I was disappointed with the decision,” says Harper, who is transgender. “The idea that it was necessary to ban trans women to protect the female category seems so far-fetched.”

She says the new rules discriminate against trans athletes and will likely hinder research on transgender women’s athletic performance.

ScienceInsider examined some of the key issues.

Is there evidence that transgender women athletes have a physiological advantage?

Not according to Eric Vilain, a geneticist at the University of California, Irvine, who specializes in gender-based biology. Very little research has been published on transgender athletes, and what has been published didn’t provide enough results to create evidence-based policies, says Vilain, who does not identify as transgender. “It’s not black and white.”

For example, a 2021 review found trans women’s muscle mass remains high after transitioning, but their levels of hemoglobin—the oxygen-carrying protein in blood—were comparable to cisgender women’s. Increased levels of hemoglobin facilitate more oxygen transport to muscles when active, and men tend to have higher hemoglobin than women.

The lack of definitive data supports the rule, a WA spokesperson told ScienceInsider. “It is precisely because there is insufficient evidence to prove that the male advantage of male-to-female transgender athletes can be removed that World Athletics has made this decision,” the spokesperson said by email.

Is there a scientific consensus about how trans athletes actually perform compared with cisgender women?

No, Vilain says. The lab studies of athletes’ hemoglobin and muscle mass say nothing about whether trans women can run faster, jump higher, or throw farther. “You have to demonstrate that before excluding” transgender athletes, he says.

A rare performance study on trans athletes, a 2015 study by Harper of eight women, found their race times slowed after transitioning from male to female, while their performance relative to sex-matched runners stayed the same. The results suggest they have no advantage over cisgender women.

Harper says that to her knowledge, no transgender women have competed internationally at an elite level. She interprets that to suggest trans women do not win all the medals or break records because of any potential physical advantage.

Where does WA’s testosterone limit for athletes with DSD come from?

Testosterone is important to athletic performance because it increases muscle mass, strength, and hemoglobin levels.

Female athletes with DSD, such as South African runner Caster Semenya, often have higher levels of testosterone than other women. While cis men in general have testosterone levels that range from 10 to 35 nmol/L, cis women’s testosterone usually stays below 2.4 nmol/L.

In a 2018 ruling, WA said transgender athletes and people with DSD could compete in women’s events as long as their testosterone levels were below 5 nmol/L. Harper was on an expert committee advising WA that last year recommended lowering the limit to 2.5 nmol/L for both trans athletes and people with DSD. But the organization chose to apply that limit only to athletes with DSD and to ban female trans athletes from competition.

Athletes can take medications to lower their testosterone. But the effects are short-lived, Harper says, so it’s difficult to maintain steady hormone levels. There needs to be tolerance for fluctuations, she says—something the previous limit of 5 nmol/L allowed.

And there’s uncertainty in this area, as well. A 2021 consensus statement from the International Federation of Sports Medicine noted a lack of performance studies of athletes with DSD before, during, or after testosterone suppression.

Vilain, for his part, calls the policy discriminatory because it only applies to athletes with DSD. It allows many cis women with elevated testosterone levels, such as those who have polycystic ovary syndrome, to compete, he says.

Athletics South Africa, the national organization that governs track and field, is reportedly taking legal advice in response to WA’s new “highly discriminatory regulations” for DSD athletes.

How will WA’s decision affect research on trans athletes and those with DSD?

It could hinder these studies by driving trans women out of international events and other professional competitions, Harper says. For example, British Athletics has already adopted WA’s rule. “I have heard from three trans athletes in other countries that they are now too afraid to compete in the sport they love,” she adds.

If far fewer trans athletes compete, the number of potential study participants will, in turn, decrease. And athletes with DSD who want to compete will have to alter their bodies by lowering their hormone levels, complicating efforts to study their apparent advantages.

With little research done to date, the new rules will make it harder for researchers to produce data to inform policy, Vilain says.

Have other athletics organizations enacted similar rules?

Yes. In 2022, the Union Cycliste Internationale, the governing body for cycling, announced a testosterone limit of 2.5 nmol/L for trans women cyclists. A few days later, FINA, the governing body for swimming, barred trans women from competing in women’s events. World Rugby has an outright ban on trans women in international women’s rugby.

The International Olympic Committee’s approach is more science-informed, says Vilain, who took part in the organization’s 2021 trans-inclusion framework. It says no athlete should be excluded from competing on the basis of an “unverified, alleged or perceived unfair competitive advantage due to their sex variations,” and no athlete should be pressure to undergo medically unnecessary procedures to meet criteria to compete.

“I would certainly hope that more data will help sway policies” in the future, Harper says.


World Athletics (WA), the governing body for track and field and other running competitions, announced last month that transgender women who went through male puberty can no longer compete in women’s events at international competitions. The policy took effect on 31 March.

WA also ruled that to compete as a woman, athletes with differences of sexual development (DSD), who have congenital conditions that cause atypical sex development, must have a testosterone level below 2.5 nanomoles per liter (nmol/L) for at least 24 months before an international competition.

WA said its rules prioritized fairness and “integrity of female competition.” The organization’s president, Sebastian Coe, said, “We will be guided in this by the science around physical performance and male advantage which will inevitably develop over the coming years.”

But Joanna Harper, a Ph.D. student at Loughborough University who studies transgender athletes’ performance, questions whether the WA fully considered the scientific evidence. “I was disappointed with the decision,” says Harper, who is transgender. “The idea that it was necessary to ban trans women to protect the female category seems so far-fetched.”

She says the new rules discriminate against trans athletes and will likely hinder research on transgender women’s athletic performance.

ScienceInsider examined some of the key issues.

Is there evidence that transgender women athletes have a physiological advantage?

Not according to Eric Vilain, a geneticist at the University of California, Irvine, who specializes in gender-based biology. Very little research has been published on transgender athletes, and what has been published didn’t provide enough results to create evidence-based policies, says Vilain, who does not identify as transgender. “It’s not black and white.”

For example, a 2021 review found trans women’s muscle mass remains high after transitioning, but their levels of hemoglobin—the oxygen-carrying protein in blood—were comparable to cisgender women’s. Increased levels of hemoglobin facilitate more oxygen transport to muscles when active, and men tend to have higher hemoglobin than women.

The lack of definitive data supports the rule, a WA spokesperson told ScienceInsider. “It is precisely because there is insufficient evidence to prove that the male advantage of male-to-female transgender athletes can be removed that World Athletics has made this decision,” the spokesperson said by email.

Is there a scientific consensus about how trans athletes actually perform compared with cisgender women?

No, Vilain says. The lab studies of athletes’ hemoglobin and muscle mass say nothing about whether trans women can run faster, jump higher, or throw farther. “You have to demonstrate that before excluding” transgender athletes, he says.

A rare performance study on trans athletes, a 2015 study by Harper of eight women, found their race times slowed after transitioning from male to female, while their performance relative to sex-matched runners stayed the same. The results suggest they have no advantage over cisgender women.

Harper says that to her knowledge, no transgender women have competed internationally at an elite level. She interprets that to suggest trans women do not win all the medals or break records because of any potential physical advantage.

Where does WA’s testosterone limit for athletes with DSD come from?

Testosterone is important to athletic performance because it increases muscle mass, strength, and hemoglobin levels.

Female athletes with DSD, such as South African runner Caster Semenya, often have higher levels of testosterone than other women. While cis men in general have testosterone levels that range from 10 to 35 nmol/L, cis women’s testosterone usually stays below 2.4 nmol/L.

In a 2018 ruling, WA said transgender athletes and people with DSD could compete in women’s events as long as their testosterone levels were below 5 nmol/L. Harper was on an expert committee advising WA that last year recommended lowering the limit to 2.5 nmol/L for both trans athletes and people with DSD. But the organization chose to apply that limit only to athletes with DSD and to ban female trans athletes from competition.

Athletes can take medications to lower their testosterone. But the effects are short-lived, Harper says, so it’s difficult to maintain steady hormone levels. There needs to be tolerance for fluctuations, she says—something the previous limit of 5 nmol/L allowed.

And there’s uncertainty in this area, as well. A 2021 consensus statement from the International Federation of Sports Medicine noted a lack of performance studies of athletes with DSD before, during, or after testosterone suppression.

Vilain, for his part, calls the policy discriminatory because it only applies to athletes with DSD. It allows many cis women with elevated testosterone levels, such as those who have polycystic ovary syndrome, to compete, he says.

Athletics South Africa, the national organization that governs track and field, is reportedly taking legal advice in response to WA’s new “highly discriminatory regulations” for DSD athletes.

How will WA’s decision affect research on trans athletes and those with DSD?

It could hinder these studies by driving trans women out of international events and other professional competitions, Harper says. For example, British Athletics has already adopted WA’s rule. “I have heard from three trans athletes in other countries that they are now too afraid to compete in the sport they love,” she adds.

If far fewer trans athletes compete, the number of potential study participants will, in turn, decrease. And athletes with DSD who want to compete will have to alter their bodies by lowering their hormone levels, complicating efforts to study their apparent advantages.

With little research done to date, the new rules will make it harder for researchers to produce data to inform policy, Vilain says.

Have other athletics organizations enacted similar rules?

Yes. In 2022, the Union Cycliste Internationale, the governing body for cycling, announced a testosterone limit of 2.5 nmol/L for trans women cyclists. A few days later, FINA, the governing body for swimming, barred trans women from competing in women’s events. World Rugby has an outright ban on trans women in international women’s rugby.

The International Olympic Committee’s approach is more science-informed, says Vilain, who took part in the organization’s 2021 trans-inclusion framework. It says no athlete should be excluded from competing on the basis of an “unverified, alleged or perceived unfair competitive advantage due to their sex variations,” and no athlete should be pressure to undergo medically unnecessary procedures to meet criteria to compete.

“I would certainly hope that more data will help sway policies” in the future, Harper says.

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