Executive Summary
Background Information
Historically, society has conceptualised sex and gender as binary categories (male/female and man/woman or boy/girl). Competitive sport, with a few exceptions1, is organised into the binary categories of male and female. This is to create fairness due to the natural physical advantages of male athletes in most sports. Some argue that binary sex classification has significant pragmatic value within competitive sport, providing a standardised and consistent framework within which sport can operate (Krech, 2017). However, others argue it is a simplistic framework, given the complex array of factors that contribute to athletic performance, and can result in perpetuating the patriarchal status quo and excluding individuals whose gender identity or biological make-up does not neatly fit into binary gender categories (Krane, Barak, & Mann, 2012; Krech, 2017). Developments in human rights law have seen ‘explicit prohibitions against discrimination on the basis of sex or gender enshrined in a range of legal instruments, including national constitutions and human rights legislation’ (Krech, 2017, p. 270). Despite this, research suggests that individuals who are transgender, intersex or non-binary continue to face exclusion and/or barriers within both competitive sport and sport-related physical activity.
Sport policy relating to the eligibility of transgender, intersex and non-binary athletes to compete in sport has developed significantly over the past 60 years. A formalised policy of sex-testing in elite sport was introduced in the 1960s, initially requiring athletes participating in women’s events to submit to visual and gynaecological examinations at competitions that are governed by the International Association of Athletics Federations (IAAF) (Love, 2014). The International Olympic Committee (IOC) first introduced chromosomal testing for competitors in women’s events in 1968 which, over the following three decades, included tests designed to identify the presence of a second X chromosome or the presence of a Y chromosome. These tests were abandoned prior to the 2000 Sydney Olympics, however, due to the ineffectiveness and ambiguity involved in determining sex through such procedures (Love, 2014). Since 2000, sporting governing bodies such as the IOC and IAAF no longer practise compulsory sex-testing for athletes competing in women’s events but have developed eligibility guidelines for the inclusion of athletes in women’s events. From an online search, it was found that several women and sport and LGBTQ+ organisations provide position statements on transgender inclusion in sport, but this is severely lacking in relation to intersex and non-binary inclusion in sport.
Research on transgender, intersex and non-binary inclusion in sport is still in its infancy. Some sub-topics of investigation are developing a growing body of research, such as transgender and intersex inclusion in elite sport. Other sub-topics have had limited research attention, such as the inclusion and experiences of non-binary people in any form of sport and physical activity and the experiences of transgender and intersex people in grassroots sport and sport-related physical activity (SPA).
1 Equestrian and luge include mixed-sex events at the Olympics where women and men compete against each other. Some other Olympic sports include mixed team events where each team has an equal number of men and women, such as tennis, badminton and sailing.
Transgender people in sport and physical activity
Sport and physical activity can play an important part in maintaining good physical, mental and social wellbeing for the increasing number of people identifying as transgender (Lopez-Canada et al., 2019). However, research suggests that transgender people face barriers in participation across the sporting landscape. At the elite sporting level, eligibility criteria have been introduced by national and international governing bodies to avoid transgender women having an ‘unfair advantage’. This is the result of some scientific studies finding that transgender women have a significant performance advantage over cisgender women due to increased testosterone levels and retaining advantaged accrued from their former male physiology (e.g. Knox, Anderson, & Heather, 2019). Other experts have suggested that the scientific evidence is not strong enough to warrant the exclusion of transgender athletes via eligibility criteria (e.g. Jones, Arcelus, et al., 2017b). Eligibility criteria can lead to the exclusion of some transgender women from competing in elite sport unless they use medication to reduce their testosterone levels (to below 10 nmol/L for the IOC regulations and below 5 nmol/L for the World Athletics regulations).
In grassroots sport and SPA, it has been found that discrimination, lack of education/awareness, binary gender classifications and sex-segregated changing areas can lead to transgender people experiencing harassment, stigmatisation, isolation and body dissatisfaction (Jones, Arcelus, et al., 2017a; Muchicko et al., 2014. This can result in transgender people choosing not to participate in these activities or choosing to participate in individual sports that avoid body exposure and are less demanding in terms of social recognition (Hargie, Mitchell, & Somerville, 2015).
Several women and sport and LGBTQ+ organisations have released statements on transgender inclusion in sport. Only one of these organisations, Canadian Women and Sport (CWS), provides a strong and clear statement outlining their position on transgender inclusion at all levels of sport (Canadian Women and Sport, 2017). CWS call for full participation for transgender people in sport and physical activity and oppose medical intervention of any kind as a condition of competition. Other women and sport and LGBTQ+ organisations promote inclusivity and fairness in sport but do not clearly state their position on eligibility criteria in elite sport.
To maintain both fairness and inclusivity in sport, some scholars have called for replacement of the gender binary in elite sport with a system that recognises the difference between people while creating space for all athletes (Anderson, Knox, & Heather, 2019; Knox et al., 2019). One suggestion of how to achieve this is a ‘multifaceted algorithm’ similar to that used in the Paralympics that would be tailored to individual sports and account for a range of physiological and social factors that affect athletic performance(Anderson et al., 2019). More exploration and research of such ideas is required to gain a better understanding of the pros and cons of different approaches and their feasibility.
Whilst there is a growing base of sociological, psychological and philosophical research on the topic of the experiences and inclusion of transgender people in sport, there are some clear areas where more research is needed. In competitive sport, this includes research that:
- Specifically and directly assesses performance advantage in transgender women athletes;
- Further explores and assesses options for new ways of classifying sport;
- Provides a better understanding on the experiences of transgender people engaging in non-participation roles e.g. coaching, spectatorship and administration.
In relation to SPA, this includes research that:
- Examines pedagogical approaches for transgender children in PE;
- Better understands the motivations of transgender people to engage in SPA;
- Better understands the benefits that transgender people can enjoy from SPA.
Intersex people in sport and physical activity
Due to having male biological attributes as well as female biological attributes, some female intersex people experience hyperandrogenism: a medical concept that is generally defined as women having excess androgen, specifically testosterone (Karkazis & Jordan-Young, 2018). Despite hyperandrogenism being a ‘natural state’ that is not the outcome of any medical intervention or manipulation, it is still considered to be a source of unfair competition by many sporting governing bodies. This is due to some scientific research concluding that increased testosterone levels (as a result of hyperandrogenism) can enhance the performance of athletes in sports and events that are dominated by basic biomotor capabilities such as strength, speed and endurance (Bermon & Garnier, 2017; Handelsman, Hirschberg, & Bermon, 2018). Other research has found no convincing evidence to support the view that hyperandrogenism is associated with performance advantage in female athletes (Ferguson-Smith & Bavington, 2014; Sonksen et al., 2018).
Eligibility criteria have been introduced across many national and international governing bodies to try to ensure equality and protect the integrity of women’s classes and events in elite sport. The most controversial and high-profile of recent cases was the introduction of the Eligibility Regulations for the Female Classification (Athlete with Differences of Sexual Development), more commonly known as the ‘DSD Regulations’, by the International Amateur Athletic Federation (IAAF) in 2018 (IAAF, 2019a). The DSD Regulations require female athletes to have a circulating testosterone level below 5 nmol/L to compete in certain women’s events. The Regulations were challenged by affected South African 800m Olympic Champion, Caster Semenya, who argued that they unfairly discriminate against athletes on the basis of sex and gender. However, the Regulations were considered lawful by the Court of Arbitration for Sport (CAS) on the basis that they are a necessary, reasonable and proportionate means of achieving a legitimate objective: fair and meaningful competition in the female category of elite athletics (Court of Arbitration for Sport, 2019).
Scholars and activists have criticised and challenged the DSD Regulations on ethical grounds. The overriding ethical concern regarding the regulations is that they imply a violation against human rights. More specifically, ethical concerns have been raised about: the policing of women’s bodies; the denial of human biological complexity; the numerous breaches of confidentiality surrounding those who have been tested for hyperandrogenism; the reinforcement of negative stereotypes and stigma; the potential for harm to athletes as a result of suppressive testosterone therapy; and an apparent targeting of women of colour from the Global South among athletes singled out for investigation (Henne & Pape, 2018; Karkazis & Jordan-Young, 2018; Loland, 2020; Mahomed & Dhai, 2019).. Ethical debates against the DSD Regulations have also questioned the sport classification system altogether, due to a privileging of some forms of genetic or physical-based classification categories (e.g. age, biological sex and bodyweight) over others (e.g. height, limb length and natural talent) and a complete lack of classification system for social and economic factors (Loland, 2020; Mahomed & Dhai, 2019). Whilst individual scholars and activists have been vocal in their criticism of the DSD Regulations, there has been a lack of collective voice amongst women and sport and LGBTQ+ organisations on the matter.
Like transgender inclusion in sport, some scholars have suggested scenarios to ensure both fair competition and the inclusion of intersex athletes in elite sport. These include an intersex category, the development of algorithms that would account for a range of physiological and social factors that affect athletic performance, and the reduced significance of sports emphasise individual testosterone-driven inequalities in biomotor capability (Loland, 2020).
There is a growing body of research focusing on scientific and ethical considerations in relation to the inclusion of hyperandrogenous intersex athletes in elite women’s sport. However, there is still a lack of consensus among experts as to the extent to which hyperandrogenous female athletes enjoy a performance advantage over cisgender female athletes. There is also a lack of conclusive evidence on potential negative health impacts of androgenous athletes engaging in suppressive testosterone therapy and a lack of research focusing on the wellbeing of athletes diagnosed as intersex athletes and how they can be best supported. Furthermore, there is a dearth of research focusing on the experiences and inclusion of intersex athletes in non-elite sport and physical activity. This is, in part, due to many intersex people being unaware that they are intersex unless they undergo a medical procedure (Cunningham, 2019; Mahomed & Dhai, 2019). Despite this, more research is needed on topics such as the benefits of sport and physical activity for individuals diagnosed as intersex and the specific challenges faced by individuals who are knowingly intersex in engaging in non-elite sport and physical activity.
Non-binary people in sport and physical activity
In contrast to transgender and intersex inclusion in sport, there has been very little awareness or discussion of the experiences and inclusion of non-binary people in sport and physical activity in the public, sporting nor academic domains. This is despite the potential benefits that inclusive sport and physical activity could bring to those who identify as gender nonconforming and encounter health disparities (including suicide attempts) compared to cisgender individuals (Clark et al., 2018).
Whilst many national and international sport organisations now have policies for transgender and intersex athletes, the vast majority of these policies do not incorporate non-binary athletes. From an online search in July 2020, no position statements were found from women and sport nor LGBTQ+ organisations on non-binary inclusion in sport. Furthermore, any research on the experiences of non-binary individuals in sport tends to come under a broader LGBTQ+ umbrella and only relates to athletes.
The small amount of research that has been conducted has found that, in some cases, non-binary individuals face similar barriers in participating in sport and physical activity than those of transgender individuals. This includes the misuse of preferred pronouns and names by coaches and teammates, feeling uncomfortable wearing gendered uniforms and a lack of gender-neutral spaces (Shortridge, 2020; Storr et al., 2020). However, non-binary individuals do also experience different challenges because, whereas binary transgender people identify with one gender, non-binary people do not identify as either male or female. This makes it particularly challenging to participate in sport and physical activity when most sports are split by gender and there is a lack of mixed-gender sports available (Storr et al., 2020).
It is clear that more research is required on the experiences and inclusion of non-binary people in sport and physical activity to better understand the benefits non-binary people can experience from being physically active, the unique challenges they face in doing so, and how they can be best supported to become and remain physically active.
Definitions
The following definitions have been sourced from Stonewall (2020):
ALLY
A (typically) straight and/or cis person who supports members of the LGBTQ+ community
CISGENDER OR CIS
Someone whose gender identity is the same as the sex they were assigned at birth. Non-trans is also used by some people.
DEADNAMING
The use of the birth or other former name of a transgender or non-binary person without their consent.
GENDER
Often expressed in terms of masculinity and femininity, gender is largely culturally determined and is assumed from the sex assigned at birth.
GENDER DYSPHORIA
Used to describe when a person experiences discomfort or distress because there is a mismatch between their sex assigned at birth and their gender identity. This is also the clinical diagnosis for someone who doesn’t feel comfortable with the sex they were assigned at birth.
GENDER EXPRESSION
How a person chooses to outwardly express their gender, within the context of societal expectations of gender. A person who does not conform to societal expectations of gender may not, however, identify as transgender.
GENDER IDENTITY
A person’s innate sense of their own gender, whether male, female or something else (see non-binary below), which may or may not correspond to the sex assigned at birth.
GENDER REASSIGNMENT
A way of describing a person’s transition from their sex assigned at birth to the gender they identify with. To undergo gender reassignment usually means to undergo some sort of medical intervention, but it can also mean changing names, pronouns, dressing differently and living in their self-identified gender.
GILLICK COMPETENCE
A term used in medical law to decide whether a child (under 16 years of age) is able to consent to their own medical treatment in relation to gender reassignment, without the need for parental permission or knowledge.
INTERSEX
A term used to describe a person who may have the biological attributes of both sexes or whose biological attributes do not fit with societal assumptions about what constitutes male or female. Intersex people may identify as male, female or non-binary.
NON-BINARY
An umbrella term for people whose gender identity doesn’t sit comfortably with ‘man’ or ‘woman’. Non-binary identities are varied and can include people who identify with some aspects of binary identities, while others reject them entirely.
OUTED
When a transgender person’s gender identity is disclosed to someone else without their consent.
TRANSGENDER, INTERSEX AND NON-BINARY PEOPLE IN SPORT AND PHYCAL PRONOUN
Words we use to refer to people’s gender in conversation - for example, ‘he’ or ‘she’. Some people may prefer others to refer to them in gender neutral language and use pronouns such as they/their and ze/zir.
SEX
Assigned to a person on the basis of primary sex characteristics (genitalia) and reproductive functions. Sometimes the terms ‘sex’ and ‘gender’ are interchanged to mean ‘male’ or ‘female’
TRANS
An umbrella term to describe people whose gender is not the same as, or does not sit comfortably with, the sex they were assigned at birth. Trans people may describe themselves using one or more of a wide variety of terms, including (but not limited to) transgender, transsexual, gender-queer (GQ), gender-fluid, non-binary, gender-variant, crossdresser, genderless, agender, nongender, third gender, bi-gender, trans man, trans woman, trans-masculine, trans-feminine and neutrois.
TRANSGENDER MAN
A term used to describe someone who is assigned female at birth but identifies and lives as a man. This may be shortened to trans man, or FTM, an abbreviation for female-to-male.
TRANSGENDER WOMAN
A term used to describe someone who is assigned male at birth but identifies and lives as a woman. This may be shortened to trans woman, or MTF, an abbreviation for male-to-female.
TRANSITIONING
The steps a transgender person may take to live in the gender with which they identify. Each person’s transition will involve different things. For some, this involves medical intervention, such as hormone therapy and surgeries, but not all transgender people want or are able to have this. Transitioning also might involve things such as telling friends and family, dressing differently and changing official documents.
TRANSPHOBIA
The fear or dislike of someone based on the fact they are trans, including denying their gender identity or refusing to accept it. Transphobia may be targeted at people who are, or who are perceived to be, trans.
TRANSSEXUAL
This was used in the past as a medical term to refer to someone whose gender is not the same as, or does not sit comfortably with, the sex they were assigned at birth. This term is still used by some although many people prefer the term trans or transgender.
