Should trans athlete policies mandate medical transition? Some advocates say ‘yes,’ others ‘no’

Gay sport news

As LGBTQ advocates fight against bans on trans athletes, most also fight for the right of high school trans athletes to participate with no transition. Some also want college sports policies to forgo transition requirements. | Katherine Jones/Idaho Statesman/Tribune News Service via Getty Images

LGBTQ leaders are largely against mandating medical transitions for trans high school athletes, some even for college.

As the national debate continues to build over whether to include trans girls and women in girls and women’s sports, another important conversation is being overlooked: How should trans girls and women be included?

For many, it’s not an easy question to answer, not even for some people fighting against outright bans on trans athletes. There are lots of perspectives and personal experiences at play.

Currently there’s a patchwork of policies governing high school sports in the United States, as each state crafts its own high school and youth sports policies. A map on transathlete.com shows a number of different approaches, from full inclusion with no medical-transition mandate in Connecticut, to outright bans on trans athletes competing in the gender category that matches their gender in Texas.

While a patchwork may create some confusion and complications, leaders in the LGBTQ space see that as preferable to any ban that outright bars trans athletes from competing in the gender category that matches their gender.

Rejecting medical transition requirements for high school athletes

While the fight against these bans rages, amongst LGBTQ-rights groups a push has emerged to embrace high school policies that allow trans girls to compete with no required medical transition and no transition period.

Advocates for these policies focus on the inherent values of scholastic sports like participation, teamwork and inclusion, while supporters of outright bans tend to focus more on who wins and who loses.

“For K-12 sports we should ensure that transgender young people can play sports consistent with who they are,” said Jennifer Levi, Transgender Rights Project Director for the GLBTQ Legal Advocates & Defenders. “That’s worked for a really long time in a number of places. Sports is such an important part of so many people’s school experiences.”

That sentiment was echoed by Human Rights Campaign President Alphonso David.

“Trans girls have been participating in sports without incident at every level,” he said. “Sixteen states allow trans athletes to compete consistently with their gender identity.”

Chris Mosier, the founder of transathlete.com, has competed in men’s triathlon, duathlon and race-walking for the better part of a decade, even representing the United States at world championships.

While he is proudly visible and vocal about his transition as an adult in elite-level sports — serving as an inspiration for other trans people — he feels strongly about protecting access to sports for trans youth and teenagers, who are already less likely to participate in sports even without the barrier of medical transition.

“Undergoing a medical transition does not make one more valid in their transgender identity,” Mosier said. “It would be unreasonable to mandate young people take medical intervention to play school sports with their friends.”

In 2010, LGBTQ sports pioneers Helen Carroll and Pat Griffin penned a report called On The Team: Equal Opportunity for Transgender Student Athletes. In the report, sponsored in part by the National Center for Lesbian Rights and the Women’s Sports Foundation, Griffin and Carroll argued for high school policies that allow trans athletes to compete as their gender “regardless of whether the student has undergone any medical treatment.”

That report stands up today as a blueprint of sorts for where many leaders of the LGBTQ community stand on the issue.

“I stand by everything in that document,” said NCLR legal director Shannon Minter. “It patiently explains why kids should just play based on their gender identity. There’s no reason to have any sort of extra restrictions for K-12.”

A group advocating against bans and for transition mandates

Conversely, a group has formed called the Women’s Sports Policy Working Group, which says it’s committed to “affirming girls’ and women’s sport while including transgender athletes.”

The organization equally fights against outright bans on trans athletes, just as HRC, GLAD, NCLR and others do. The group has testified written op-eds against trans-athlete bans. Yet diverging from those other organizations, the WSPWG pushes for the adoption of inclusion policies that mandate a transition period in competitive sports, including in high school.

This position has created a wall between that group and other LGBTQ organizations, as the latter outright reject any policy that would require a medical treatment for high school participation.

“You don’t want to do anything to change the timeline for a young person to seek out medical care, and you don’t want to impede young people’s ability to play sports and have that important socializing experience,” Minter said.

While many people at LGBTQ organizations expressed respect and appreciation for a lifetime of equality work put in by WSPWG’s Nancy Hogshead-Makar and other members of the group, a divide over how to include trans high school athletes persists.

Erin Buzuvis, one of the country’s leading legal minds in the space and a law professor at Western New England University, said access to participation is the essence of scholastic sports, not winning or losing. She pointed to a number of ways athletes show up on the field or the court differently, and how participation is the thread that runs through all of them.

“Why is it so important that we need to create the fiction of a level playing field in high school athletics?” Buzuvis asked. “Most people who think it through already realize there is so much diversity of talent and ability. Why is that more important than affirming and including some of the most marginalized members of a community?”

In Athlete Ally’s opposition to high school policies mandating medical transitions, Anne Lieberman, director of policy and programs, says facts and science are too often cherrypicked by people to push an anti-trans ideology.

“These conversations are polarizing, lack nuance, and are not grounded in the purpose of sport for 99% of the population: to be a part of a team and to experience the joy and community that comes with playing the sports we love,” Lieberman said.

Do trans high school athletes have a competitive advantage?

Some critics of policies that lack a transition requirement point to the success of Connecticut high school sprinter Terry Miller, who won a state and New England championship in the 100-meter dash as a sophomore in 2018, as well as sprinter Andraya Yearwood.

Yet many advocates for trans inclusion in sports say that being a trans girl does not automatically mean she has an unfair advantage over cisgender girls, pointing to hard work and determination as factors contributing to their success.

To want to mandate a medical transition to compete, “you have to accept the idea that there is a competitive advantage, and we know that doesn’t exist,” David said.

Lieberman echoed that sentiment.

“Transgender and nonbinary student-athletes who participate in sport, or wish to, have no inherent advantage, and are participating in sport for the same reasons as their cisgender peers,” Lieberman said.

In echoing this sentiment, LGBTQ advocates point to the fact that trans athletes have been allowed to compete as their gender across the United States for many years, and the number of state champions who have been trans is very low. To be sure, there are literally countless trans athletes who are not the best player on their team, let alone their state.

“We have a lot of experience, many years, of inclusive policies and haven’t seen that develop in the way some people see this happening,” Levi said. “I know there are some people who care deeply about women’s and girls’ sports who want to make sure there are opportunities for women and girls to succeed at the highest level, but the threats to that aren’t coming from trans students.”

Minter admitted that, while there has not been a national high school champion shattering girls records, there is the chance of it happening, even if the chances, he said, are miniscule.

“I can’t say, ‘no that would never happen,’” Minter said. “But how utterly ridiculous to latch on to something that has never happened and is highly unlikely to ever happen, and to use that to undermine these really important policies that are critical for one of the most marginalized group of kids in the country.”

Runner Juniper Eastwood, who supports transition mandates for trans athletes, points to her own experience as an example of the need for a medical transition.

When Eastwood, who is trans, competed in boys high school track and field in Montana before transitioning, she posted a personal best of 3:50 in the 1500-meter run. If she had run in the girls category without any transition, that time would have made her the North American women’s record-holder of any age.

The NCAA policy and college trans athletes

When Eastwood competed under the NCAA policy, her college time running in women’s track and field had ballooned to 4:27. The NCAA policy mandates a medical transition.

There is some agreement from LGBTQ leaders that a medical transition requirement for competitive athletics at the collegiate level is an appropriate policy.

“I understand that June wants to make sure that NCAA policy is upheld, and I’m totally on board with that,” Minter said of the college-level policy mandating medical transition.

Other LGBTQ groups do support mandating some medical transition for some trans college athletes.

“NCAA policy for competitive elite sports at colleges makes sense and has also been operating well for a long time,” said GLAD’s Levi. “So I’m in support of the NCAA policy applying to the sports it currently applies to.”

Where the policy does not apply are sports that aren’t governed by the NCAA. Those include club sports like ultimate, as well as non-varsity sports teams like the successful UC-Santa Barbara rowing team. Also not governed by NCAA policy are intramural sports.

Advocates point to the different age brackets, as well as the elevated importance of winning and losing in college sports, as key differences from high school sports.

Yet support for the NCAA policy seems to be split amongst LGBTQ leaders. When pressed on whether HRC supports the current NCAA policy, David avoided taking a definitive position. Lieberman went further.

“We support a policy that does not require medical transition or invasive gatekeeping at the college level,” Lieberman said of Athlete Ally’s position. “Less than 1% of college athletes go on to play elite sports, and an even smaller number of NCAA athletes overall identify as transgender and nonbinary. The majority of college athletes are playing sports for the love of it, for the experience with their peers, and to be a part of a community.”

Lieberman pointed to Canada’s U Sport policy, which generally allows college-level trans women in Canada to compete in the women’s category without a medical transition.

Carroll, one of the authors of the 2010 On The Team report, said via text that her position on the NCAA’s trans-inclusion policy has not changed in that time. Mosier did not respond to questions about the college policy.

Multiple requests to speak to the ACLU’s Chase Strangio, who has become a loud legal voice in these conversations, went unreturned. The ACLU has broadly argued against medical-transition mandates to compete in sports.

Wherever each organization or advocate falls on the question of transition mandates for trans athletes, they are all nonetheless unanimous that outright bans on trans athletes in a category that affirms their gender are unnecessary and, some say, cruel.

How many state legislatures and courts turn away from bans toward policies that create a path to inclusion is yet to be seen.

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