Transgender Women In Sports: The Dilemma

Transgender Women In Sports: The Dilemma


Leonard Zwelling

This blog has been a strong supporter of any person affirming his or her or their gender identity. That’s not the issue for today. The issue is athletic competition and most specifically the case of Lia Thomas, the swimmer from the University of Pennsylvania who used to be on the men’s swimming team there and now competes as a woman after her gender transition. When Thomas competed as a male, she was ranked 462. Now, competing as a woman, she is number 1 with a bullet, setting records in meets regularly. Is this right?

I am quite certain after my experience at Legacy Clinic that transgender people have unique challenges, both medical and psychological and they deserve all the care that anyone else should have. I had to learn all about transitions and the differences between those whose puberty is delayed through the use of drug therapy until their gender identity can be clear to them in early adolescence and those like Lia Thomas who competed as an adolescent and young adult as a man and then transitioned. No matter how much Ms. Thomas’ testosterone is blocked now, she was androgenized as a young man and all that muscle is not going away.

When this was an issue in K-12 athletics, I was unsure of the answer because a lot depended upon when a biological male started the process of feminization. In this case, it is self-evident with the records being set by a former male who was not a great swimmer, that she has something the rest of the girls don’t have. This is not about political correctness or freedom of expression. This is about college- and world-class competition being fair and right now the overwhelming evidence is that when Ms. Thomas is in the pool she has a leg (and a Y chromosome) up on the rest of the competition.

If in our “woke” world, we choose to acknowledge the biological basis of sex (XX vs. XY chromosomes), but are less sure of the basis of gender because it is self-evident that gender is not biphasic, that’s just fine. It, like many other things in medicine, needs careful research and evaluation. But rushing to isolate one variable, testosterone levels, as the arbiter of whether or not someone can compete as a woman may be too simple. I am quite sure over time, with additional research, the determinants of world-class athletic performance will be identified (hemoglobin oxygen-carrying capacity, lung volume, muscle mass, and muscle composition) and what these variables are for a biologic woman vs. a biologic man will become clear. It’s probably not isolated to testosterone levels. Until that research is done, I think any reasonable person can see that the case of Ms. Thomas is a major outlier and her competing as a woman cannot stand on the world stage, for example at the Olympics.

This has been an issue since Renee Richards, the former Dr. Richard Raskind, sought to compete in women’s tennis. There are no easy answers because athletic competition is so near and dear to us as humans, but so is fairness. Lia Thomas competing as a woman a few years after competing as a college level male is just not right. I am truly sorry for her, but this is simply too much of an advantage to overlook. Ms. Thomas has every right to live her life as she chooses. But competing as a female after having been a male into her late teens simply seems an unfair advantage no matter how much she suppresses her testosterone levels. There’s probably more to this and until we are certain, the record stands for itself—especially the ones she is all of a sudden setting in the pool.

4 thoughts on “Transgender Women In Sports: The Dilemma”

  1. Sports is always a competition.
    In virtually any sport, muscle mass matters.
    Males have somatic cell karyotype XY, women XX. For athletic competition, why is that not as valid as weight limits for lightweight, welterweight, heavyweight?
    Gender is a role. You should be free to pick it & be left alone, & change it when you want. But karyotype is not a role. What am I missing?

  2. Even an XY karyotype is not definitive when one considers conditions such as androgen insensitivity syndrome. Testosterone levels can be high, but the inability of cells to respond would negate any benefit. So even from a purely scientific standpoint, this issue is complicated.

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