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Guest posts are contributed by members of our community. The views expressed in guest posts are those of the author(s) and are not necessarily endorsed by the Genetics Society of America. If you'd like to write a guest post, e-mail jtreboschi@genetics-gsa.org.

I am a former women’s NCAA swimmer, and I support Lia Thomas.

Guest post by Sam Sharpe PhD.


interACT: Advocates for Intersex Youth is the oldest and largest nonprofit dedicated to advancing the legal and human rights of people born with intersex traits. Founded in 2006, interACT oversees the largest youth-led intersex advocacy group in the United States, is at the forefront of intersex litigation, and regularly advises public and private entities on how best to support the needs of intersex people. interACT’s mission is to put an end to non-consensual, medically unnecessary surgeries performed on intersex children in an attempt to erase their intersex traits and make their bodies conform to society’s perception of what a “normal” body is supposed to look like. 

Education and raising awareness about intersex issues is also a big part of what we do at interACT. Last year, we partnered with GSA and pgED to co-present a webinar discussing the relationship of sex and genetics, the long history of sex testing in athletics, and how these practices still have lasting impacts today. As of April 2022, at least 10 states have implemented legislation explicitly banning transgender youth from participating on sports teams that are in alignment with their gender identity, and 15 states have banned trans youth from seeking life-saving gender-affirming health care. While these anti-transgender laws are explicitly designed to discriminate against transgender people, many don’t realize that they also affect intersex people. You can learn more about how on our website.

In this post, Sam Sharpe details the historical context for these pervasive laws and the bogus arguments that attempt to link high testosterone levels to an inherent increase in athleticism, but in reality, do nothing more than showcase society’s intransigent commitment to transphobia, intersexphobia, and the patriarchal policing of women’s bodies.  

-Bria Brown-King, interACT: Advocates for Intersex Youth


I am also a trans and intersex person, a lifelong athlete, and a biologist. I vehemently believe trans women belong in women’s sport, and I recognize that the backlash that accompanies any level of success by a trans woman athlete is part of a much larger history and context.  

Sex verification and suspicion  

Outrage and suspicion based on the idea that men are pretending to be women in order to dominate women’s sports goes back over 100 years. 

When women’s participation in athletics increased in the early 1900s, this created significant anxiety that the position of (white) men in society was being threatened and the (white) ideal of women as delicate, feminine, and passive was in jeopardy. These concerns ranged from the myth that exercise and sport could damage reproductive capacity to the belief that the strained facial expressions of women athletes during exertion were unfeminine and ugly. 

As women’s involvement in sports grew, and it became apparent that women actually can excel at sports without their internal organs falling out, suspicions arose that these fast, strong, muscular athletes might not actually be women. As a result, women athletes were required to bring “medical femininity certificates” to verify their sex to international competitions beginning in the 1940s and 50s.

In the 1960s, the success of the Soviet Union in women’s athletics increased anxieties about the “authenticity” of women athletes’ sex and the possibility that men disguised as women were competing in women’s events. The “medical femininity certificate” was replaced by a requirement that a panel of doctors examine the genitals of every woman competing in international athletic competitions. This was humiliating and short lived; it was soon replaced by chromosomal testing.

However, even chromosomal testing proved to be an ineffective method of “sex verification” because human sex comprises multiple traits which come in different combinations. From the late 1960s until 2000, this policy failed to identify any men pretending to be women, but it did identify, humiliate, and traumatize multiple intersex women athletes born with traits such as Complete Androgen Insensitivity Syndrome—meaning that they have XY chromosomes but no ability to respond to testosterone. Some of these athletes did not previously know that they were intersex and only found out upon their disqualification from competition for traits of which they had no prior awareness.  

After mandatory chromosomal testing was deemed unethical and traumatic for intersex athletes and abolished in 1999, the International Amateur Athletic Federation (IAAF) maintained the ability to perform selective sex testing, later reclassified as “hyperandrogenism testing,” on women athletes if questions arose about their sex. In 2018, after protests from disqualified athletes, the IAAF revised the guidelines around sex verification testing. The new guidelines only applied to a handful of track and field events and stated that women athletes with “testosterone levels equalling or exceeding 5 nmol/L who are androgen sensitive” would be excluded from participation. In 2019, this was further revised to apply only to women athletes with “testosterone levels equalling or exceeding 5 nmol/L who are androgen sensitive and who have XY chromosomes and testes.” Under the current policy, the same athlete could be considered a man while running the 400 meters but a woman while running the 200 meters, highlighting the inconsistency of this definition of sex.

Trans athletes and testosterone myths

There is no single, simple, or obvious way to decide who counts as a woman because human sex refuses to be divided neatly into two categories, as is demonstrated by 60 years of failed attempts by the IAAF (now known as World Athletics). Definitions and perceptions of sex and femininity are also deeply racialized. The project of sex verification in women’s sport was precipitated by anxieties about women’s athletics threatening white femininity, and the athletes who have been subjected to “selective” hyperandrogenism testing have disproportionately been women of color from Africa and Asia who do not conform to hegemonic standards of white femininity.

Although sex verification testing has been applied to cisgender women athletes at times, all transgender women competing in women’s Olympic events were required to maintain a total serum testosterone level of below 10 nmol/L for at least 12 months prior to competition from 2003 until the 2022 Olympics. All trans women competing in women’s events in the NCAA and international athletics have been subject to regulations requiring that they be on testosterone suppressing medication, which has been shown to reduce testosterone in trans women to at or below average levels for cis women within a year.

In 2021, the International Olympic Committee (IOC) released an updated framework to go into effect after the 2022 Olympics that removes restrictions on both intersex and transgender women athlete’s testosterone levels unless it can be specifically proven that their transgender or intersex status provides a consistent, specific, and unfair advantage in their sport. 

This framework is non-binding and some federations have already said they will not accept it, but it reflects the growing evidence disproving the widespread belief that higher endogenous (naturally-occurring) testosterone levels provide a consistent and meaningful advantage across sports. A 2014 paper by Healy et al. found that elite cis men and women athletes actually had overlapping ranges of endogenous testosterone. This demonstrates both that some elite cis men athletes have testosterone levels below the typical range for cis men—yet are still elite athletes—and that endogenous testosterone levels are not the sole or defining factor separating the athletic performances of elite cis men and elite cis women athletes.

The more inclusive understanding of sex diversity outlined in the IOC’s new framework also challenges the argument that trans women should not compete in women’s sport because they supposedly possess an innate and universal athletic advantage due to being assigned male at birth, regardless of their transition status. Diversity in sex traits extends beyond endogenous testosterone levels, and there are no specific physical traits that trans women have which no cis women have. There are some cis women who are tall and muscular, who can grow beards, who produce high levels of testosterone, or who have Y chromosomes. There is immense biological variation within the category of cis women—a category which includes many intersex women. There are multiple examples of transphobic attempts to point out women athletes who are believed to be trans based on their appearance when the women in question are actually cisgender. This is simply recapitulating the anxieties and surveillance of women athletes’ biology and adherence to standards of white femininity that lead to a century of failed attempts at “verifying” woman athlete’s sex status. 

Crucially, claims that trans women have a sports performance advantage and are taking athletic opportunities away from cis women are not borne out, as there are no examples of trans women being disproportionately dominant in women’s sports. 

What constitutes an unfair advantage in sport?

Related to this discussion is also the larger question of how fairness is defined in sport. There is an inherent level of unfairness in all sports, and decisions about what is fair are not always clear cut. It’s up to the governing bodies in each sport to decide what constitutes an unfair advantage, and these decisions are continuously being revised as technology and training methods evolve.

In 2022, elite athletes are not expected to have average physical characteristics—in fact, in many sports, it’s expected that they don’t. Most naturally-occurring physical traits, even extraordinary ones, are considered fair advantages. 

Scott Hamilton, an Olympic gold medalist in figure skating, had a brain tumor as a child that prevented him from growing for several years and reduced his adult height. Being small can be an advantage in figure skating, but Scott Hamilton isn’t considered a cheater because his childhood illness made him shorter. Being tall is an advantage in volleyball, but there was no outcry that three-time Olympic gold medalist Kerri Walsh Jennings had an unfair advantage because she is 11 inches taller than the average woman in the US. There has been extensive discussion about Michael Phelps’s extraordinary body, which includes long arms, a long torso, above average flexibility, and below average lactic acid production, all of which are considered fair advantages.

However, the exceptions to this overall acceptance and celebration of unique bodies in sport are women athletes with sex traits which are perceived as failing to conform to expectations of cisnormative white femininity. These exceptions include both trans women and the cis women of color who were disqualified from sporting events because their naturally high testosterone levels were deemed an unfair advantage: Pratima Gaonkar, Santhi Soundarajan, Caster Semenya, Pinki Pramanik, Dutee Chand, Beatrice Masilingi, and Christine Mboma.

By contrast, men athletes with naturally high testosterone levels are not subjected to sex verification and are not considered to have an unfair advantage. It is inconsistent and unscientific to claim that endogenous testosterone is the only naturally occurring physical trait which provides an unfair advantage in sport (and only in women’s sport) when every other naturally occurring physical trait variation, no matter how extreme, is a fair advantage.

There are also many accepted “fair” advantages in sport that are not naturally occurring physical traits. In elite athletics, it is considered fair for athletes that have access to higher quality equipment, the ability to train full time due to economic security, and the ability to employ a full team of professionals to maintain their body to compete against athletes without these privileges.

In swimming specifically, a $500 tech suit can provide both a physical and mental advantage that increases racing performances. High school swimmers who can afford tech suits have a known advantage over high school students who can’t, but this is considered to be a fair advantage by USA Swimming and by high school conferences. We aren’t seeing legislation proposed to ban tech suits in high school swimming though, we are seeing legislation to ban trans girls from competing in high school sports because this is ultimately about bigotry and not about fairness.

Actual issues of fairness in women’s sports include the lack of opportunities, support, regulation of coaching and medical staff (extremely apparent in the exposure of extensive sexual abuse within USA gymnastics), and financial payoff for women athletes, but these issues do not generate the same level of consistent media attention or public outrage.

New headlines; old bigotry  

The public commentary about Lia Thomas has been riddled with transphobia, dehumanization, and lies under the guise of concern about women’s sport. Coming out as trans, dealing with unsupportive teammates, physically transitioning and undergoing a second puberty while training as a D1 student athlete, and then winning an event at NCAA championships is an incredible achievement—one for which Lia has been thoroughly punished. Strangers set against her participation have fabricated lies about her times pre-transition, her level of dominance post-transition, and the details of her body. Strangers supporting her have argued that her failure to break the 500 Freestyle record or to win either the 200 or the 100 Freestyle at NCAA championships means she has the right to compete. Cis women have been allowed to dominate NCAA championships for decades, but Lia daring to swim fast enough to win one race has prompted headlines about “the end of women’s sport.” To borrow from trans cyclist Rachel McKinnon: Why should a trans woman’s right to compete in sports be contingent on her not succeeding?While transmen and nonbinaryathletes face transphobia, they are not subjected to the same level of scrutiny, criticism, dehumanization, and punishment. At the end of the day, this is and has always been about the cultural obsession with scrutinizing women’s bodies and the transmisogynistic insistence that trans women are always illegitimate, deceptive, and predatory. It’s always been about fear, disgust, and dehumanization of women who aren’t seen as compliant to narrow, racist, transphobic, and exorsexist ideas about femininity. It’s always been about the anxiety that if a woman is too good at sports, she can’t possibly, really, actually be a woman.


About the Author

Sam Sharpe

Sam Sharpe graduated from Carleton College in 2014 where they earned a BA in Biology and competed on the swim team for four years. They are currently working towards a PhD in Biology at Kansas State University and have presented nationally and internationally on plant evolutionary ecology, increasing inclusion in STEM education, and understanding biological variation in sex and gender. Sam served in a leadership role for the transgender student organization Gender Collective for five years and is a current board member for InterConnect.

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