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IOC guidelines suggesting trans women should not have to reduce testosterone have been contradicted by a BMJ report
IOC guidelines suggesting trans women should not have to reduce testosterone have been contradicted by a BMJ report. Photograph: Denis Balibouse/Reuters
IOC guidelines suggesting trans women should not have to reduce testosterone have been contradicted by a BMJ report. Photograph: Denis Balibouse/Reuters

IOC’s new transgender guidance criticised as unfair towards female sport

This article is more than 2 years old
  • Medical experts claim IOC is focusing on inclusion not science
  • Head of World Athletics’ medical department backs statement

The International Olympic Committee’s new transgender framework has come under fire from medical experts who work for multiple sports federations, including World Athletics, World Triathlon and the International Cycling Union, who say it opens the door to unfair competition in female sport.

In a notable intervention, the scientists warn that IOC’s new guidance – which states there is no need for trans women to lower their testosterone to compete against natal women – ignores the science on sex, gender and performance and focuses mostly on inclusion. The new framework, which also applies to athletes with differences of sex development, such as the South African 800m runner Caster Semenya, is due to be rolled out after next month’s Winter Olympics. It comes amid the high-profile cases of the weightlifter Laurel Hubbard, the first open trans women to compete in an Olympics, and the US trans woman Lia Thomas, who recently set a number of collegiate swimming records.

However scientists, who are linked with the International Federation of Sports Medicine and European Federation of Sports Medicine Associations, want the IOC to think again. Writing in the British Medical Journal Open Science & Exercise Medicine, they also point out that the IOC’s new position that there should be “no presumption of performance advantage” for trans women “is in stark contrast with the outcome of the 2015 IOC consensus, the scientific evidence, and the subsequent assessment of numerous sports medicine associations/commissions”.

The statement, which is signed by 38 authors, including the head of World Athletics’ medical department, the medical director of cycling’s ruling body the UCI and the chair of World Rowing’s medicine commission, also calls on the IOC to set formal standards, based on competitive fairness and the best available science, for sports to follow.

One of the authors, Yannis Pitsiladis, told the Guardian: “We believe this position statement is very important because it will force the IOC to open the debate. Yes, the inclusion of human rights is absolutely essential. But equally important is the inclusion of scientific and medical principles in determining a solution. And the IOC framework is not based on medical and scientific principles.”

The scientists argue there is a path to allow trans women to compete in female sport by lowering testosterone. According to Pitsiladis, one way to achieve this is to change rules regarding testosterone depending on the sport, with less emphasis on using medication in events like shooting, and more in collision sports.

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However other scientists insist there is overwhelming evidence to show there is no way to allow trans women into female sport without sacrificing fairness. They point to recent studies showing that trans women maintain significant advantages from undergoing male puberty even when they subsequently lower testosterone.

That was a position also taken by the five UK Sports councils in September. They argued that there was no magic solution which balances the inclusion of trans women in female sport while guaranteeing competitive fairness and safety – and, for the first time, told sports across Britain that they would have to choose which to prioritise.

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