"In a Clash With a Transgender Woman, the Ordinary Woman Will Break Bones." A Scientist From Liverpool On Transgender People In Sports

Women's sports are about to change dramatically. The International Olympic Committee (IOC) recently published a set of guidelines for international sports federations on the issue of transgender people to protect their rights. The new guidelines will take effect after the Beijing Olympics. In 2022 there will be many more transgender athletes, such as weightlifter Laurel Hubbard.

Ildus Akhmetov, M.D., Associate Professor at Liverpool John Moores University Research Institute of Sport and researcher at the Federal Medical and Biological Agency, in an exclusive interview with Metaratings.ru, shared his opinion on the IOC manifesto on transgender athletes.

– Recently, we have heard a lot of emotional opinions of the State Duma members on this topic. From the scientific point of view, I would like to understand how dangerous this statement of the IOC is. What can we say about it now?

– Yes, that's right, there is a danger to the sports movement. The IOC has removed itself, shifting the responsibility to the federations. In 2015, the IOC said that sports federations had the right to adopt their policies towards trans women. Since then, the federations started to act individually.

– Wasn't the IOC originally based on testosterone indicators?

– In 2004, the IOC recommended that only men who had undergone a gonadectomy (an operation to remove the reproductive organs) and taken testosterone-reducing drugs to be allowed to compete in women's competitions, but they had to wait two years after the operation.

Then in 2015, the IOC updated the rules and eliminated the need for a gonadectomy. At the same time, testosterone had to be lowered to 10 nanomoles per liter and kept at that level for at least 12 months. It was mandatory to be listed as a woman on the documents.

Some federations went their way, proposing stricter eligibility criteria. The rugby federation banned trans women from competing among women because they understood that there would be great risks of injury and, most likely, trans women would injure regular women. The athletics, cycling, rowing federations said that reducing testosterone to 10 nanomoles per liter was too mild a condition, and we should reduce it to 5.

When the IOC saw that everyone was starting to interpret and understand everything in their way and that there are some peculiarities, they just pulled themselves off. They said: "Guys, you decide everything on your own."

It must be added that the previous admission criteria left a loophole for some men. The fact is that there is a small percentage of people with low testosterone levels among the elite male athletes. For example, we found 2.5% of men with testosterone levels of less than ten nanomoles per liter in our Russian national team. It turns out that these men, who perform on a good level, despite the low level of testosterone, can change the sex in the passport and be easily sent to women's competitions. No one would be able to refuse their participation.

– How does the decision to allow trans women to participate in women's competitions look from a scientific point of view?

– To put it mildly, not quite logical. It turns out that the fight for minority rights in our sport implies a fight against the rights of the majority. It is not so easy to find a balance here.

There could be two options: a transwoman who became a woman before puberty is one thing. In Europe, in some countries, children before puberty can go for sex reassignment surgery or start hormonal therapy without parental permission. Then the human body will be arranged a little differently.

– What if the person is already past puberty?

– In such a case, there will be a clear advantage of a man. Firstly, muscle memory remains. Secondly, the male genotype is likely to continue to manifest itself, and there would be a clear advantage for a man who became a trans woman over other women. If we go back to testosterone, it is not a determinant of success in sport. By the way, the IOC has finally recognized this in the new rules. Because the contribution of testosterone to strength and sprinting ability is no more than 30-35%, other factors influence strength and speed. You must understand that men have other advantages besides testosterone that are not affected by surgery and hormone suppression.

A man is always taller, which is already an advantage. Men have a more defined bone mass, a stronger tendon and ligament apparatus, a lower risk of injury from strokes, falls in games, and other contact types of sports. If ciswomen and transwomen clash, ciswomen will break bones or tear ligaments. Men naturally have more muscle mass and less fat than women. Accordingly, this is also an advantage for any athletic activity. Besides, we must realize that men, on average, have 10% more fast muscle fibers, and they are actively used in strength sports, martial arts, and competitive sports, where speed and strength qualities are required.

There is also an element of psychology: men are emotionally more stable, they can get involved faster, they can be more aggressive, for example, in martial arts, and this is another advantage.

– How well is this field studied when a person changes genders and prepares to compete among other genders?

– Unfortunately, little research has been done on how a person's physical qualities change after sex reassignment surgery or hormone therapy. For sure, muscle mass might slightly decrease after hormonal correction. Accordingly, strength only slightly decreases. However, for example, a person's stamina and agility do not change.

It is well known that men are superior to women in many physical qualities. Therefore, in general, transwomen will keep the advantage. A simple example is Laurel Hubbard. Before the sex change, he lifted 300 kilograms. Seven years later, when the sex change happened, and he resumed training and became a woman, his record in competitions was 285 kilograms, which means that he worsened his results by 15 kilograms. But it's probably because of his age - he's 43 years old now.

– Also, he made a pause in his career.

– Yes, that could be an important factor, too. Altogether, it had such an effect that his strength performance dropped only by 5%. Most likely not because of the suppression of testosterone levels, but because of age and the long pause. It raises the question: how was he allowed to compete in weightlifting? Especially if you look at the current results of many weightlifters, Laurel claimed silver at the Olympics, but at the expense of all the failed attempts, there was no resonance, no scandal. Everyone got away with it because he failed the weight snatch and left the competition early.

At the same time, Laurel took many medals at local tournaments, outperforming the ciswomen who rightly expressed dissatisfaction. I don't think that's very fair to women. Another thing would be if they weren't winning medals but were just somewhere in the top 100, for example. Then let them do it, and we'll be watching and gathering statistics. But if they are going to qualify for prizes, then, of course, it's unfair to ordinary women.

– It's clear with Hubbard. You said that some federations were making refinements on trans athletes, but that was an exception. Now it has to go as a stream. How do you get this kind of work started?

Sports scientists say that special studies need to be done for each sport, but there will be a problem with sampling. It won't be easy to find people, elite athletes, who would agree to participate. We need an adequate sample, at least 20 people in each sport, and, accordingly, to see if there is an advantage or not after the sex change.

– How do we deal with the situation now that the number of transgender people in the Olympic movement has increased dramatically?

– There are three ways to solve the problem. The first one is to allow the athlete to compete if it is proven that there is no gender reassignment advantage, but we have not seen this yet. It is an unlikely event.

The second option is to introduce a correction factor into the results of competitions within individual sports. For example, sometimes the Wilkes formula is used in strength sports, and it considers a person's weight and gender. Therefore, if there are competitions between men and women of all weight categories, you can equalize everyone with the help of Wilkes formula, and the strongest person may be a girl from a lightweight category. In that case, please compete in weightlifting or powerlifting, but we need to figure out exactly what the correction factor should be for transwomen. So far, it is not known.

The third option is to do separate competitions, but this is also a bit romantic because there are few transgender people, and it is unlikely to attract much attention. The spectacle will be low due to the small number of participants and little competition. In general, there are a lot of problems, and scientists are unanimous in the opinion that, to begin with, it is necessary to collect statistics on individual sports.

– We covered the topic of transgender people. But how do scientists feel about allowing women to compete if they have high testosterone levels?

– The situation here is different. The fact is that such women have not had a sex-change surgery but have high levels of testosterone naturally. Sports geneticists believe that such women should not be excluded from general women's competitions because it is part of their talent. In modern high-performance sports, medals are won exclusively by gifted men, and each has its advantage over the others. It may be testosterone, high height, defined muscle mass, high hemoglobin levels, reaction speed, and other factors, which may be due to rare genetic traits.

The history of testosterone in athletics is paradoxical. It all started with South African 800-meter runner Caster Semenya. After she won two gold medals at two consecutive Olympics, the IAAF and WADA commissioned a scientific study that showed that in the 400, 800, and 1500 meters, high testosterone levels gave an advantage over women with normal testosterone levels. Based on that study, the IAAF banned Semenya from international competition in the 800-meter run but said that let her testosterone levels drop if she wanted to participate. Caster did not want to do this essentially and continued to compete at the regional level. There are no bans in South Africa; she is a national hero there.

Going back to that sponsored study, there was no evidence that high testosterone levels give any advantage at 100 or 200 meters. Probably because of the small sample size. That's the paradox of the situation because you can't go out for the 400, 800, and 1500 meters, but you can go out for the 100 and 200 meter short sprints. You could say that Namibian track and field athlete Christine Mboma took advantage of this and won Olympic silver this summer in Tokyo. Our study showed that in the 100 and 200 meters, high testosterone also gives an advantage to women with high testosterone, but this has been established in all sprinting disciplines of many sports, not just track and field. Nevertheless, even though testosterone gives an advantage, I believe that women with high testosterone levels should not be prohibited from competing in women's events because every elite athlete has their strengths. 

- After the IOC has left this issue alone, will we have to rely on the federations' sanity to introduce the criteria for admission competently?

– That's right. The responsibility lies on the federations and their scientific groups. I think the number of scientific studies in this area is about to increase. One of my students, who deals with testosterone in sports, is going to Australia next summer, where he and his colleagues will conduct a series of experiments on transgender volunteers. Now, this is a very hot topic. We hope that in 5 years, when there will be some statistics, the issue will become clearer.

– Can we assume that there will already be more transgender people at the Olympics in Paris?

– I think so if there are transgender people who are comfortable in competing. Right now, many transgender people are in the shadows. It is psychologically difficult for them to perform because there will be a lot of attention to them, including criticism from female competitors and the media. Hubbard's example showed this. It all depends on how brave transgender people will be and whether the international federations will compete.

– Is sport gradually becoming a compromise phenomenon with more blurred boundaries?

– Yes, but I think when a lot of scientific evidence comes out, people will react appropriately, and emotional decisions will be reconsidered. Right now, a lot of people are trying to be tolerant of the issue of transgender acceptance. But as specific scientific studies come out, people will realize that somewhere there has been over-tolerance. Fair play should come first. Now the balance has shifted in the direction of tolerance. People are making hasty statements, trying to please minorities, and forgetting that there are science, honesty, and ciswomen, who are the majority. It's unfair to apply some policy to them that will shut them out once and for all from winning a medal. Even in chess, women can't handle the male competition. If we let trans women into all sports, I believe that they would take 90% of the medal places.

– Some people might think that you are a person from Russia and say that because we are not the most tolerant country. Is your reasoning the thoughts of the entire global scientific community?

– I am now presenting a weighted average opinion of most scientists who deal with the physiology, biochemistry, and genetics of sport. We have experts in sports science in the ethics and psychology of sport. They may have their own opinion on whether or not to allow someone to compete. That's another topic. On the other hand, I speak on behalf of scientists who deal with the biomedical issues of sport. We believe it is too early to allow trans women to compete because no data shows that they have no advantage over regular women.

– Does it feel like there will soon be a debate about the participation of queer people who mentally feel that they are of a different gender but have not made any physical or chemical changes to their bodies? Example: This year, Canadian soccer player Rebecca Quinn became the first Olympic champion to identify as transgender publicly, but physically she remains a woman.

– This is possible if we are talking about a particular country and local tournaments. But at the level of international competitions, such a scenario is not likely to happen because it is necessary to consider logic, science, and the interests of all countries and different cultures.