Sex, Science, and Fairness in Women's Sports | Opinion

As an Olympic medalist and eight-time U.S. National Cycling Champion, I've always been a big proponent of women's participation in sports, and that has led me to explore the complex and sometimes heated issue of transgender women competing in the female category of cycling. At first, I didn't know much about the topic, but I felt strong empathy for transgender women and wanted to support anything that would help them align their athletic experiences with their gender identity. I also became aware of some current professional female cyclists who feel like they can't speak up on the issue for fear of losing their jobs, and I felt empathy for them too.

In the pursuit of understanding, I dove deep into the scientific research, as I did not want to take the appearances of the situation at face value. As a board member of the Homestretch Foundation, which has been fighting hard for women's rights in cycling since its inception, I have a firm belief that we have a duty to uphold fairness in sport. If we were not concerned with fairness, every sport would just have one category of competition and both sexes would compete together. But that is not how our athletic system is set up. Instead, we acknowledge the clear biological differences between female and male post-pubertal individuals.

Before I bring in the science, let's examine gender. Gender is only part of the story of human identity. For many, "gender" seems to point to either male or female; however, when considered with reference to social and cultural differences rather than biological ones, or the range of other identities that do not correspond to established ideas of male and female—transgender male or female, transgender as non-binary, non-binary, gender-queer, or two spirit, to list some of the most common—the meaning of gender greatly widens.

Someone's gender can be a conscious choice—but one's sex can not. Anatomically, biologically, and physiologically over 99 percent of us were born with either an XX chromosome or an XY chromosome. (Intersex births range from only 0.018 percent to 1.5 percent of the population.) The sex differences in these XX and XY chromosomal sets are dramatic and play a unique role from the day we are conceived until the day we die.

I spent most of my learning journey alongside a trusted coach and colleague, Dr. Eric Sternlicht, Ph.D, from Chapman University. I read numerous peer-reviewed studies and quickly found a common agreement: men typically have substantial physical advantages over women in competitive sports at the highest level. This fact led to separate male and female events in competitions like the Olympics. Recognizing that this system doesn't accommodate transgender athletes, the International Olympic Committee (IOC) established a rule. It decided that transgender women could compete in the female category if they kept their testosterone level below 10 nmol/L for at least a year before and during the competition. Although the IOC hasn't fully explained the science behind this testosterone threshold, it appears to consider it enough to equalize the natural physical advantages men have over women, making competition within the female category fair.

Several studies have investigated the effects of testosterone suppression on the changing physical characteristics and performance abilities of transgender women. A comprehensive review of this research indicates that testosterone suppression in transgender women does not eliminate the performance advantage typically seen in men, raising questions about the notion that these measures ensure fair competition. This is due in part to the substantial performance gap between adult men and women, which can range from 10 to 50 percent across various sports. In my sport, track cycling, the average gap is 16 percent. In running, the gap is slightly smaller, yet by the age of 14, junior male records already surpass the records of elite adult female athletes in 100-meter, 800-meter, and 1500-meter running events.

Studies that examine the effect of reducing testosterone levels on muscle mass and strength in transgender women typically show only minor changes, with about a 5 percent decrease in lean body mass, muscle size, and strength typically observed after a year of treatment. In fact, no study has reported muscle loss exceeding 12 percent, and this was after 3 years of testosterone suppression therapy. Considering the significant initial differences in muscle mass between males and females—approximately 40 percent—the reduction achieved by a year of testosterone suppression can reasonably be viewed as minor compared to the initial advantage. Even after 3 years of testosterone suppression in transgender women, the muscle mass advantage that males have over females—and the resulting impact on performance—is clearly not negated.

Data of this kind have prompted experts in physiology and bioethics to assert that "the advantage to transwomen afforded by the IOC guidelines is an intolerable unfairness. This does not mean transwomen should be excluded from elite sport but that the existing male/female categories in sport should be abandoned in favour of a more nuanced approach." To reduce this matter to an uncomplicated issue of circulating testosterone levels is painfully inaccurate and reductionist.

One possible answer to the problem could be the introduction of a "non-binary open" race category in which both transgender men and transgender women could participate, while being scored separately. I acknowledge that this solution, like many others for complex issues, is not without its own flaws. Nonetheless, if the Union Cycliste Internationale (UCI) and IOC's primary goal is to uphold fairness and ensure the inclusion of biological female athletes, it is time for them to revisit current regulations pertaining to the participation of transgender women in female categories across various sports, including cycling.

I understand this will take time, and I understand most transgender athletes fighting this battle now may not see a day when they are fully recognized as equals. I can relate. Title IX was passed the year before I was born, yet I experienced anything but equality between sexes in my sport. Back in my day we didn't even earn a living wage, while the men, who at the time were doped to the gills and therefore cheating, brought home six- and seven-figure salaries.

At the 2012 Olympic Games, where my team brought home a silver medal in team pursuit track cycling, seven U.S. women won medals that Olympics, while the men, who had been afforded every luxury one could imagine, came in with a total of zero medals. As an elite U.S. National Team cyclist, I brought home a salary of $12,000 per year, hardly enough to call a living wage. I had a full-time job, while traveling the globe as a "professional" cyclist.

We women had to fight for a fair wage, fair race distances and fair treatment regarding equipment and coaching. We are still not there. We have a long way to go to enjoy an equal and fair space alongside the men, but we will keep standing up for ourselves until equality is met. The transgender competition fight will be a long one, but I do believe fairness wins in the end, even if it doesn't look exactly the way we imagined from the outset. If the UCI decides to give transgender athletes their own category, you'd better believe I will be in the stands cheering.

Dotsie Bausch is an 8-time US National Champion, Olympic silver medalist (2012 London Games) and a former world record holder. Since retiring from cycling, Dotsie founded and serves as the executive director of Switch4Good, an evidence-based nonprofit organization that passionately advocates for a dairy-free world and plant-based living: www.switch4good.org

The views expressed in this article are the writer's own.