Wed | Oct 4, 2023

Michael Abrahams | Why the transgender ban is fair

Published:Tuesday | March 28, 2023 | 12:32 AM
Caster Semenya reacts before the women’s 5,000 metres race in Regensburg, Germany, in June 2021. Track and field banned transgender athletes from international competition while adopting new regulations that could keep Caster Semenya and other athletes w
Caster Semenya reacts before the women’s 5,000 metres race in Regensburg, Germany, in June 2021. Track and field banned transgender athletes from international competition while adopting new regulations that could keep Caster Semenya and other athletes with differences in sex development from competing.

Last week, World Athletics banned transgender women from competing in the female category at international events. As of March 31, no transgender athlete who has gone through male puberty will be permitted to compete in female world-ranking competitions.

Transgender people deserve empathy. They are often misunderstood, unfairly judged, discriminated against, bullied, and physically assaulted. Their risks of suffering from mental illness and being suicidal are significantly higher than the general public. They are a genuinely vulnerable community.

Discriminating against them is unfair. If a transgender person applies for a job as an accountant, teacher, or architect, for example, they should not be denied employment based solely on their gender identification. Similarly, if they enter singing, writing, or art competitions, gender should not be a factor.

However, if as adults they wish to compete against their cisgender peers in events where muscle strength and speed are factors determining success, valid concerns arise. Transgender men, in general, will not be as strong as cisgender men, so in competing against them, they will be at a disadvantage. Similarly, transgender women will have an unfair advantage over ciswomen if they compete against them in these events. The fact is that even though transgender women athletes may identify as and look like biological females, they are not. And if they transition after puberty, some of the advantages gained at that time will persist.


In sports, fairness is essential. This is why boxing has divisions based on weight. So in male boxing, a heavyweight boxer weighing over 200lbs would not be allowed to fight a flyweight weighing 112lbs. This is why there are age categories in our Inter-Secondary Schools Boys and Girls’ Championships. So Class Four athletes in their early teens do not go up against bigger, stronger, and faster Class One athletes who are in their late teens. And at the Paralympics, able-bodied athletes do not compete against those who have suffered disabling injuries.

So weight, age, and degree of physical disability are factors to be considered when constructing level playing fields. And gender is another factor.

During male puberty, boys form more red blood cells than their female counterparts, enabling them to store and use oxygen more efficiently, an effect further aided by their increased lung capacities and larger hearts. They are also generally taller. In addition, they develop broader shoulders, which gives them a leverage advantage, and their narrower hips lead to more efficient movement dynamics. Their longer arms and legs and bigger hands and feet, accompanied by the development of superior muscle and bone strength, give them reach and stride advantages and firmer grips and allow them to punch and kick harder, throw farther, run faster, lift heavier weights, and jump higher and farther. Certain sporting events consider these differences and make adjustments based on them. For example, men and women have different tee boxes in golf, different three-point lines in basketball, different net heights in volleyball, and different hurdle heights in track events.

Testosterone is the primary hormone responsible for the male pubertal changes that give them athletic advantages. During transitioning, testosterone blockers and estrogen (the primary female sex hormone) are used. In addition to producing a more feminine appearance, these drugs change fat distribution, lower levels of red blood cells, and decrease bone strength and muscle and lean body mass.


However, even after these alterations, once male puberty has taken place, some of the original changes persist, along with the advantages. For example, a recent study in the British Journal of Sports Medicine found that transwomen retain an athletic edge over their cisgender peers after a year of hormone therapy. The researchers found an advantage in upper body strength (push-ups) over female controls for one to two years after starting gender-affirming hormones and an edge in endurance (1.5-mile run) over female controls over two years after beginning the hormones. An example of this advantage can be seen with the transgender female swimmer Lia Thomas who competed for the University of Pennsylvania. While competing on the men’s team, Thomas was ranked 65th in the 500-yard freestyle. After transitioning, while competing as a woman against cisgender women, Thomas won the 500-yard freestyle competition, among others.

The transgender ban is not just about fairness, but also safety. Transgender male athletes are not clamouring to enter the boxing ring with their cisgender peers. Similarly, allowing transgender women to compete against cisgender women in one-on-one contact sports may place the latter at risk. For example, in an MMA (mixed martial arts) fight in 2014, Fallon Fox, a biological male who transitioned to female, fractured the skull of her opponent, Tamikka Brents, within the first two and a half minutes of the first round. Brent’s orbital bone was fractured. She sustained a concussion and received seven staples to her head.

The transgender ban is not about discrimination or transphobia, but about fairness to ciswomen and providing a level playing field for them. At the same time, as more transgender persons enter sports, it is only fair to provide spaces where they, too, will be provided level playing fields in which they can excel fairly. The best option would be to create separate categories for them. Hopefully, the relevant sports authorities can make this a reality.

Michael Abrahams is an obstetrician and gynaecologist, social commentator and human-rights advocate. Send feedback to and, or follow him on Twitter @mikeyabrahams.