Masculine, feminine: a dichotomy deeply ingrained within our respective cultures. Gender expectations may be applied from the moment a medical practitioner announces the sex (e.g., male or female) of a neonate. Globally, a male (but not female) may be wrapped in a blue blanket as an infant, allowed to engage in assertive play as a child, and encouraged to seek a female companion for a community-held event. However, modern science debunked the synonymous relationship between psychological gender and physical sex. The medical and sport science communities have used terms such as transgender, transsexual, gender nonconforming, and intersex, to describe individuals whom are not readily identifiable under the above binary classifications.

The American Psychological Association (APA, 2011) defined transgender as “an umbrella term for persons whose gender identity, gender expression, or behaviour does not conform to that typically associated with the sex to which they were assigned at birth.” Sexual reassignment surgery and hormone therapy are two medical interventions designed to bring about congruence among the psychological gender identity and physical sex. Not all transgender individuals, however, have the financial means, cultural acceptance, and/or desire to undergo the aforementioned treatments. Gender identity may also be expressed through mannerisms; speech patterns; and/or gender-preferred clothing, pronouns, and/or names.

Trans males (female to male) and trans females (male to female) have experienced marked discrimination and have been the recipients of violent acts according to the Human Rights Campaign (HRC, 2009). The 1997 San Francisco Department of Public Health Study (as cited by Wamsley, 2008) found that over eighty percent of transgender respondents indicated verbal abuse, and over thirty percent noted physical abuse.

Equality in sport participation with regard to sexual minorities (gay, lesbian, bisexual, transgender, and questioning; GLBTQ) has been publicly debated. Kye Allums [first public United States-based National Collegiate Athletic Association (NCAA) transgender basketball player], Lana Lawless [successfully sued the Ladies Professional Golf Association (LPGA) for the right to compete], and Caster Semenya (South African woman who was initially stripped of her gold medal in the World Track and Field Championships following gender ineligibility allegations) are readily recognised not only for their athletic accomplishments, but for the gender scrutiny that followed.

Numerous sport governing organisations have constructed, or deferred to already established, policies regarding transgender equality in sport. The International Olympic Committee`s (IOC) Stockholm Consensus, which is widely adapted, focused primarily on transitioned athletes (e.g., those who underwent sex reassignment surgery and/or hormone treatment for at least two years). The National Collegiate Athletic Association`s (NCAA) updated policy on transgender participation similarly noted eligibility considerations based on hormone treatment and team classification (e.g., segregated sex or mixed team) (Lawrence, 2011). Despite these efforts, Sykes (2006) noted several historical accounts in which governing sport associations have successfully petitioned exemptions from gender equality legislation (see pages 7-9, Mainstream Sports Seeks Exemption from Transgender Rights).

The purpose of this ICSSPE Bulletin is multifaceted. The contributors collectively sought to expand the general knowledge base, and investigated various aspects which underpinned policy development regarding participation in sport by transgender athletes. The World Professional Association for Transgender Health (WPATH) recommended a multi-disciplinary medical and mental health support team to assist in gender identity development and transformation (WPATH, 2011). The unique needs of transgender athletes, however, were not taken into account under the WPATH`s Standards of Care. Renee Richards, M.D., successfully fought for her right to play in the United States Open tennis tournament as a professional female (trans female) athlete in 1977. Dr. Richards expressed the critical role tennis played for her during a radio interview with Neal Conan of National Public Radio:

Certain aspects of sport subculture (e.g., conformity and homophobia, Loughran, 2009; and transphobia, Cavanagh & Sykes, 2006) have contradicted the norm of individual expression espoused throughout the GBLTQ community. According to Loughran (2009), American acceptance rates for gay and lesbian civil rights were lower within athletic populations than in the general public. This might be attributed, in part, to: misinformation, lack of exposure to gender nonconforming individuals, and/or concerns regarding a competitive advantage (particularly in trans females; Loughran, 2009; Wamsley, 2008).

Sport psychology consultants are poised to help facilitate a cultural shift within an athletic organisation, while providing assistance in the success of trans-athlete performance. The distinct position of the practitioner enables him or her to relate updated information about gender nonconformity, fosters a non-judgmental environment, and provides individual and team mental skills training. Unfortunately, there is a significant gap in the sport psychology literature regarding service delivery within this underserved marginalised population. The information below has been adapted from several related fields: Counselling and mental health; education (school psychology, teacher education, and academic advising); coaching education; and social psychology. These suggestions are not intended to reflect Best Practices; rather the purpose is to ignite discussion, provide guidance for neophyte practitioners, and highlight an area of critical need for research and further understanding.

 

 

Sport psychology is an interdisciplinary science (kinesiology and psychology) that seeks to capitalise on psychological skills in order to enhance performance and enjoyment in sport and exercise (Cox, 2007). Consultants are primarily concerned with two broad relationships: The psychosocial and physical impact of sport participation throughout human development, and the psychological aspects of performance (Cox, 2007). The educational backgrounds of applied practitioners vary. Consultants typically have specialised training in one or more of the following fields: counselling, kinesiology, coaching/physical education, sport sciences, and/or education (Dalloway, 2011), in addition to sport psychology.

The WPATH Standards of Care (2011) noted, “Mental health professionals should have familiarity with gender nonconformity, act with appropriate cultural competence, and exhibit sensitivity in providing care” (p. 21). Sport psychology consultants are ethically bound to practice within the scope of their formal training (e.g., competency; AASP, 2011). Therefore, unless holding relevant credentials permitting one to engage in mental health counselling with the unique needs of transgender individuals, sport psychology practitioners are highly encouraged to refer the athlete to a licensed clinician [for additional information on this topic, please see Competency of mental health professionals working with adults who present with gender dysphoria (WPATH, 2011, p. 22-23)]. This is not to infer that a sport-based consultation and outside psychological counselling cannot co-exist (see Individual section below).

The consultant may wish to explore personal beliefs and attitudes related to GLBTQ prior to working with a transgender athlete. This can be accomplished through self-awareness exercises, such as bracketing with a skilled practitioner. Concerning revelations that could negatively impact the therapeutic relationship or outcomes should be addressed. Furthermore, the consultant should seek out opportunities for professional development (e.g., workshops, seminars, and/or additional supervision; WPATH, 2011). Smith (2006) also recommends interacting with gender nonconforming individuals and reading memoirs/biographies depicting the lived experiences of transgenders (e.g., Herman, 2009). Consultants should be cognisant that their word choice (e.g., partner rather than boy/girlfriend), tone, and nonverbal communication (e.g., facial expressions, body position), reflect acceptance of the GLBTQ athlete (Moorhead, 2005).

 

 

GLBTQ individuals reportedly requested mental health services at a higher rate than the general population (Singh & Shelton, 2010). This author was unable to locate comparison data for the prevalence of psychological services sought between non-GLBTQ and GLBTQ athletes. This may be due to a lack of available research, tracking, and/or non-disclosure.

Raj (2002) contends gender and sexual identity affirmation and validation drive therapeutic goals and interventions. Sport psychology consultations with a transgender athlete will most likely focus on performance enhancement (e.g., emotional management, attentional shift, goal setting, etc.) and enjoyment (e.g., motivation, interpersonal relationships, conflict resolution, and so forth). Mental skills training programmes should be individualised and tailored to the specific needs of the competitor. However, it is important to understand the unique struggles faced by gender nonconforming athletes. Knowledge of potential comorbid psychological issues, and when to refer an athlete for counselling, should be discussed with an experienced practitioner (please refer to the confidentiality and supervision sections of your professional organisation`s code of ethics). The Human Rights Campaign (2009) provides a free informative booklet entitled, Transgender visibility guide: A guide to being you. This web-based document provides an overview of gender nonconformity and transition, disclosure process (e.g., planning who to tell, how they might react, etc.), common feelings and reactions, and transgender statistics and myths.

GLBTQ individuals may have experienced: “Anxiety, depression, self-harm, a history of abuse and neglect, compulsivity, substance abuse, sexual concerns, personality disorders, eating disorders, psychotic disorders, and autism spectrum disorders” (Bockting et al., 2006; Nuttbrock et al., 2010; Robinow, 2009; as cited in WPATH, 2011). Richards, in the aforementioned NPR interview, described her pre-hormonal treatment period as the “turbulent years,” (Conan & Richards, 2007, p. 6) and stated that after transitioning “there is always that fear that you might be found out” (Conan & Richards, 2007, p. 9). A listener, “Andre,” echoed these emotions: “I lived in terrible fear for decades of my life, and I had paid a terribly high cost in depression and migraines that were so debilitating” (Conan & Richards, 2007, p. 8). The sport psychology consultant may assist the athlete in developing coping strategies (Loughran, 2009), while simultaneously advocating for the rights of all athletes for a safe environment marked with acceptance and respect (see Team section below).

 

 

The athletic team may be a microcosm of the dominant heterosexual society. Internalised negative beliefs pertaining to gender nonconforming individuals may lead to harassment and violence. Male athletes who are underperforming may be taunted for “playing like girls.” Likewise, the sexual orientation of females may be questioned if exhibiting athleticism through assertive physical play. Comments reflecting heterosexism and gender stereotyping are rampant in athletic locker rooms and performance situations (Griffin, Perrotti, Priest, & Muska, 2002). Transgender athletes may develop feelings of discomfort and isolation and become ostracised from peers and coaching staff (either overtly or indirectly).

Challenging homophobia in sport may facilitate team cohesion and have a positive impact on performance, learning, and psychological well-being of all athletes, regardless of sexual or gender orientation (Griffin, et al., 2002). Sport psychology consultants have a responsibility to promote a safe environment through education, advocacy, and modelling appropriate behaviour (Griffin, et al., 2002). Educational efforts should involve all members of the organisation (e.g., administration, coaching staff, support services, and athletes). Informative materials (e.g., pamphlets, community resources, recommended reading) should be easily assessable. Dr Richards (2007) reportedly found solace as a teenager by reading “Man into Woman,” a book about a trans female Danish painter.

Cognitive and cognitive-behavioural techniques may be employed to challenge faulty thought patterns stemming from fear, misinformation, and internalised stereotypes. It should be noted, however, that the overarching goal is to create a safe environment based on equality and mutual esteem. Religious and personal beliefs pertaining to GLBTQ individuals should be acknowledged and respected by the practitioner (Griffin, et al., 2002). Validity testing (e.g., client must support claim with evidence) can be used to explore the faulty belief that trans-athletes (particularly trans females) gain an unfair performance advantage. The consultant may also pose a series of questions to promote self-discovery of stereotypes that are being reinforced within the team environment (e.g., guided discovery). Griffin et al., (2002) accomplish this end through the use of an educational video (It Takes a Team! Making Sports Safe for Lesbian and Gay Athletes), follow-up discussion guides and handouts (note: the reader is highly encouraged to review these documents).

Sport psychology consultants can assist athletic organisations in creating action plans for athletes and coaches (Griffin, et al., 2002). Participants generate a list of observable behaviours as well as practical ideas to increase tolerance and understanding (e.g., attend sensitivity training). Athletes and coaches can engage in role play exercises to demonstrate appropriate and inappropriate actions. Members of the athletic organisation can also provide positive reinforcement to those adhering to these `contracts` in order to promote adoption of tolerance and mutual respect. Team building activities may also be beneficial to foster interpersonal relationships, communication, and trust among players.

Gender expectations, along with contradictory scientific evidence, anecdotal reports, and differing cultural histories, contributed to early policy development with regard to transgender participation in sport (Sykes, 2006). Transgender athletes who did not fall neatly into one of the aforementioned binary categories were excluded from their chosen pursuits as a result. Transgender individuals have been identified throughout history and amongst various societies around the globe. Scientific understanding of the unique experiences of transgender individuals appears to be emerging. Research is in dire need to better understand the psychosocial impact of transgender participation in sport, as well as establishing Best Practices for sport psychology service delivery in this marginalised group. It is the hope of the contributors of this special topic journal that the enclosed articles foster greater understanding, ignite scholarly debate, and guide international policy development for non-discriminatory inclusion of transgender athletes in competitive sports.

 

 

Federation of Gay Games - http://gaygames.com.

Gay and Lesbian Athletes Association - http://glaa.org/.

Human Rights Campaign - www.hrc.org.

National Center for Transgender Equality - www.transequality.org.

Transgender Law Center - www.transgenderlawcenter.org.

Women`s Sports Foundation - www.womenssportsfoundation.org.