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| Feature | No.62 October 2011 |

Participation by Transsexual and Transgender Athletes: Ethical Dilemmas Needing Ethical Decision Making Skills
Meg Hancock & Mary A. Hums
“What rules, indeed what ethic, should govern the ability of transsexual athletes to participate in competitive sport?” (Reeser, 2005, p. 698)
Introduction
Sport has long been recognised for its physical, psychological, social, and educational benefits. In fact, the United Nations Educational, Scientific, and Cultural Organisation (UNESCO) crafted the International Charter on Physical Education and Sport, in accordance with the Universal Declaration of Human Rights, which stated that access to physical education and sport should be assured and guaranteed for all human beings (UNESCO, 1978). The Charter implored national and international governing bodies to encourage universal participation in physical activity and sport with the belief that sport, as a common language, has the potential to promote peace, respect, and friendship. UNESCO also underscored the utility of sport in achieving high levels of “physical, intellectual, and moral powers” (UNESCO, 1978, para. 5), which contribute to the development of individuals and societies.
Yet, throughout history, educational institutions, national sport governing bodies, and international sport federations have developed policies, which preclude individuals from participation and competition (Reeser, 2005; Sykes, 2006). Thus, individuals excluded from participation are less likely to benefit from the positive physical, psychological, and intellectual development acquired through sport. Sport organisations argue, however, that such policies were adopted to ensure fair competition and a level playing field (Reeser, 2005) regardless of their (intended or unintended) exclusionary consequences. In other words, policies were adopted to address people and practices perceived as threats to fair competition.
Historically, gender has often been at the root of exclusionary practices and policies in sport (Reeser, 2005; Sykes, 2006). Sport as an institution perpetuates the gender binary through the continued regulation of sex-segregated activities (Sykes). In addition, gender identity – more specifically, athletes who identify as transgender – has become an important topic of conversation for national and international sport organisations. Much of the controversy surrounding transgender athletes in competition at any level is grounded in maintaining a level playing field (Coggon, Hammond, Holm, 2008; Reeser, 2005; Sykes, 2006; Teetzel, 2006).
Transgender is an umbrella term used to describe individuals whose gender identity does not match their assigned birth gender (Griffin & Carroll, 2011). The concern for sport organisations is not necessarily transgender athletes per se, but more so with athletes who identify as transsexual. By definition, a transsexual individual is likely to alter his/her body surgically and/or hormonally to match his/her gender identity (Griffin & Carroll, p. 3). For example, a male-to-female (MTF) transsexual is a person born with characteristics defined as biologically and anatomically male, but may identify as female. The individual may elect to engage in hormone therapy or undergo surgical procedures to change her body to reflect her gender identity. Reeser (2005), however, contended that we cannot fault the athlete for identifying as transsexual as it is recognised medical condition. Several scholars suggested the benefits of transgender participation in sport for the transathlete and his/her teammates (Barber & Crane, 2007; Griffin & Carroll, 2011; van Ingen, 2011). Is it fair, then, to exclude the athlete from the benefits of athletic participation?
This paper explores the juxtaposition between the ethic of fair play and access and inclusion for transgender athletes, including those identified as transsexual. We begin with a brief overview of the evolution of transgender policies in sport. We also address ethical dilemmas faced by sport organisations as they pertain to fair competition and inclusion and access. Finally, we suggest an ethical decision-making model for sport organisations exploring the creation and implementation of policies designed for transathletes, but with the understanding that such policies affect all athletes.
Transgender Policies in Sport
Administrators working in sport organisations at every level from youth to elite must now reconsider conceptualisations and regulation pertaining to gender in order to address ethics of fair play and access and inclusion (Sykes, 2006). This section explores examples of transgender participation policies at international, collegiate and university, and youth sport levels.
International Olympic Committee. Between 1968 and 2000, the International Olympic Committee (IOC) required female athletes submit to gender verification testing to ensure eligibility for competition. In other words, the IOC used gender verification testing to ensure that women competing in Olympic events were, in fact, women. The implementation of gender verification testing was the result of speculation that some countries competing in the 1936 Berlin Olympic Games had men pose as female athletes to gain not only a competitive edge, but also political power (Reeser, 2005). The IOC suspended gender verification testing just before the 2000 Sydney Olympic Games after 29 other international sport federations determined that scientific methods for verifying an athlete`s sex were unreliable (Reeser, 2005; Ritchie, 2003). While the international sport community no longer routinely engages in gender verification testing, concern about the integration and participation of transsexual athletes remains (Reeser, 2005).
Identifying as transgender would not preclude any athlete from participation on a team. However, identifying as a transsexual and undergoing hormone therapy or surgical procedures to bring the physical body in line with the gender identity poses issues for sport governing bodies. More specifically, a transsexual male (female-to-male) may have a competitive advantage over other women when he begins taking hormones such as testosterone. Conversely, a transsexual female (male-to-female) may be viewed as having a competitive advantage because she is perceived to have physiological characteristics (e.g., height, weight, strength) that are male.
In 2004, the IOC introduced the Stockholm Consensus, which defined the transsexual athlete as someone who has undergone sex reassignment surgery and is being treated with sex hormones to adopt the physiology of the opposite sex (IOC, 2003). More specifically, the IOC stipulated that a transsexual athlete can only participate in Olympic competition when he/she meets the following requirements:

- Surgical anatomical changes have been completed, including external genitalia changes and gonadectomy
- Legal recognition of their assigned sex has been conferred by the appropriate official authorities
- Hormonal therapy appropriate for the assigned sex has been administered in a verifiable manner and for a sufficient length of time to minimise gender-related advantages in sport competitions. (IOC, 2003, para. 4)

The IOC also requires that male-to-female transsexuals wait two years following a gonadectomy even though medical science indicates levels of testosterone drop to minimal levels within one year of surgery (Goorin & Bunck, 2004).
The Stockholm Consensus has become a template for international sport organisations interested in developing policies to regulate the participation of transsexual athletes in an effort to maintain an ethic of fair play. However, the Consensus appears to single out male-to-female transsexuals as the threat to a level playing field. According to Reeser (2005), there is little evidence to suggest that female-to-male transsexual athletes “pose a significant competitive threat to male athletes in most sports” (p. 699). In its attempt to include transsexual athletes in Olympic competition, is the Stockholm Consensus discriminatory?
National Collegiate Athletic Association. In the United States, the National Collegiate Athletic Association (NCAA) adopted a new policy regarding the participation of transgender athletes in intercollegiate sport competition (Lawrence, 2011). The policy allows transgender student-athletes the opportunity to compete “in accordance with their gender identity while maintaining the relative balance of competitive equity among sports teams” (Lawrence, 2011, para. 2). The following policies specify requirements for transgender student-athlete participation (Griffin & Carroll, 2011, p. 13):

- A trans male (FTM) student-athlete who has received a medical exception for treatment with testosterone for diagnosed Gender Identity Disorder or gender dysphoria and/or transsexualism, for purposes of NCAA competition may compete on a man`s team, but is no longer eligible to compete on a women`s team without changing that team status to mixed team.
- A trans female (MTF) student-athlete being treated with testosterone suppression medication for diagnosed Gender Identity Disorder or gender dysphoria and/or transsexualism, for the purposes of NCAA competition, may continue to compete on a man`s team but may not compete on a woman`s team without changing it to a mixed team status until completing one calendar year of testosterone suppression treatment.

Similar to the IOC, the NCAA policy appears to single out the male-to-female transsexual student-athlete as a greater threat to the integrity of fair competition. Additionally, FTM student athletes who are not taking testosterone may choose to participate on a men`s or women`s team. A MTF transathlete, however, cannot compete on a women`s team when she is not taking hormone treatments because the athlete is perceived to have a competitive physiological advantage. Is it fair, then, to allow a FTM transathlete to compete on a team that is more aligned with his gender identity when a MTF not engaging in hormone is prohibited from doing so? Many transgender people choose not to undergo hormone therapy or surgery. Are we then forcing student-athletes to make decisions about participation because policies are too broad?
Youth Sport
Studies on youth have shown that participation in sport and physical activity promotes physical health and reduces stress, anxiety, and depression (Allender, Cowburn, & Foster, 2006; Seefeldt & Ewing, 1997). Additionally, physical activity and sport improves confidence, enhances self-esteem, improves body image (Allender, Cowburn, & Foster, 2006; Bailey, Wellard, & Dismore, 2004; Seefeldt & Ewing, 1997) and lowers rates of depression (Boone & Leadbetter, 2006). It also provides opportunities for peer-to-peer social interaction beyond family networks (Brady, 1998; Meier, 2005; United Nations, 2003).
While studies on the effects of sport and physical activity are encouraging, studies on transgender youth found that physical education classes and athletic events are unsafe environments (Kosciw, Greytak, Diaz, & Bartkiewicz, 2010). Moreover, little research has been conducted on transgender children and youth involvement in sport. However, research on transgender youth has shown that 33.2% of transgender youth have attempted suicide (Clements-Nolle, Marx, & Katz, 2006) and 74% reported being sexually harassed (GLSEN, 2001).
Barber and Krane (2007) suggested that teachers and coaches have the opportunity to champion inclusion of all students, but many are ill-equipped to do so, particularly when talking about gender identity and expression. Furthermore, early childhood educators may consider gender identity and expression moral issues better suited for discussion at home than at school. As a result, schools often lack inclusion policies, particularly those geared toward transgender students. For example, if a boy wants to participate on the softball team because he identifies as a female but has not transitioned, would school administrators allow his participation? IOC and NCAA guidelines would prohibit participation, but a study by the Women`s Sports Foundation (n. d.) suggested there are no physiological differences between boys and girls before puberty. In other words, there is no competitive advantage for a boy playing on a girls` team.
The aforementioned example presents an ethical dilemma. A dilemma that, in one context has a clear solution, but when presented in another context becomes more difficult to solve. Ethical decisions are, then, context specific (Jones, 1991). Therefore, adopting an ethical decision-making framework may help sport administrators embrace their specific value orientations, while also providing individuals with a more rational and reasoned explanation of policy creation and its implementation (Bartlett, 2003).
Ethical Decision Making
Sport administrators are challenged to solve complex questions on a daily basis. When making decisions, a good sport administrator knows that it is necessary to use a logical process to come to a conclusion. This tenet is true whether the decision is a business decision, a personnel decision, or an ethical decision. It may hold even more true when being faced with an ethical dilemma.
A topic such as the one at hand in this paper is underpinned with ethical dilemmas. An ethical dilemma occurs when there are, “(a) significant value conflicts among differing interests, (b) real alternatives that are equally justifiable, and (c) significant consequences to stakeholders” (McNamara, n.d., Ethics Tools section). Clearly, these conditions exist when discussing the issue of sport participation by transgender and transsexual athletes.
Making a decision about the eligibility of transgender and transsexual athletes may seem to differ depending on the context. Are we talking about recreational level sport, youth sport, or elite level sport? Yet while these sporting contexts may differ, the sport administrators dealing with the issue still need an organised process by which to come to a decision. We would like to suggest that sport administrators keep in mind the following generally applicable ethical decision making model as a guide in these situations (Hums, Barr, & Gullion, 1999, p. 64; Zinn, 1993):

1. Gather all available info – Decision makers rarely have all the information they truly desire to make a decision. However, they must try and assess the information they can aggregate in a timely fashion to address the issue at hand. For example, gather the most relevant medical and legal information available.
2. Examine personal beliefs – It is good to hold to one`s personal beliefs, and people often hold strong beliefs about issues related to sexual identity. However, one must also be cognisant of when holding to those beliefs becomes an impediment to solving the dilemma.
3. Consult with your peers – It is likely that someone else in another sport organisation has been confronted by a similar question about transsexual or transgender athlete participation. Discuss the issue with your trusted peers, but remember to keep information confidential about the athlete in question.
4. List your options – It is always good to have options and put as many solutions as possible on the table for discussion. It helps to put them in writing to be able to compare and contrast them. With this issue, a range of decision outcomes are possible.
5. Look for a win/win solution – Try to find a solution that will be the most fair to all parties involved - the athlete, opponents, sport governing bodies. While this is not always possible, it should be the “end goal.”
6. Sleep on it – These types of decisions take time. Decision makers must avoid the temptation to make a hasty decision. Take time to really see all sides of the issue and how all parties will be impacted.
7. Make your best decision – After weighing all the options and considering all sides of the issue as thoughtfully as possible, this is the best anyone can ask. People will have strong opinions regarding transsexual and transgender athletes, but if an administrator takes care to make the best decision, many questions can be addressed.
8. Evaluate – Too often sport administrators overlook this step. What impact did the decision have? In retrospect, was it the right decision? If not, how can one make the appropriate adjustments to come to a fair and equitable outcome? Over time, new information and knowledge about transsexual and transgender athletes will emerge. A decision made now will need to be evaluated to see if it stands the test of time.

Is it easy to apply this model? Not always, but it does give sport administrators some structure when deliberating on this topic.
Conclusion
Transgender young people have the same right to participate and benefit from the positive aspects of athletics as other students do. School athletic leaders, in response to this interest, must identify effective and fair policies to ensure that transgender students have an equal opportunity to participate on school sports teams (Griffin & Carroll, 2010, p. 6).
As sport administrators/managers, we are charged with developing and cultivating inclusive and safe environments for current and prospective athletes – youth to elite. Our decisions will not be easy, particularly as they pertain to participation by transgender and transsexual athletes. We must grapple with the ethic of fair play and opportunities for access and inclusion. Medical science offers new information on the effects of hormone therapy and surgical procedures almost daily. In recent years, lawmakers in several countries have passed legislation intended to stop discrimination and abuse of transgender people. Socially, communities may embrace myriad forms of gender identity and expression, while others will reject it, leaving transgender individuals isolated.
Understanding the transgender athlete and the issues he/she may encounter in competition, in medicine, and in society can help us think more critically about policy and implementation. Using an ethical decision making model can help us ensure fair competition, while also being more cognisant of consequences for all athletes. Sykes (2006) contended that future sport policies on gender require an “ethical vulnerability to …hybrid bodies” (p. 12) which “requires a capacity to live with instability rather than break down in the face of transitions; to seek out the most expansive rather than familiar forms of gender/sex legislation in sport” (p. 12). Therefore, as sport administrators, we must be innovative, forward-thinking, and ground breaking. Our athletes have done it, why can`t we?
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Contact
Prof. Dr. Mary A. Hums
University of Louisville
Louisville, USA
Email: mhums@louisville.edu
Dr. Meg Hancock
University of Louisville
Louisville, USA
Email: mghanc01@louisville.edu

http://www.icsspe.org/