The decision to restrict the participation of transgender swimmers at an elite level has heightened debate over fairness and inclusion, and sparked conflict between athletes and researchers alike. By Martin McKenzie-Murray.

The debate over FINA’s decision on transgender athletes

American transgender swimmer Lia Thomas at a college competition in March.
American transgender swimmer Lia Thomas at a college competition in March.
Credit: Brett Davis-USA TODAY Sports

This week in Budapest, as the city hosted the swimming world championships, FINA called an extraordinary general congress to vote on one of the most divisive issues in sport today: the recognition and eligibility of transgender athletes. The outcome immediately generated world news, community division and a precedent for other sporting bodies who have been wrestling with the issue – with varying degrees of conclusiveness – for years.

That outcome? At the specially called congress, 71 per cent of FINA’s 152 national federations voted to ratify FINA’s new gender inclusion policy, which effectively denies competition to male-to-female transgender athletes whose transitions were made after one of the early stages of puberty or age 12, whichever is later.

Some context is needed. FINA – the International Swimming Federation – is recognised by the International Olympic Committee to administer and govern international aquatic sports. Its authority is not limited to swimming (both pool and open water); it also oversees water polo, diving, high diving and synchronised swimming.

Earlier this year, FINA announced a “working group” to examine the eligibility of transgender athletes, and to help design a gender policy that would attempt to balance what many have described as incongruous principles: inclusion and competitive fairness.

There were at least two important contexts to FINA’s work. The first was the success of Lia Thomas, a young swimmer who in March became the first American transgender athlete to claim a major college sports title when she won the National Collegiate Athletic Association 500-yard freestyle title. She would soon declare her Olympic ambitions, and no doubt FINA was watching.

Thomas’s participation was predictably controversial, but especially over one specific issue. The country’s chief governing body, USA Swimming, mandates that transgender athletes complete three years of hormone-replacement therapy before competing in female competition. Thomas was six months shy of fulfilling this, but the governing body for college sport overrode the edict and allowed her to compete.

This rancorously divided American swimmers and duelling petitions soon emerged that both demanded and objected to her inclusion. In an exclusive interview with ESPN in May, Thomas said: “The biggest misconception, I think, is the reason I transitioned. People will say, ‘Oh, she just transitioned so she would have an advantage, so she could win.’ I transitioned to be happy, to be true to myself.”

The second important context to FINA’s working group – and this week’s vote on its resulting policy – was the unworkable irresolution that emerged from two distinctively different positions of the IOC on one hand and the International Federation of Sports Medicine and the European Federation of Sports Medicine Associations (EFSMA) on the other.

In November last year, the IOC released its “Framework on Fairness, Inclusion and Non-Discrimination on the Basis of Gender Identity and Sex Variations”. As FINA highlighted in its report this week, the IOC rejected “the presumption that the male sex confers an athletic advantage”.

This was objected to by both the International Federation of Sports Medicine and the EFSMA in a joint statement in January, an objection that FINA summarised in this week’s report: “According to the Joint Position Statement, the IOC’s focus on only one aspect of the human rights analysis meant that it failed to take proper account of ‘the scientific, biological or medical aspects’, in particular that ‘high testosterone concentrations, either endogenous or exogenous, confer a baseline advantage for athletes in certain sports’ such that ‘it is clear to uphold the integrity and fairness of sport that these baseline advantages of testosterone must be recognized and mitigated’. ”

This conflict was unworkable, and FINA determined to resolve it. It established a “working group” of three parts. One was made up of athletes and coaches, both former and current, and included transgender athletes. The second was scientific, and included physiologists, endocrinologists and experts in athletic performance. The final group comprised lawyers with expertise in sex discrimination, human rights and sports law.

What did each group determine? The athlete group formed the majority view that competitive fairness had to be maintained. Their prevailing view was also that female athletes already experience fewer opportunities, and by diminishing competitive fairness this inequality would only be worsened. FINA explained the group’s view: “Competitive fairness must remain the primary objective in the establishment of competition categories … In the majority view, FINA should remain committed to the separation of athletes in sport into men’s and women’s categories based on biological sex and should allow male-to-female transgender athletes (transgender women) and athletes with 46 XY DSD [disorder of sex development] with a female gender identity to compete in the women’s category pursuant to eligibility criteria that are consistent with, and do not undermine, that commitment [to redressing gender inequality].”

The view of the medical (or “scientific”) group, complemented the view of athletes. Their conclusion was that the performance gap between males and females varies upon the sport, but that the gap – of whatever size – becomes universal after puberty. The major difference is testosterone. Before puberty, the hormone exists in roughly equal amounts in males and females, but after puberty, men have at least 15 times more of it, generating “not only anatomical divergence in the reproductive system, but also measurably different body types/compositions between sexes ”, FINA reported.

“According to the Science Group, if gender-affirming male-to-female transition consistent with the medical standard of care is initiated after the onset of puberty, it will blunt some, but not all, of the effects of testosterone on body structure, muscle function, and other determinants of performance, but there will be persistent legacy effects that will give male-to-female transgender athletes (transgender women) a relative performance advantage over biological females. A biological female athlete cannot overcome that advantage through training or nutrition. Nor can they take additional testosterone to obtain the same advantage, because testosterone is a prohibited substance under the World Anti-Doping Code.”

FINA says the third part of the working group – the one comprised of lawyers – read the findings of the athlete and medical groups and accepted “FINA’s core commitment to equality of opportunity for both male and female athletes.

“Thus, its task was to reflect FINA’s commitment to a sex-based women’s category as necessary to ensure that FINA does not discriminate against – and is able to empower – female athletes, and that Aquatics is able to promote male and female athletes and male and female sport equally. It is also understood that, as with any form of affirmative action, FINA’s effort not to discriminate against female athletes and thus to ensure a sex-based women’s category itself has exclusionary effects.”

Here was the rub. FINA is committed to upholding strictly regulated divisions of sex, in order to promote competitive fairness and redress female inequality. To do so requires it to be bluntly exclusionary for some male-to-female transgender athletes. The interests of both cannot be perfectly balanced.

Australian swimmer and four-time Olympic gold medallist Cate Campbell addressed FINA’s congress before the vote. Her speech, given in support of FINA’s new policy, summarised the difficulty of achieving balance: “Usually, inclusion and fairness go hand in hand,” she said. “To create a place that is inclusive is to create a space that is fair. Transgender, gender-diverse and non-binary athletes’ inclusion in the female category of elite sport is one of the few occasions where these two principles come into conflict.

“The incongruity that inclusion and fairness cannot always work together is one of the reasons why it is so difficult to talk about this topic.”

Not only difficult to talk about, but also difficult to govern. To this end, FINA stressed that “gender diversity is welcome. For example, female-to-male transgender athletes (transgender men) who are not using exogenous androgens remain eligible for … the women’s category; and male-to-female transgender athletes (transgender women) remain eligible for, and are welcome to compete in, the men’s category whether or not they are suppressing their endogenous androgens.”

FINA also said it was looking at creating open competitions, in which everyone could compete.

The conclusions of FINA’s scientific group were contested, including by Dr Ada Cheung, an endocrinologist with Melbourne’s Austin Health and a member of the Trans Health Research program. “We actually don’t know if there’s a biological advantage for trans women over cisgender women because the science is not clear,” she told The Age. “FINA’s report is really based on a group of people’s opinion, it’s not a gold standard. No research has really been done into trans female swimmers or any elite athletes that are transgender. The jury is out.”

Cheung went on to say that hormone replacement therapies might leave a physical composure – height, broader shoulders – that suggests superior strength and athletic performance but in fact disguises lost muscle mass and bone density. “I’ve used the analogy in the past of a four-wheel drive with a hatchback engine,” Cheung said. “It might look powerful but performance doesn’t necessarily match appearance.”

This chimed with what Hannah Mouncey, a transgender footballer who was denied eligibility for the AFLW in 2017, told The Saturday Paper last year: “When you’ve got no testosterone … My bench press went from 150 kilos down to about 60. My squat went from about 200 kilos down to 70.

“But that’s not just limited to strength. Your cardio, or aerobic capacity, is equally affected. Also, you lose a lot of muscle really quickly. I lost about 20 kilos of muscle in about five or six weeks.”

But other physiologists and endocrinologists – beyond FINA’s scientific group – argue that there are still legacy benefits from exposure to testosterone, even after years of hormone replacement therapy. As Cheung said, the jury is out on precisely where and when the biological advantages end.

As medics were divided, so too were Australian swimmers. Cate Campbell was joined by three-time Olympic gold medallist Emily Seebohm in welcoming the policy, while former national butterfly champion Madeline Groves tweeted: “Shame on everyone that supported this discriminatory and unscientific decision.”

Prime Minister Anthony Albanese offered tacit support for the decision – or, at least, for the independence of sporting authorities to determine their own policies – while criticising his predecessor’s invocation of the issue in the recent election campaign.

FINA has gone first here, and in rejecting the IOC’s framework has established a precedent that will likely be followed by others – including, midweek, the International Rugby League – in the future.

This article was first published in the print edition of The Saturday Paper on June 25, 2022 as "Swimming against".

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Martin McKenzie-Murray is The Saturday Paper’s associate editor.

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