Fairness and Inclusion: Is it time to replace the gender binary in elite sport?

Taryn Knox1, Associate Professor Lynley  Anderson1, Professor Alison Heather2

1Bioethics Centre, University Of Otago, Dunedin, New Zealand, 2Department of Physiology, University of Otago, Dunedin, New Zealand

How should we respond when an elite athlete wishes to move from the male division to the female division or vice versa? While trans-male athletes (those who have transitioned from female-to-male) pose little threat to men’s sport, there is much more debate concerning the impact trans-women will have on women’s sport. Evidence indicates that trans-women retain some physiological benefits of a life with male testosterone levels prior to transitioning. Recently, Olympic guidelines were updated so that trans-women’s testosterone levels need only be below 10 nmol/L – three times the normal testosterone range for cis-women. Trans-women may indeed have a physiological advantage over cis-women. Herein lies the dilemma: the principle of inclusion suggests that trans-women should be able to compete in line with their gender identity, but this is inconsistent with the principle of fairness. However, sport is rife with inequities, including those arising from the genetic lottery that results in some of us being very short and others very tall. This gives weight to the argument that we should allow trans-women with high levels of testosterone to compete against cis women.

There are at least three potential responses this dilemma. The first is to let trans-women compete against cis-women without any restrictions– inclusion over fairness. The second is to only permit trans-women athletes to compete against males – fairness over inclusion. The third and fourth options attempt to balance fairness and inclusion. The third option is to lower the Olympic testosterone range for trans-women to meet that of cis-women. The fourth option replaces the gender binary in elite sport with multiple categories based on an athlete’s past and present testosterone levels (and other parameters). Contesting the gender binary and breaking down the borders between the traditional categories of male and female will simultaneously fulfil the principles of inclusion and fairness.


Lynley’s main areas of research interest is in sports medicine ethics, particularly the contemporary cultural and economic context of elite sport. Alison’s research focuses on how the sex hormones, estrogen and testosterone, affect the body.

Taryn is interested in the philosophy of psychiatry, and issues of social justice faced by the queer community.

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