Beyond Fairness: The Biology of Inclusion for Transgender and Intersex Athletes

In November 2015, the International Olympic Committee (IOC) reached a consensus on “Sex Reassignment and Hyperandrogenism” allowing transgender athletes to compete after one year of hormone replacement therapy (HRT) and without sex reassignment surgery (SRS). These recommendations have been applauded by some who argue that these guidelines are supported by the limited scientific data and are in line with current social and legal recognition on transgender issues. There are however, many who oppose allowing transgender women to compete against cisgender women under any conditions, especially in those cases where gonadectomy has not been performed. While much of this opposition is based on a lack of understanding of the transformative nature of HRT, there are also those who have legitimate concerns over the paucity of scientific studies to support the new IOC guidelines.