The history of transgender athletes in sport

Introduction

The discussion of gender in sports is not new in the world of professional, amateur, and even high school athletic events. This chapter starts by exploring historic definitions of gender within the context of sport and then outlines some of the challenges that remain with the current methods used to determine gender in competition. Conversations regarding the fairness in athletic competition have been ongoing in the modern era as early as the 1936 Olympics (Berg, 2009). Throughout time, there persists a desire for fairness, equity, and inclusion in sports competition, with sports commonly divided to create a field of competition among biological sex, weight, age, level of competition, and affiliation [ ]. Historically, the basis for the divide with biological sex is to eliminate potentially unfair competition of males masquerading as females to gain an advantage in competition [ ]. Physiologically there are known differences between genders that relate to sports competition, such as women having less lean muscle mass, higher body fat, and lower aerobic capacity compared to men [ ]. Gender identity, however, has led to evolving, ever-changing definitions of male and female genders for the purposes of sport. As noted by Joan Harper, “Human biology does not neatly divide into two categories” [ ]. While human gender identity, sex, and sexuality are more complicated than the below selected definitions can elaborate, there are only two gender-based categories of competition in sport. At the time of publication, athletes must compete in one of two categories: male or female.

Definitions

The following definitions were selected from the University of California San Francisco Guidelines for Primary Care 2016 and Care of the Transgender Athlete from Current Sports Medicine Reports to ensure clarity and consistency with terminology within the chapter (Deutsch, 2016) [ ]:

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  Gender identity: A person's internal sense of self and how they fit into the world, from the perspective of sex.

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  Sex: Historically, has referred to the sex assigned at birth, based on the assessment of external genitalia, chromosomes, and gonads. It is often used interchangeably with gender; however, this difference has become essential in transgender people.

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  Transgender: A person whose sex identity differs from the sex assigned at birth. It may abbreviate to trans.

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  Transgender man: Someone with a male sex identity and female birth-assigned sex.

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  Transgender woman: Someone with a female sex identity and a male birth-assigned sex.

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  Cisgender: A non-transgender person (cis means “same side” in Latin).

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  Nonbinary: Individuals who do not identify as either female or male. Either transgender or gender nonconforming individuals may have nonbinary gender identity.

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  Gender affirmation/transition/gender reassignment: The process of an individual transitioning and period during which an individual transitions to a new gender. This may include physical, social, legal, medical, and/or surgical processes and personal adjustment.

The 1930–1950s

Dora Ratjen, raised as a female by her parents, competed in the high jump for Germany in the 1936 Olympics and later set the world record at the European Athletics Championships. Shortly after the record-setting performance, she was accused of "cross dressing,” arrested, and determined by German Reich sports officials to be a male. As a result, Dora changed her name to Heinrich, and Germany subsequently returned the medals won and struck her name from the record books (Berg, 2009) [ ]. Of note, when Ratjen died in 2008, medical records indicated ambiguous genitalia, with speculation that any intent to deceive was unintentional [ , ]. American Helen Stephens also competed at the 1936 Olympics against the defending Olympic champion, Polish runner Stanislawa Walasiewicz [ ]. Stephens defeated Walasiewicz, causing the latter to accuse the former of being a man. Although the exact method is unknown, Stephens was “examined” and determined to be a woman. Unfortunately, Walasiewicz was shot and killed in a department store robbery in the 1980s. The autopsy revealed ambiguous sexual features [ ]. Soon after Stephens' accusation of being a male, her coach, and future President of the International Olympic Committee, Avery Brundage, advocated for systematic screening for “suspicious cases” [ ] ( https://olympics.com/ioc/former-presidents ).

After canceling the 1940 and 1944 Olympic Games due to World War II, the International Olympic Committee (IOC) began requiring female competitors to bring documentation from their physicians to prove their gender and thus their eligibility during the 1948 Olympic Games [ ]. The IOC, however, did not define femininity [ ]. The physician documentation of gender was based on their judgment in the context of their nation's definition of gender and did not require an internationally recognized gender test [ ].