The inclusion of transgender people in sport is relatively new and has proven to be complex. The impacts of inclusion policies, or lack thereof, are significant and reach far beyond sport to affect how trans people are included in other areas of society. Sport can have a positive impact on the physical and mental health of transgender people and can contribute to lifesaving opportunities and enhanced wellness.

In 2021, the CCES commissioned E-Alliance to complete a review of scientific and grey literature on transgender athlete participation in competitive sport. Transgender Women Athletes and Elite Sport is a review of research articles published in the English language between 2011 and 2021 inclusive. The report is divided into two sections, one that encompasses biomedical studies and a second that encompasses sociocultural studies.

The report’s authors recommend that all reasonable efforts should be made to make sport inclusive and accessible for transgender individuals. However, the scope of this review was limited to binary trans women who are elite athletes and was not sport specific. As a result, the conclusions are not directly applicable to other trans or non-binary populations and other levels of sport.

This literature review is one component of a larger scope of work that aims to support leaders and policy makers and provide access to critical research insights.

Key Findings

Key Biomedical Findings
  • Biological data are severely limited, and often methodologically flawed.
  • There is limited evidence regarding the impact of testosterone suppression (through, for example, gender-affirming hormone therapy or surgical gonad removal) on transgender women athletes’ performance.
  • Available evidence indicates trans women who have undergone testosterone suppression have no clear biological advantages over cis women in elite sport.
Key Sociocultural Findings
  • Biomedical studies are overvalued in sports policies in comparison to social sciences studies.
  • Policies that impact trans women’s participation in elite sport are the continuation of a long history of exclusion of women from competitive sport – an exclusion that resulted in the introduction of a ‘women’s’ category of sport in the first place.
  • Many trans “inclusion” sport policies use arbitrary bounds that are not evidence based.
  • Cissexism, transphobia, transmisogyny and overlapping systems of oppression need to be recognized and addressed for trans women to participate in elite sport.