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Transgender Policy in Sport, A Review of Current Policy and Commentary of the Challenges of Policy Creation

Ingram, Benjamin James MD1; Thomas, Connie Lynn MD2

Current Sports Medicine Reports: June 2019 - Volume 18 - Issue 6 - p 239–247
doi: 10.1249/JSR.0000000000000605
Training, Prevention, and Rehabilitation/Special Communication

This review starts with a brief history of sex policy in sport followed by an exploration of the current state of transgender sport policies. Transgender in sport, from the high school to the professional level, is a frequent news topic. Fairness in women's athletics is at the center of transgender sport policy deliberations and public debate. Despite a long history of policy attempts and revisions, the female category in sport is not precisely and universally established, complicating transgender athlete policy development. Scientific evidence is scant on fairness for transgender athletes. For a variety of social factors, many transgender athletes do not have a positive experience in sports and the younger is the athlete the more challenging it becomes to create inclusive rules. Challenges remain in making competition rules fair, but inclusive, so that transgender athletes participate in sport. The medical and scientific community will continue to provide key input.

1Madigan Army Medical Center, Monterey, CA; and

2U.S. Army Womack Army Medical Center, Pinehurst, NC

Address for correspondence: Benjamin James Ingram, MD, Madigan Army Medical Center, Monterey, CA; E-mail:

Copyright © 2019 by the American College of Sports Medicine.