Thread by @Scienceofsport

The @dailymaverick asked me to do a piece on the trans woman in sport issue. It’s necessarily short and high level, but here it is. Writing it made me realize there are some key questions everyone who wades into the debate upfront should answer. Wanted to share them here (1/_)

The first question, before any other “shots are fired”, should be:

“If there is ZERO evidence for what happens to performance and/or biology in trans women undergoing treatment, what should happen for sport? Would you allow inclusion, or would you exclude until it exists?” (2/)

This is so important because it reveals a “value system” and understanding of women’s sport. If you believe in inclusion in the absence of evidence, you’re saying that women’s sport should be OPEN to self-ID, and then evidence must be provided to prove unfairness or risk. (3/)

On the other hand, if you say exclusion until evidence exists, you’re stating that women’s sport should remain CLOSED unless evidence can be provided to assure its participants that it is fair and safe to open it to athletes who have benefited from T during development (4/)

Once you’ve answered this first question, then you move to number 2, which is:

“The current policies for inclusion require suppression of T for 12 months, in order to allow participation without unfairness or harm. How strong is the evidence that this is actually achieved?” (5/)

Here’s where it gets as tricky as you want it to be, and you can act in bad faith to say “Ah, we are so helpless, there is no good research in athletes to answer this, we simply can’t say”. Which is why your answer to Q1 is important. However, such self-despairing pity is also...

...not even true, because there are some studies. In runners, there are 2 studies, neither particularly good. One finds that in 8 runners, with self reported times, spanning two decades, with no controls, no report of training, or even T levels, performance advantages are removed

The other showed that in DSD athletes who can use T, the suppression of T slowed performance by 5.7%, which is half the typical male advantage. So you could call it 1-1, but really neither study is very good. So then you find some good studies. (7/)

Those good studies are unfortunately not directly in athletes, but they are the ones that should really make sports organizations sit up and take notice. They show, without exception, that trans women who have suppressed T lose only small amounts of mass, muscle mass & strength

The result is a retained advantage over the correct reference group of females. The problem, of course, is that these comparisons are in non athletes, so both baseline and subsequent training induced changes are not directly assessed. But go back to Q1 now. Remember we said ZERO

...evidence, right? Well there’s NOT zero evidence. There’s actually a lot to suggest retained advantages, and when you look at published literature you find that training may make these even larger. How sport & scientists can ignore these is astonishing. It’s 12-0 on evidence

However, you may still hold that line, that there’s zero (or maybe you think insufficient) evidence, and so this inclusion should be the default. Which is fine, but that’s what should be stated upfront. Basically, you have to declare whether women’s sport is Closed or Open (11/)

Then you have to evaluate the “fix” - testosterone suppression. If you think it works to create fairness, safety AND inclusion, you’re ignoring a dozen studies that point in exactly the opposite direction. Now you have to treat women’s sport as open AND ignore evidence (12/)

All of which would make me wonder what the agenda is? Inclusion at the expense of all else? Ok cool, but then own it, and say “I think women’s sport should be open, despite available contradictory evidence with limitations, and I don’t care about fairness and safety of females”.

At least if you did that, it would frame subsequent disagreements, would be honest, and your position could earn some respect. But to pretend you’re holding up “scientific evidence” as a basis for inaction & then ignoring that which strongly suggests the fix doesn’t work? Come on

So if you believe in “open women’s sport to biological males until evidence shows we shouldn’t”, say so at the start, save us debate time. If you believe it should be closed, but also in inclusion, let me know which evidence you think supports this, I’d like to see it (13/13)