The physical advantage a transgender athlete may have has dominated debate around participation, but there are other perspectives, like mental and emotional impacts, that haven’t been part of the discussion, writes Ashley Stanley

During her 20 years playing netball, Sarah Michelle Hansen-Vaeau says she’s experienced bigotry and hate.

While much of the focus may be on what physical advantage the Polynesian transgender woman may have on the court, it’s her mental state, she says, that takes a knock.

A transgender athlete’s mental and emotional wellbeing doesn’t seem to have been taken into consideration in the latest public discussions around athletes like Kiwi weightlifter Laurel Hubbard, who’ll be the first recognised transgender athlete to compete at an Olympic Games in Tokyo.

It’s just one of many factors that appear to be overlooked in this controversial topic. And it’s not the first time. 

Hansen-Vaeau, believed to be the first international transgender sports coach in the world, has heard the common one-sided argument focusing on her physical abilities while playing. Mostly at the expense of a more holistic view of her health and wellbeing. 

“I don’t care what anyone says, I’ve played 20 years of international netball, trained against nearly every professional club side and franchise and international teams and there’s always a little bit of that on your mind,” says Hansen-Vaeau, referring to people questioning whether she has an unfair physical advantage.

“People often think of the physical but most sports it’s your mental prep, it’s your ability to participate and perform in an environment. The brain moves everything, so if your brain is elsewhere or you’ve got these things happening, your performance is going to inevitably decline.”

A New Zealand survey of the health and wellbeing of transgender and non-binary people found they were nine times more likely to have high levels of psychological distress, and half avoided playing in sports teams, worried about discrimination.

Hubbard’s selection into the New Zealand Olympic team has tipped the public into another divided ‘debate’ around transgender athletes. 

It’s hard to miss the opinions flooding online platforms, filling newspaper headlines – both in New Zealand and around the world – and the heated discussions between colleagues and family members.  

But there seems to be a few perspectives missing from these conversations and spaces.

“There are so many barriers where it’s easier for trans people to opt out of playing sport and that has huge implications on that sense of connection,” – Jack Byrne, University of Waikato researcher.

Very few, if any, transgender athletes have spoken in media coverage, and the public discourse seems to focus primarily on either the ‘for’ or ‘against’ argument around Hubbard’s inclusion, and in extreme cases, her existence. 

What could be fleshed out further, is a more broader, inter-related picture around transgender athletes, communities and society, and the impacts when discussing already-marginalised people’s lives. 

Points that may seem irrelevant to Hubbard’s achievement, but are connected and necessary in understanding different views and the bigger picture.

Factors like what kind of experiences do transgender athletes encounter; why are their voices often not included in coverage? More generally how is health and wellbeing for transgender and non-binary people? Is testosterone the only factor influencing athletic performance, and how will society and sport be shaped around this historical moment? 

To add to the questions, so far there hasn’t been a lot of research around transgender athletes, and there is no definitive data or statistics available surrounding the number of trans athletes across sporting levels in New Zealand or internationally. All academics LockerRoom spoke to say it would be difficult to actually find any figures. 

Including first-hand voices and experiences 

Hansen-Vaeau says her experiences in sport have been mixed. “I think it’s like anything, when you’re different. I’ve had amazing experiences participating and coaching, and then I’ve had some not so good ones, where people are just misinformed and uneducated,” says Hansen-Vaeau, who coached the New Zealand Men against the Silver Ferns in 2019. 

“And it goes back to discrimination, especially when it comes to coaching, because there’s no so-called physical advantage when I’m a coach.”

After experiencing a complaint from the opposition in a tournament about her involvement in a netball game, Hansen-Vaeau joined the board of the New Zealand Men’s and Mixed Netball Association.

“I joined to make some changes, to make sure that sport was inclusive of everyone wanting to play, and see what they were offering to the community,” Hansen-Vaeau says. “I’m a strong advocate for everyone’s rights to play netball, not just transgender individuals.”

Sarah Michelle Hansen-Vaeau (second row, far left) with the NZ Men’s netball team and the Silver Ferns. Photo: supplied. 

World Netball, the sport’s global governing body doesn’t have a policy around transgender athletes yet, but Hansen-Vaeau says Netball New Zealand have “done an amazing job at looking past surgical [requirements] and understanding identity and choice.”

“And a lot of the local competitions have also done that, where you don’t have to have reassignment [to play], which we know is costly and also really dangerous, especially for those of us who have been on hormones for a really long time,” says Hansen-Vaeau.

The side effects of being on hormone medication – to alter estrogen and testosterone levels – is a burden, Hansen-Vaeau says.  “I think the biggest thing is the physical, so once you’re on hormone therapy, you gain weight and your ability to train at the max capacity is majorly affected,” she says. 

“Long term, trans women suffer liver and kidney issues, just because of the way hormones work, but it’s a risk you run if that’s the choice you make.” 

Unfortunately there are not a lot of other options if you want to participate. “If you don’t take hormones people kind of judge you. It’s not only cisgendered people – the trans community can also be hurtful towards people who they don’t feel are on hormones,” says Hansen-Vaeau.

When it comes to transgender rights, Hansen-Vaeau knows all too well a lot of people are “bigoted and hateful.” 

“It’s really sad to see that they can’t just treat people as people. But I do find it comical when people come at me, because they don’t understand,” says Hansen-Vaeau, who completed research on the decolonisation of transgender women in the Pacific. 

“I’m like ‘You’ll never play in front of a stadium where you’re called the ‘f’ [f*ggot] word from the sideline’, or have a whole group of men calling you down an alleyway after prizegiving because you’re trans. So they’ll never understand the struggle.” 

Getting her through difficult situations have been her allies and “sisterhood.” 

“I’m so blessed and fortunate that having coached high performance sport, I have a lot of friends and family who are in the Silver Ferns or play in the ANZ Premiership who are real champions of trans being able to just participate and play netball. So I draw on a lot of them for support,” Hansen-Vaeau says. 

“But it also comes down to being stubborn. I’m so stubborn that I’m not going to let anyone get to me. Or stop me from doing what I love and what I enjoy.” 

When support makes a difference

Hansen-Vaeau’s experiences reflect the findings of the 2018 ‘Counting Ourselves’ research project – a survey of 1,178 participants in New Zealand relating to the health and wellbeing of transgender and non-binary people.  

Jack Byrne, a senior research officer in the Trans Health Research Lab at the University of Waikato, was one of the survey leads. As dismal as some of the results were, Byrne says they also wanted to capture the participant’s positive experiences. 

“The things that make a difference are when people have support from others,” he says. “Whether that’s support from family or support from trans community members. But that positive support from people who care about you really makes a difference.”

Especially when the main findings show levels of discrimination, violence and harassment are much higher for transgender and non-binary people when compared to the overall population in New Zealand – whether that be at school, in the workplace or in public spaces. 

When people experience discrimination, it negatively impacts their mental health and wellbeing. “In our research, trans and non-binary people were nine times more likely to have high levels of psychological distress and much more likely to have thought about suicide or had attempted suicide,” says Byrne. 

People often think about elite sport in these discussions, Byrne says, but most of the impact happens at a much lower level. “We know that trans people stop playing [sport] really early on and they stop doing things like going to the gym because they’re worried about discrimination.”

Just over 60 percent of those who participated in the survey were worried about how they would be treated as a transgender or non-binary person in competitive sport, 58 percent avoided going to the gym and 50 percent avoided playing in sports teams for similar reasons. 

“Most of us hope the young people in our lives will play some sort of sport or recreation,” Byrne says. “But there are so many barriers where it’s easier for trans people to opt out of playing sport and that has huge implications on that sense of connection.”

“I think we need to be very careful about the language we are using because there’s a lot of damage that can be done to transgender people in our communities,” – sports sociologist Holly Thorpe. 

The discussions around Hubbard and the Olympics are interesting, says Byrne, because it’s at one end of the sports spectrum, but it’s impacting on people’s views about other types of sport. 

For example, the Sport New Zealand guidelines currently being developed around transgender inclusion are for community-based sport. “It’s about someone being able to play in their school team in the local non-competitive sport of any sort,” he says. “And yet people are basing their opinions about that on whether or not it’s fair for a trans person to be performing at the Olympics. A lot of things are being conflated in those discussions.”

The University of Waikato survey included questions around schools having sport policies for transgender and non-binary people, but it didn’t specifically look at how sporting organisations can create safer environments and policies. 

However, Byrne says there are some good examples of policies being developed overseas. “In Australia, a whole lot of sporting codes came together and came up with a trans inclusive policy. And they were the big names over there, like rugby, netball and cricket.” 

Whatever sporting organisations do to be better at inclusivity in general, Byrne says they should extend to trans athletes. 

“It’s about principles; how can we just apply our current policy in ways that realise ‘Oh this could be a problem for trans people as well’,” he says.

“Because if you say ‘Oh we’ll have to do this for trans people’, it’s like people resent it, and see it as the trans person being the problem instead of collectively, of course, everyone caring about the same things. And it’s normalising that as much as possible.”

Examples include privacy of personal details, appropriate uniforms and the set-up of facilities. 

Testosterone – performance advantage?

The existing research is heavily weighted towards testosterone providing physiological advantages to athletes. But some experts say that’s only one part of a much more complex picture in transgender athletic performance.   

Alison Heather is a professor at the University of Otago and her research area of expertise is around sex hormones – primarily how they affect cardiovascular and respiratory physiology. 

Heather has researched how testosterone can provide performance advantages. “All you have to do is look at the world records to know that a male physiology outperforms a female physiology and that’s across any sport,” says Heather, who recently developed a test to spot designer estrogens and androgens used as doping agents in sport.

“If you look at strength sport, there’s anything up to a 30 percent difference [between men and women] in the world records, and then in endurance sports, we’re looking at like 10 to 12 percent. I’m talking averages here, I’m not talking an individual athlete versus an individual athlete.”

In 2004, Danish golfer Mianne Bagger became the first trans woman to play in a professional golf tournament, at the Australian Women’s Open. Photo: Getty Images. 

She says it begins in utero, when an embryo first starts to become male and is exposed to high levels of testosterone. 

“There are three surges in utero that basically set up long-term bone structure, cardiovascular size of the heart, lung structure, size of the lung, and how the brain network forms,” she says. All factors that can potentially add to having a physical advantage. This stays relatively the same until puberty, when testes in males start to produce testosterone. 

The current International Olympic Committee guidelines allow any transgender athlete to compete as a woman providing her testosterone levels are below 10 nanomoles per litre for at least 12 months before their first competition. 

Heather says this needs to be considered further, as “drawing a line in the sand” around nanomoles does not take into account testosterone that has been in someone’s body before transitioning. 

There needs to be much more discussion around this whole area and a lot of factors should be considered, she says. 

“I think they are taking one physiological parameter, here and now, and it should really be put into the context of all the other physiology that can enhance a performance,” says Heather. “Like height, lever length, body mass index, what is your oxygen carrying capacity – there are so many different physical parameters that could be looked at.”

And then there are the non-physiological components. Everyone who provided comments for this article agrees that testosterone is not the only factor affecting performance. 

“You talk to any sport psychologist and there is such a mental part to most sports,” Heather says. “But if we’re talking about all of those things being equal, say the socio-economic being equal, competitiveness being equal, mental game being equal, we still have to have a fair playing field from the get-go. 

“And if someone is ultimately stronger, has a body mass index or muscle mass distribution that’s more male-like than female, then for some sport, it’s always going to be an advantage.”

Heather has been one of a group of academics in New Zealand who have published in this area, primarily on her expertise of sex differences between male and female. But she hasn’t been involved in research specifically with transgender female athletes. Very few have globally. 

Holly Thorpe, a sports sociologist from the University of Waikato, says the science around transgender athletes is “unsettled” – not united or conclusive. 

“A lot of the research from the scientific physiology side has focused on testosterone and the advantage of testosterone in someone’s body during childhood and adolescence and how that may make someone have those natural kinds of advantages even after they’ve transitioned,” she says.

“But that really kind of looks at one part of a very much more complicated, complex picture in terms of performance and achievement in sport. 

“Things like our training environment, the kinds of support and resourcing that we have access to, personality factors, there are so many other considerations in terms of performance so to get really focused on nanomoles of testosterone, it oversimplifies a much more complex picture of performance.”

University of Waikato sports sociologist Holly Thorpe. Photo: supplied. 

There doesn’t seem to be research that examines a range of factors affecting athletic performance with transgender athletes. The limited available studies focus on specific areas, such as testosterone, in isolation, and note as part of their research limitations that more cross-disciplinary research is needed with transgender athletes and should be sport specific. 

Another area to be mindful of is XX or XY chromosomes are not the only sex combinations. “We’re talking less than one percent of the population, like very small numbers, that can have cross over in their XY chromosomes,” says Heather. “It’s a very very small number…nobody knows what causes that or if there is a cause as such.” 

But transgender females and males are different scenarios to DSD [different sex development] athletes, says Heather, and should not be discussed in the same debate. 

“A lot of people confuse the two and they try to talk about DSD female or DSD athletes in the same breath as a trans athlete, and I don’t think that’s right,” she says. “I think it’s a different discussion and two different debates for the likes of the IOC or the International Weightlifting Federation.” 

Something Heather also recommends should be done following Hubbard’s inclusion. “Although this is all being debated, she has qualified under the rules as they currently are,” she says.

“I don’t like the debate that’s happening in New Zealand, targeting particular athletes, because they’ve done nothing wrong.

“So rather than slamming that kind of thing, it has to go back to the IOC. If people think it’s not fair, then it’s on the IOC to look at what are safe and fair regulations.”

Shaping views and society

Thorpe is also concerned about how Hubbard’s achievement is being discussed. The type of language and framing in the media has the potential to shape societal views around transgender athletes and people.  

Thorpe recognises how controversial this topic is, and the multiple perspectives being shared. “I can hear in a lot of people’s comments, some of the ways that people are talking, are underpinned by fear. Fear of the unknown, a fear of sport – something that they love, something that’s grounding for them – changing.” 

Fear is not a great place to come at this topic from, says Thorpe. “And even when people come at it from science, I think sometimes science is being selectively used to speak over top of fear.”

Laurel Hubbard with medals from the 2017 IWF world champs. Photo: Getty Images. 

In her area of expertise, Thorpe understands the long history of sport, how it’s been structured and the role it’s played historically in reinforcing certain ideas including gender binaries. 

“We can go back in time and look at various groups who have been excluded from sport, racially, based on sexuality, different ethnicities, and genders, women too, were excluded from sport with whole rationales behind that,” Thorpe says.

“Very logical rationales seemingly at the time, by really well-respected people in societies, like doctors, who made these petitions why women shouldn’t do sport. It’s not dissimilar to what we’re hearing today on why transgender women shouldn’t participate in sport.”

There are assumptions that transgender women in sport are almost monstrous, says Thorpe. “People who are trying to cheat, or people who are dressing up as women, to prey on young girls in bathrooms. I mean some of that stuff is quite transphobic language and ideas,” she says.

“And I think we need to be very careful about the language we are using because there’s a lot of damage that can be done to transgender people in our communities – to transgender athletes, and to children who may be struggling.

“They’re hearing this language in the news, they’re hearing their parents speaking about this and so the ways we talk about it really matter.” 

Thorpe is in the process of undertaking research around media representations of Hubbard. “I think the media have the potential to lead the way here. I think the media plays a really important role on how the general public comes to land on this.”

The research team will look at media coverage of Hubbard before, during and after the Tokyo Olympics.  

“We’re anticipating that’s going to tell us quite a lot about society’s response to this important moment in time, and it’s going to be a significant teachable moment,” she says, “but we don’t know what the key lessons are going to be.” 

This will be an ongoing conversation that certainly won’t be finished after Tokyo, says Thorpe. 

“I think this is going to be a part of a longer process of social change through sport,” she says. “We’re seeing in society more broadly, schools trying to do so much work around supporting transgender children, or children who are struggling through gender issues, we’re talking about bathrooms, and we’re trying to make spaces more inclusive.” 

For Thorpe, the issue always comes back to what is sport and what is the role of sport in society.

“Yes, sport at the Olympics is about performance and achievement, but more broadly the role of sport, the real power of sport in society, the Olympic movement more broadly is much more than ‘higher, faster, stronger’,” she says.

“It’s about trying to build towards a society of peace, of understanding, of empathy and of values.” 

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