Protecting Transgender Children: All Should Have the Right to Play

April 8, 2021. Medium. Duke University. By Anna Paschall.

2020-21 Duke School of Medicine Schweitzer Fellow

On March 11, Mississippi became the most recent state to ban transgender participation in sports. North Carolina, South Dakota, Texas, Michigan, Arkansas, Missouri, Tennessee, Alabama and Montana are considering similar legislation, to name a few. The goal of all these proposed laws is the same: to prevent transgender individuals from competing alongside their same gendered peers in team and individual sports.

Participation in team and individual sports promotes healthy behaviors that often last into adulthood. It encourages good psychosocial development, promoting collaborative leadership skills, social bonds and self-esteem. Sports are also one more weapon in fighting the ongoing childhood obesity pandemic in the United States.

For all these reasons, we must stand against this onslaught of legislation and protect the rights of transgender children and adolescents to participate in sports.

Proposed new federal legislation would prevent transgender athletes from competing with peers of their same gender via modification of Title IX rules. For now, though, no cohesive federal legislation addresses transgender sports participation, and the issue is determined by state policies.

Proponents of the new state bills say that transgender women are at a competitive advantage over their cis-gendered peers. The NCAA and the International Olympic Committee take a similar stance. Those organizations do not explicitly bar participation by transgender women. However, they only allow transgender female athletes to compete following medical interventions such as hormonal treatment with estrogen — hormones that induce female body development and suppress testosterone.

The stated reason for this requirement is a concern that transgender female athletes may have competitive advantage over cis-gendered female athletes. It’s possible that minute differences in performance may have significant implications in professional leagues and the Olympics. But this is not the only population affected by these policies.

Many school districts base their policies on those of the NCAA and International Olympic Committee. As a result, these organizations’ approach often extends to elementary and middle school children — an especially troubling development.

For pre-pubertal children, multiple research studies have failed to find definitive evidence that transgender women have physical advantages over cis-gendered women. When a child chooses to undergo a physical transition, the process takes many years. Hormonal interventions generally are not recommended until around the age of 16, once an individual has undergone counseling and learned more about themselves. Taking their cues from the NCAA and IOC, some school districts are requiring transgender children and adolescents to undergo invasive medical interventions with possible lifelong implications, simply to participate in sports alongside their peers. That’s a high price to pay.

Organized sports help children and adolescents develop peer connections, self-esteem and leadership, conflict-resolution and teamwork skills. Participation in organized sports also correlates with improved mental health among children who have experienced adverse childhood events.

Transgender children and adolescents frequently experience ostracization, bullying and aggression in school, leading to high rates of depression, anxiety and suicidal ideation. Of transgender students who experience extensive bullying at school, an estimated 42% later attempt to take their own lives. Yet by excluding transgender individuals from sports or requiring proof of sex at birth prior to participation, we further ostracize them.

Children and adolescents are often seen as vulnerable, and numerous policies and safety rules exist for their protection and well-being. Transgender children are especially vulnerable, and the deserve the same level of protection and concern.

We must act to protect the rights of all children to participate in sports, regardless of gender identity. Let’s urge our representatives to stand against legislation infringing on the rights of transgender individuals.

All children should have the right to play. Their physical and mental health may depend on it.

Anna Paschall is a medical student and aspiring pediatrician at Duke University School of Medicine and a 2020–2021 NC Albert Schweitzer Fellow.