Transgender athletes in boxing: is it fair and safe?

doi:10.15406/mojsm.2024.07.00168

MOJ

eISSN: 2574-9935

Sports Medicine

Commentary Volume 7 Issue 2

Transgender athletes in boxing: is it fair and safe?

Nitin K Sethi,¹

Verify Captcha

Regret for the inconvenience: we are taking measures to prevent fraudulent form submissions by extractors and page crawlers. Please type the correct Captcha word to see email ID.

Victor Khabie²

¹Department of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, United States of America
²Department of Orthopedics, Northern Westchester Hospital, United States of America

Correspondence: Nitin K Sethi, MD, MBBS, FAAN, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, Chief Medical Officer, New York State Athletic Commission, USA

Received: July 26, 2024 | Published: August 8, 2024

Citation: Sethi NK, Khabie V. Transgender athletes in boxing: is it fair and safe?. MOJ Sports Med. 2024;7(2):78-79. DOI: 10.15406/mojsm.2024.07.00168

Download PDF

Abstract

The recent controversy surrounding Olympic boxers Imane Khelif and Lin Yu-ting has again ignited concerns regarding participation of transgender athletes in combat sports such as boxing. Concern was raised for the health and safety of the opponents. Should transgender athletes be allowed to participate in combat sports such as boxing and mixed martial arts (MMA)? Is it a fair competition between the two combatants? More importantly is it safe when a transgender boxer squares up against a cisgender combatant in the ring?

Keywords: boxing, transgender combatants

Commentary

Imane Khelif and Lin Yu-ting reportedly failed unspecified gender eligibility tests when DNA tests showed them to have XY chromosomes. These results were never officially published.¹ Imane Khelif’s father while sharing an official “looking” document identifying Imane’s sex as a female at birth said the following "Having such a daughter is an honor because she is a champion, she honored me and I encourage her and I hope she will get the medal in Paris…. Imane is a little girl that has loved sport since she was six-years-old."² As of this publication, the International Olympic Committee (IOC) has denied claims that they are transgender and has stood by its decision of their eligibility to compete.

Since details about the gender eligibility tests were never officially release, whether Imane Khelif and Lin Yu-ting are transgender or not remains unknown. At this time, it would be prudent to reserve judgement about the gender of Imane and Lin. Instead, the focus of the combat sport community and the sport’s governing bodies should be to determine whether it is fair and safe for a transgender boxer to compete against a cisgender boxer.

Discussion

Much of the debate and controversy about transgender athletes competing in combat spots is centered around transgender women boxing cisgender women. Higher testosterone level, differences in body fat, musculature and bony structure give the transgender boxer an advantage over her cisgender competitor.³ This is not a bout between two equally matched combatants and such a bout raises concern for the health and safety of the cisgender female boxer.

Combat sports such as boxing are unique in that every punch thrown at the opponent’s head is thrown with the intention of winning by causing a knockout which is nothing but a concussive head injury. Boxing carries considerable risk for both acute and chronic neurological injuries. Despite efforts to make the sport safer by having greater medical supervision, boxers at times succumb to traumatic brain injuries (TBIs). Traumatic subdural hematoma (SDH) remains the most common cause of boxing related mortality.⁴

IOC guidelines require that all trans women athletes declare their gender and not change that assertion for at least four years, as well as have a testosterone level of less than 10 nanomoles per liter for at least one year prior to competition and throughout the period of eligibility. It is not medically advisable to adopt this metric when it comes to boxing. While testosterone can be used as metric to ensure fairness at the time of the bout, by the time a transgender woman boxer launches her amateur or professional career she has already gone through male puberty thus conferring her with the musculature and bony structure of a male. Such a boxer has an unfair advantage over her cisgender woman opponent. Allowing the transgender woman boxer to compete raises concern for the health and safety of her cisgender woman opponent.

The IOC allows trans men athletes (athletes who transitioned from female to male) to participate without any restriction. Again, when it comes to combat sports such as boxing, it is medically inadvisable to allow a transgender man to fight a cisgender man. While testosterone can again be used as metric to ensure fairness at the time of the bout, by a time a transgender man boxer launches his amateur or professional career he has already gone through female puberty thus conferring him with the musculature and bony structure of a female. Such a boxer is at a disadvantage against his cisgender man opponent and raises concern for the health and safety of the transgender male boxer.

Recognizing and accepting the gender identity of a boxer and championing to protect transgender boxers against discrimination at their workplace and in employment should be something we all fight for and support.^5,6

Conclusion

While transgender boxers have the right to fight, testosterone alone as a metric fails to ensure a fair and safe bout between transgender and cisgender combatants. The medical community needs to find better metrics to ensure a level playing field and keep the bouts fair, competitive, entertaining, and safe for all combatants. Till that is achieved it is medically unadvisable to allow transgender athletes to box their cisgender counterparts.

Acknowledgments

The views expressed by the authors are their own and do not necessarily reflect the views of the institutions and organizations which the authors serve.