The internet forums have been full of discussion recently regarding transgendered females and BJJ competition. As someone who could potentially compete (and has) competed in the same category as a transgendered female, I’ve listened to the debates with interest.  It made me want to dig deeper into the topic to try and make sense of it both for myself and thought it might be useful to share what I found to help other people. This isn’t a simple topic that I could skim over so I make no apologies that this is one of my longer blogs! 

So what’s triggered this?
I’m not going to go into specific details of the individuals being discussed in the UK as ultimately this is not about a person but a whole topic. However, if you’re interested in finding out more about it recent events or simply hearing a first-hand account of the complexity of her own personal experiences of transitioning and participating in BJJ then I thoroughly recommend the Raspberry Ape podcast which can be found here.

Also, let’s be clear BJJ isn’t the only sport to be facing these types of discussions and no sport has come up with a definitive approach. For example over in New Zealand, there has been controversy over Laurel Hubbard who competes as a female 90+kg weight lifting who has set world records and won various competitions. Hubbard, born Gavin, made history as the first transgender woman to represent New Zealand in an international competition.

Obviously being transgendered isn’t just about male to female transitions but this blog is going to focus on this topic. Partially because it’s the area of the most discussion but also because generally in sport there is a consensus that athletes transitioning from female to male do not have a competitive advantage and generally compete at their own risk.

Finally, what does need to made clear is that in the UK Gender reassignment and someone’s gender status is a protected characteristic covered by the Equality Act. Everybody has the right to happiness and that includes being in a body that reflects their gender. I also believe that BJJ as a recreational activity should be for everyone and that’s as clubs and gyms we should try to ensure everyone has a great experience of BJJ. This blog is purely about looking at things from a competitive experience.

The Policy Bit
The UK doesn’t have a single governing body for BJJ so there isn’t an agreed policy on the situation. The UKBJJA are trying to create one but this hasn’t really happened yet and in either case, it doesn’t yet have the coverage or recognition as a national body at this time. The IOC does have guidelines and a number of transgender competitors have taken part in a range of sports both domestically and internationally. Details of their policy can be found here. 

USA Wrestling also uses these guidelines as does tThe IBJJF. However, as they don’t have any systems in place to actually follow these then they are potentially open to abuse. I must stress that I do not believe this is the case currently in the UK but any system reliant on honesty may be open to misuse or open to question. However, the IOC guidelines are not a blanket ruling and many sports have their own policies. The Association of Boxing Commission’s policy is also often quoted as an example – it is similar to the old version of the IOC policy with the main difference is the requirement being two years postoperative. Copies of this policy and a range of different sports policies can be found on Transathlete.com

A slightly less controversial example of how it could work is mirroring the therapeutic exemption usage (TUE) in sports. Your doctor signs a form to explain that you need a drug for a medical reason (in my case it was an asthma inhaler). This was then sent to the governing body medical lead who gave clearance, which was recorded in the event of a query or drugs test. No competition organiser ever needed to know. It should be similar here were an athlete should only need to liaise with one person at the governing body who can clarify issues and queries when they arise across competitions avoiding the need to speak and demonstrate eligibility to every event.

The Science Bit
Testosterone is usually at the heart of most debates and is one of the measures within most policies. Joanna Harper a scientist and transgendered female who has written a range of article of gender and sport sums up “While there is no perfect solution to the vexing question of how to decide who gets to compete in women’s sport, I believe the most optimal method we have available to us in 2017 is to use testosterone levels to divide athletes into male and female categories.” (1)

The IAAF (Athletics) recently funded research into the performance enhancing effects of testosterone after its rules on limiting the testosterone levels of female athletes (particularly in the case of hyperandrogenism) were suspended after the court of arbitration in 2015 rule against them due to lack of evidence. Researchers measured blood testosterone levels in 1,332 female athletes competing across 21 track and field disciplines at the 2011 and 2013 world championships. Those with the highest levels of testosterone demonstrated significant advantages over those with the lowest levels – notably in the 400m (2.7% faster), the 400m hurdles (2.8% faster), the 800m (1.8% faster), the hammer throw (4.5% longer) and in the pole vault (2.9% higher) (2).

What we do know with regards to transgendered athletes is that generally there is a research consensus that if an individual transitions before puberty that there isn’t any physical advantage. it is also agreed that testosterone can be produced in both sexes by the adrenal glands but the majority is produced by the relative sex organs (women also have testosterone get 25 percent of their circulating testosterone from their ovaries) in particular the testes in men so post-operative transgender women do not have the ability to produce significant levels of testosterone even compared to their cis-women counterparts which explains why some rule sets within sport feel the need to still require surgery.

However, not all transgendered individuals want to undergo full surgery, after all, it doesn’t affect how you’re perceived socially and it is complex and painful surgical procedures that is not without risk. Additionally, some individuals feel that having to prove that they have had surgery is intrusive and degrading. From a sports perspective, it is potentially a throwback to the origins of gender testing in sports when a female athlete could be requested to “parade nude” to a doctor to prove they were female. This form of testing continued in international sport and the Olympic movement until the late 60’s when testing progressed to chromosome testing.

In anti-doping, testosterone is measured differently as it’s done mainly through urine testing. They look for something called the T/E ratio. A ratio outside of 4:1 is seen as an indicator of doping (MMA Junkie actually has a really quick and simple explanation) but it does mean doping and doping control measures are not really comparable for this debate.

In terms of average female testosterone levels, it’s not black or white. They vary between individuals and by age. Testosterone levels are at their lowest points in women during puberty and adolescence, and at their highest during the pre and postmenopausal periods. They can also be affected by medical conditions such as PCOS and ovarian tumors. But in terms of ranges:-

• Males: 300 to 1,000 nanograms per deciliter (ng/dL) or 10.41 to 34.70 nanomoles per liter (nmol/L)
• Female: 15 to 70 ng/dL or 0.52 to 2.43 nmol/L

For transgendered females to compete under the IOC guidelines they need to declare their gender and not change that assertion for four years, and demonstrate a testosterone level of fewer than 10 nanomoles/liter for at least one year prior to competition and throughout the period of eligibility. Clinically, the only robust guide I could find gave a practical target for hormone therapy for transgender women (MtF) is to decrease testosterone levels to the normal female range (30–100 ng/dl) although I believe this pre surgery (3)

Now, this obviously raises the first debate as the IOC levels are obviously quite a high upper threshold.  Realistically if individuals are receiving medical care and support than their levels will potentially be lower. But, if the IAAF research mentioned earlier in the blog is correct then the potential higher a level of testosterone when compared to a cis female (who was within normal ranges) would still enable a competitive advantage. It definitely an area needing further research to provide a more robust range and measurement taking into account the effectiveness of hormone therapy etc.

A lower policy level may be a solution to this and is something that is potentially practical based on the information I found but it definitely an area needing further research to provide a more robust range and measurement taking into account the effectiveness of hormone therapy etc.

The Science Bit Part 2
Following the debate around testosterone, there is usually a debate about other traits that may have developed post-puberty specifically surrounding endurance, muscle density, and bone density providing an unfair advantage.

As well as some scientific studies there is a host of personal narrative reports on the internet regarding the effects of transitioning and the loss of sports performance. I wasn’t able to find any sports specific research in grappling (including judo or wrestling) and obviously, that is a challenge. Eric Vilain, a professor of human genetics at UCLA and a consultant to the IOC medical commission, stated: “There is 10 to 12% difference between male and female athletic performance. We need to categorize with criteria that are relevant to performance. It is a very difficult situation with no easy solution.” (4)

But based on the generic research there is a general conclusion that all the indicators mentioned below do decrease due to transition but there is uncertainty whether or not it is equal to a cis female in the performance sense. This obviously is hindered by the relatively small sample sizes for researchers to work with some reports taking years to collect the relevant data. 

Muscle Mass – Gooren & Bunck in 2004 (5) concluded that the depletion of testosterone reduced muscle mass resulting in levels overlapping with cis women but did not statistically “reverse it”. So essentially there is a reduction in muscle mass and in some cases, it is comparable to that of cis females but not always. The research concluded that the question of fairness would depend on what individuals were willing to find acceptable.

Bone Density – Skeletal shape doesn’t change (length of bones and height etc) but there is a debate over bone density changes. Rutesche et al in 2005 (6) concluded that bone mineral density does change eventually but it is generally preserved over a median (average) of 12.5 years under combination therapy.

Endurance – In a lot of the article I read comments in regarding a reduction in red blood cells and a reduction in endurance as a result of hormone therapy due to the role testosterone plays in red blood cell production and the role they obviously play in delivering oxygen around the body.  This makes sense but I couldn’t find a solid piece of research looking at this and its levels compared to cis females. However, as with all my research, I am only using public domain academic research and not full university search engines etc. There may be newer research available etc.

Therapy Effects – I haven’t seen specific research on certain combinations of treatment being faster or more affected in creating the desired physiological changes, The only analogy I can think of is female contraceptives. Reactions vary among individuals. Some have great outcomes whilst others have more after effects. It’s really an individual thing. Individuals can take some treatments only to change midway and gain much greater benefits.

Although with everything being said is there ever a true level playing field? There is always someone bigger, who’s trained longer and that’s before we get into the whole discussion of sandbagging!

Informed Consent / Sports Ethics
For me, this falls into two debates. The concept of a level playing field and also informed consent and personal responsibility.

The level playing field argument is very much where the science comes in as very much a question about of whats seen as an acceptable threshold and barrier. The concept of a level playing field is why things anti-doping exist in elite sport. But there’s a strong argument that it can never exist. Some athletes train full time, some are better funded, some can afford to train and compete more and others might simply be sandbagging!

But on the side of informed consent is potentially where my motivations for doing this blog lies the most. We do a sport where the aim is to win by obtaining a submission through pain or joint manipulation or by the threat of loss of consciousness through restricted air/blood flow. Yes, informed consent is generally used as a medical term but it’s ultimately about making the decision to proceed, knowing the risks and implications and that athletes should be made aware to make a decision that affects their own personal safety.

But without a definitive and clear body of research and policy then it actually hard to know if there is any advantages regarding a person’s transgendered status so why should you have to disclose it?  Plus they are simply entering the category that matches their legal gender. But don’t disclose and there are accusations of “hiding” and “witch hunts” but if individuals choose to disclosure then they’re relying on people perception, education and prejudices about the issue which we know from the internet and life are very mixed.

But it’s also very much a case of a lose/lose for any transgendered athlete, which is why I really struggle with the issue of disclosure at this point in time. It’s not fair or equitable for them as individuals either. We don’t expect people to “out” themselves in any other aspects of their lives. We don’t care if they’re gay or straight, vegan or carnivore but there is an expectation that people should declare their transgendered status. The issue is there due to the lack of a solid recognised governing body nationally and internationally.  As they would have that athletes’ records, apply their policy and monitor it appropriately. But we don’t have one and that’s why this is still part of the debate and left to athletes and competition organisers.

Is it more an issue of size?
According to Joanna Harper, a competitive runner, scientist, and transgender woman,.“There are definitely sports in which transgender women have somewhat of an advantage. But there are also sports like gymnastics where transgender women are never going to be successful. There will never be an elite trans woman gymnast.” (7)

One of the commonalities with many of the transgendered athletes queried in the UK BJJ scene is actually their size. Often these athletes are at the heavier end of the weight classes (80kg plus). Often these women are competing in an open-ended merged division with women around 74kg. Whilst it’s great to consider BJJ to be a great equaliser. As Helio intended with smaller people being able to beat large opponents with skill.  The reality is that whilst that may apply to an untrained opponent. In competitive BJJ usually when the skill is equal (as it may well be within a belt level) then size will usually win out!

Surely one of the quickest solutions whilst policy is clarified is to amend the women’s weights categories so that there are Super Heavy and Ultra Heavy options (as there are for men). It means women will have the choice whether to move up a category. In the short term, it might mean small division and women in the heavier categories potentially having fewer fights. But over time these categories will grow as potentially will the ones immediately below them. Alternatively, we move to an Abu Dhabi-style situation with a maximum weight cap for their divisions and absolute. The rule was made for safety reasons. Although some argued that it was about spectators, image, and sponsors. In either case from a female viewpoint, this prevented Tayane Porfirio (IBJJF World Absolute Champion) from competing this year so it did have implications and has potential problems.

Conclusion
This article was never designed to give a definitive answer on the subject is way too complex for one person to do – let alone someone who is far from a specialist! This blog only really skims a lot of the issues but hopefully brings together a range of information and signposts people to further reading etc.

For me, this is a complicated issue that goes way beyond keyboard warriors, athlete, and coaches. If anything, however, it highlights the need to:

1. Address the weight category issues in women’s BJJ
2. The need for a national / international body with the credibility and leverage to help support work and research into these areas.

Being athlete centered needs to be at the heart of everything we do as a sport and sometimes that leads to a tricky balancing act. This is not a topic that will be resolved overnight but if we are truly going to be an inclusive sport we need to start really looking as a sport at how best we move forward to ensure the integrity of our sport but also how we support all under-represented groups and balance their needs whether it’s women, disabled people or members of the LGBTI community.

Other sources/references
(1)  The Guardian – Using testosterone to categorise male and female athletes isn’t perfect, but it’s the best solution we have
 (2) British Journal of Sports Medicine – Serum androgen levels and their relation to performance in track and field: mass spectrometry results from 2127 observations in male and female elite athletes
(3) Practical Guidelines for Transgender Hormone Treatment
(4)  Is it fair for Caster Semenya to compete against women at the Rio Olympics?
(5) Transsexuals and competitive sports.
(6) Cortical and trabecular bone mineral density in transsexuals after long-term cross-sex hormonal treatment: a cross-sectional study. 
(7) Testing, hormones, hatred: What it’s like to compete as a transgender athlete