Gender affirming support in sport
The challenge
Participation rates of trans people in sport are exceedingly low, yet given high rates of depression and increased cardiovascular risk, the potential benefits of sports participation are great. (Moreland et al. 2023)
What we know
Transgender (trans) people identify with a gender different from their birth sex and often face higher rates of depression and mental health challenges. Transitioning to live as their gender identity can help. This may include taking hormones to change their bodies to better match their gender identity. While hormone therapy can improve wellbeing, it also carries health risks such as increased cardiometabolic disease and changes in bone health. For trans women, taking feminising hormones may reduce oxygen uptake and endurance. The impact of hormone therapy on athletic performance remains unclear due to limited evidence.
Despite the many benefits of sports, trans participation remains very low. They face ongoing debate about whether it is fair or appropriate for trans or gender diverse people to participate in sports at any level, including school children. Sometimes trans people are excluded, discriminated against or harassed. However, Australian guidelines support trans participation in community sports, including tennis, rugby, Australian Rules Football, hockey, netball, water polo, touch football and university sports.
Insights for coaches and officials
The physical, social and mental health benefits of sport are important for people who are transitioning. Being physically active can lower cardiovascular risk and is good for bone health. Sporting communities with inclusive polices make everyone feel welcome and supported. Regular exercise is also good for mental health and wellbeing. These benefits are especially helpful for people going through such big life changes who can face stigma and exclusion.
Due to individual differences, gender affirming hormone therapy affects people in varied ways. With limited evidence on its impact on performance, an individual approach is recommended. If you notice gender affirming changes are limiting someone (whether due to psychological or physiological symptoms), it’s best to refer them to their doctor. You can also support trans participants by using their preferred pronouns and appropriately handling their personal information. Other ways you can support trans participants are:
- Coaches – focus on creating supportive and inclusive training environments, that are flexible to differing needs. Consider the needs for changes in hydration and rest, changes to mood, changes to muscle strength and bone health and how this may alter coaching approach to support new needs.
- Officials – focus on creating a safe competition space free from harassment and bullying. Consider the need for conversations around increased risk of injuries given implications for bone health, particularly in endurance sports like running.
More resources
Australian Sports Commission: Trans and gender diverse inclusion