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We know an article like this is slightly, if not incredibly controversial. That said, we will be using language in this article that might be slightly confusing for people who might not be educated on the transgender community. We will do our best to make sure we explain how a lot of that works, as best we can at least. That said, this article might seem odd to some. How could transgenders, especially trans-females, now have any true advantages over biological women. You might be surprised to learn there are more transgender people in sports than you know of. That is because they win or lose at their sport just as often as anyone else.
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However, the most recent story that turned heads was the news of Lia Thomas winning the NCAA 100m Freestyle swimming competition. Of course, Lia turned heads because she happened to be born male. Therefore, beating the other women seemed to be unfair, according to several outraged onlookers. Thomas is indeed biologically male, but she transitioned fully before moving into women’s swimming. She followed all the rules laid out by the NCAA too. What’s lost here is that Lia is not exactly dominating in the pool, as her win recently was one of only a handful of races she came in 1st. That said, we wanted to discuss transgender people in sports and why their supposed advantage is really not prominent at all.
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Left to right: Ivy League swimmers Iszac Henig, Lia Thomas and Schuyler Bailar in Boston, Massachusetts. Photo Credit: Wikimedia Commons
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Lia Thomas
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Before getting involved in women’s swimming, Lia Thomas had earned her way on to the University of Pennsylvania Swimming team as a man. Like many transgender people in sports have done, Thomas actually waited until after high school to decide on transitioning. She came out to her family in 2018 as transgender, but she had questioned her gender identity toward the end of her time in high school. Of course, 2018 was also her first year on her college swimming team. Could she transition and still keep doing the thing she loved, swimming? That was up in the air, so Lia kept swimming for the men’s team.
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She came out as transgender to her team and coaches during her Junior season. This also included the women’s swimming team at the college too. Of course, she began undergoing hormone therapy for her transition in May of 2019. Yet, in order to maintain her eligibility, she had to swim for the men’s team during the 2019-2020 academic year. It was not until 2021 that Lia could swim for the women’s team, as she had to take off a full year. Since starting on the women’s team, Thomas has had success yet she had to pass all the same NCAA regulations as “cisgender women,” otherwise known as biological women.
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Lia Thomas accepts the winning trophy for the 500 freestyle as second-place finisher Emma Weyant and third-place finisher Erica Sullivan watch during the NCAA Swimming and Diving Championships. Photo Credit: NCAA
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Lia Thomas Controversy
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In January 2022, Thomas went up against Penn rival, Yale. She finished sixth in the 100m freestyle race, where she lost to four cisgender women but also a transgender man who was transitioning without hormone therapy named Iszac Henig. Her finishes here among other races allowed her to qualify for the NCAA Championships in many races. The big one was, of course, the 100m freestyle. She’d win this race with a time of 4:33.24, becoming the first openly transgender athlete to win an NCAA Division-I National Championship. The win was massive for Lia, but also for transgender athletes all over the world.
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Emma Weyant, a cisgender woman who happens to have previously won the Olympic Silver medal in this same event, finished just behind Thomas. However, notable swimming phenom Katie Ledecky, a cisgender female, still holds the NCAA record for this event, with a time of 4:24.06. This was Thomas’ only win at the event, as she placed fifth in the 200m freestyle, and in the finals of the 100 freestyle, she finished eighth out of eight swimmers. Thus, the assumption of dominance was shattered here but people are still up in arms over Lia’s “biological male” advantage.
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Sex vs Gender confusion. Photo Credit: Lancet Series on Gender Equality, Norms & Health
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Sex & Gender Confusion
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A lot of people have been confusing sex and gender over the years, essentially connecting them to being the same thing. This is not only inaccurate, but it causes people to be confused. That confusion can develop into anger or worldview issues, leading them to despise the entire concept. You should be aware of one fact to leave with from this section. Sex is biological and Gender is social. What does this even mean? Your sex is unchanging, and you will always be born as one of the three sexes (male, female, intersex). No matter what happens, your sex is never going to be different than what it was when you came out of your mother.
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However, your gender is simply what YOU identify as. That is why it is a social term. Your decision to be seen as a specific gender is only presented when in a social situation. We, as humans, like to categorize ourselves… and gender was essentially used for that alone, mostly for written categorization. In fact, “gender”, in technical use, goes back a long way. The term was originally Old French or Late Middle English. It meant to sort or “what type” of class a person was, based on the “genus” of someone. We did not regularly use “gender” outside of grammatical categorization very often in scientific papers or research until after 2001.
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A diverse group of men and women. Photo Credit: Melitas/Shutterstock
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The Many Faces Of Gender
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The gender term became relatively popular post-2001, making it somewhat new compared to “sex.” Considering we used the sex term for thousands of years in some form or another. Interestingly, the rise of “gender” socially meant that people would use it as its original meaning intended. However, some, especially those who identify in the US as, conservatives, began to associate gender and sex as the same thing. They were not alone, as one’s gender became a popular question to ask on employment forms and even for hospitals. The confusion led many to hate the very idea of the several additional genders that go beyond male and female.
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Since gender is supposed to categorize the person, roughly 76 genders came to be. It infuriated many, but it was due to the fact that they seemed to confuse sex and gender. It was not that the people who added to the gender list were wrong here. Among the genders you’ll see things like Butch, Genderfluid, Cisgender, Nonbinary, Polygender, and of course “transgender” would also be part of this. This among many more, of course. That is why one’s gender is important, because you could find that you fit a specific gender that your sex alone does not properly define for you. Consider it like a submenu, getting to the details of someone beyond the broad terms. Of course, even with this understanding, many believe the gender list is a bit too long. Therefore, the exact gender listing will differ depending on who you ask.
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Direction signs or crossroads signpost saying “New Life”. Photo Credit: Take Photo/Shutterstock
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How One Transitions Will Differ
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Transgender people in sports often have to go about things differently than your average trans-person. We will cover athlete transitioning and all that comes with that in the next section. However, for the average transgender person, the way one goes about their transition could differ wildly. Many will undergo hormone therapy, regardless of their age at the time of their transition. Yet some will not for one reason or the other, we cover one specific reason in the next section for athletes. But some might not want to be completely transitioned, which is completely okay. That might mean they’ll go about transitioning a bit differently. Since transitioning means one is switching their main gender, a biological man might begin using make-up, wearing dresses, and shaving more often to fit their trans-female move.
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Yet a biological female might use less make-up or none at all, wear more male-centered clothing, etc. Of course, some like to go the full way with not only using hormone therapy but also going through with surgical procedures. For biological men, this means getting rid of the twig and berries and replacing this with a lovely female part. Some procedures are so successful here that this area can work a lot like the cisgender version. Biological females will lose a lot of breast mass with the addition of testosterone and removal of excess estrogen. But some can still remain that might need surgery to remove. Many trans-males will also undergo a hysterectomy to prevent periods and baby-making. Yet many trans-males might still want to birth future children, and won’t do a hysterectomy to allow this.
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Female athletes running on track. Photo Credit: EvrenKalinbacak/Shutterstock
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Transitioning For An Athlete
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Transitioning genders as an athlete is very difficult, especially at the college level. For both male or female transgendered people, the rules and regulations one must undergo can be tough. But trans-women likely have it the toughest. Testosterone being cut back means that a lot of your biological male advantages will be suppressed or disappear entirely. Muscle is harder to get and maintain, and even strength entirely can be lost. For cisgender women, small supplements can help them elevate testosterone for a short period, and they have nothing to risk for their body in doing so. Some might even have regularly higher T-Levels naturally, giving them a competitive advantage somewhat. For trans-female athletes, you cannot go above the set T-Level marks at all nor risk anything with potential supplements.
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Even though they can be aware of your transition, transgender people do not get special treatment. Losing your small male advantage is not easy. Lia Thomas actually finishes behind her original personal bests before transitioning now. In the 500m freestyle, she is over 15 seconds slower than she was before her transition. We also referenced Iszac Henig, a trans-male who Lia competed against. Henig could not compete in the women’s swimming events as he transitioned from female to male if he underwent full hormone therapy. This is because he’d need to increase testosterone to do so. Thus, he had to put full transitioning behind just to compete, but Lia COULD undergo hormone therapy during her transition because she is “losing” not “gaining” testosterone. Plus, she still competed with the men at the time.
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Michael Phelps swimming 200m butterfly swim. Photo Credit: Salty View/Shutterstock
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What Is A Competitive Advantage?
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A lot of people make a big deal out of competitive advantages. However, very few people make a big deal out of this for cisgender men and women. If someone like Shaquille O’Neal walks onto the basketball court, I’d expect he could likely dominate inside the paint. He’s 7 feet tall, so it is expected that he uses his height advantage. If we look at swimming, Michael Phelps has an advantage competitively as he has an an abnormally large wingspan. This helps him A LOT in the pool, as combined with his height, his wingspan can allow him to move and finish races faster.
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Katie Ledecky, whom we mentioned earlier, is 6 feet tall and has some of the fastest times among ALL females in swimming history. That includes both cisgender and transgendered females. Her height is an advantage, but no one looks down on her for that. No one bats an eye at her for having this advantage either. In the case of Lia Thomas, who is 6’4, her height is an advantage just as Katie’s is for her. But that is not a worthy enough advantage to ban her from women’s swimming. Natural competitive advantages are fine, but this does not make someone unbeatable. All of the people we referenced above have advantages, but ALL lost before in spite of it. The advantages one has does not ensure success.
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Young transgender man smiling. Photo Credit: Kostiantyn Voitenko/Shutterstock
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The Trans-Female Advantage
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To be fair to those up in arms over transgender people in sports, we can certainly understand where they are coming from. They want the competitions to be fair, and a trans-person could ruin that in their eyes. Most do not seem to care about trans-males in sports, in spite of being the most common trans athletes. However, many do care about trans-females. The reasoning makes some sense in theory. They feel that since this trans-female athlete is biologically a male, they’ll naturally have more advantages over cisgender females. However, this is often incredibly misguided. First, you should be aware that most transitions tend to happen in the teenage years.
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This results in trans-girls using puberty or hormone blockers. Therefore, they never undergo male puberty that would allow them to essentially gain the larger muscle or body mass that boys will develop. Of course, without testosterone-driven puberty, the young trans-female cannot ever develop the male body that would give her an advantage over cisgender women in sports. Her body developed exactly as a cisgender female’s would… with small exceptions. What of those like Lia who waited until after puberty? As we referenced, her transition caused her to lose a lot of muscle and body mass. While her height remained, cisgender women can be tall too and it is therefore not a “biological male” advantage for trans-women.
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Chemical molecular formula hormone testosterone. Photo Credit: GrAl/Shutterstock
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Testosterone
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Most of us know about the hormone, testosterone. Most males are born with it and it will increase as they get older, especially during puberty. Spikes will come, sometimes at random, during teenage years. When these increases in T-Levels come about, a young man might experience changes. This includes an increase in body hair, especially on the face. Their frame will also get larger, which comes with an increase in body mass overall. Testosterone is classified as a natural anabolic steroid within males. This is one reason why transgender people in sports have to avoid having T-Levels above a specific number.
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These steroids allow cisgender males to develop muscle and bone mass, which is best used during puberty stages if one is going to develop a traditional male body. Testosterone levels can affect one’s behavior and mood, which is why some boys will develop anger issues during puberty years. As they are being hit with an increase in T-Levels that can be difficult emotionally. Of course, male testosterone comes from the testicles, but it also comes from a female’s ovaries too. The difference is that testicles produce much more than ovaries, by around eight times the amount.
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Hormone testosterone level measuring scale. Photo Credit: GrAl/Shutterstock
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T-Level Advantage
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Since Testosterone is able to develop muscle and body mass, it is best to use during puberty stages. That is why so many transgender people believe if a biological female is going to transition to a transgender male, they need to do their transition during this time. As it would give them the proper puberty development that cisgender males will have. Yet some transition later on in life. Biological females are actually more sensitive to the testosterone hormone. In fact, it is due to their sensitivity that testosterone (along with an aromatase inhibitor) has been used to treat breast cancer in females. Yet testosterone can be abused in sports, which can be tough for transgender athletes. Since transgender people in sports will sometimes be in the middle of their transition, they have to increase or decrease T-Levels. Obviously depending on the transition.
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Biological females seeking to transition cannot undergo hormone therapy while competing because even after puberty, testosterone can be used to aid a person physically. Since, again, women are more sensitive to it, testosterone can allow them to increase in muscle mass – if nothing else. That allows them to potentially move faster and become stronger. Yet biological men seeking to transition will often see a very big decrease in these things as they lower their T-Levels. This actually gives them a disadvantage over cisgender male athletes. Yet it might also hurt them against cisgender female competitors too. Since these women never changed their natural hormone levels, they spent their lives training and competing under what they had.
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Chemical formula of female sex hormone Estrogen. Photo Credit: Arcady/Shutterstock
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Estrogen
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Like males with testosterone, biological females produce quite a lot of estrogen. Both estrogen and testosterone act as steroid hormones (steroids that act like hormones). T-Levels give one their size and hair growth, which women obviously need just like men. Biological females simply do not need it as much due to their larger need of developing a proper reproductive system. Since women are the only humans that can have children, their reproductive abilities are important to the population. While estrogen is part of a group of sex hormones, its main popularity is what it does to the body physically.
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However, these changes to one’s body does not actually give them physical advantages over other females or males the way testosterone does. It does affect the body, but only for growth in specific areas, if anything. In fact, one can have higher levels of estrogen and ultimately be worse off. High E-Levels in women can lead to heavier periods, fatigue, and even weight gain. For men, higher E-Levels can cause fatigue too, as well as unhealthy sperm, and breast growth. Therefore, it does not really give you much competitive help. That is why among transgender people in sports trying to transition, trans-males can compete while undergoing hormone therapy. As there is no true advantage estrogen offers them.
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Teenager boy shaving. Photo Credit: Phoenixns/Shutterstock
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The Odd Thing People Accept Among Transgender People In Sports
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Going back to the idea of potential “fairness,”; transgender people in sports often have to battle against the notion that their size might cause issues. This is more of a problem that trans-females have to go through over trans-males. Since trans-males transitioned from being biologically female, people assume their change isn’t as much of a problem. Yet, if done during puberty, their hormone therapy will allow them to develop the same way any cisgender male would. In fact, they might even have a slight advantage since they are getting regular exact hormone treatment. Many cisgender males do not have “exact” T-Levels working during puberty years. T-Levels might be higher some days and lower on others.
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However, trans-males get exactness, which will allow them to develop exactly as a traditional cisgender male would. Of course, it should be noted that this might affect the deepness of their voice, body hair growth, and muscle mass. Although, it does not guarantee a height change from what it would have been if they decided to not transition. Do keep in mind that HGH injections are an option. All of this means they do not really have an unfair advantage once they get out of puberty. Yet during that point, they “could” have an advantage physically over cisgender males. But it would likely be quite minimal. Transgender people in sports have to be aware of their T-Levels while competing. Trans-males will likely still need to do hormone therapy, but they cannot cross over a specific level most of the time.
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Man and woman standing back to back holding arms crossed. Photo Credit: Roman Samborskyi/Shutterstock
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Male Size Vs Female Size
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We already referenced how if one undergoes hormone therapy during puberty years, a trans-male will develop body wise at pretty much the exact level a cisgender male would. Yet if done after this, they’ll be able to transition and get larger in their body. However, it simply won’t be at the best rate possible. Most people know that men and women have size differences. Again, this is due to the sex hormones each sex produces. Cisgender men are naturally going to be larger on average as a result of their natural testosterone levels from puberty into adulthood. Cisgender women will be smaller on average due to their lack of higher T-Levels, and their body’s reliance on estrogen.
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Interestingly, the height of men and women are not too far off when you average both sexes worldwide. In fact, the CDC claims the average height for a man worldwide is about 5 feet, 9 inches. For women, height averages around 5 feet, 4 inches worldwide. One would assume American men are larger than the 5’9 height but we really aren’t. While cisgender male bone mass and density is naturally bigger than an average cisgender female’s, scientists cannot simply rely on this assumed mentality worldwide. Women can be larger than men too and in some countries, the sizes between men and women are actually pretty close. This includes both their height and weight.
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Male and female NYALA drinking at a waterhole. Photo Credit: WOLF AVNI/Shutterstock
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Sexual Dimorphism
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Sexual dimorphism is simply defined as a systematic difference between individuals of different sexes in the same species. For most mammals, the male will be larger on average than the female of the species. Usually, most species with vertebrae will see the male grow larger than the female. However, this can differ in some species where most similar species will see the male grow larger whereas another species might see the opposite. Due to males normally being larger, it is irregular for us to see females in this role. Which is why that is defined as “reverse sexual dimorphism.” Scientists assume that this occurs over long periods of time, where the male ancestors might have been larger but died out. Whereas smaller males did not, which meant they’d be the ones that did the mating with females.
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As a result of the smaller male size, their male offspring would also end up being smaller too. Meanwhile, females remained at their same size without much change. Resulting in females being larger over a period of time. Yet some argue that was not the case, as females would simply be smaller too. Those scientists claim women might be larger due to the needs potential children will have. From milk to more size to keep their babies warm. Several female birds of prey are larger than the males of their species. These larger females can outcompete smaller ones for mates. On top of that, these females can properly defend themselves against potentially aggressive males due to their size. They can also dominate the smaller male mates, which might allow them to prevent males from hurting future offspring.
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Dutch man & woman in Netherlands. Photo Credit: Fokke Baarssen/Shutterstock
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Nations Where Sexes Are Largest
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It should be noted that we’re only discussing averages here, not guaranteed height and weight for all male and female people. We’re also only using the cisgender averages, due to most data available only using them over the additional transgender men and women. The Netherlands, Denmark, Iceland, Lithuania, Norway, Sweden, Slovenia, Slovakia, Estonia, Montenegro, Croatia, Serbia, Czechia, and finally Bosnia and Herzegovina are known for men and women being larger than the average for their sex. For example, the average height for women in all of these countries is 5’5 to 5’7 with a weight of 153.3 to 165 pounds.
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Since the worldwide average for cisgender male height is 5’9, this is only a few inches shorter. Many Dutch women are actually at or taller than this exact height. What might shock you the most is that the worldwide weight average for a man is 136.7 pounds. Some nations, such as America, see their men reach around 200 pounds on average. North America overall, on average, have the heaviest men. However, the weight is still roughly 177 pounds. Women in all of those nations above, average a weight of just below the NA weight but larger than the worldwide male average. When looking at things worldwide, sizes can certainly differ. But we’re all actually pretty close.
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Human & Ape Hand. Photo Credit: David Carillet/Shutterstock
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Our Animal World Relatives
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Before we separated from our other Hominid cousins during the evolutionary process, we were not much different than the average ape today. Males were bigger than females in that time, but both were larger in body mass overall compared to humans now. This is because most species grow based on the climate they are in. It is also why those with, say, thicker fur might be found in colder regions of the world. Larger body masses can equal more body heat, which allows one to stay warmer. Since humans did not yet invent fire, our size was really important to our warmth. Yet some early humans actually were not very large at all.
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During the era of the Neanderthal, males weighed between 170 to 190 pounds while females weighed between 140 to 160 pounds. Meanwhile, average male height was 5 feet, 5 inches compared to female height of 5 feet, 2 inches on average. Which is, yet again, very close in size. In fact, you can date things back just a few thousand years and you’ll once again see only small differences. Men and women on average were only separated by an average of 20 pounds. Which is pretty much nothing when you think about it. This is also true as recently as 100 to 200 years ago too. Height was also not too far off, with many men being shorter on average compared to today. Meanwhile, women were roughly just an inch or two shorter during that same period compared to today.
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Man and woman standing on the rooftop with the same height. Photo Credit: Leolintang/Shutterstock
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Why Human Averages and History Matters
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When you open up the science like we just did, we can search world history as well as our current world. In all of that time, it is clear that the differences between men and women have always been minimal. In fact, one could even point out that today men and women are closer in size than they ever have been. From average weight to average height. We can also stack up women from specific regions against men from others, and the women will actually be taller and/or weigh more. Therefore, the bodies of the females will actually be larger. Meaning their bone mass and density will end up being better than the males.
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Ultimately, that is important to think about. When you consider the issues transgender people in sports have to deal with, a lot of it comes from people that are ignorant of the actual facts. There is this assumption that men are somehow always so much larger than women, when that just is not true. One might say, this could be the case on average…but in athletics surely male and female differences will be too big. Males and females could not possibly compete with each other then, right? It is just too much. However, this has been proven false in several instances. One of the biggest ways we proved it false is from a sport where men “should” be better.
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Athletic man and woman with hands clasped arm wrestling. Photo Credit: Undrey/Shutterstock
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The Sport Of Wrestling Has Proven Women and Men Can Compete Against Each Other Already
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For years, there was no such thing as a “girl’s wrestling team” at most high schools and even colleges across the United States. As a result, if girls wanted to compete, then they had to wrestle the boys. At some competitions, the boys might refuse to wrestle a girl in their division. Yet this concept was eventually retired where women were treated just like “one of the boys.” However, just because they “could” wrestle the boys, that does not mean cisgender girls could actually beat cisgender boys on the regular to win a State Championship, right? WRONG! In fact, in just the last few years we have seen quite a lot of success in states where there are still not a lot of female wrestling teams.
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Only going off of the last few years alone, a lot of cisgender girls have become their state’s first female state wrestling champion. This seemed to start in 2020, with North Carolina High Schooler Heaven Fitch, who became her state’s first female wrestling champion. As a Junior, she won in the 1A 106-pound division. In 2022, South Carolina 16-year-old June Welch won in her state’s AAA 106-pound division title to become the first female state champion. June then responded to people who said girls should not wrestle boys after this, saying: “They can. Obviously, because I did. I wanted to win the whole thing when we came here. Winning my semifinal match made me want to win more.”
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Girl wrestling with boy. Photo Credit: muzsy/Shutterstock
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What Did This Prove?
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It is pretty obvious that the high school girls we referenced were in some lower weight classes. However, wrestling is based entirely on everyone competing in specific weight classes. Therefore, they wrestled the boys in their weight class. Keep in mind what we referenced earlier. These high school cisgender boys are going through puberty and developing larger frames and muscle. If nothing else, a wrestler will certainly develop a lot of muscle over time. Even in high school, you need to be in great shape to wrestle. Smaller divisions are still going to involve boys in great shape all with high testosterone that will be much larger than any female they face.
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Think about that for a second. These girls defeated boys who all supposedly had an edge. The boys in puberty were only getting the aid of natural testosterone, only getting stronger. Their T-Levels are SIGNIFICANTLY higher than the girls they face. Thus, if testosterone rates were so incredibly important. If the muscle boys had was so significant. Then why were those girls able to defeat them? The answer is simple. Their natural edge did not do as much for them as assumed. Therefore, it tracks that transgender people in sports, especially trans-females, do not really have an edge over their competitors. Especially due to having to heavily reduce testosterone, unable to benefit from it.
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Man waving transgender flag. Photo Credit: Nito/Shutterstock
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Transgender People In Sports Are Under Attack
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Some might claim that trans-females should not compete with cisgender girls. You can have that opinion if you’d like. But the overwhelming evidence shows that trans-males are the most common of the community to compete in sports. However, over 20 states are trying to stop transgender athletes from competing with cisgender athletes from gender they switched to. Meanwhile, others are trying to ban transgender people in sports from competing at all, regardless of their biological sex. This is clearly insane based on the metrics we referenced.
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Yet it’s even crazier when you think about the fact that it will affect mostly trans-males, who do not have any supposed natural edge. Plus, this presents a slippery slope. How do you confirm if a person is trans? You have to do a body examination, which is invasive. Other cisgender women who might simply be dominating in their sport might be accused of being transgender. Simply for just being good at their sport, they’d potentially face a ban unless they prove to be naturally female. Something that they should not even have to do. More importantly, it only occurred because they were good at their sport.
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SEMENYA Caster running women’s 800m in the Rio 2016 Olympics Games. Photo Credit: Celso Pupo/Shutterstock
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The Slippery Slope Is Already Made Of Ice Internationally
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We referenced a slippery slope of issues that could happen for transgender people in sports. Yet that slope might end up affecting everyone. For example, South Dakota recently passed a bill banning trans-female athletes, but also claimed ALL kids competing will have to disclose their genetic and reproductive biology to compete. Which just shows only one example of things going too far already. Imagine how much worse it could get from here. If you don’t have a good imagination, we’ll just give you something to consider. Most of the women who tend to get the most backlash are black or brown trans-women and even cisgender women. While there is a lot of transphobic issues involved here, there is also a lot more sexist and racist issues involved too.
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White and black athletes can both be good at their sport, but if a black woman dominates then they will now be assumed to be transgender. Perhaps the person who has experienced this the most is South African track star Caster Semenya who is a two-time Olympic Gold Medalist & three-time World Champion. Interestingly, Caster actually has naturally higher T-Levels. While assigned female at birth, she was born intersex. Due to her impressive success, Caster was made to undergo sex testing just to compete. Then the World Athletics governing body told her she could not compete unless she took medication to suppress her testosterone. Which not only affects any natural increase, but could drop her even below normal female rates.
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Where did we Find This Stuff? Here are Our Sources:
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Centers for Disease Control & Prevention (CDC)
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National Institutes of Health
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World Athletics Governing Body
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European Society of Endocrinology
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National Collegiate Athletic Association (NCAA)
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American Civil Liberties Union (ACLU)
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United States Anti-Doping Agency (USADA)
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UK National Health Service (NHS)
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Oxford University
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Harvard University
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Boston University School of Medicine
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The Guardian
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NBC News
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Sports Illustrated
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