Transphobia and Discrimination: Transgender Athletes

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

Individuals grappling with their gender identity are involved in 1 of the rare issues showing up in the sports pages, general news pages, and opinion pieces at the same time. The precipitant is not the crucial controversy and physician role of whether gender-affirming care is legal or not. Rather, it is sports, that popular pastime for the general public. This follows the executive order prohibiting transgender individuals from serving in the military. However, it is one thing to make a military decision which lies under the government responsibility and another thing to essentially practice medicine by fiat.

Specifically, the controversy is whether individuals who have transitioned physically and hormonally from a male gender identity to a female gender identity have an undue and significant advantage in sports, and whether their presence is also uncomfortable for the female athletes.

On Wednesday, the executive order was signed to ban transgender women from competing in women’s sports. Actually, the research to date finds no general athletic advantage to those who have transitioned male to female at any age.¹ It is also self-evident that there are always physical variations in athletes and those with such advantages provide no handicap to the rest, perhaps other than certain golfing tournaments.

Speaking of handicap, if the very small number of trans women athletes are thought to have a sports advantage, why not give a handicap to trans men since they would be disadvantaged due to their original female physiology? Then, what about all those on the fluid spectrum of gender identity with no physical changes or partial ones?

No, the issue is not one of trans performance. It is one of transphobia and discrimination.

I worked as a medical director of a clinic specializing in gender identity concerns from about 1990-2010, the only such center in the Midwest during those years. At the start, it was a time when the erroneous psychoanalytic interpretations of gender identity were finally beginning to be discarded and behavior modification therapy techniques were going the way of the harmful conversion therapy for homosexuality. Of the couple of hundred, from teenagers to old age, that I supported through their gradual personal and societal change, none seemed to be doing the change for gains of any kind, other than to be who they firmly believed they were gender-wise. Once accomplished, they were virtually always mentally better. They were the most courageous patients that I ever saw.

The Hippocratic oath to “do no harm” is usually thought to apply to what we physicians do: our actions. It can also be a guidepost to other individuals and groups who do not want to harm others. In addition, and less often considered, it can apply to what we do not do, our passivity. Not trying to help transgender individuals organizationally and personally in this time would likely be causing harm.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

Reference

1. Oberlin DJ. Sex differences and athletic performance. Where do trans individuals fit into sports and athletics based on current research? Front Sports Act Living. 2023:5:1224476.