November 17, 2022 — Today, Athlete Ally, interACT: Advocates for Intersex Youth, the National Women’s Law Center, and the National Center for Transgender Equality responded to news that the American Medical Association has adopted a policy opposing the use of specific hormonal guidelines to determine gender classification for athletic competition as well as related eligibility requirements that prescribe mandatory medical testing, treatment, or surgery for transgender athletes and athletes with intersex traits who wish to compete in alignment with their identity.
The new AMA policy also opposes physician participation in testing or “certifying” an athlete’s sex or gender for the purpose of satisfying third-party requirements. These new policy positions, approved following a hearing this past Sunday morning, came as a direct response to eligibility criteria issued by World Athletics that require athletes with naturally higher testosterone levels, such as transgender women athletes and some athletes with intersex variations (often referred to in this context as “differences in sex development,” or “DSD”), to medically suppress their testosterone levels in order to compete in women’s categories.
Athletic “sex testing” and redefining eligibility rules based on particular sex traits have been decried by many in the medical community, including the World Medical Association, as unscientific and “contrary to medical ethics.” Individual sex traits like hormones can vary widely, including among cisgender, non-intersex athletes. Despite that innate testosterone levels have not been demonstrated to confer an performance advantage among women athletes, hormone-based eligibility rules have arisen with the purported goal of promoting “fairness” in sport. The end result of such discriminatory policies is effectively a requirement for athletes to submit to invasive examinations, medical procedures, and surgeries to participate in accordance with their gender identity – pressures that jeopardize athletes’ dignity and autonomy and may not be at oddsligned with their own health needs.
“The AMA opposes athletic eligibility regulations that contribute to discrimination and stigma attached to naturally occurring differences in gender and sexual identity, sexual development and orientation,” said AMA Board Member, David H. Aizuss, M.D. “Unnecessary medical interventions to change natural hormone variations as a prerequisite for athletic competition must not be forced on physicians to artificially alter the natural ability of transgender athletes and athletes with differences in sexual development.”
“We welcome this announcement from AMA as a critical step forward in affirming that transgender and intersex athletes deserve to participate in the sports they love, free from discriminatory, invasive, and unnecessary policies,” said Anne Lieberman, Director of Policy and Programs at Athlete Ally. “ The AMA has underscored that the criteria sport governing bodies like World Athletics have used to justify harmful practices has no basis in science or in medical best practices, and does nothing to promote fairness in women’s sports. We are grateful to see the AMA promoting a healthy and safe athletic environment for all.”
“Natural sex and gender diversity should be embraced, not punished. In sport as well as in other contexts, imposing arbitrary boundaries on the wide range of our embodied reality does an injustice to intersex, transgender, and nonbinary people; ironically, rules that demand the alteration of our innate characteristics deny us the ‘level playing field’ that they purport to create,” explains interACT’s Executive Director Erika Lorshbough. “We applaud the news that the AMA has voted to oppose stigmatizing examinations, the policing of hormones and other sex traits, and forced medical interventions to conform to sex stereotypes, which are all common sources of harm faced by children and adults with intersex variations outside of athletic settings. Recognizing that athletes’ health, dignity, and well-being depend on being free from such discriminatory practices should spur the AMA to take action to safeguard bodily autonomy in children’s hospitals and state legislatures too.”
“By adopting this policy, the American Medical Association recognizes what we’ve always known: that transgender, nonbinary, and intersex people belong, and have the right to be part of public life as our true selves,” says Rodrigo Heng-Lehtinen, Executive Director of the National Center for Transgender Equality. “The medical requirements many trans athletes have to comply with in order to participate in sports are rarely based on any meaningful or reliable scientific data, and requiring them to submit to medical examinations to prove themselves is completely dehumanizing. We all have a right to bodily autonomy, and we applaud the AMA for recognizing that.”