What Happens When Sports Regulate Identity? Thoughts on Gender Testing and Body Image in Track & Field Athletes
World Athletics, the organization that regulates track and field guidelines has recently announced that starting in 2026, they will begin gender testing for female athletes. This will entail chromosome testing to see if those racing as a female athlete, have a “Y” chromosome. Have we gone back in time? Perhaps. Gender testing was discontinued in the 1990s when it was said to be unethical. So why is it back?
What is Gender?
If we rewind to what we learned about gender in school, you may remember phrases such as a female has XX chromosomes or a female has certain body parts, such as breasts and ovaries. They have even tried to identify females by the level of testosterone in their bodies. The thing is, all of these factors do not always add up to present a certain gender. An important term to understand here is Differences in Sexual Development or DSD. In simple terms, this is when hormones, genes, or reproductive organs do not align with the development of what is identified as the “normal” standard. Examples of what DSD would look like are someone with female (XX) chromosomes, but genitals that appear male, or male (XY) chromosomes but having genitals that appear female. To learn more about the different types of DSD, check out Differences in Sex Development.
What is Gender Testing?
When it comes to being put into a single box of one gender, things start to get complicated. We do not live in a black and white world or a binary world. However, World Athletics has been trying to identify a way to create “fairness” within the sport, and this has led to a long history of different types of gender testing.
An endocrinologist at Yale School of Medicine expressed in an article written back in 2000 that gender testing was “discriminatory against women with disorders of sexual development” and had “shattering consequences”. This article was written after gender testing through chromosomal testing was eliminated from the Summer Olympics.
About 10 years later, gender testing came into question again, this time through testing testosterone levels. Many DSD athletes were soon unable to compete due to “higher than normal” testosterone levels, unless they went through hormone therapy to lower the testosterone. Despite these women feeling as though they had no choice but to medically alter their bodies in order to do something they love, they will soon go back to being unable to compete.
Transgender Women in Sports
The other part of this is transgender women. When someone experiences gender dysphoria, they feel disconnected and misaligned from the gender assigned at birth. By altering their hormones, it helps them feel more aligned with who they are and how they identify. Minimal research has been done on transgender women and the long-term effects of altering hormones. However, there was a study done on transgender women who went through feminizing hormone therapy in comparison to cisgender men. Over a period of about 8 years, while taking estrogen and testosterone blockers, they were shown to have about 32% more fat mass than cis men. This also showed lower lean mass by 17%, lower quadriceps strength by 25%, and 33% less bicep strength than cis men. Even their VO2 max shifted to be more aligned with cisgender women and lower than cisgender males. What this shows us is that long-term hormone therapy significantly reduces mass and strength in transgender women that is more aligned with cis women than cis men, potentially creating a more equal playing field.
The New Rules of Gender Testing in Track & Field
Despite the differences between transgender women and DSD athletes, they are being clumped into the same category within these new rules. World Athletics now has a Female Category where athletes must have XX chromosomes. If this is not the case, then they must be completely insensitive to androgens.
An androgen is a sex hormone, and everyone has them. However, males tend to have more of the hormone. Androgens are made in both the male and female reproductive systems. An example of an androgen is testosterone. In every athlete, no matter how they identify, androgens help with bone density, muscle development, puberty, and red blood cell production. Androgen Insensitivity Syndrome is a type of DSD that impacts very few female athletes. So what about the rest? And what about a transgender female with (XY) chromosomes that has worked to reduce their testosterone, but their body is still able to respond to androgens the way it is supposed to?
DSD track and field athletes such as Caster Semenya, Francine Niyonsaba, or Christine Mboma have all been impacted by the rulings over the years, and with these new guidelines, will no longer be able to compete.
So is gender testing “protecting women in sports” or increasing shame around how one identifies and the body they are in?
How Gender Relates to Body Image
In all of these cases, these athletes identify as female. Yet, World Athletics is attempting to strip them of their identity. World Athletics banned transgender females from competing in 2023.
As an eating disorder therapist in Cherry Hill, NJ, my mind automatically goes towards the shame this creates within a population that is already in the minority and is already more likely to struggle with their mental health. Transgender females struggle with feeling isolated and out of place, stemming from body dysmorphia and gender dysphoria. Identifying as female helps them feel more authentic, yet we are stripping their ability now to compete in a sport that has also been a big part of their identity because they do not have XX chromosomes.
In the case of DSD women, they are being told they are not “female enough” to compete, despite identifying as a female their entire life. Stripping their ability to compete is so much more than taking away their athletic identity.
Body image is about more than how you feel about the shape and size of your body. It is about how you view your body and what it can do for you. For many of these athletes, being told you are not “female enough” to compete is a shot against a piece of their identity. This can lead to an increase in negative body image, further gender dysphoria, and shame because, ultimately, it is a way of saying “hey, you don’t fit in”.
None of this is simple because we do not live in a binary world. More research must be done to establish appropriate information for guidelines. Many fighting for transgender rights and the rights of DSD athletes do not have an answer. However, shaming someone for their body and identity doesn’t seem right, especially when such shame can increase the risk of eating disorders in athletes who are already navigating intense physical and emotional pressures. So what can we do to help? World Athletes asked folks to submit answers to a series of questions, providing feedback on their own perspectives. Unfortunately, they still voted to go forward with the new rules.
Continue Fighting the Fight for All Athletes
The Court of Arbitration in Sport (CAS) is a place for athletes to challenge these rules. Some athletes have spent their entire careers challenging past guidelines and fighting to be able to compete in a sport they love. However, this has been proven to be a long, emotional process with no guarantee of winning. Every athlete needs to decide for themself if going to court is best for them.
As Nikki Hiltz, a non-binary athlete, said recently, “Visibility alone will not keep transgender people safe. Only love, acceptance, solidarity, and action can win the fight against trans lives.”
If you are an ally, looking to support transgender and DSD rights in sports, there are many different ways to do so. Every state and sport tend to have their own policies and regulations, but these tips can be a few ways to get started.
When people misgender your trans friends, correct them.
Donate time or money to help organizations fight for fair treatment in sports.
Be an openly proud trans friend and ally.
Educate yourself because, as I learned through writing this post, there are so many moving and complex pieces.
Take care of the trans/DSD athletes in your life because they are fighting a battle like no other.
Support their unique journey that they chose. Not every transgender or DSD athlete decides to take hormones or go through surgery. Meet them where they are without judgment.
You Deserve Support - For the Unique Challenges of Eating Disorders in Athletes
If you're an athlete navigating complicated feelings about your body, identity, or your place in the world of sports, you're not alone. At Serendipity Counseling Services, we offer a compassionate space for athletes from all backgrounds to explore their experiences through eating disorder therapy and body image support. Whether you're questioning the pressures you've faced or simply need a place to unpack it all, support is available. Here’s how to get started:
Schedule a free 15-minute phone consultation to talk about your experience and ask any questions.
Book your first eating disorder therapy session and begin working with a therapist who understands the complexities of eating disorders in athletes.
Start moving toward healing in a space where your identity, body, and story are respected.
More Therapy Services Offered in Cherry Hill, NJ & Online in MD and PA
Alongside individual therapy, I offer specialized support for runners and facilitate support groups that give athletes a safe, judgment-free space to connect and heal. I’m also involved in advocacy and speaking engagements to raise awareness and reduce stigma around eating disorders in the athletic world. When you feel ready, know that compassionate support is available.
About the Author: An Eating Disorder Therapist in New Jersey
Kate Ringwood is a licensed professional counselor and lifelong runner with a deep understanding of the challenges athletes face. After competing at the high school and collegiate levels, Kate was inspired to help others redefine their relationship with running, body image, food, and performance. Her passion for this work led her to open Serendipity Counseling Services, where she offers a compassionate, athlete-informed approach to healing. Kate has also been a guest on several podcasts, where she shares insights on mental health, eating disorders, and the complexities of sport culture.
