This review looks at the debate on transgender athletes' participation in competitive sport across four areas: medical evidence, policy and law, media narratives and lived experience. It argues the issue is a wider governance challenge, not only a question of eligibility.
Drawing on research, policy documents, media analyses and first-person accounts published between 2015 and 2026, the authors move beyond framing the topic as a simple choice between fairness and inclusion.
They find that the physiological evidence on factors such as testosterone and puberty is limited and varies widely across sports. Policy is shaped as much by governance priorities, legal culture and politics as by science, as the IOC’s changing approach since 2015 shows. Media coverage influences how the public views transgender athletes, while athletes’ own accounts highlight exclusion and pressures often missed in policy debates.
The review calls for interdisciplinary evidence, transparent procedures, sport-specific governance and the meaningful inclusion of transgender athletes’ voices.
Chiu, Y. C. and Shen, Y. C. (2026). Frontiers in Sports and Active Living. doi: 10.3389/fspor.2026.1648181. Published under a CC BY 4.0 licence.
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