Editor’s Note: Excerpts from this story were featured in an episode of The Whole Story with Anderson Cooper, “The Playing Field: The Battle over Transgender Athletes,” which airs on CNN on Sunday 8pET.
Like any competitive swimmer, Meghan Cortez-Fields knows how high the stakes can be in a sport where mere hundredths of a second can mean the difference between victory and defeat.
But she is among the few who have feared what victory may bring.
“I was afraid that if I was able to win, all of my success would be discredited because I was trans,” Cortez-Fields, a senior on the women’s swim team at New Jersey’s Ramapo College, told CNN.
As an NCAA competitor, Cortez-Fields underwent more than a year of hormone therapy, blood tests and testosterone tracking to meet the association’s transgender athlete guidelines and achieve her dream of swimming alongside other women.
In recent weeks, however, the NCAA has faced a flood of calls to further restrict the participation of trans students after a much smaller athletics association, the National Association of Intercollegiate Athletics (NAIA), voted to effectively ban trans women from competing in most of its women’s sports programs.
Last month, the NCAA announced its policy is “under review.”
Marshi Smith, the co-founder of the Independent Council on Women’s Sports (ICONS), which fights against trans women’s participation in women’s sports, applauded the NAIA’s ban as a “crucial measure” and called on the NCAA to “release a policy that protects the women’s category.”
Critics like Smith argue that transgender women – even those who have undergone treatment to lower their testosterone levels – have unfair physical advantages that would deprive cisgender women of opportunities to succeed.
But transgender athletes and their advocates point to a lack of consistent, direct research to support this claim. They say trans women deserve the right to compete alongside their peers.
“The idea that trans women are taking over women’s sport is a pretty outside statement given the number of trans women who are competing in the NCAA,” said Anna Baeth, director of research at Athlete Ally, an organization that advocates for LGBTQ equality in sports.
Baeth estimates fewer than 40 of the NCAA’s more than 500,000 athletes are known to be transgender.
Last month, Athlete Ally sent the NCAA letters signed by more than 400 current and former professional and collegiate athletes, as well as hundreds of researchers and advocacy groups, imploring the organization to continue allowing transgender athletes to compete.
“To deny transgender athletes the fundamental right to be who they are, to access the sport they love, and to receive the proven mental and physical health benefits of sport goes against the very principles of the NCAA’s Constitution,” read the letter signed by athletes including retired US women’s national soccer team star Megan Rapinoe.
“Every single student should have access to the lifesaving power of sports.”
‘I believed I needed to sacrifice being trans in order to swim’
Competitive swimming pools have become a battleground in the fight over transgender athletes’ exclusion, exploding into focus when University of Pennsylvania swimmer Lia Thomas became the first transgender athlete to win an NCAA Division I title in 2022.
Smith, the ICONS co-founder, said watching Thomas compete “was really devastating.”
“It’s unfair,” she said. “I felt like I was witnessing women shriveling up.”
The NCAA’s policy was revised in 2022 to align “transgender student-athlete participation with the Olympic Movement.”
The association takes a sport-by-sport approach, which allows trans players to participate if they have undergone one year of testosterone suppression treatment and meet the testosterone level required by their sport’s national or international governing body.
Trans women athletes, including Cortez-Fields, say competing alongside other women is a crucial step toward feeling like their authentic selves and can help combat feelings of isolation.
“Trans people have existed since the beginning of time. But we win and it becomes an issue,” she said.
For Cortez-Fields, plunging into the muffled echo of the water has always felt like a sacred moment. But that embracing environment became increasingly fraught as she began to express her trans identity during her second season on the men’s team.
“Wearing a men’s suit, having to tape my breasts, even just competing against men – it starts to hurt more because it feels like a part of you is dying and wilting away,” she said. “I believed I needed to sacrifice being trans in order to swim.”
Cortez-Fields spent more than a year undergoing hormone therapy, meticulously tracking her testosterone levels and trying to train even as her body no longer allowed her to glide through the water with the speed and stamina she once did.
Finally, in her senior year, she was cleared by the NCAA to compete on the women’s team, which Cortez-Fields said at the time was “one of the most exciting things that’s ever happened.”
She recalls her final meet in February as “one of the best meets of my entire life.”
“Every single moment was just magical,” she said. “I just felt like I was literally flying to the water.”
During the meet, Cortez-Fields broke two school records and placed 2nd in the 100-yard butterfly – successes she says were scrutinized by anti-trans groups and conservative news outlets but widely celebrated by her teammates.
“The majority of the women I have met and swim against, they have celebrated me. They make me feel like I deserve to be there, and I should fight for my place there,” she said.
What the research does – and doesn’t – say
The debate is complicated by a lack of significant research – and scientific consensus – on whether trans athletes, particularly trans women, have an athletic advantage over their cisgender peers, even after they have undergone testosterone-reducing therapies.
Dr. Joshua Safer, executive director of the Mount Sinai Center for Transgender Medicine and Surgery, said many elite sports associations are trying to craft policies without meaningful data on how trans athletes perform in their specific categories, such as soccer or basketball.
“If you’re trying to be ‘fair’ – however fair is defined – then you need to look at individual athletic activities directly,” Safer said. “It would be a matter of taking transgender people who participate in sports and looking at them before and after some of their treatments and really measuring differences, especially in common sports.”
Such studies may be especially difficult to perform given the relatively small number of trans athletes known to be competing at elite levels.
Though research is ongoing, a 2017 review in the journal Sports Medicine found “no direct or consistent research” showing trans people have an advantage.
A more recent October 2023 review concluded that sex differences do develop following puberty, but many are “reduced, if not erased, over time by gender affirming hormone therapy.” Qualities such as height and limb length appear to be “less malleable,” the study said, though it pointed out that there are no efforts to restrict cisgender athletes who are exceptionally gifted physically.
Until more data is available, Safer believes governing bodies like the NCAA should be wary of enacting sweeping restrictions so that “we don’t get ahead of ourselves.”
“Associations should err on the side of being cautious and inclusive until data indicates that there may be an advantage, and then they can make adjustments,” he said.
Looking for a lifeline in Title IX
In the absence of a scientific consensus, both sides have argued their case by invoking Title IX, which prohibits sex-based discrimination in federally funded education programs.
Trans advocacy organizations remain hopeful that President Joe Biden’s administration will follow through on its proposal last year to revise Title IX to bar schools from enacting bans on transgender athletes.
“Title IX is really the only major legislation at the federal level that protects cisgender women athletes, and we do believe that should apply to trans athletes,” said Baeth with Athlete Ally. “We want Title IX to consider gender, not just sex assigned at birth.”
Any direct mention of trans athletes was notably missing, however, from the Biden administration’s changes to Title IX last month, which expanded protections for LGBTQ students. Before the new changes were announced, a senior Biden administration official told reporters that the process of reviewing the trans sports protections is “ongoing.”
But some cisgender athletes and conservative lawmakers see the inclusion of trans women in women’s sports as a striking violation of Title IX’s nondiscrimination rule.
In March, more than a dozen current and former collegiate female athletes sued the NCAA over its transgender participation policy and accused the organization of a “radical departure from Title IX’s original meaning” by allowing trans women to compete against cisgender women.
Their outcry was echoed last month by more than a dozen Republican lawmakers who wrote in a letter to NCAA president Charlie Baker that they believe transgender women’s participation will deprive cisgender women “of a fair opportunity to compete and achieve athletic success.”
Republican lawmakers at the state and local level have largely driven the push to bar trans people from competing in sports aligning with their gender identity, and their efforts have not been confined to elite competition. Restrictions against trans players have spread across Little League baseball diamonds, high school soccer fields and into the halls of state legislatures nationwide.
At least 25 states have laws or regulations in place that ban transgender students, particularly trans women and girls, from participating on the team that aligns with their gender identity, according to the Movement Advancement Project, a nonprofit think tank that tracks such legislation.
Cortez-Fields says that while the bans are not surprising, she fears the impact they’ll have on many trans children who may already be struggling to overcome feelings of isolation.
“Part of gender affirming care, in a sense, is being able to compete on the team of your gender and with fellow people of your gender,” she said.
“It’s such a small minority, but that minority does matter, and they deserve their fair participation as well.”
CNN’s DJ Judd contributed to this report.