Sport has played a defining role in Kristen Worley’s life for as long as she can remember.
“I grew up in a sporty family. My father was a champion sailor, and I was surrounded by opportunities to try skiing, sailing, all kinds of things.”
For most of us, the pastimes we choose become part of who we are and how we define ourselves; for Worley, who was born male and transitioned to female in her late 20s, sport became enmeshed in an intense personal struggle for a sense of identity and acceptance.
“Through grades six to nine, I was confused about how to project myself to my peers, and I’d get bullied all the time. It wasn’t until grade seven at 10-11 years old that I found long-distance running and set a school record.
“Finally I’d found an avenue where my friends could relate to me, see me as an OK kid, a cool kid, and accept me.”
Growing up in Toronto, Canada in the Seventies (“a very conservative environment”) Worley clung to the sense of belonging provided by sport — in lieu of a supportive place in which to work through her intensifying gender-identity issues.
In her early teenage years, she became an accomplished waterskier, making the Canadian national team by age 15. Meanwhile, she ran and cycled obsessively, driven by a complex mix of competitiveness, repression and anxiety.
“I became seriously anorexic in grades 10 and 11. Now, looking back, I was dealing with a lot of body-image issues… what we now call gender dysphoria, but at the time I didn’t understand how it was affecting me.”
By her mid-teens, Worley was cycling vast distances as a ritual that helped soothe the mounting pressures and worries.
“Certain aspects of cycling, such as shaving my legs, helped me deal with the anxieties related to my gender and body issues… Some people use drugs or alcohol; for me, it was sport.”
Individuals with gender dysphoria feel as though they are in the wrong body; their gender identity, emotionally and psychologically, is at odds with their biological sex. “Your body goes one way,” as Worley puts it, “and your brain goes another.”
Social expectations often add to the difficulties. “We’re taught from day one that we must fit into one of two socially-designed slots, solely based on our birth sex, and it’s amazing how powerful that is.”
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Cycling was not merely an outlet for Worley; it was means of survival. It helped her stave off suicidal feelings and “gave me a sense of community when times were really dark. It literally saved my life”.
In her late-teens, Worley switched to bike racing, made swift progress to national-level competition and set her sights on making it to the Olympics.
But, in her early-20s, she suffered a crash that shattered her pelvis and left her on crutches for six months. The enforced break meant that Worley no longer had an escape from her internal conflicts and had to confront them head-on. So began her journey to gender reassignment surgery.
Worley’s return to sport post-transition, in 2002, came after she heard that another trans cyclist (and fellow Canadian), the downhill mountain biker Michelle Dumaresq had been barred from competing following complaints from other athletes.
Deducing that Dumaresq had been unfairly treated, Worley assisted in campaigning for the return of her racing licence — and together they won. Little did Worley realise she was embarking on a battle that would last for the next 14 years.
In 2003, the International Olympic Committee (IOC) “recommended” that trans athletes be permitted to compete provided they had undergone sex reassignment, hormone therapy, and could provide legal recognition of their sex change — subject to a “confidential case-by-case evaluation”.
Worley became the first athlete in the world subjected to this new policy: “I had to sit in front of panels of men who I did not know, asking me questions about my sexuality, my gender, my body; I had to give up all my medical information; I was gynaecologically tested… I was violated, it was completely humiliating.”
The dos and don’ts after every ride
Maintaining a balance
Returning to sport proved hugely difficult. The male-to-female transitioned body cannot produce androgens (male sex hormones), which has profound physiological effects.
Worley explains: “Within three months of my surgical transition, I went through spontaneous menopause… We’re now able to show that, because I don’t have any hormonal response in my body, [without sufficient synthetic testosterone] my health declines. No matter how much I train, my body continues to atrophy.”
In 2006, Worley applied for a therapeutic use exemption (TUE) for synthetic testosterone, submitting new evidence showing its necessity for male-to-female transitioned athletes.
The Canadian anti-doping authority (CCES) took a year to approve the application and insisted on another round of tests.
“I lost a whole season waiting, and by the time I got the TUE, my health was failing.” Her hopes of making it to the 2008 Olympics were dashed, she adds.
Worley persisted in making comeback attempts, working with physiologists, still hampered by her body’s low levels of androgens — hormones vital for hundreds of physiological processes including red blood cell production, temperature regulation, and metabolism.
“In races, I’d feel like I was suffocating on the bike… and despite doing 600km per week, I couldn’t lose a single pound of bodyweight.”
After much trial and error, the beleaguered athlete managed to boost her androgens to health-sustaining levels and began rebuilding her fitness.
She focused on track training, and was achieving performances that gave rise to hope that she might qualify for the 2012 Olympics. But returning to competition would require another TUE.
On receipt of Worley’s application: “they [the CCES] started to put me through the whole process again… I lost another year.” Once again her dream of returning to elite competition was thwarted. Enough was enough.
“Finally I went to the UCI in 2013, and said I can’t sign my licence, I said I’ve got to deal with this and get it sorted out, and make it right for all the other athletes.”
Those ‘other athletes’ included not only trans people, but also female athletes whose eligibility to compete had been called into question.
Worley provided advice and support to 800m runner Caster Semenya, who was subjected to gender verification tests, intrusive press speculation and suspended from competition following her victory in the 2009 World Championships.
The Canadian also supported Indian sprinter Dutee Chand after her country’s athletic federation dropped her from its 2014 Commonwealth Games team on the grounds that her hyperandrogenism condition (naturally higher levels of testosterone) rendered her ineligible to compete.
Semenya is due to compete in the 800m events at the Rio 2016 Olympic Games, with recent performances making her favourite for gold.
Cleared to compete since the testosterone limit was suspended by the CAS, the South African nonetheless faces mounting press attention and scrutiny – further fuelled by Seb Coe’s hint that the IAAF is seeking to reinstate the testosterone rule.
For Worley, imposing physiological limits on athletes like Semenya is entirely unfair and non-objective.
Beyond the high-profile cases, it is alleged that in the run-up to the 2012 Olympics, four young female athletes from developing countries, each of whom had a mix of male and female anatomical characteristics, underwent surgical castration in an attempt to comply with the IAAF’s and IOC’s rules, resulting in negative health consequences.
Last year, the surgeon involved, Dr Charles Sultan, told Sports Integrity Initiative’s Andy Brown that he regretted having performed the procedure.
Changes are under way: last year, the IAAF’s ‘hyperandrogenism’ rules (a testosterone limit) were suspended, leaving athletes like Semenya and Chand clear to compete.
Trans athletes are no longer required to undergo surgery but male-to-female trans competitors must comply with a testosterone limit — a limit Worley argues is unfairly prohibitive, unsupported by science and a threat to health.
In Worley’s view, it is unethical and unjustifiable to set limits on naturally occurring androgen levels, restrict synthetic testosterone below the level needed to maintain health or impose gender verification testing.
I put it to her that, without any limits, women with exceptionally high androgens may be regarded as having an unfair advantage.
Worley counters that it is unfair to exclude from competition a woman on the basis that the androgens she produces naturally and healthily (or requires in synthetic form for health) exceed an “arbitrary” limit — one not underpinned by science.
I have another nagging worry: what’s to stop a man competing as a woman dishonestly solely in order to cheat? “Historically it has never happened. It’s a 0.001 order of risk.”
Avoid making these mistakes
I’m still not entirely satisfied: doesn’t the removal of physiological criteria effectively, if not intentionally, abolish the means of objective distinction integral to male/female categories in sport? Is Worley content to see these categories disappear?
“It would be great to move more toward the Paralympic model — ability-based categories… It’s going to take time for that evolution to occur, but the discussion needs to begin.”
In certain sports, the gap between men’s and women’s performances has been closing for years, and Worley believes that de-segregating men and women athletes would further “raise the game” for women and catalyse progress towards parity in funding and profile.
For Worley, imposing a testosterone limit is unfair because it inevitably constrains, excludes and potentially harms certain women without justification: an abuse of their human rights.
She points out an additional (and paradoxical) unintended consequence of policing gender in women’s sport while ignoring the wide variation in physiology among men: female-to-male trans athletes are permitted to take higher doses of synthetic testosterone despite the fact their physiology heightens the effect of the hormone.
“Some XX-born athletes are outperforming XY athletes in endurance events… We’re creating little supermen!”
So strong is Worley’s conviction that sport’s policies on gender are inconsistent, harmful and unjust that in May last year she took out a lawsuit in the Human Rights Tribunal of Ontario against the UCI, IOC, Cycling Ontario Association (OCA) and Cycling Canada Cyclisme (CCC).
The tribunal’s interim decision was made public on July 20 and determined that the case should proceed to to a full hearing. Whatever the outcome, sport’s governing bodies will have to review their rules very carefully.
Worley is now in her mid-40s and, though she will not get another shot at Olympic glory, still keeps fit cycling and running most days. She has led an extraordinary life, overcoming enormous personal and sporting struggles, and now channelling her hard-won fortitude into a battle of global significance.
“I always believed the diversity fight I had as a child, all the building of strength, would lead me down a path towards helping promote change… I was just a shy little kid who used to get bullied in the playground, and yet here I am taking on the biggest sports organisations in the world.”