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The debate over transgendered female fighter Fallon Fox continues. On one hand, you’ve got a lot of prominent doctors in the field of transgendered surgery saying all advantages of once being a male have dissipated two years after gender reassignment therapy. On the other, you’ve got someone who was once a man fighting women in a cage, and that seems pretty damn absurd on its face. A lot of people have weighed in on this now from trainers like Pat Miletich to promoters like Dana White to other female fighters like Rosi Sexton, who also happens to be a sports therapist and osteopath. Here are some of her concerns:

2) None of us have a right to compete in professional MMA. People are routinely denied a licence to compete if their medical status means that there could be an increased risk either to themselves or their opponent.

3) MMA is a relatively safe sport, providing that participants are evenly matched by size, strength and ability. We have gender and weight classes not only to ensure fairness, but also to reduce the risks.

4) Contrary to some of the assertions by Fox’s supporters in the media, there appears to be no good scientific evidence that proves Fox does not have a performance advantage over someone who was born female. Expert opinion is still just opinion – and it seems divided on the subject. Experts may also have their own biases. Specialists in gender reassignment may not be equally knowledgeable about exercise physiology.

5) The experts supporting Fox have been quite cautious in their assessment. ”She probably does not have a significant advantage” and “her musculature is comparable to that of a woman” are a long way from saying “we know for a fact that she does not have a performance advantage over someone born female”.

6) The differences between men and women in sport depend on a great deal more than current hormone levels and muscle mass. For example, men have a higher ratio of type II to type I muscle fibres, which is associated with improved speed and explosive power, and a heart that is larger relative to body size. It’s not clear to what extent either of these would change after sex-reassignment surgery, or what implications that would have for performance in this case. Because of the bone structure that is developed while still growing, men also have a greater lung capacity and a narrower pelvis, giving a biomechanical advantage – factors which are highly unlikely to be reversed by hormone treatment.There are likely to be other factors that differ between men and women in terms of athletic performance that we aren’t even aware of.

7) Fox’s supporters point to the fact that male to female transgender athletes are allowed to compete as female in the olympics to support their argument that she should be able to compete in the women’s division in MMA. The IOC appears to base it’s policy on the principle that without firm evidence that an unfair advantage exists, transgender fighters should be allowed to compete in the interests of inclusivity. I agree that equality of participation is a nice ideal, and it’s a reasonable argument if we’re talking about sports like tennis or kayaking. But in a sport where one participant is trying to do physical damage to another, the burden of proof should be reversed. We need good scientific evidence to support the assertion that Fox has no advantage as a result of having been born male. Lack of evidence of an advantage isn’t sufficient – especially when so little evidence exists.

Sexton didn’t shut the door completely to Fox’s participation in MMA, but took issue with the fact that her opponents weren’t told she was transgendered before they fought. As for Fox herself, she thinks that should be the norm:

“I don’t believe that a transgender fighter should have to disclose her personal medical history to other female fighters before they fight.  It’s simply for the reason the medical community and the scientific community have come to the consensus that post-operative transsexual fighters who have been on hormone-replacement therapy and testosterone suppression, when they’re going from male to female, haven’t been found to have any physiological advantages over other women.”

Fox is coming from a position where she refuses to consider any angle on this from which she and all other transgenders aren’t considered female on level with any normal female. Unfortunately, you can’t really do this – she may be a she, but she is still transgendered. That’s a medical fact and it doesn’t go away no matter how progressive about the whole thing you want to be, especially when you’re considering her for things like mixed martial arts.

As Rosi Sexton pointed out, this isn’t a passive sport where a potential advantage like this results in her having a killer serve that lets her dominate on the tennis court. We’re talking about her ability to hurt her opponents here, and we should be deeply concerned if the male->female process leaves her with an unfair advantage in this. Fox claims medical consensus is on her side, but does that consensus hold up when pitting transgendered against woman in a cage fight? I’d say more research is needed.