Va. Crafts Policy for Trans High School Athletes

On Wednesday, the Virginia High School League, the governing board that oversees athletics for the state's 313 public high schools, passed a resolution that aims to allow transgender students equal opportunity to participate in high school sports -- but the policy's requirement that trans students undergo gender-confirming surgery before participating in gender-segregated sports could make it tough for them to take advantage of the policy.

After four state high schools sought the league's guidance on how to include transgender athletes in school sports on a gender-appropriate basis, the VHSL's 27-person executive committee, made up of principals and athletic directors, approved the motion by a unanimous vote. As written, the policy stipulates that transgender students must participate on the team that corresponds with their birth sex until they have undergone clinical, social, and surgical treatment to transition into their authentic gender.

The surgery requirement, however, will leave nearly all transgender students out in the cold, since most are unable to access gender-confirming surgery until they are at least 18 years old. The full conditions for qualification include a continuous hormone replacement therapy regimen (for a vaguely worded "sufficient length of time") along with "surgical anatomical changes, including external genitalia changes and gonadectomy."

The World Professional Association for Transgender Health's Standards of Care are widely recognized as the best practices which medical providers should follow when treating gender dysphoria. Under the section marked "Criteria for Surgeries," the association suggests that the following requirements be met before pursuing any type of genital surgery:

1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and give consent for treatment;
3. Age of majority in a given country;
4. If significant medical or mental health concerns are present, they must be well controlled.
5. 12 continuous months of hormone therapy as appropriate to the patient's gender goals (unless hormones are not clinically indicated for the individual).

The age of majority in Virginia is 18. Given that most high school students don't turn 18 until their senior year, it's virtually impossible for a transgender student to meet the new league standards to play on a team that corresponds with their gender identity. Further complicating a minor student's access to such procedures is the reality that these types of surgery regularly cost tens of thousands of dollars, are often not covered by insurance, and are sometimes not desired by trans individuals as part of their physical transition.

As written, the policy is likely to provide little help to trans students, and stands in stark contrast to California's approach, which allows trans students to participate in athletics that correspond with their gender identity without the requirement of hormones or surgery.