Swimming's blanket ban on transgender women competing in international women's events is the polar opposite of the International Olympic Committee's framework suggesting inclusion first and review on a case-by-case basis.
Sport's governing bodies now feel pressured into picking sides in what has become a culture war, although experts warn that Australian anti-discrimination policies would prevent such blanket bans from being adopted here.
The international governing body for aquatic sports, FINA, announced its "inclusionary policy" this week bit it has left others describing it as "exclusionary".
The policy allegedly cost the organisation $US1 million ($1.45 million) to research and was reportedly designed to withstand any legal or human rights challenge.
Delegates at the Extraordinary Congress being staged on the sidelines of the World Championships in Budapest did not get to see the 24-page document until 14 minutes before they were asked to vote on it.
Just over 71 per cent of the 274 delegates voted in favour of the policy, 15 per cent voted against, and just over 13 per cent abstained.
Transgender women can only compete in international competition if they transition before experiencing 'any part of male puberty beyond Tanner Stage 2 or before age 12'.
According to the World Professional Association for Transgender Health (WPATH), that requirement is "unethical".
Dr Jamison Green is the chair of WPATH's ethics committee and a former president of the organisation.
"Where [FINA's] current policy sits is outside the field of practice," Dr Green told The Ticket.
"People don't transition medically before they are 12, that just doesn't happen. That would be unethical."
Lia Thomas win at intercollegiate swim titles puts spotlight on policy
Despite being established more than 40 years ago with a mission to help devise evidence-based public policy, only two sporting bodies have sought WPATH's advice — the National Collegiate Athletic Association in America (NCAA) and World Anti-Doping Agency (WADA).
FINA's policy was handed down after the focus on NCAA swimmer Lia Thomas, who in March became the first transgender woman to win a title at the intercollegiate championships. Her winning time for the 500 yards freestyle was more than nine seconds behind the record, and her times in other distances would not currently qualify her for the Olympics or World Championships.
"The federations that have issued their regulations that are exclusionary at this point are failing, and I think they are going to have to revise those regulations at some point and I hope it's soon because this is really harming generations of people," Dr Green said.
"This filters down and young children are the ones who are going to suffer from this exclusion.
"They won't be able to be part of their community, they won't be able to share experiences with their peers, they won't be able to learn the skills that are needed to survive, and it's not just who's the strongest and the fittest, it's about how do we get along.
"That's one of the things sports teaches us, and it's very, very important to humanity."
Cate Campbell comments criticised
Cate Campbell, Olympic gold medallist and chair of the Australian Olympic Committee's athlete's commission, delivered an emotive speech to FINA delegates ahead of the vote that was widely praised in swimming circles.
"Usually, inclusion and fairness go hand-in-hand. To create a place that is inclusive is to create a space that is fair. Transgender, gender-diverse and non-binary athletes' inclusion in the female category of elite sport is one of the few occasions where these two principles come into conflict.
"The incongruity that inclusion and fairness cannot always work together is one of the reasons why it is so difficult to talk about this topic.
"Usually, they are terms of absolutes which work together, yet science now tells us, that in this issue, they are incompatible.
"I stand before you, as a four-time Olympian, a world champion and a world record holder. I stand before you, as a beneficiary of fair, elite competition. Yet my job today is not to explain the nuances of FINA's transgender policy. Nor is it to defend the conclusions reached by medical and legal professionals of much greater intellect than mine.
"My role is to stand before you, as an athlete who has enjoyed many, many years in this sport and who hopes to continue to enjoy a few more years. To stand here and tell the transgender and gender-diverse community that we want you to be part of the broader swimming community.
"We see you, value you and accept you."
Campbell goes on to say that men and women are physiologically different, which cannot be disputed and supports the recommendation of a separate category for transgender women.
Transgender woman Kirsti Miller, who has competed in numerous sports pre- and post-transitioning, says the situation is a lot more nuanced.
"Well, they didn't see us, or accept us, or value us, because none of us were in the room when they voted on us," Miller said.
"I would have adored to have been there and they could've asked me anything. I don't call anyone transphobic for asking questions."
Miller points to FINA's recommendation to create a separate category for transgender swimmers as dangerous.
"In many places in the world if I was to compete in a separate trans category that could get me killed," she said.
"Marking us as 'the other' is not inclusion. That is not inclusion at all.
"I'm not angry, I'm disappointed in Cate that she didn't reach out and speak to people like me and some of the other sporting organisations that have dealt with this for years. It made me sad that she has 'othered' us. I would still like to sit down with Cate here today and she can ask me anything."
'We just have to find a balance'
Sporting bodies such as FINA often refer to scientific data comparing the differences between men and women in arguing against transgender inclusion, ignoring the fact cis elite athletes are not in the normal range and studies on transgender athletes are still limited.
The lobby to preclude transgender women from competition constantly refers to them as biological males. This suggests a misunderstanding, at best, or wilful dismissal, at worst, of the years-long process required to transition with tests showing a steady decline in physical advantage.
One of the most influential women's voices in world sport is former US Olympic swimming champion Donna de Verona. She was a long-serving member of the IOC's Women in Sport Commission, a founder of the Women's Sports Foundation and now serves as an adviser to Champion Women, a group heavily involved in the lobbying to keep women's sport for those born female in what's been termed a "safe space".
"We are not in favour of banning transgender youth in sports at all. We just have to find a balance that's fair to everyone, and that's a problem in our country now because it's become such a political football.
"The far right has captured it, and the far left is saying everyone should play, there should be no policy, we just have to find a middle ground.
"Anyone of us that has been sidelined understands what its like to be left out and not have a support system."
"I know they [FINA] worked very hard for a very long time and brought in scientists, athletes, researchers and human rights experts to develop their policy. From my point of view, they did the best they could in providing a balance."
FINA's working group charged with designing an open category for transgender swimmers does not currently have a deadline to work to. FINA has also been reluctant to reveal the science they relied on in reaching their policy decision, and who their experts were.
The lack of transparency has led to an ugly, bigoted social media campaign built on fear, targeting trans athletes and their support groups.
De Verona says while there may never be a transgender swimmer at the Olympics, the addition of trans swimmers at lower levels of the sport has raised other concerns.
"We have a whole different system in the United States where we are struggling with how to be fair, how to look at recreational sport versus participatory sport and how to look at elite sport.
"In this country, high school sport is a pathway to scholarships and opportunity and elite sport, which then leads to the Olympics and so on.
"They are two distinct things and there is a lot of fear on both sides.
"What I'm concerned about is all those states that want to ban transgender kids from school sports on every level without any policy.
"That's fearmongering and it's not the appropriate direction so that's why we're all struggling on the National Olympic Committee level, on the federation level and on each sport, and we're trying to find the answer.
"We're in a whole world of confusion and what does it come down to? Yes, it comes down to fairness, I think, and protected class, but if we also really believe that everyone should enjoy sport, we have to accommodate every population."
Australia can be a 'global leader'
Australian sports organisations, such as Swimming Australia, would be unable to bring in a blanket ban such as FINA's, because of anti-discrimination laws. In relation to sport, discrimination on the basis of strength, stamina and physique is possible but advantage cannot be assumed, it needs to be proven.
Former sex discrimination commissioner and UN special rapporteur for discrimination against girls and women, Elizabeth Broderick, says Australian sports are in a position to be global leaders on the issue, believing there is a genuine commitment to do so.
"I'm fortunate enough to convene a group of CEOs of all the national sporting organisations across this country and just recently we had a deep dive into these issues," Ms Broderick said.
"It wasn't just from one perspective, we were able to get an international perspective, we were able to include the voices of the lived experience of transgender women athletes, and also from the science of leading endocrinologists.
"To come to it firstly with an open heart but also a strong belief in dignity, respect, inclusion and equality… is the context in which we should be having this discussion.
"I really feel optimistic actually that here in Australia we can be counter-cyclical. I know a lot of global bodies have set blanket bans in the last few days and I think Australia can do something different."
