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As advocates and scholars dedicated to advancing equality for women and girls, we believe that sport can empower all people – and to change the world. Exclusion and restrictions for transgender athletes undermine this cause. Transgender athletes are not and have never been a threat to women's sport. There are, however, serious and well-documented threats to women's sport that warrant attention, including unequal opportunities in participation and leadership, inequitable funding and pay, uneven media coverage, a lack of sponsorship opportunities, sexual harassment and abuse and incomplete implementation of gender equality policies (Bisgaard & Støckel, 2019; Cooky et al., 2021; Hindman & Walker, 2020; Lough & Greenhalgh, 2019; Novkov, 2019; Pape, 2020; Raso, 2019; Schultz, 2018; Staurowsky et al., 2020; Yanus & O'Connor, 2016; Zerunyan, 2017).

A close reading of peer-reviewed, researched-based and credible sources allow us to better understand the experiences of trans athletes, to dispel the dangerous misinformation peddled in recent media accounts and political debates, to outline critical legal and policy discussions about trans athletes, and to highlight why access to sport matters for everyone. There is a clear consensus across multiple disciplines: the future of sport includes transgender women and girls.

Transgender people experience significant health and healthcare disparities in comparison to cisgender people. Limited access to quality, trans-competent healthcare in the USA is a central social determinant of these inequities. In this chapter, we expand on the burgeoning literature on accountability structures and transgender healthcare through an analysis of individual interviews with cisgender medical providers about their and their colleagues’ capacity to provide trans-competent healthcare. First, we find that providers report unfamiliarity and uncertainty concerning transgender people, their healthcare needs, and related issues. Although providers regard such ignorance as a structural problem within medical education and practice, the solutions they proffer rely on the benevolence and personal initiative of individual providers to seek out trans-specific information and training. This upholds the boundaries between what is considered “normal” (i.e., cisgender centered) healthcare and trans-competent healthcare. Second, we find that cisgender medical providers who want to provide quality healthcare to transgender people engage in emotion work that prioritizes the comfort and ignorance of their cisgender colleagues and inhibits institutional change. In sum, we argue that, regardless of their intentions, cisgender providers engage in practices that maintain healthcare as a cisnormative accountability structure and, in turn, contribute to the persistence of transgender health and healthcare disparities.

This chapter examines the surgical body modification experiences of transgender and cisgender people in the United States. It analyzes how surgery consumers with different gendered histories pursue “enhanced” embodiment. Both cisgender and transgender people obtain similar surgeries, but their procedures are differently regulated. Based on 40 in-depth interviews, this chapter compares the presurgical and postsurgical experiences of transgender and cisgender people. The findings show that cisgender and transgender people felt similarly about their bodies before surgery and reported corresponding cosmetic and psychological motivations for surgery. Both groups also had comparable postsurgical outcomes and used surgery to actualize a more desirable gendered embodiment. Ultimately, surgery resulted in changed gendered embodiment that enhanced the self for both groups. It could be psychologically transformative for cisgender people and provide more of a cosmetic effect for transgender people. These findings complicate disparate regulations of transgender and cisgender surgeries. They highlight surgeries as body technologies that enhance gendered embodiment allowing both cisgender and transgender consumers to articulate gendered concepts of the self.

In this chapter, we explore the lived experiences of transgender and gender non-conforming (TGNC) prisoners, arguably the most vulnerable minority in the prison estate, using the data from our correspondence study with transgender women and non-binary individuals incarcerated in male establishments in England and Wales. We provide a brief review of the extant literature, describe the English prison system and the regulations concerning transgender prisoners, and analyze two axes of vulnerability of TGNC prisoners: social (stemming from relationships between prisoners) and institutional (resulting from the prison regime). Along the social axes, we find, in contrast with prior research, that our respondents defied the stereotypes of trans prisoners as submissive to males in a hypermasculine prison society and as involved primarily in abusive relationships. Along the institutional axes, we find that, despite the progressive by international standards transgender prison regulations, prisoners were subject to vicissitudes in treatment that negatively affected their ability to express their gender and their health. Focusing on access to gender-affirming items (clothing, prosthetics, make-up) and gender-affirming medical treatment, we develop recommendations for the prison service that could improve the conditions of confinement for TGNC prisoners.

Possibilities for self-representation for transgender (trans) and gender non-conforming (GNC) youth must be conceptualized in relation to youths’ placement within frames of power. Powerful institutional forces in youths’ lives include schools and policing and, as is evidenced by youths’ statements, extend to mass media portrayals. Library approaches that reify the inclusion of representative texts do not adequately meet the needs of trans and GNC youth. As a profession, librarianship must reflect on ideological approaches to gendered embodiment to push against an ongoing repetition of institutional harms done to trans and GNC youth.

This chapter offers examinations of information needs, complex online worlds, and incorporation of histories made invisible by power alongside critical literacy skills as crucial aspects of providing services to all possibly or actually trans and GNC youth. It critically situates the circumstances of trans youths’ lives in relation to the effect that adult perceptions have on trans and GNC youths’ ability to access resources. It provides a framework for reflection on how young adult librarians often unconsciously limit library access by enacting gendered expectations that do not always match the possibility or actuality of youths’ experiences or self-conceptions. The chapter outlines modes of communication – through library materials, programs, community resources and partnerships – that convey deeper understandings of trans and GNC experiences to possibly or actually trans and GNC youth.

Purpose: In this chapter, I critically examine how federal regulation and guidance impact gender policing and transgender inclusion within educational institutions.

Approach: I utilize feminist critical discourse analysis to examine the “Dear Colleague Letter on Transgender Students” and its underlying assumptions related to transgender inclusion and gender policing in institutions of education.

Findings: While the federal regulations and guidance currently in place protect some transgender individuals, they also re-stigmatize some transgender individuals by policing the acceptable ways of being transgender and reinforcing the gender binary.

Social Implications: I suggest other areas within the educational institution to address in order to achieve transgender inclusion.

Value of Paper: This chapter critically examines the logistics and effects of federal regulation on gender and transgender inclusion.

Purpose: We respond to a call for studies of “embodied experiences of stigma in context” by investigating how transgender embodiment shapes perceived needs for access to and experiences of “sex-specific” cancer screenings (SSCS) (e.g., breast and prostate exams, Pap smears) in the North American healthcare system.

Design/Methodology/Approach: We analyze data from semistructured interviews with a diverse sample of 35 transgender-identified adults. Based on thematic narrative analysis, we explore four themes in relation to embodiment: discrimination; discomfort and hyperawareness of genitalia; strategic reframing and active management; and SSCS health care encounters as positive and gender affirming.

Findings: In relation to SSCS, transgender individuals experience discrimination, do emotion work, and actively manage situations to obtain needed health care, and sometimes forego care because barriers are insurmountable. Health care providers' responses to transgender embodiment can disrupt health care encounters, but they can also facilitate access and create opportunities for affirmation, agency, advocacy, and new forms of interaction. Embodiment- and gender-affirming interactions with health care providers, which varied by gender, emerged as key influences on participants' experiences of SSCS.

Research Limitations/Implications: Our sample primarily includes binary gender-identified individuals, and while our interview guide covered many topics, the SSCS question did not explicitly reference testicular exams.

Practical Implications: Cancer prevention and detection Cancer prevention and detection require health care professionals who are prepared for differently embodied persons. Preventive cancer screenings are not “sex-specific”; they are relevant to individuals with medically necessary needs regardless of gender identity or embodiment.

Social Implications

Originality/Value: Few medical sociologists have focused on transgender embodiment. Findings enhance our understanding of how transgender embodiment and minority stress processes influence access to needed SSCS.

After the first transgender athletes participated in the 2020 Tokyo Olympics, some called for the immediate exclusion of transgender women in sports while others argue that this exclusion is discriminatory behaviour in violation of human rights law. Under current standards, the International Olympic Committee (IOC) has sought to address the balance between fairness and inclusion by allowing eligibility to be decided on a sport-by-sport basis for all transgender athletes (IOC, 2021). What if an international federation or national governing body concludes that transgender athletes should be prohibited or subjected to rigorous conditions for participation? Would those qualifications stand up to legal challenge by an affected athlete? Will some athletes have better legal protection based on the location of their challenge?

The United States (US) and United Kingdom (UK) have domestic legal provisions that protect transgender individuals from discrimination based on their gender identity whereas the European Union (EU) includes protections based on sex alone (Patel, 2021). This chapter will discuss transgender inclusion policies in Olympic sport and address how potential challenges to the policies will be handled in court using existing case law. Legal precedent in similar challenges is rare. However, when eligibility policies do not explicitly ban transgender athletes or appear to be a targeted response to a specific athlete or individuals, it becomes more likely that those policies will not be considered discriminatory. Courts are hesitant to interfere in a governing body's policies if that organization appears to have a legitimate reason for its sport governance decisions.

This chapter explores age-based variations in the healthcare experiences of transgender people. Specifically, we outline how transgender people narrate their experiences with coming out and transition in later life as well as possibilities for future research and clinical practice concerning older transgender populations. To this end, we begin with a review of the limited literature on older transgender populations including the ways such findings converge and diverge from studies of younger transgender populations. Then, we analyze data gathered from older transgender people throughout the United States concerning their experiences with health events, healthcare providers, and healthcare settings. For this empirical analysis, we draw on over 250 qualitative responses from transgender people over the age of 40. The findings of this chapter demonstrate the importance of adjusting existing healthcare protocols to provide adequate care for aging transgender populations. Specifically, our analyses highlight gaps in access and quality of healthcare delivery as well as issues related to medical education, trans-inclusive protocols, and sex-gender segregated medical traditions. The implications of our work here reveal important possibilities for expanding transgender healthcare access as well as existing barriers to such access. We specifically utilize the case of our respondents and the existing literature to illuminate gaps in needs assessment and healthcare delivery concerning older transgender populations. We will conclude the chapter with recommendations for bridging such gaps in research, education, and system operation.

Transgender prisoners are subject to violence of many kinds. They are tortured, beaten, sexually assaulted, raped, and denied access to qualified public health services. This is because legal and justice systems in most countries disregard the unique conditions, needs, and requirements of transgender people. Transgender prisoners around the world suffer from mental health issues and lack of continuous access to sexual health services and hormone treatment. Like most countries in Southeast Asia, and regardless of a significantly large population of transgender prisoners, Thailand still provides no standard policies on how transgender prisoners should be managed, and transgender prisoners’ experiences remain under-researched. Through an anthropological and gendered lens, this chapter theoretically and practically examines transgender prisoners’ gendered life experiences behind bars in Thailand, debates transgender prisoners’ vulnerabilities and the myths behind them, identifies challenges around gendered-housing, analyses cultural nuances of Thai (trans)gender performativity in prisons, discusses the impact of heterosexual-binary prison management, and offers real-world policy recommendations, which are urgently needed by the Thai justice and correctional system.