Valentina Petrillo, the transgender sprinter at Paralympics – the rules, the science and the future (2024)

On Monday at 10.48am local time, Valentina Petrillo, a transgender athlete, lined up on the white line of Stade de France’s purple athletics track ready to run in the first round of the 400m T12 race at the Paris Paralympics.

Petrillo’s presence has attracted particular attention and will likely attract more if she medals. At last year’s World Para Athletics Championships, she won bronze in the 200m and 400m T12 events.

Sport, at times, is at the centre of debates and when the world’s biggest competitions take place, the scrutiny is immense. In this case, arguments have raged over transgender athletes, their inclusion and competitive advantage.

The International Paralympic Committee (IPC) says it “welcomes” Petrillo, while World Para Athletics (WPA) rules state a person who is legally recognised as a woman is eligible to compete in female categories. However, Katrin Mueller-Rottgardt, a German Paralympian racing in Petrillo’s200m T12 category on Friday, has spoken out about Petrillo’s advantage having gone through male puberty.

This article is not looking to fan the flames but answer key questions readers may have regarding the rules, the science and the future…

Who is Petrillo?

The 51-year-old sprinter, who was assigned as male at birth, is a parent of one boy. She started running as a child but stopped when she was diagnosed with Stargardt disease, a degenerative eye condition, at the age of 14. Her vision is limited to one fiftieth of the normal range and she began para athletics aged 41, competing in male categories. Petrillo won 11 national titles in the male T12 visual impairment class between 2015 and 2018.

Valentina, supported by her wife, started living as a woman in 2018 and received hormone therapy, including testosterone suppression, in January 2019. After transitioning, she ran her first official race as a female para-athlete in 2020, winning gold in the 100m, 200m and 400m T12 events at the Italian Paralympics Championship. At last year’s World Para Athletics Championships, she won two bronzes and has also competed against non-disabled women.

“For 44 years I had no tools, I thought I was the only one in the world experiencing this situation,” she told Italian site Odiare non e uno sport (Hate is not a sport) in 2021. “I was born in Naples in the seventies, where the femminielli were considered the ‘scum’ of society.”

Petrillo’s running times decreased six months after starting her treatment. She was 11 seconds slower in the 400m and 2.5 seconds in the 200m. She told the BBC that, as an athlete, accepting not sprinting as quickly was difficult, but the compromise was for her happiness.

Is she the first transgender athlete?

No, she is the second. Dutch transgender athlete Ingrid van Kranen, who died in 2021, finished ninth in the women’s discus final at the Rio 2016 Paralympics.

The circ*mstances were different with Van Kranen though. Her transition was not widely known or reported at the time, meaning there was not the scrutiny on her — either from fellow competitors or the media — that we have seen with Petrillo.

What are the rules for trans athletes at the Paralympics?

In 2021, the International Olympic Committee (IOC) and International Paralympic Committee (IPC) devolved responsibility to each international sport federation to make their own policies. The IPC reiterated this when contacted by The Athletic. That means there is no one rule for all sports regarding transgender inclusion.

What are the rules for trans athletes in para-athletics?

World Athletics has a different policy from World Para Athletics (WPA). Transgender women are not allowed to compete in World Athletics female categories, but they are allowed to compete in World Para Athletics female categories. If Petrillo attempted to compete in the Olympics or other non-disabled international athletics competitions, she would not be allowed.

Under rule 4.5, World Para Athletics states a person who is legally recognised as a woman is eligible to compete in female categories.

The WPA added “transgender athletes must provide evidence that their total testosterone level has been below 10 nanomoles per litre of blood for at least 12 months prior to their first female competition, and for as long as they remain competing in female competition”.

What has Petrillo said?

After qualifying sixth fastest for the semi-finals on Monday, Petrillo said: “The atmosphere inside the stadium is just fantastic so for me it’s a dream come true.

“It’s September 2, 2024 right? Let’s mark this down as a historic day. From this day forth I don’t want to hear any more talk about discrimination or prejudice for trans people.

“There are so many people who die for the mere fact of being trans people, who kill themselves for the mere fact of being trans because they lose their job because the sport doesn’t include them and now I’ve made it so we can all make it if I’ve made it, I’ve done my little bit and we can all make it.”

She ran a personal best of 57.58 seconds in the semi-final on Monday night but finished third and did not qualify for the final.

“I tried until the end, I couldn’t do it,” Petrillo said after the race. “I missed that last straight. I pushed harder than this morning and I tried. They are stronger than me. There is nothing I can do. I had to do 56 (seconds) to get into the final. It’s impossible, 57.58 I have to be happy even though I’m a little upset.

“But I hope my son is proud of me,” Petrillo said, beginning to cry. “That’s important to me because I’m a trans dad, it’s not everyone’s dream dad. But I hope he will be proud of me.

“I hope he will always stand by me, I hope that he loves me even if I am like this. I can’t help it if I’m like this, I’m sorry. Don’t treat trans people badly. We suffer. It’s not fair. We don’t hurt anybody.

Petrillo previously said, via the BBC, that she has been waiting for the Paralympics for the last three years and has done “everything possible to earn it”.

“I deserve this selection and I want to thank the Italian Paralympic Federation and the Italian Paralympic Committee for having always believed in me, above all as a person as well as an athlete.”

In response to those who believe it is unfair for Petrillo to compete, she said: “This is not a lifestyle choice for me, this is who I am.

“And the way I am, like all transgender people who do not feel they belong to their biological gender, should not be discriminated against in the same way that race, religion or political ideology should not be discriminated against.

“And sport that imposes rules based on a binary way of thinking does not factor this in. It is sport that has to find a solution and excluding transgender athletes is clearly not that solution.”

What have others said?

The IPC said it “wishes all athletes competing at the Paris 2024 Paralympic Games the best of luck with their competition” when contacted by The Athletic.

However, one of the athletes running against Petrillo in the 200m, Mueller-Rottgardt, told Bild earlier this month: “Everyone should live in everyday life the way they feel comfortable. But I find it difficult in competitive sports. She (Petrillo) has lived and trained as a man for a long time, so there is a possibility that the physical requirements are different to those of someone who was born a woman. This could give her an advantage.”

On behalf of 30 athletes, the Italian lawyer and former athlete Mariuccia Fausta Quilleri sent a petition to the Italian Athletics Federation and the ministries for Equal Opportunities and Sport, opposing Petrillo’s participation.

“Every federation can choose between the concepts of inclusion and sporting fairness,” Quilleri told the BBC when asked about Petrillo’s Paralympic selection. “World Athletics has chosen the principle of the Olympic spirit: they have stayed true to the idea of fair competition. On the other hand, the Italian Paralympic Federation has chosen inclusion.

“It is the visually-impaired athletes who will be beaten by Petrillo that will have to take up the protests with their federation. Unfortunately, it is those at the top of the federations who have allowed this to happen.”

One powerful voice of support for transgender athletes in sport is the former soccer player Megan Rapinoe, who appeared 203 times for USWNT during her career. In an interview with Time magazine two years ago, Rapinoe made a strong case for inclusion.

“Show me the evidence that trans women are taking everyone’s scholarships, are dominating in every sport, are winning every title,” she said. “I’m sorry, it’s just not happening. So we need to start from inclusion, period. And as things arise, I have confidence that we can figure it out. But we can’t start at the opposite. That is cruel. And frankly, it’s disgusting.”

Are there any plans to change the rules?

World Para Athletics, in a statement to The Athletic, said any future changes to their rules would only be considered following “appropriate consultation with teams and athletes and taking into consideration the rights and best interests of all those involved”.

The International Paralympic Committee told The Athletic it is up to the international federations to “develop their sport-specific rules”. Earlier this month in Paris, however, the IPC president Andrew Parsons said sport has to be “guided by science, come up with better answers for transgender athletes”.

Parsons said he was prepared for the criticism, but emphasised the need to “respect our rules”. “For the moment, World Para Athletics allows her (Petrillo) to compete, so she will be as welcome as any other athlete.”

He noted the need to treat transgender athletes respectfully, but also added: “Science should give us the answer because we also want to be fair with the other athletes in the field of play.”

What do scientists think about the differing rules?

“It’s not a good situation,” says Alun Williams, professor of sport and exercise genomics at Manchester Metropolitan University’s Institute of Sport. “It doesn’t make a lot of sense for anybody involved: trans athletes, other athletes, the sporting authorities. It doesn’t make sense they (sports and para-sports) all have different rules.

“Those federations don’t have the expertise, capacity, funding, knowledge or bandwidth to think through these very difficult questions and get to a good answer.

“The arguments about the biology and physical advantages are pretty consistent in maybe not all sports but most, even within athletics, across nearly all the track and field events. In theory, they should all be reaching the same conclusion.

“They may have different agendas, different organisations’ decision-makers have different opinions. I’m not surprised they end up with different regulations.”

Dr Joanna Harper, a leading researcher of trans athletes and a postdoctoral scholar at Oregon Health & Science, says it’s a challenging situation not just for trans athletes but everyone who cares about sports and that beyond science, individuals have made “widely conflicting decisions”.

She disagrees, however, with a one-size-fits-all approach and believes “the science points to having different effects on different sports”, so each federation should make their own regulations.

Is there evidence to show whether trans women hold any physical advantage in athletics?

To answer that, Williams considers two steps: before and after an athlete transitions. “Before they transition, trans women are genetically and biologically no different from other men,” Williams says.

“Do men have an advantage over women at that stage? There is an overwhelming mountain of evidence saying very clearly, yes. It might be 10 to 15 per cent in running events, a bit more in those involving upper body strength. That’s why traditionally almost all sports have two categories for male and female.”

The advantages stem from male puberty.

How does an athlete’s body change during puberty?

Testosterone levels increase during male puberty, which has an impact on physical attributes and can affect performance in sport.

“Testosterone is the key driver for the increase in bone length and mass, longer arms, legs, and thicker bone, so they’re heavier,” Williams previously told The Athletic in an article on transgender footballers.

“An increase in muscle mass gives a lot more strength and power. Larger organs, like a larger heart, are key for pumping blood around the body, especially in endurance-type performance.”

“If you have more haemoglobin, the protein that grabs oxygen from the lungs and carries it to the muscles, circulating in the blood, you can better transport oxygen around the body to muscles when they work, which helps endurance performance.”

Is the male advantage removed or reduced when an athlete transitions?

“It’s hard to make definitive claims about exactly what trans women do and don’t do athletically,” says Harper. “The real question is, in this case, what happens after said athlete undergoes a supervised gender-affirming hormone therapy, which in Petrillo’s case involves testosterone suppression.”

According to Williams, “the perfect study doesn’t exist”, while Harper adds the data are “sparse” and the science is in its “infancy”.

Williams highlights research limitations, such as how to measure muscle strength, body composition and the participants themselves who are usually not trained athletes.

“There are better and more relevant measures of strength for running, such as leg strength,” says Williams. “Most studies don’t do that, they use hand grip strength. Ideally, you would have studies using good measurements and well trained people who then lower their testosterone.

“There’s over a dozen studies that have researched when trans women have lowered their testosterone levels. The results are fairly consistent: some of the advantages (from male puberty) mentioned above reduce a bit. The haemoglobin level decreases a lot from a typical male to a typical female level.”

Petrillo spoke of her low haemoglobin, via the BBC, after her transition in 2021, as well as a change in metabolism causing weight gain, not having the same physical strength and suffering from anaemia and mood swings. “I’m not the same as before,” she said.

“Most scientists in this area would pretty confidently infer from the studies, even with their limitations, that when someone lowers their testosterone when they transition, that is not going to slow them in those kinds of races to the extent of the advantage they would have got from previously going through male puberty,” says Williams. “Trans women hold a physical advantage in any athletic or para-athletic event.”

Harper acknowledges that “anyone who goes through a testosterone-fueled puberty gains substantial athletic advantages over those who don’t” and compared to cis women, trans women are, in her words, “taller, bigger and stronger, even after hormone therapy”. She notes, however, that those qualities are advantages in many sports within all male or all female categories. A taller basketball player may have an advantage over their competitors, for example.

“The question isn’t whether somebody is absolutely stronger in terms of moving their body, but if they have a greater relative strength,” she says. Harper points to the paper, Strength, Power and Aerobic Capacity of Transgender Athletes: A Cross-sectional Study by Hamilton et al. published in April, which suggests trans women do not have higher relative strength and so would not have an advantage in sprinting, but would do in discus throwing.

“We don’t have definitive answers at this point. The data I’ve seen so far would lead me to conclude that it’s reasonable to have her compete.”

Is it fair for trans women to compete in female athletic events, therefore?

Although Harper does not dispute trans women were developed under the influence of male levels of testosterone and emphasises the importance of gender-affirming hormone therapy and testosterone suppression, she does not think it is “problematic for her (Petrillo) to be racing”.

“From the data I have gathered, plus my own personal experience, therapy and testosterone suppression makes enough of a decrease in performance that is reasonable to allow her to compete.

“In most sports, testosterone suppression mitigates — doesn’t eliminate — the advantages of going through a testosterone-fuelled puberty to the point where trans women and cis women can engage in meaningful competition.”

Williams, however, disagrees and thinks it’s “probably not” fair. “There are two reasons why I would say probably rather than definitely not. The evidence, although pretty convincing, could always be better.

“The only other argument for saying it would be fair is the philosophical standpoint on the status of trans women: some insist they are women, in which case they should be eligible to compete in the women’s competition, separate from any evidence of physical advantage.

“For me and most other scientists who research these topics, the evidence is strong enough to justify not allowing trans women to compete in the women’s category.”

There was a gender row in the Olympics regarding Algerian boxer Imane Khelif and Taiwan’s Lin Yu-ting. How do the two situations compare?

“That is very different because you’re not talking about transgender people,” says Williams. “The regulations that were applied to those boxers and the discussion was about people with differences in sex development, DSD.

“In the case of trans women, genetically and biologically, up until the point of transition, they are indistinguishable from all other men. Then they transition. In the vast majority of cases, DSD is because of a rare genetic difference compared to most of the population which affects their biology. That is partly related to their internal and external sex organs and how they appear.

“The non-biological or psychological difference is that transgender athletes know they are transgender and what is happening. Whereas in some cases, people have no idea they have DSD. In other cases, they might know that something about their biology is unusual, but they haven’t had a medical examination and maybe they don’t want that.”

As regards Khelif and Lin, the IOC, in response to questions from The Athletic about a written clarification of comments made by president Thomas Bach, declined to say whether it believed they had differences in sex development. You can read more on them here.

Can’t trans women compete with men or in an open category?

This question was addressed by my colleague Nancy Froston in her excellent piece from a couple of years ago on trans footballers. She wrote: “Trans women identify as female and suffer from gender dysphoria, which makes asking them to compete in male categories inappropriate. Open categories are under consideration in several sports as a possible solution to allow transgender women to compete, although it remains to be seen how that could look in various individual sports such as swimming or athletics.”

We asked Harper her thoughts on this and she was very clear.

“Trans women do not belong in men’s sports because trans women aren’t men,” says Harper. “Trans women are women. It’s important when creating rules for trans women in sports to consider the physical differences between trans women and cis women. At the heart of this matter should be that trans women belong in women’s spaces. It shouldn’t be a question of whether trans women are allowed in women’s sports, but under what conditions?

“If an ‘open’ category is where everyone in that category is male except for trans people, then you are othering trans people and not in any way honouring who trans people are. You’re just saying they can compete with men and we’ll just change the name. But that doesn’t fool anyone.”

Where do we go from here?

“Who knows?” says Harper, who vows to continue her research. “I don’t know where we go from here. Where do the sports governing bodies go? I don’t know. So many sports are doing different things. How do we get to a place where this won’t be controversial? I just don’t have answers.

“Whatever decisions governing bodies make on trans athletes, there’s going to be controversy. Sports governing bodies need to be careful. The IPC has obviously been careful on this, World Athletics has been careful. They came to different decisions.”

Petrillo running in the Paralympics will make headlines and stir up controversy yet again. “Petrillo is a human being,” Harper reminds readers. “She’s following the rules that are in place, she’s not cheating.

“They’ve allowed her to compete. She’s competing.”

(Top photo: Matthias Hangst/Getty Images)