title: Sport and Transgender People: A Systematic Review of the Literature Relating to Sport Participation and Competitive Sport Policies.
abstract: BACKGROUND
  Whether transgender people should be able to compete in sport in accordance with their gender identity is a widely contested question within the literature and among sport organisations, fellow competitors and spectators. Owing to concerns surrounding transgender people (especially transgender female individuals) having an athletic advantage, several sport organisations place restrictions on transgender competitors (e.g. must have undergone gender-confirming surgery). In addition, some transgender people who engage in sport, both competitively and for leisure, report discrimination and victimisation.
  
  
  OBJECTIVE
  To the authors' knowledge, there has been no systematic review of the literature pertaining to sport participation or competitive sport policies in transgender people. Therefore, this review aimed to address this gap in the literature.
  
  
  METHODS
  Eight research articles and 31 sport policies were reviewed.
  
  
  RESULTS
  In relation to sport-related physical activity, this review found the lack of inclusive and comfortable environments to be the primary barrier to participation for transgender people. This review also found transgender people had a mostly negative experience in competitive sports because of the restrictions the sport's policy placed on them. The majority of transgender competitive sport policies that were reviewed were not evidence based.
  
  
  CONCLUSIONS
  Currently, there is no direct or consistent research suggesting transgender female individuals (or male individuals) have an athletic advantage at any stage of their transition (e.g. cross-sex hormones, gender-confirming surgery) and, therefore, competitive sport policies that place restrictions on transgender people need to be considered and potentially revised.
authors.affiliation: Nottingham Centre for Gender Dysphoria, 3 Oxford Street, Nottingham, NG1 5BH, UK.|School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK.
authors.forename: Bethany Alice
authors.initials: BA
authors.lastname: Jones
authors.affiliation: Nottingham Centre for Gender Dysphoria, 3 Oxford Street, Nottingham, NG1 5BH, UK. J.Arcelus@nottingham.ac.uk.|Division of Psychiatry and Applied Psychology, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK. J.Arcelus@nottingham.ac.uk.
authors.forename: Jon
authors.initials: J
authors.lastname: Arcelus
authors.affiliation: Nottingham Centre for Gender Dysphoria, 3 Oxford Street, Nottingham, NG1 5BH, UK.
authors.forename: Walter Pierre
authors.initials: WP
authors.lastname: Bouman
authors.affiliation: School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK.
authors.forename: Emma
authors.identifier: http://orcid.org/0000-0002-7359-1759
authors.initials: E
authors.lastname: Haycraft
mesh_terms: D015444:Exercise; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D013177:Sports; D063106:Transgender Persons / Q000331:legislation & jurisprudence* / Q000523:psychology