Anti-Trans Initiative Could Require Student Athlete Genital Exams
A Washington ballot initiative would require student athletes in girls' sports to verify their sex through genital exams, genetic testing, or hormone analysis.
Student athletes in Washington State who wish to compete in girls’ sports could face genital exams under an anti-transgender ballot initiative headed to voters in November.
The initiative would require students to compete on teams corresponding to their sex assigned at birth and verify their “biological sex” before being cleared to play. The measure would bring Washington in line with laws or regulations in 27 states that bar transgender girls from competing on female-designated middle and high school teams.
Under the initiative, students could verify their biological sex through a visual genital exam, a genetic test, or a blood test measuring testosterone levels. The genital exam, which could be conducted by a medical professional without physical contact, would likely be the simplest option to administer, according to Seattle NPR affiliate KUOW.
It’s unclear who would conduct the exams, when or where they would take place, or how the ban on transgender athletes would be enforced.
The initiative is backed by Brian Heywood, a conservative hedge fund manager, and his political action committee, Let’s Go Washington.
Since 2007, transgender students have been allowed to compete on teams that align with their gender identity, and athletes are not currently required to provide medical verification of their sex assigned at birth to be eligible for competition.
Justin Kesterson, assistant executive director of the Washington Interscholastic Activities Association, the governing body for middle and high school sports, says the WIAA is aware of only about 10 transgender athletes among the state’s 200,000 student athletes.
Backers of the initiative argue that allowing transgender girls to compete in women’s sports is unfair and places cisgender girls at a physical disadvantage because transgender girls — particularly those who have undergone male puberty — may possess physical and physiological advantages.
“This is not OK,” Heywood told KUOW of the state’s lack of sex-based restrictions on athletic participation. “Boys are welcome to play in whatever sport they want within the confines of their biological teams.”
Heywood said he does not believe the initiative would impose new medical requirements on student athletes. However, enforcing the ban would require significant changes to the way athletes are screened.
Currently, student athletes must complete a physical examination focused primarily on heart health, breathing, and vision to ensure they can safely compete in sports. But neither the state’s recommended evaluation form nor medical eligibility forms sent to schools require doctors to verify a student’s sex.
Similar forms used by Seattle Public Schools, the state’s largest school district, contain boxes where a doctor can indicate a student’s sex assigned at birth and “identified gender.” However, they do not require physicians to perform genital exams or blood tests on student athletes.
Dr. Erica Li, a pediatrician who supports the ban, acknowledged that sports physicals do not require sex verification but noted that annual pediatric checkups do. She said children who see a pediatrician should receive a brief genital exam to ensure puberty is “progressing properly.” That information, she argued, could be used to confirm a student’s sex assigned at birth without requiring a separate examination for sports eligibility.
Li also argued that students could undergo genetic or hormone testing to verify their sex instead of a genital exam. She added that a doctor could review a student’s birth records, although the initiative does not explicitly list birth records as an acceptable form of verification.
But Dr. Grace Shih, a family medicine physician who opposes the initiative, said sports physicals differ from annual checkups, where a genital exam might occur. She said she would not feel comfortable including information from a routine checkup — which is far more comprehensive — on a sports eligibility form.
Shih told KUOW she is concerned about the financial and logistical barriers posed by sex verification requirements, noting that many cisgender girls — particularly those from lower-income backgrounds or rural areas — do not have regular doctors or insurance coverage for routine checkups.
Former school nurse Katie Johnson, who also opposes the initiative, said schools with large numbers of students who lack regular access to doctors often conduct sports physicals in “batches,” with a volunteer physician examining students in a gym or other public setting. Requiring doctors to conduct genital exams for sex verification would make those screenings far more difficult to administer.
“Students don’t take their clothes off,” Johnson said of group sports physicals. “They’re fully clothed.”
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