Last month, the chairman of the Samoa 2019 Pacific Games, Loau Solamalemalo Keneti Sio, described the participation of transgender weightlifter Laurel Hubbard in the over-87 kilograms event, where she won two golds, as "unfair".
As insidethegames reported at the time, there was a cheer from the local crowd when the 41-year-old New Zealander, who transitioned to female in 2012, failed at a final clean and jerk lift, enabling Samoa’s Iuniana Sipaia to take the gold medal in that particular discipline.
Hubbard responded by blowing a kiss and waved to the crowd before departing the competition platform.
Loau told the Samoa Observer that the Pacific Games Council is obliged to follow rules set out by the International Olympic Committee (IOC) and the International Weightlifting Federation (IWF).
Despite this, he claimed the decision to allow Hubbard to compete was "unfair" and the reaction from the home crowd had been "understandable".
"They have allowed New Zealand transgender weightlifter Laurel Hubbard to lift in the women's category and there is nothing we can do about it," Loau said.
"We all know that it is not fair to the women lifters but that is a reality we face in the world of sports.
"The rules have changed and we cannot deviate from these rules.
"The IOC and IWF do not discriminate against transgender athletes and while this may be hard to accept, we must learn to adapt to these rules because it will not change for anyone."
These were not the first criticisms of Hubbard’s participation in women’s events.
After she won gold in the over-90kg category at the 2017 Australian International event, several of her competitors criticised the decision to allow her to take part, and the Australian Weightlifting Federation’s chief executive Michael Keelan said it was "unfair" to other competitors.
There was further adverse comment when she competed at last year's Commonwealth Games in the Gold Coast, where she looked set for gold until having to withdraw because of an elbow injury.
After Hubbard’s winning performance at the Pacific Games the Samoa Prime Minister Tuilaepa Aiono Sailele Malielegaoi told Reuters: "I really don’t think he - she - should ever participate in this [tournament] but I realise we have to [be] inclusive and we cannot exclude these people.
"They ought to participate in these Games in their own category.”
At the Pacific Games Closing Ceremony the Prime Minister called for further "consultations" on transgender sports policies.
He said: "Samoa has learned a lot from these Games.
"National sports organisations should hold consultations on transgender sports policies so we can understand the balance of human rights and gender implications."
That balance is particularly difficult to strike.
Sport in general, and elite sport in particular, is about pushing to the edge of the rules without transgressing them.
In that respect, there was nothing unfair about Hubbard’s participation, or subsequent success, at the Pacific Games.
She has chosen to be female, which is her right. She has operated within accepted IOC guidelines.
The question is - are the guidelines fair on Hubbard’s conventionally female competitors?
It is unfortunate for Hubbard that she has become emblematic in the debate that is currently taking place over this issue, a debate that is likely to become even more heated as the New Zealand lifter heads for next year's Olympic Games in Tokyo.
Last Monday Reuters reported that the New Zealand based lobby group "Speak Up For Women", which advocates that sport must be categorised by sex rather than gender identity, had called on the country's National Olympic Committee and Sports Minister Grant Robertson to "defend women's sport".
The group’s spokesperson, Ani O’Brien, said: "Kiwis know that males competing in women's sport is blatantly unfair."
The call followed criticism from British advocates "Fair Play for Women", who wrote on Twitter that sports officials needed to "wake up" in the days after Hubbard's Pacific Games victories.
Is this what you call a “small but vocal minority”? 96%?@NewshubNZ @grantrobertson1 @nzolympics @SportNZ— Ani ⚢ (@aniobrien) August 3, 2019
We are speaking for the 96% & speaking up for women’s sport. @SpeakUp4WomenNZ #SexNotGenderIdentity pic.twitter.com/lIJpFL4VMI
Their broad position has been backed in recent months by former British Olympians such as athletes Paula Radcliffe and Dame Kelly Holmes, and swimmer Sharron Davies.
But for all the focus on Hubbard, the debate over the transgender issue in sport is also proceeding in areas beyond weightlifting.
Last month, the Canadian news outlet ctmirror.org reported in its education section that three female athletes, including Glastonbury High School junior Selina Soule, had filed a complaint with the US Department of Education’s Office of Civil Rights arguing that their Title IX rights had been violated by the Connecticut Interscholastic Athletic Conference policy that allows transgender girls to compete in girls’ sports without any hormone treatment.
"Just like my fellow competitors I race to win," Soule said. "But that’s virtually impossible now in an unlevel playing field."
Donna Lopiano, a consultant on Title IX rights and other sports management issues, said: "I don’t know of a woman athlete who doesn’t want trans girls to be treated fairly.
"But the cost of treating her fairly should not come at the cost of discriminating against a biologically-female-at birth woman."
However, opinion is polarised on this issue in Connecticut, just as it is elsewhere.
A total of 16 Connecticut women’s rights and gender justice groups - including NARAL Pro-Choice Connecticut, the New Haven Pride Center, and Planned Parenthood of Southern New England - signed a statement supporting "the full inclusion of transgender people in athletics".
The statement read: "Transgender girls are girls and transgender women are women. They are not and should not be referred to as boys or men, biological or otherwise.
"We speak from expertise when we say that non-discrimination protections for transgender people – including women and girls who are transgender – advance women’s equality and well-being."
The IOC guidelines that currently apply to transgender athletes were issued in 2015. They state any transgender athlete can compete as a woman provided their testosterone levels are below 10 nanomoles per litre for at least 12 months prior to their first competition.
I understand that the IOC Athletes Commission were never consulted over this ruling.
Sean Ingle, in The Guardian, highlighted a fundamental query regarding the guidelines: "…bear in mind the following: women’s testosterone levels range from 0.52 to 2.42 nanomoles per litre, while men’s are 10.41 to 34.70nmol/L.
"Meanwhile the IOC guidelines for transgender athletes, published in 2015, require them to drop their levels to 10nmol/L for 12 months in order to compete as women – a figure much higher than normal."
The IOC guidelines are severely critiqued by Dr Antonia Lee in an article written for medium.com.
"Briefly the previous requirement for transgender surgery was removed while the length of time during which an athlete had to demonstrate testosterone levels within allowable limits was reduced from two years," she wrote.
Lee maintains that what has been billed as a scientific consensus paper offers "no research references whatever".
She adds: "I find it intriguing that in a short commentary in Current Sports Medicine Reports (November 2016), three of the IOC consensus meeting participants argued: 'Given the paucity of relevant research and the likely impact of decisions relating to transgender and intersex athletes, there is now an urgent need to determine not only what physical advantages transgender women carry after HRT [hormone replacement therapy] but also what effect these advantages may have on transgender women competing against women in a variety of different sports.
"'Properly designed intervention studies are required to investigate the effect of the transition (both MTF and FTM transitions) on trainability and performance'”.
Lee also refers to "the methodological flaws in the work of IOC consensus meeting participant, Joanna Harper".
Reuters reports that researchers at the Dunedin-based University of Otago said in a peer-reviewed study published in July that the IOC guidelines were "poorly drawn" and the mandated testosterone level was still "significantly higher" than that of women.
The study advocated that the IOC ditch its "binary" approach to competition and consider introducing a transgender category or find another solution that balances the desire for inclusion with the need for a level playing field.
Ian Miles Chong, managing editor of humanevents.com, highlighted other details of the paper, which appeared in the British Medical Journal’s Journal of Medical Ethics, in which researcher Lynley Anderson and her associates Alison Heather and Taryn Knox argued against proposals capping testosterone levels.
The researchers found that the 10nmol/L level permitted by the IOC was "significantly higher than that of cisgender women, whose sex and gender align as female".
“’It is 10 to 20 times higher than a cis female, so this is one of my major concerns," argued Heather. "At the moment we are really targeting inclusiveness for our trans females to compete in a female division and in that aspect we are not considering a fairness issue for cis females.
"The researchers also argue that the advantages transgender women have over biologically female counterparts extends well beyond testosterone levels. Namely, they have denser and larger muscles, better muscle distribution, and higher lung capacities. Males even have an advantage when it comes to the amount of oxygen they can accumulate."
But such research has been dismissed by transgender advocates and athletes.
"The opinions of scientists although valid, are just that, opinions," said New Zealand mountain biker Kate Weatherly, who transitioned as a teenager and has become a national champion competing against women.
"I'm not winning by crazy margins and the anecdotal evidence does point to me having little to no advantage."
Australian outlet ABC reported Dr Ryan Storr, a lecturer in sports development at Western Sydney University, saying there has been a rise in anti-trans sentiment and that many claims about trans athletes having a natural advantage were unproven or incorrect.
"He [Dr Storr] agreed the area was under-researched, but said until there was evidence to prove trans women had a clear advantage, they should be allowed to compete in the interests of human rights," the ABC report said.
"Dr Storr, who is also founder of LGBT sport charity Proud 2 Play, said there was a misconception that a man could wake up and self-identify as a woman the next day, saying transition was a long physical and psychological process."
Daryl Adair, an associate professor in sports management at the University of Technology Sydney, claimed that there needed to be more clarity from sporting bodies to ensure athletes who had transitioned from male to female weren't "demonised", adding: "One of the elements missing from this debate is that transgender athletes are not doing anything wrong - they're playing by the rules.
"Yet those who are competitive … are widely vilified. Angst should be directed at the rule makers.
"It's in the IOC's hands now. Either they come out with robust evidence for their position or they reconsider their policy."
The need for more research on this sensitive issue offers common ground for the polarised factions.
Fair Play for Women research director, Dr Nicola Williams, also wants more research - but told ABC: "We must suspend the rules now and wait for that data in the next five, six, seven years and then decide.
"In the meantime there have to be other arrangements for transgender people so that they can compete fairly and females can compete fairly."
Commenting on Hubbard's Pacific Games victories, Williams said: "Any reduction in testosterone, even to zero, wouldn't actually reverse the male performance advantage that someone has when they go through male puberty, because we can't reverse that."
In an article written for the Irish Examiner on this broad topic last month, journalist Cathal Dennehy said: "But here’s the thing: if we are to accept the unregulated presence of male biology in women’s sport, that women born without male sex organs must compete against those who have them on the premise that biology is fundamentally unfair, why not abandon the women’s category altogether?
"After all men and women compete against each other in horse racing – why not in athletics, or boxing? The answer is obvious, and should underpin the debate about women’s sport which is, fundamentally, a protected category."