To the Virginia Board of Health:
I write in strong opposition to the petition submitted by The Family Foundation that seeks to amend regulations to ban transgender women from sports and gender-aligned public facilities, and disturbingly, to designate transgender women as a “public health threat.” This petition is not only medically unfounded and scientifically inaccurate, it is also deeply discriminatory, ethically indefensible, and legally precarious. I urge the Board to reject it in its entirety.
Leading medical and public health institutions—including the American Medical Association, the American Public Health Association, the American Psychiatric Association, and the World Health Organization—all affirm that transgender people do not pose a threat to public health. What endangers public health is not the presence of trans individuals in society, but the violence, discrimination, and exclusion they face.
Research consistently shows that transgender individuals, especially youth, face elevated risks of depression, anxiety, substance abuse, and suicidality—not because of their gender identity, but because of societal rejection. A 2022 survey by The Trevor Project found that trans youth who have access to affirming environments, including sports teams and public facilities that align with their gender identity, are significantly less likely to consider or attempt suicide.
This is a public health crisis, but it is one caused by marginalization—not inclusion.
Transgender women have been eligible to compete in NCAA women’s sports under clear hormone-based guidelines since 2011. In over a decade, no credible evidence has emerged showing that transgender athletes dominate or displace cisgender competitors at a systemic level. A 2021 study in the British Journal of Sports Medicine found that after 12 months of gender-affirming hormone therapy, transgender women experience significant reductions in muscle mass, strength, and hemoglobin levels, bringing their physiology into closer alignment with cisgender female athletes.
The International Olympic Committee has also affirmed that no athlete should be excluded based solely on sex characteristics or gender identity, urging a case-by-case approach rooted in science—not ideology.
Exclusionary policies are not about fairness—they are about control. And they disproportionately hurt all women, particularly those who are gender nonconforming, women of color, or who do not fit stereotypes of femininity. We've already seen cisgender girls subjected to invasive scrutiny in states that have passed similar exclusionary laws.
Transgender women’s participation in sports and public life is not a threat—it is a benefit:
Inclusive sports environments build stronger, more resilient teams and promote mental well-being for all youth, including cisgender athletes.
Gender-equitable systems, shaped with input from transgender people, are more nuanced and just for everyone.
Solidarity across gender identities strengthens the fight against sexism, harassment, and gender-based violence, which are true threats to public health.
Trans inclusion fosters respect, empathy, and diversity, essential social values that improve outcomes in schools, workplaces, and healthcare settings.
The petition's language echoes historical abuses of public health authority, where marginalized groups were labeled as threats to justify their exclusion. The Board must not repeat those mistakes.
Furthermore, the proposed policy changes would likely violate federal civil rights laws, including:
Title IX, which protects against sex-based discrimination in educational settings;
The Equal Protection Clause of the U.S. Constitution;
Section 1557 of the Affordable Care Act, which bars gender identity discrimination in health programs receiving federal funding.
Adopting these changes would expose the Commonwealth of Virginia to costly litigation and national condemnation.
Transgender women are not a threat to sports, public health, or society—they are our neighbors, classmates, coworkers, and family members. Their inclusion is not only a matter of fairness—it is a public health imperative.
The Family Foundation’s petition is based on misinformation, rooted in prejudice, and directly contradicts the values of evidence-based policymaking, health equity, and civil rights that the Virginia Board of Health is sworn to uphold.
I respectfully urge the Board to reject this petition entirely and to stand with the medical and public health communities in protecting the dignity and health of all Virginians, including transgender women.
Sincerely,
Catherine Vacovsky
Midlothian, VA
May 13, 2025
