The requirement for bottom surgery presents two major issues. The first is that not all trans people even want surgery — many do not. The second issue is that a surgical requirement is little more than a transgender tax. While the hormones our bodies run on tend to have a huge effect on strength, genitals are just along for the ride; again, science and medicine back this up. However, gender-confirming surgeries are extremely expensive and rarely covered by insurance. For the vast majority of trans athletes, following USATF’s rules means a cost starting at $20,000 on the low end. And regardless of how surgery is paid for, there are only around a dozen doctors in the U.S. who will even perform these surgeries, meaning there are long waitlists for surgery. According to current statistics, less than 1 in 5 trans women have had gender-confirming surgeries, and even fewer trans men have.
Amelia Gapin (@totallyamelia)(@foreveramelia on Twitter), “The Hardest Part is Simply Registering: The Challenges of a Transgender Runner,” Runhaven.com July 2015. And yes, she did have bottom surgery last month. Read more here