One of Australia's leading sports medical officers says it's time to embrace transgender athletes as the Australian Sports Commission and Human Rights Commission edge closer to developing a framework for the future.
But a schedule clash prevented AFL medical staff from attending a high performance sports medical officer forum in Canberra just weeks after officials banned Hannah Mouncey from playing in the AFLW.
Dr David Hughes spoke to medical officers from the AOC, athletics, cricket, basketball and netball on Thursday about the need to put guidelines in place to ensure all sport is inclusive.
Mouncey's bid to be drafted by an AFLW team last month has divided opinion about transgender athletes playing in professional or semi-professional competitions.
The AFL said Mouncey, a former Australian men's handball player, would have an unfair size and strength advantage if she joined a semi-professional women's team.
However, the AFL says Mouncey, 100 kilograms and 190 centimetres, is still free to play in the amateur Canberra league.
AIS chief medical officer and Australian Olympic team doctor Hughes hoped developing guidelines for future cases would make it easier for sports and athletes to cope.
"From a medical side of things there are issues with males transitioning to females with hormonal manipulation," Hughes said after giving his presentation.
"That's a medical issue. At the moment, the rule is testosterone levels need to be below 10 nanomoles for 12 months prior to being eligible to compete in the female category.
"I think we've got some basic principles in line [for guidelines for sports], we want to ensure we collaborate and take opinions broadly.
"I see this [gender diversity] as the next phase of developing inclusive policies ... there are tricky issues but I have no doubt we will see more transgender athletes, male and females, competing in sport going forward."
Mouncey says she has not considered having gender reassignment surgery, citing the $30,000 costs as one of the major reasons.
She is set to play for Ainslie next year and is still considering another bid to play in the AFLW next year.
Mouncey's testosterone levels fall well below the 10 nanomoles requirement, but the AFL was concerned she would become too big and too strong to play in a female competition.
"We want to work with sporting organisations in Australia so we can assist ... and to get an outcome that ensure inclusiveness and fairness for all who want to have their lives enriched by sport.
"We're not in the business of dictating to anybody, but I think we're seeing movement in the sporting spectrum.
"We don't want to roll this out three times. We want policy guidelines that are useful to sports to help them be fair to all.
"I wouldn't describe it as a problem. Society values are different now ... I don't see it as anyone has done anything wrong or acted with poor intent, we're just working through issues before rolling out a national policy for all sports."
The future of transgender athletes and gender diversity was a hot topic at the medical officer's meeting, but they also started putting plans in place for heat training before the Tokyo Olympic Games in 2022 and spoke about the improved concussion awareness in Australian sport.