Nobody who knows me would call me an athlete. If I wasn’t picked last for team sports at school, then it was next to last. Every time. Because of this pathetic natural ability, I have never been one who availed myself of all the sports opportunities I was given.

Yet I remember—and remember celebrating—when Title IX became law in 1973 when I was in the 10th grade. It prohibited discrimination on the basis of sex in any federally-funded education program or activity. Therefore, the money spent for my high school’s all-male football program, so my athletic female classmates argued, should now be matched, dollar for dollar, for sports programs benefiting them. I completely agreed and argued alongside them. However, even though Title IX was now law, those dollars did not flow toward female athletes without a fight.

My high school years were also when the Equal Rights Amendment was being hotly debated. Every day, conversations swirled around me, centering on the need for women to receive equal pay for equal work, and to be treated with respect and not merely as sex objects by men. Friends started calling themselves feminists, and though I’ve never labeled myself in this way, I certainly sympathized then, and sympathize now, with their underlying desire to be treated fairly.

Since I was leaving high school for Wellesley, a woman’s college and a liberal one at that, I anticipated that most of my college classmates would consider themselves feminists, and that was indeed the case. Most of the issues my feminist friends considered important seemed to be justice issues, seeking equal treatment for women—something I’ve always respected.

I’ve spent the decades since college glad for the women who are willing to stand up for even-handed treatment of men and women, speaking out when they see bias.

So that is why the transgender sports issue perplexes me so much. It was a year ago I first heard of a transgender female high school student winning a track race with a time that wouldn’t have been competitive as a male. I honestly expected feminist voices everywhere to cry, “Foul play!”

Why do I not hear the voices of my feminist friends?

What happens when women do speak out could be the reason. Famed tennis player Martina Navratilova wrote on February 19 in The Sunday Times that it was “insane” for female transgender athletes to achieve honors “that were beyond their capabilities as men.” Again, I thought these comments would lead to a groundswell of support for her. But I was very wrong. Instead, she has been labeled “transphobic” and removed from the advisory board of Athlete Ally, which supports LGBT sportspeople.

Piers Morgan, in a Daily Mail commentary, quotes former Olympic swimmer Sharron Davies: “‘There is a fundamental difference between the binary sex you are born with and the gender you may identify as,’ Davies said. ‘To protect women’s sport, those with a male sex advantage should not be able to compete in women’s sport. Every single woman athlete I’ve spoken to, and I have spoken to many, all of my friends in international sports, understand and feel the same way as me. It’s not a transphobic thing. We have no issue with people who are transgender.’”

It seems the kneejerk response to those who are speaking out in defense of biologically female athletes is to call them transphobic. But maybe they are not so much “trans-phobic” as “femina-philic.”

As a physician, I have great compassion for people who were born as one biological sex and now perceive themselves to be another gender. Their biology does not correspond with their self-perception. There is a mismatch. Legally they may be considered to be whatever gender they wish to be, but that does not change their biology.

A transgender male can say he is exactly the same as all other males, but every one of his cells still has two X chromosomes. A transgender female’s cells still have XY. Just saying something different doesn’t make it so.

In an opinion piece in The New York Times, Duke Law Professor Doriane Coleman wrote:

“Starting in puberty there will always be boys who can beat the best girls and men who can beat the best women.

Because of this, without a women’s category based on sex, or at least these sex-linked traits, girls and women would not have the chance they have now to develop their athletic talents and reap the many benefits of participating and winning in sports and competition. Eric Vilain, a geneticist who specializes in differences of sex development, has been blunt about it: removing sex from the eligibility rules would ‘be a disaster for women’s sport … a sad end to what feminists have wanted for so long.’”

It has only been 150 years that women have been seeking to participate in physical activity for competitive reasons and not just recreational. But it wasn’t until 1896 that the first intercollegiate competition for women—in basketball—was held. Women’s sports, with one hard-won victory after another, have made great strides since then.

Feminists, seeking equality on behalf of women’s rights and interests, have been at the forefront of this movement. And now, I propose, they have another injustice to rectify.