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In the summer of 2023, Union Cycliste Internationale (UCI), cycling's international governing body, and USA Cycling (USAC), cycling's US governing body, faced a dilemma. Austin Killips, the first openly transgender woman to win an official UCI women’s stage race, had just won several high-level cycling competitions. Although Killips had participated in accordance with UCI guidelines, there was immediate criticism both from some other athletes and parts of the public about the inclusion of transgender women participants in cycling competitions. While the science and research into transgender women's competitive and physical advantage over cisgender female athletes was nascent and inconclusive, some contended that testosterone levels for transgender women, however minimized through hormone treatment, still provided a competitive advantage for these athletes. Particularly given rising social upheaval over transgender rights in more politically conservative areas in the United States, the two organizations had to determine a course of action. They could adhere to the current guidelines as set by UCI in 2022 and try to ignore angry denunciations, or they could try to determine how best to adjust the rules. While USAC and UCI were separate organizations, USAC typically followed UCI's lead, although it had some autonomy in setting regulations. UCI and USAC both realized that they would receive criticism from various groups of stakeholders no matter what they decided to do. This case covers this situation as well as the history of transgender athletes, and gives a brief overview of the research on transgender athletes and competitive advantage. A supplemental B case, UVA-E-0504, outlines the decision UCI and USAC made.