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The Virginia High School League on Wednesday approved the participation of transgender athletes in prep sports.

The motion passed by 27-0 vote of the league’s executive committee, which is made up of school principals and athletic directors, among others, from throughout the state. The VHSL oversees athletics at 313 public high schools in Virginia.

“It is a reality that there are transgender students who are interested in participating in athletics,” said Ken Tilley, executive director of the VHSL. “It’s something we recognize we need to be of service to our schools and our students.”

A person is considered transgender when he or she identifies with a gender other than his or her birth sex. This includes changes in dress or appearance.

But to comply with the league’s policy, the athlete will have to make physiological changes, too.

The athlete must have undergone sex reassignment, including surgical removal of the external sex organs and the ovaries or testes. He or she must undergo hormonal therapy such that it minimizes gender-related advantages in sports competition.

If the student stops taking hormonal therapy, he or she will be required to participate in the sport of his or her birth gender.