The issue is particularly nettlesome with individuals who have transitioned from male to female because of the belief that they might still have a physical advantage until their hormone therapy — which not every transgender person chooses to have — is complete.

“When you start talking about transgender athletes, a male-to-female individual, we want to ensure that that is truly a decision that is permanent,” said Bobby Cox, the commissioner of the Indiana High School Athletic Association. “It is not a decision that, ‘I just decided today that I am going to be a girl and I am going to go play on a girls’ team’ and perhaps, disadvantage those kids that are on the team and imbalance the competition.

“And as we progress down this path,’’ he added, “and as we spend more time and energy with advocacy groups and medical professionals in this area, I think that there will be additional amendments to our policies.”

There is no reliable data on the number of transgender high school athletes. Only about 0.6 percent of the adult population identifies as transgender, according to federal data from 2016. Researchers from the Williams Institute, who conducted the study, reported that 0.56 percent of adults in Indiana reported identifying as transgender.

In Texas, 0.66 percent of adults said they identify as transgender, the fifth-highest percentage in the country (behind Hawaii, California, New Mexico and Georgia). Still, transgender children are considered an at-risk minority outside of sports. According to The New England Journal of Medicine, the rate of suicide attempts among transgender people is 40 percent, compared to 4.6 percent among those who are not transgender.

Relatively new policies are already being massaged and amended. In July, the Indiana state association voted unanimously to adjust its surgery requirement. It now no longer requires transgender students who are transitioning from female to male to have sex reassignment surgery in order to compete in the gender with which they identify. But that stipulation is still in place for someone transitioning from male to female.

The group asserts it is acting in the name of fairness, but transgender rights activists accuse members of simply not wanting transgender people to participate, out of fear that those athletes will have an unfair advantage.