Or maybe those that take performance-enhancing drugs will just have to accept that their body modification choices preclude participation in competitive sport.

There are trans-identifying female athletes who don't take testosterone and compete in women's sports, recent example in the last Olympics being Hergie Bacyadan in women's boxing. There's no exclusion on participation as long as the same rules as for everyone else are followed.

Again, you’re just highlighting the fact that trans people’s bodies are very variable and that this is a complex issue. There isn’t a simple, obvious solution that everyone (currently) agrees is fair. The current rules around trans athletes receiving testosterone as part of gender affirming care are quite complex and variable. I don’t have a take on exactly what the rules should be. I’m just making the point that there are no easy solutions.