Study Examines the Athletic Performance of Transgender Women

The issue of transgender athletes in sports remains a hot-button issue. On the high school level, some states have sought to ban transgender athletes from competing in girls’ sports. Other states allow athletes to compete in boys’ and girls’ sports based solely on self-identity.

Of the 200,000 women who participate in college sports, it is estimated that about 50 are transgender athletes. The National Collegiate Athletic Association requires that transgender women undergo testosterone suppression treatment for a year before becoming eligible for women’s events. But the NCAA does not set permissible limits of testosterone for transgender athletes.

A new study by researchers at the Children’s Mercy Hospital, Division of Adolescent Medicine in Kansas City and the San Antonio Military Medical Center finds that transgender women athletes maintain an athletic advantage over other women even after a year of beginning testosterone suppression treatment.

The authors reviewed fitness test results and medical records of 29 transmen and 46 transwomen who started gender-affirming hormones while in the United States Air Force. Prior to gender-affirming hormones, transwomen performed 31 percent more push-ups and 15 percent more sit-ups in one minute and ran 21 percent faster in a 1.5 mile run than their cisgender female counterparts. After 2 years of taking hormones, the push-up and sit-up differences disappeared but transwomen were still 12 percent faster.

The authors concluded that the “use of gender-affirming hormones are associated with changes in athletic performance and demonstrated that the pretreatment differences between transgender and cisgender women persist beyond the 12 month time requirement currently being proposed for athletic competition by the World Athletics and the International Olympic Committee. This study suggests that more than 12 months of testosterone suppression may be needed to ensure that transgender women do not have an unfair competitive advantage when participating in elite-level athletic competition.”

Undoubtedly, as we approach the start of the Olympic Games in Tokyo this summer, this issue will be widely debated. The authors admit that the “development of evidence-based guidelines for transgender inclusion in elite athletic competition by governing bodies for athletics requires further research to define the timing of changes associated with testosterone.”

The full study, “Effect of Gender-Affirming Hormones on Athletic Performance in Transwomen and Transmen: Implications for Sporting Organisations and Legislators,” was published on the website of the British Journal of Sports Medicine. It may be accessed here.