Strength, power and aerobic capacity of transgender athletes: a cross-sectional study

Author:

Hamilton BlairORCID,Brown AndrewORCID,Montagner-Moraes StephanieORCID,Comeras-Chueca CristinaORCID,Bush Peter GORCID,Guppy Fergus MORCID,Pitsiladis Yannis PORCID

Abstract

ObjectiveThe primary objective of this cross-sectional study was to compare standard laboratory performance metrics of transgender athletes to cisgender athletes.Methods19 cisgender men (CM) (mean±SD, age: 37±9 years), 12 transgender men (TM) (age: 34±7 years), 23 transgender women (TW) (age: 34±10 years) and 21 cisgender women (CW) (age: 30±9 years) underwent a series of standard laboratory performance tests, including body composition, lung function, cardiopulmonary exercise testing, strength and lower body power. Haemoglobin concentration in capillary blood and testosterone and oestradiol in serum were also measured.ResultsIn this cohort of athletes, TW had similar testosterone concentration (TW 0.7±0.5 nmol/L, CW 0.9±0.4 nmol/), higher oestrogen (TW 742.4±801.9 pmol/L, CW 336.0±266.3 pmol/L, p=0.045), higher absolute handgrip strength (TW 40.7±6.8 kg, CW 34.2±3.7 kg, p=0.01), lower forced expiratory volume in 1 s:forced vital capacity ratio (TW 0.83±0.07, CW 0.88±0.04, p=0.04), lower relative jump height (TW 0.7±0.2 cm/kg; CW 1.0±0.2 cm/kg, p<0.001) and lower relative V̇O2max (TW 45.1±13.3 mL/kg/min/, CW 54.1±6.0 mL/kg/min, p<0.001) compared with CW athletes. TM had similar testosterone concentration (TM 20.5±5.8 nmol/L, CM 24.8±12.3 nmol/L), lower absolute hand grip strength (TM 38.8±7.5 kg, CM 45.7±6.9 kg, p=0.03) and lower absolute V̇O2max (TM 3635±644 mL/min, CM 4467±641 mL/min p=0.002) than CM.ConclusionWhile longitudinal transitioning studies of transgender athletes are urgently needed, these results should caution against precautionary bans and sport eligibility exclusions that are not based on sport-specific (or sport-relevant) research.

Funder

International Olympic Committee

Publisher

BMJ

Reference48 articles.

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4. International Olympic Committee . Framework on fairness, inclusion and non-discrimination on the basis of gender identity and sex variations, 2021. Available: https://stillmed.olympics.com/media/Documents/News/2021/11/IOC-Framework-Fairness-Inclusion-Non-discrimination-2021.pdf

5. National Health Service . Shared Care Prescribing Guidance For Treatment of Gender Dysphoria in People Assigned Male at Birth Transitioning to a Feminine Gender Identity, 2022. Available: https://gic.nhs.uk/wp-content/uploads/2022/12/Shared-Care-Protocol-Trans-Feminine-v10.3_approved-22.12.2022.pdf

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