Do Transitioned Athletes Compete at an Advantage or Disadvantage
Do Transitioned Athletes Compete at an Advantage or Disadvantage
Do Transitioned Athletes Compete at an Advantage or Disadvantage
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<strong>Tr<strong>an</strong>sitioned</strong> <strong>Athletes</strong> <strong>an</strong>d Competition 3<br />
1.0 Abstract<br />
<strong>Tr<strong>an</strong>sitioned</strong> <strong>at</strong>hletes present a unique challenge to sp<strong>or</strong>t governing bodies with respect to<br />
determining the eligibility of such <strong>at</strong>hletes to compete against physically b<strong>or</strong>n men <strong>an</strong>d women.<br />
The IOC Stockholm consensus on sex reassignment in sp<strong>or</strong>ts allows tr<strong>an</strong>sitioned men <strong>an</strong>d<br />
women to compete against members of their new sex provided th<strong>at</strong> sex reassignment surgery is<br />
complete, the individuals are legally recognized as a member of their new sex <strong>an</strong>d proper crosssex<br />
h<strong>or</strong>mone administr<strong>at</strong>ion has been ongoing f<strong>or</strong> <strong>at</strong> least two years. The basis behind this<br />
st<strong>at</strong>ement is to minimize the effects of previous sex h<strong>or</strong>mone exposure on <strong>at</strong>hletic perf<strong>or</strong>m<strong>an</strong>ce.<br />
The purpose of the current review is to examine the scientific evidence th<strong>at</strong> exists to determine if<br />
tr<strong>an</strong>sitioned <strong>at</strong>hletes compete <strong>at</strong> <strong>an</strong> adv<strong>an</strong>tage <strong>or</strong> disadv<strong>an</strong>tage as compared with physically b<strong>or</strong>n<br />
men <strong>an</strong>d women. Men outperf<strong>or</strong>m women in <strong>at</strong>hletic events by approxim<strong>at</strong>ely 11-18%,<br />
potentially as a result of well known sex differences including th<strong>at</strong> men are taller, have a gre<strong>at</strong>er<br />
maximal aerobic <strong>an</strong>d <strong>an</strong>aerobic capacity, muscle mass <strong>an</strong>d strength <strong>an</strong>d altered substr<strong>at</strong>e<br />
utiliz<strong>at</strong>ion characteristics. The observed sex differences are the result of differences in<br />
testosterone <strong>an</strong>d estrogen. Testosterone increases muscle mass <strong>an</strong>d strength, bone size <strong>an</strong>d<br />
mineral content <strong>an</strong>d haemoglobin content. Estrogen has a profound effect on substr<strong>at</strong>e<br />
metabolism during exercise, increasing the reli<strong>an</strong>ce on lipid st<strong>or</strong>es. As both testosterone <strong>an</strong>d<br />
estrogen c<strong>an</strong> influence perf<strong>or</strong>m<strong>an</strong>ce measures it is imp<strong>or</strong>t<strong>an</strong>t to ensure th<strong>at</strong> tr<strong>an</strong>sitioned <strong>at</strong>hletes<br />
have sex h<strong>or</strong>mone levels within the n<strong>or</strong>mal physiological r<strong>an</strong>ge f<strong>or</strong> their new sex. While<br />
h<strong>or</strong>mone concentr<strong>at</strong>ions in tr<strong>an</strong>sitioned women fall in line with those of physically b<strong>or</strong>n women,<br />
tr<strong>an</strong>sitioned men spend the maj<strong>or</strong>ity of time with supraphysiological levels of testosterone <strong>an</strong>d<br />
higher estrogen as compared with physically b<strong>or</strong>n men. Cross-sex h<strong>or</strong>mone administr<strong>at</strong>ion to<br />
tr<strong>an</strong>sitioned individuals results in haemoglobin <strong>an</strong>d subcut<strong>an</strong>eous f<strong>at</strong> content <strong>an</strong>d muscle crosssectional<br />
areas similar to those values in physically b<strong>or</strong>n men <strong>an</strong>d women. To d<strong>at</strong>e, no study has<br />
examined the effects of cross-sex h<strong>or</strong>mones on <strong>an</strong>y objective measures of <strong>at</strong>hletic perf<strong>or</strong>m<strong>an</strong>ce<br />
(maximal aerobic capacity, time trials). Additionally, no trial has been conducted in tr<strong>an</strong>sitioned<br />
<strong>at</strong>hletes as compared with physically b<strong>or</strong>n men <strong>an</strong>d women <strong>at</strong>hletes. As such, there is no concrete<br />
evidence to supp<strong>or</strong>t <strong>or</strong> refute the position th<strong>at</strong> tr<strong>an</strong>sitioned <strong>at</strong>hletes compete <strong>at</strong> <strong>an</strong> adv<strong>an</strong>tage <strong>or</strong><br />
disadv<strong>an</strong>tage as compared with physically b<strong>or</strong>n men <strong>an</strong>d women <strong>at</strong>hletes.
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