The focus on transgender people is increasing, shedding light on the prejudice they face in competitive sports.
Recently, several U.S. states have proposed legislation requiring students to be assigned to teams based on their gender at birth. This misguided belief, especially regarding transgender girls having a biological advantage over their cisgender teammates, is resulting in the exclusion of transgender people from participating in competitive sports.
In his editorial in the Journal of The Endocrine Society, Joshua Safer, MD, emphasizes the importance of sports participation for transgender people in terms of their health. He urges physicians and endocrinologists to promote exercise for its physical and psychological benefits and avoid discriminating against transgender individuals without evidence.
The discussion around testosterone being a major driver of athletic ability mainly focuses on the period after puberty. This implies that prepubertal kids can play sports without being restricted by their sex assigned at birth.
Concerns arise when transgender women undergo hormone treatment after puberty and the timing of hormone reaffirming therapy. There are questions about whether pubertal changes confer advantages or disadvantages to transgender athletes.
Elite sport bodies have set standards and guidelines for testosterone levels to be more inclusive and fairer for transgender and cisgender athletes. However, more field research is needed before well-informed decisions can be made.
There is currently no evidence to support the claim that transgender women or men have an advantage over cisgender women or men in athletic competition if their hormone levels are similar.
Physical activity is especially important for transgender individuals, as they are at higher risk of various health issues. Yet, they often avoid sports due to fear of discrimination and stigma.
Transgender participation in competitive sports has been a subject of much debate, particularly surrounding transgender women athletes. The controversy revolves around whether exposure to testosterone from typical male puberty provides a performance advantage over cisgender counterparts.
The International Olympic Committee (IOC) and the National Collegiate Athletic Association (NCAA) have set regulations for transgender athletes, focusing on testosterone levels. However, evidence on the effects of testosterone levels on athletic performance remains inconclusive.
There is a lack of clarity on how feminizing hormones impact athletic performance in transgender women, leading to conflicting evidence on the subject. As a result, more research is needed to understand the impact of hormone therapy on transgender athletes.
As endocrinologists, it is important to advocate for research in transgender medicine to create evidence-based policies and improve inclusivity and fairness in sports.
Anuja Chore, MD, and Ricardo Correa, MD, EdD, FACP, FACE, contributed to this article.
It’s Up To Endocrinologists to Encourage and Counsel Transgender Patients
Joshua Safer, MD, emphasizes the responsibility of healthcare professionals to encourage participation in sports and avoid fear-driven policies concerning transgender individuals in sports.
Existing evidence fails to conclusively prove that high levels of testosterone significantly impact performance in female sports, raising concerns about the necessity of hormonal treatments for transgender athletes.
More research is needed to understand the impact of hormone therapy on transgender athletes and improve existing policies to achieve a fair and inclusive environment for all athletes, regardless of their gender identity.
Diana Colleen M. Dimayuga, MD, contributed to this article.
Read the editorial here and a Q&A on its highlights here.