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

Lavender Room
1

Interesting findings, VO2 max in particular.

A groundbreaking study that was sponsored by the International Olympic Committee and released late last week sought to compare a range of athletic abilities between trans athletes and their cisgender counterparts. The finding that trans women athletes are at a relative disadvantage in many key physical areas relating to athletic ability and perform worse on cardiovascular tests than their cisgender counterparts

**Objective **The primary objective of this cross-sectional study was to compare standard laboratory performance metrics of transgender athletes to cisgender athletes.

Methods 19 cisgender men (CM) (mean±SD, age: 37±9 years), 12 transgender men ™ (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.

Results In 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.

Conclusion While 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.

2

The VO2 part is not really surprising. I have posted in the past how there is direct and measurable correlation between Vo2 and Testosterone and how trans endurance athletes who have been on HRT for 2 + years seen a significant reduction in performance. The public, and private, studies I have seen show a drop off of 13-19%…but there are outliers. There are always outliers. It also significantly diminishes your ability to recover. The equality in bone density is also not a surprise. Lower Vo2, inability to recover, and low bone density are the primary reason why you have seen no M2F trans distance runners at a high level.

While the study does have some flaws it accurately highlight how blanket big government bans are a mistake and this matter is best left up to the sporting federations.

3

Interesting findings, VO2 max in particular.

A groundbreaking study that was sponsored by the International Olympic Committee and released late last week sought to compare a range of athletic abilities between trans athletes and their cisgender counterparts. The finding that trans women athletes are at a relative disadvantage in many key physical areas relating to athletic ability and perform worse on cardiovascular tests than their cisgender counterparts

**Objective **The primary objective of this cross-sectional study was to compare standard laboratory performance metrics of transgender athletes to cisgender athletes.

Methods 19 cisgender men (CM) (mean±SD, age: 37±9 years), 12 transgender men ™ (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.

Results In 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.

Conclusion While 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.

I skimmed the article so maybe I missed something but the biggest problem I see with generalizing their findings is that they basically didn’t control for training status, or even really address it (again, maybe I missed it). The athletes were roughly a third endurance athletes, a third “power” athletes and a third team sports. If for instance the TW had more power athletes and less endurance athletes than the CW, it wouldn’t be very surprising to find lower VO2max. I assume they didn’t further break down the groups and make comparisons based on their training status, e.g. comparing the endurance trained TW and CW, because they lacked the power to find significant differences.

4

I skimmed the article so maybe I missed something but the biggest problem I see with generalizing their findings is that they basically didn’t control for training status, or even really address it (again, maybe I missed it).

Still surprising even given that - needing to arrange the athletes into different buckets in order to see an expected effect.

If for instance the TW had more power athletes and less endurance athletes than the CW, it wouldn’t be very surprising to find lower VO2max

Though the TW also didn’t have great results in power either. They simultaneously perfomed not great vs. CW in relative VO2max and relative power generation.

One interesting detail was the distributions. Though the averages for TW were sometimes lower, they had a huge range. For examples the relative power test (middle right) in the below. TW had a cluster of the top 4 results…and the bottom 4 results.

There was one TW who was just off the charts in power - beating all the CM even in absolute power generation. (I assume the same person in the different graphs). Around 9000W peak absolute power and ~2200W average absolute power is leigt!

bjsports-2023-108029-F4.large.jpg

5

Interesting findings, VO2 max in particular.

A groundbreaking study that was sponsored by the International Olympic Committee and released late last week sought to compare a range of athletic abilities between trans athletes and their cisgender counterparts. The finding that trans women athletes are at a relative disadvantage in many key physical areas relating to athletic ability and perform worse on cardiovascular tests than their cisgender counterparts

**Objective **The primary objective of this cross-sectional study was to compare standard laboratory performance metrics of transgender athletes to cisgender athletes.

Methods 19 cisgender men (CM) (mean±SD, age: 37±9 years), 12 transgender men ™ (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.

Results In 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.

Conclusion While 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.

I skimmed the article so maybe I missed something but the biggest problem I see with generalizing their findings is that they basically didn’t control for training status, or even really address it (again, maybe I missed it). The athletes were roughly a third endurance athletes, a third “power” athletes and a third team sports. If for instance the TW had more power athletes and less endurance athletes than the CW, it wouldn’t be very surprising to find lower VO2max. I assume they didn’t further break down the groups and make comparisons based on their training status, e.g. comparing the endurance trained TW and CW, because they lacked the power to find significant differences.

They required participants to either play in a competitive sport or do physical training at least 3x per week. That covers a wide range.

6

This research is monumentally awful and embarrassing, but it can and will be used to support a conclusion that it cannot reach.

Compare trained female athletes with trans women who work out now and then, with radically different body fat percentages from Day One, and then conclude that the trans women who work out a few days a week and have much more fat don’t perform as well.

Ross Tucker has already thrown this one straight under the bus, where it belongs.

7

We should be doing more studies like this to really figure out the what the rules should be here. Maybe there is a huge advantage, maybe an disadvantage, maybe it should be different for different sports, because I think we want more data here.

It is probably going to be difficult to do studies like this because trans athletes are very very rare to begin with and ones at a high level even rarer.

I just think there are going to be very reasonable rules for trans athletes to compete at many levels, while keeping things fair*.

*as fair as sports can be based on advantages of things like genetics and money being issues.

8

This research is monumentally awful and embarrassing, but it can and will be used to support a conclusion that it cannot reach.

Compare trained female athletes with trans women who work out now and then, with radically different body fat percentages from Day One, and then conclude that the trans women who work out a few days a week and have much more fat don’t perform as well.

Ross Tucker has already thrown this one straight under the bus, where it belongs.

I have not read, or listened to Ross’ take on this yet but he usually is fair when it comes to this topic. One issue I have is the size of the study, it is pretty small. I know that several Feds in the U.S., Canada, Netherlands, and the U.K. have been gathering data from their trans athletes for years. Would be more interesting to see that data. I saw some of it a few years back and it was interesting.

Ross has been clear that he thinks that M2F trans athletes maintain a competitive advantage in speed, strength, and impact sports and has presented studies that back up his position. He has also said that there is the verdict on endurance sports is still up in the air as the studies appear to indicate that the significant reduction in Vo2 etc. eliminates the competitive advantage. This study seems to back up that position.

9

Compare trained female athletes with trans women who work out now and then

Where in the study did you read or conclude this? It reads to me like the recruitment requirement - as @ike stated - was for being a competitive athlete or training at least 3x per week. There is no mention the CW were required to be trained athletes and the TW were required to be more recreational. It’s possible that the distribution could have somehow ended up that way - but I don’t see the information to reach that definitive conclusion in the study. The authors state repeatedly that the small sample size and cross-sectional (vs. controlled) nature of the study are major limitations - indicating acknowledgement that it’s quite possible that the CW cohort was over-represented with baller athletes and the TW side over-represented with relative couch potatoes.

but it can and will be used to support a conclusion that it cannot reach

Of course any study can be used to support any conclusion you want, but the actual authors of this one reach no strong conclusions. They have a very long section on study limitations and mostly conclude that much larger longitudinal studies are needed to reach real conclusions given those limitations, “A long-term longitudinal study is needed to confirm whether these findings are directly related to gender-affirming hormone therapy owing to the study’s shortcomings, particularly its cross-sectional design and limited sample size, which make confirming the causal effect of gender-affirmative care on sports performance problematic.”

That is a tentative conclusion the authors reached. Basically, “This needs to be studied more.”

Ross Tucker has already thrown this one straight under the bus, where it belongs.

Who is Ross Tucker? My first Google hit brings up a former NFL offensive lineman who hosts *The Morning Kickoff with Ross Tucker. *Is this the person you mean?

10

**Who is Ross Tucker? **

He’s a co-author of an excellent science-based sports site called the Sports Scientists. The only ‘black mark’ that the light minded use against him is that he academically trained under Tim Noakes. There’s some good stuffs over at the SS site:
https://sportsscientists.com/who-are-we/

11

**Who is Ross Tucker? **

He’s a co-author of an excellent science-based sports site called the Sports Scientists. The only ‘black mark’ that the light minded use against him is that he academically trained under Tim Noakes. There’s some good stuffs over at the SS site:
https://sportsscientists.com/who-are-we/

OK, that’s better! Despite the Noakes affiliation. :slight_smile: Noakes went kind of wacko at some point, IMO.

12

The trans women had higher BMI, fat mass and absolute fat mass, to a level of statistical significance. They compared apples to oranges, in more ways than one, and concluded they are different fruits.

I’m not saying the authors will overplay the results. They will write the limitations and stand behind that, as they should. It is the media, posters, and advocates that will generalize it. That happens far too often.

We see that studies with small sample sizes and questionable methods often lead to people shouting from the rooftops that things are universally true, like “one in five women in college are raped or sexually assaulted.” Even the authors of the studies that prompted these claims wrote in the limitations that people should not make those conclusions. Yet they do, to advocate a point. The same will happen here.

https://www.politifact.com/article/2014/may/02/are-20-percent-women-sexually-assaulted-they-gradu/

13

Interesting findings, VO2 max in particular.

A groundbreaking study that was sponsored by the International Olympic Committee and released late last week sought to compare a range of athletic abilities between trans athletes and their cisgender counterparts. The finding that trans women athletes are at a relative disadvantage in many key physical areas relating to athletic ability and perform worse on cardiovascular tests than their cisgender counterparts

**Objective **The primary objective of this cross-sectional study was to compare standard laboratory performance metrics of transgender athletes to cisgender athletes.

Methods 19 cisgender men (CM) (mean±SD, age: 37±9 years), 12 transgender men ™ (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.

Results In 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.

Conclusion While 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.
The study does not, and, cannot account for as Martina Navratilova calls them “failed male athletes.” Those who are actually “pretty good” at a sport, but relish winning over basic dignity and sportsmanship (sportspersonship). Scientific study aside; Sorry if that offends, but I’m not in the minority on this.

14

I’m sure I can read through the study to find faults, and then someone will find faults in my assertions lol, these studies seem to be rushed with political timing of things, and likely to be done very poorly.

15

The trans women had higher BMI, fat mass and absolute fat mass, to a level of statistical significance. They compared apples to oranges, in more ways than one, and concluded they are different fruits.

Right, that’s the nature of a cross-sectional. Though the authors did report in relative (to mass) performance, not just absolute.

Deciding to somehow normalize by fat mass is playing games as well. It’s unknown how much of the extra fat mass is a legitimate aspect of transition (it’s pretty well established at this point that TW under hormone therapy gain fat and lose muscle) and how much might be bias in cohort creation. If the authors decided to normalize for mass-related metrics during cohort creation they could be gaming the results in the other direction by negating effects of the natural tendency of biological males to gain fat when their T is cut off.

Rather than doing any such “gaming” they just used random assignment and then reported performance results in absolute and relative (to mass) terms.

Though I read studies ever day, this isn’t my field. So I’m very tentative to making any judgement as to study quality.

What I do dislike about many critiques of studies is that online critics demand the perfect study. Large sample sizes, perfect cohort creation, removal of every known form of bias through RCT or care longitudinal. When those who’ve done these types of studies in real life vs. the internet understand how incredibly expensive that is, and how incredibly long it takes. Someone a study that takes a quick stab at something to guide the creation of future studies is OK. As long as its understood as being just that. This study was probably a very small grant from the IOC. And the authors - at first glance - seemed to have announced their limitation repeatedly and thoroughly.

I put the study strength at about a 2 on the 10 scale, with 10 being the “perfect study.” That alone doesn’t mean it’s a shit study (though it could be shit for other reasons I’m not aware of). It just means it’s a tiny piece of information to add to the pile. Information that may be reversed at some later point in time. Science isn’t a continual forward march in one direction. It’s fits and bursts in various directions, with the movement towards conscensus sometimes nearly imperceptible.

16

Interesting findings, VO2 max in particular.

A groundbreaking study that was sponsored by the International Olympic Committee and released late last week sought to compare a range of athletic abilities between trans athletes and their cisgender counterparts. The finding that trans women athletes are at a relative disadvantage in many key physical areas relating to athletic ability and perform worse on cardiovascular tests than their cisgender counterparts

**Objective **The primary objective of this cross-sectional study was to compare standard laboratory performance metrics of transgender athletes to cisgender athletes.

Methods 19 cisgender men (CM) (mean±SD, age: 37±9 years), 12 transgender men ™ (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.

Results In 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.

Conclusion While 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.
The study does not, and, cannot account for as Martina Navratilova calls them “failed male athletes.” Those who are actually “pretty good” at a sport, but relish winning over basic dignity and sportsmanship (sportspersonship). Scientific study aside; Sorry if that offends, but I’m not in the minority on this.

Do you really think there are men that are willing to go through two years of hormone therapy just so they can be mediocre female athletes?

Do you have an example of this?

17

I’m sure I can read through the study to find faults, and then someone will find faults in my assertions lol, these studies seem to be rushed with political timing of things, and likely to be done very poorly.

Tell me you didn’t ready the study without…oh wait, you just plainly said you haven’t read it. You didn’t read it then announced what you’d find if you actually read it.

This, in study world, is called confirmation bias seeking. You want to see a particular result, and either you’re damn well going to find it or else you’ll “just know” that it’s “political” or “rushed” - just know without actually reading anything.

18

Interesting findings, VO2 max in particular.

A groundbreaking study that was sponsored by the International Olympic Committee and released late last week sought to compare a range of athletic abilities between trans athletes and their cisgender counterparts. The finding that trans women athletes are at a relative disadvantage in many key physical areas relating to athletic ability and perform worse on cardiovascular tests than their cisgender counterparts

**Objective **The primary objective of this cross-sectional study was to compare standard laboratory performance metrics of transgender athletes to cisgender athletes.

Methods 19 cisgender men (CM) (mean±SD, age: 37±9 years), 12 transgender men ™ (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.

Results In 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.

Conclusion While 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.
The study does not, and, cannot account for as Martina Navratilova calls them “failed male athletes.” Those who are actually “pretty good” at a sport, but relish winning over basic dignity and sportsmanship (sportspersonship). Scientific study aside; Sorry if that offends, but I’m not in the minority on this.

Do you really think there are men that are willing to go through two years of hormone therapy just so they can be mediocre female athletes?

Do you have an example of this?
I’d say Lia Thomas did pretty good against females

19

We should be doing more studies like this to really figure out the what the rules should be here. Maybe there is a huge advantage, maybe an disadvantage, maybe it should be different for different sports, because I think we want more data here.

It is probably going to be difficult to do studies like this because trans athletes are very very rare to begin with and ones at a high level even rarer.

I just think there are going to be very reasonable rules for trans athletes to compete at many levels, while keeping things fair*.

*as fair as sports can be based on advantages of things like genetics and money being issues.

Exactly people often act as if scientists can magically create data and that it’s trivial to do so. Can’t be easy to locate transgender athletes and then have them be willing to be part of a study. In a case like this you have to make do with what you have. I’m sure if they could test 100’s of people they’d break down their groups for comparison differently so that they had more homogeneous groups to compare.

The study is still going to have useful information that can be compared to the rest of the literature even if it isn’t the “best” study to answer questions that some people might have.

20

Interesting findings, VO2 max in particular.

A groundbreaking study that was sponsored by the International Olympic Committee and released late last week sought to compare a range of athletic abilities between trans athletes and their cisgender counterparts. The finding that trans women athletes are at a relative disadvantage in many key physical areas relating to athletic ability and perform worse on cardiovascular tests than their cisgender counterparts

**Objective **The primary objective of this cross-sectional study was to compare standard laboratory performance metrics of transgender athletes to cisgender athletes.

Methods 19 cisgender men (CM) (mean±SD, age: 37±9 years), 12 transgender men ™ (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.

Results In 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.

Conclusion While 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.
The study does not, and, cannot account for as Martina Navratilova calls them “failed male athletes.” Those who are actually “pretty good” at a sport, but relish winning over basic dignity and sportsmanship (sportspersonship). Scientific study aside; Sorry if that offends, but I’m not in the minority on this.

Do you really think there are men that are willing to go through two years of hormone therapy just so they can be mediocre female athletes?

Do you have an example of this?
I’d say Lia Thomas did pretty good against females

She had the 6th fastest time in the nation before transitioning so I don’t think she qualified as “failed”.

I think I may have misunderstood your, and Martina’s, point. I don’t think there are any men transitioning just to win more but if your point is that a more high level athlete might have a different response the data on that is mixed. Lia did well but under the new rules would not be allowed to compete. June Eastwood was a top male runner. When she transitioned there was lots of concern about her dominating, she didn’t. She had one decent season then faded. She also competed under the old rules of only a single year of HRT. Based on her more recent performances she did not do well after 2 years of HRT. The only other person I can think of is Pippa York. She transitioned after she retired but has talked about how there is no way she could be competitive as her Vo2 dropped like a rock and she could not recover while on HRT.