A study published in the British Journal of Sports Medicine found that transgender women maintain an athletic advantage over cisgender women for at least two years after starting hormone therapy. The study, which was conducted by reviewing the medical records and fitness test results of 29 transgender men and 46 transgender women in the US Air Force from 2013 to 2018, has raised questions about the current one-year waiting period for Olympic athletes transitioning from male to female.
The study was led by Dr. Timothy Roberts, a pediatrician and the director of the adolescent medicine training program at Children’s Mercy Hospital in Kansas City, Missouri. Dr. Roberts conducted the study while working in the Air Force under co-author and physician Lt. Col. Joshua Smalley, at a clinic coordinating care for airmen beginning or continuing their gender transition. Active duty service members in the Air Force are required to take a physical readiness test every six to 12 months, providing Dr. Roberts and his colleagues with access to robust data on the fitness levels of service members before, during, and after hormone replacement therapy.
The fitness assessment included in the physical readiness test consisted of tests of pushups, sit-ups, and running speed. The study found that, for the first two years after starting hormone therapy, transgender women were able to do 10% more pushups and 6% more sit-ups than cisgender women, and were 12% faster on the 1.5 mile run. After two years on hormone therapy, however, the performance of transgender women became comparable to that of cisgender women.
The study’s results suggest that transgender athletes may have an advantage over cisgender athletes for a period of time after beginning hormone therapy, and that this should be taken into consideration when determining eligibility for competitive sports. The current International Olympic Committee guidelines require transgender athletes transitioning from male to female to undergo hormone therapy for at least one year before being eligible to compete. However, the findings of this study suggest that a longer waiting period may be more appropriate in order to level the playing field.
Dr. Roberts, the lead author of the study, stated that “for the Olympic level, the elite level, I’d say probably two years is more realistic than one year. At one year, the trans women on average still have an advantage over the cis women.” He added that, while the study’s methodology is solid, there are some limitations to the data. In particular, there is no information available on the participants’ individual training habits, and there was no coordination between when subjects started hormones and when they took their annual fitness test.
Despite these limitations, the study provides valuable insights into the athletic performance of transgender athletes after beginning hormone therapy. It will be important for future research to continue to explore this issue in order to ensure fair and equal competition in sports.