Abstract
Sport is historically designated by the binary categorization of male and female that conflicts with modern society. Sport's governing bodies should consider reviewing rules determining the eligibility of athletes in the female category as there may be lasting advantages of previously high testosterone concentrations for transwomen athletes and currently high testosterone concentrations in differences in sex development (DSD) athletes. The use of serum testosterone concentrations to regulate the inclusion of such athletes into the elite female category is currently the objective biomarker that is supported by most available scientific literature, but it has limitations due to the lack of sports performance data before, during or after testosterone suppression. Innovative research studies are needed to identify other biomarkers of testosterone sensitivity/responsiveness, including molecular tools to determine the functional status of androgen receptors. The scientific community also needs to conduct longitudinal studies with specific control groups to generate the biological and sports performance data for individual sports to inform the fair inclusion or exclusion of these athletes. Eligibility of each athlete to a sport-specific policy needs to be based on peer-reviewed scientific evidence made available to policymakers from all scientific communities. However, even the most evidence-based regulations are unlikely to eliminate all differences in performance between cisgender women with and without DSD and transwomen athletes. Any remaining advantage held by transwomen or DSD women could be considered as part of the athlete's unique makeup.
| Original language | English |
|---|---|
| Pages (from-to) | 1401-1415 |
| Number of pages | 15 |
| Journal | Sports Medicine |
| Volume | 51 |
| Issue number | 7 |
| Early online date | 24 Mar 2021 |
| DOIs | |
| Publication status | Published - 31 Jul 2021 |
Bibliographical note
Funding Information:Ultimately, even the most evidence-based policies will not eliminate differences in sporting performance between athletes in the elite category of female sports. However, any advantage held by a person belonging to an athlete in this category could be considered part of the athlete’s unique individuality. Whatever the solution, there is an urgent need for a well-coordinated multidisciplinary international research program, backed by appropriate research grant funding and athlete participation, to generate the evidence to inform future objective policy decisions. Such decisions should be based on the best available scientific evidence from the best available scientific practice and the decisions made will also require a firm political resolve to fairly integrate transwomen and DSD women athletes into elite female sport.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Physical Therapy, Sports Therapy and Rehabilitation