Overview
- Published in the British Journal of Sports Medicine, the review pooled 52 studies covering 6,485 participants aged 14–41, including 2,943 transgender women and 568 cisgender women.
- Despite slightly higher lean mass, transgender women showed comparable upper- and lower-body strength and VO₂ max to cisgender women one to three years after hormone therapy.
- Hormone therapy was linked to increased fat mass and reduced lean mass and upper-body strength in transgender women, whereas transgender men generally gained muscle and strength.
- The evidence base was constrained by heterogeneity, short follow-up periods, minimal control for confounders such as training and nutrition, and scarce data on elite athletes or sport-specific performance.
- Study authors say the current data do not justify blanket bans on participation, and experts offered both support and criticism while calling for better-controlled, longer, sport-specific studies to guide eligibility policies.