How does hormone transition in transgender women change body composition, muscle strength and haemoglobin? Systematic review with a focus on the implications for sport participation

Review written by Dr Fiona Wilson info

Key Points

  1. Hormone therapy in transwomen decreases strength, lean body mass and haemoglobin.
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BACKGROUND & OBJECTIVE

Increasing visibility of gender-diverse people in society means sport must consider inclusion of transgender people in competitions. There is evidence that there are performance-related differences between male and female athletes, but differences between cisgender women and transwomen who have received gender affirming hormone treatment (GAHT) are not so clear.

There are no published prospective studies which have measured how performance changes after a transgender athlete transitions. Studies in non-athletes show lean body mass (LBM) (1), muscle cross-sectional area (CSA) (2), and haemoglobin (Hgb) (3) all change through transitioning. This review aimed to consider how these changes are associated with athletic performance.

Performance-related differences between cisgender women and transwomen who have received gender affirming hormone treatment are not so clear.
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Athletes require support services including medical teams who understand their physiology and injury profiles.

METHODS

In their systematic review and meta-analysis of 24 studies, the authors examined changes in LBM, muscle CSA, strength and Hgb in longitudinal studies where transwomen were taking GAHT. In cross-sectional studies, data in transwomen were compared to both cisgender women

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