Study finds that trans and cis women's athletic ability aligns post-hormone therapy

A comprehensive new analysis published in the British Journal of Sports Medicine indicates that transgender women exhibit comparable athletic capabilities to cisgender women after one to three years of hormone therapy. This significant finding challenges long-held assumptions regarding inherent athletic advantages for trans women in sports.

The systematic review and meta-analysis, titled Body composition and physical fitness in transgender versus cisgender individuals, synthesized data from 52 studies involving a total of 6,485 participants. The cohort included 2,943 trans women, 2,309 trans men, 568 cis women, and 665 cis men, predominantly adults, with seven studies focusing on adolescents.

Researchers observed that while transgender women may present with slightly greater lean mass compared to cisgender women, this difference did not translate into a measurable advantage in either upper- or lower-body strength. Furthermore, cardiovascular fitness levels were found to be equivalent between trans and cisgender women, LGBTQ+ Nation reports. Crucially, both groups demonstrated lower strength and cardiovascular capacity when compared to cisgender men included in the studies. The analysis also noted that trans men undergoing several years of hormone therapy experienced increased lean mass, decreased fat, and enhanced strength.

The study's authors concluded that "the convergence of transgender women’s functional performance with cisgender women, particularly in strength and aerobic capacity, challenges assumptions about inherent athletic advantages derived solely from [gender-affirming hormone therapy] or residual lean mass differences."

Acknowledging the scope of the current data, researchers highlighted certain limitations. The examined studies did not include elite athletes, whose physiological responses to hormone therapy might differ. There was also a scarcity of research encompassing diverse ages, sports, or competitive tiers. The authors advocated for future long-term, longitudinal studies focused on performance-specific metrics in transgender athletes, while recognizing the practical challenges posed by the limited number of high-performance transgender individuals in specific sports.

This research contributes to the ongoing discourse surrounding the inclusion of transgender women in women’s sports, often marred by claims of insurmountable athletic advantages. Such arguments frequently overlook the impact of hormone therapy in leveling the playing field and sometimes appear to mask underlying animosity toward transgender individuals.

The reality remains that transgender women represent a small minority in sports, and their participation does not diminish the achievements of cisgender female athletes. As transgender golfer Hailey Davidson articulated in 2024, the notion that a trans woman can "win just by showing up" disrespects the profound talent and dedication of all female athletes.