Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage

Emma Hilton and Tommy Lundberg in Sports Medicine (2020)

This paper reviews how differences in biological characteristics between biological males and females affect sporting performance and assess whether evidence exists to support the assumption that testosterone suppression in transgender males removes the male performance advantage and thus delivers fair and safe competition.

It finds that the performance gap between males and females becomes significant at puberty and often amounts to 10–50% depending on sport. The muscular advantage enjoyed by males who suppress their testosterone production in order to identify as women is only minimally reduced. Sports organisations should consider this evidence when reassessing current policies regarding participation of males who identify as women in the female category of sport.