Sporting Performance of Athletes of the Gender Spectrum: A Cross-sectional Comparison Study Protocol

The question of integrating transgender athletes into their affirmed gender categories is becoming more prominent with sports governing bodies portraying mixed messaging when it comes to answering this question. Testosterone is beneficial to baseline sports performance, and it has been suggested that the differences in circulating testosterone concentrations between cisgender men and cisgender women explain most of the baseline differences in sports performance between the two groups. However, a secondary factor relative to sports performance is the physiological re-distribution of fat mass driven by gender-affirming hormone treatment (GAHT) and the loss of/gain of muscle mass with GAHT in both trans women and trans men and their effects on transgender sporting performance. Previous studies lack data on sports performance measures outside muscular strength and performance measures such as aerobic capacity, power and strength should be studied in tandem within an athletic cohort of trans women and trans men and compared with cisgender women and cisgender male athletes to ascertain whether any lasting advantages are present. New sports performance data on transgender athletes must be generated to inform a decision-making process to inform if the current policies in place are accurate or inexact to maintain fairness and the integrity of sport. Accordingly, this manuscript aims to further provide sports performance and anthropometrical data from a cross-sectional analysis of athletes from 4 groups, trans men (n = ≥6 ) and trans women (n = ≥6) who have undergone ≥ 1 year of GAHT, cis men (n = ≥6) and cis women (n = ≥6) to provide further evidence and consequently, guidance to sport’s governing bodies for the eligibility of transgender athletes.