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    Since , the International Olympic Committee have permitted transgender athletes to compete in the Olympic Games under the gender with which they identify. Some elite female athletes, including Paula Radcliffe and Dame Kelly Holmes, have recently questioned this and similar policies , calling for more research into whether transgender women have inherent athletic advantages over their cisgender competitors. This idea stems from the fact that men are, on average, taller than women, and have higher testosterone levels and greater muscle mass. On top of this, men tend to have less fat mass, greater bone density and a higher capacity to carry oxygen in the blood. In total, an elite male athlete performs, on average, ten per cent better than a female equivalent. Some athletes believe, therefore, that transgender women retain a performance advantage after transitioning.
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    Can transgender athletes be fairly integrated into women's sports? - BBC Science Focus Magazine

    Males enjoy physical performance advantages over females within competitive sport. The sex-based segregation into male and female sporting categories does not account for transgender persons who experience incongruence between their biological sex and their experienced gender identity. Whether this regulation removes the male performance advantage has not been scrutinized. Here, we review 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 women removes the male performance advantage and thus delivers fair and safe competition. The performance gap is more pronounced in sporting activities relying on muscle mass and explosive strength, particularly in the upper body.
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    Can transgender athletes be fairly integrated into women’s sports?

    Feminizing hormone therapy , also known as transfeminine hormone therapy , is hormone therapy and sex confirmation therapy to change the secondary sexual characteristics of transgender people from masculine or androgynous to feminine. Some intersex people also take this form of therapy, according to their personal needs and preferences. The purpose of the therapy is to cause the development of the secondary sex characteristics of the desired sex , such as breasts and a feminine pattern of hair , fat , and muscle distribution.
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    Overall, in this project, we are interested in increasing the knowledge about sex hormones and the consequences of changing the hormonal milieu during adulthood. We explore the effects on skeletal muscle, heart, vessels and adipose tissue. In this particular study, we have chosen to comprehensively assess changes in strength, muscle mass and muscle composition with gender-affirming hormonal therapy. This is currently a hot topic in sports because sport-governing bodies are forced to form regulations on participation for transgender individuals who undergo hormone therapy and wish to compete in the category that matches their gender identity. To date, there is very little scientific data on physical changes with cross-hormone therapy, not least in terms of muscle strength.
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