Transgender Athletes and Sports Performance: A Review of Physiological, Hormonal, and Functional Evidence
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Abstract
The participation of transgender people in high-performance sports has become a topic of growing scientific, social and sporting relevance, especially in the face of debates on inclusion, competitive equity and international regulation. This study aimed to analyze physiological and hormonal evidence related to the participation of trans athletes in high-performance sports, with emphasis on the impacts of hormone therapy on physical performance and the guidelines established by international sports agencies. This is a narrative review of the literature, carried out through searches in the PubMed, SciELO and NIH databases, in addition to institutional documents of the International Olympic Committee (IOC). Studies published between 1966 and 2024 were included, , totaling 45 scientific articles. The results show that hormone therapy promotes significant changes in body composition, muscle strength, hormonal profile and aerobic capacity of transgender people. In trans women, a reduction in lean mass and muscle strength was observed, in addition to redistribution of body fat; in trans men, there was an increase in muscle mass and a reduction in adipose tissue. Part of the literature points out that certain physiological characteristics may remain partially preserved, keeping the debate on competitive advantages open. In addition, the inclusion of trans athletes involves biological, social, psychological and institutional factors, such as transphobia, social exclusion and difficulties in accessing health and sport. It is concluded that there are still scientific limitations related to the scarcity of long-term studies with elite athletes, and new research is needed to build more well-founded sports criteria, reconciling inclusion, security and competitive justice.
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