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Trans Athletes + Hormones: A Breakdown

Updated: Jul 9



Everything you need to know about trans athletes, hormones, and individual variability for trans women + trans men athletes.


Trans Women

  • Some studies suggest that hormone therapy can reduce physical performance measures in transgender women to levels comparable to those of cisgender women, but there is also evidence indicating that some advantages, such as bone structure and lung capacity, might not be fully negated.

  • Transgender women (male-to-female, MtF) who undergo hormone replacement therapy (HRT) typically take estrogen, possibly in combination with anti-androgens, to induce feminine physical characteristics and to reduce masculine features. The goal of HRT for transgender women is to achieve hormone levels within the typical range for cisgender women (individuals whose gender identity matches their sex assigned at birth).

  • Hormone Levels

    • Estrogen: The primary hormone therapy for transgender women involves estrogen, which promotes the development of female secondary sexual characteristics, such as breast growth, redistribution of body fat to a more typically feminine pattern, and softening of skin.

    • Anti-Androgens: Many transgender women also take anti-androgens to reduce the effects of testosterone, such as facial and body hair growth and the prevention of further masculinization. Reducing testosterone levels allows estrogen to be more effective in creating feminine characteristics.

  • Achieving Hormone Levels 

    • Hormone Levels: With appropriate medical supervision and treatment, many transgender women can achieve estrogen levels and testosterone levels within the typical ranges for cisgender women. However, individual responses to hormone therapy can vary based on factors like age, the specifics of the HRT regimen (e.g., dosages and routes of administration), and the individual's health profile.

    • Monitoring and Adjustment: Regular monitoring by healthcare professionals is essential to adjust hormone doses to ensure that levels remain within the desired range, and to manage any side effects or health risks associated with hormone therapy.

  • Individual Variability 

    • It's important to recognize that while HRT can significantly alter hormone levels to match those typically found in cisgender women, individual experiences and outcomes can vary. The extent to which HRT affects physical characteristics and hormone levels can depend on several factors, including how long the person has been on HRT, their age at the start of HRT, and individual biological differences.

    • Through carefully managed HRT, transgender women often achieve hormone levels similar to those of cisgender women, although there is variability in how individuals respond to the therapy.

Trans Men

  • Testosterone is considered a performance-enhancing drug (PED) in the context of sports. Testosterone is an anabolic steroid, a type of PED that increases muscle mass, strength, and endurance by promoting protein synthesis in cells. This can give athletes an unfair advantage in terms of physical performance and recovery times.

  • Testosterone as a Performance Enhancing Drug

    • Due to its performance-enhancing effects, testosterone is banned in competitive sports by most international sports organizations, including the World Anti-Doping Agency (WADA). Athletes are prohibited from using testosterone and other anabolic agents except under specific medical conditions for which they can apply for a Therapeutic Use Exemption (TUE). The TUE allows an athlete to use a prohibited substance if there is a clear medical need and if the use of the substance does not enhance performance beyond returning the athlete to a normal state of health.

    • The use of testosterone and other anabolic steroids without a TUE is considered doping, a violation of anti-doping rules that can result in penalties, including suspension from competition, fines, and stripping of titles or records. Anti-doping organizations use drug testing to detect the presence of testosterone and other banned substances, employing methods to distinguish between endogenously produced (naturally occurring in the body) testosterone and exogenous (synthetic) testosterone to identify doping.

  • Hormone Levels 

    • Transgender men (female-to-male, FtM) who undergo hormone therapy with testosterone can achieve testosterone levels within the male physiological range, making their levels similar to those of cisgender men (individuals whose gender identity matches their sex assigned at birth). However, the specific outcomes can vary based on factors such as the dosage, the method of testosterone administration (e.g., injections, patches, gels), the individual's metabolism, and how their body responds to hormone therapy.

    • Testosterone therapy in transgender men is designed to induce the physical changes associated with male puberty, including increased muscle mass and strength, redistribution of body fat, deepening of the voice, and growth of facial and body hair. The goal of hormone therapy is often to align the individual's physical appearance more closely with their gender identity and to achieve hormone levels that are consistent with those typically found in cisgender men.

    • Regular monitoring by healthcare providers is essential to adjust the hormone dosage as needed and to ensure that testosterone levels remain within a safe and effective range. This monitoring helps to manage any potential side effects of hormone therapy and to ensure that the desired physical effects are achieved.

    • It's important to note that while testosterone therapy can align trans men's hormone levels with those of cisgender men, individual experiences with hormone therapy can vary. Factors such as age, health status, and the duration of hormone therapy can influence the outcomes of this treatment.


Please note that non-binary and non-gender-conforming athletes can choose to take or not take hormone replacement therapy (HRT). Similar individual variability will factor into their competitive advantage or lack thereof.

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