Transgender women elite athletes may need more than the recommended year of feminising hormone therapy to remove the competitive advantage conferred by testosterone, suggests new research.

Transgender women elite athletes may need more than the recommended year of feminising hormone therapy to remove the competitive advantage conferred by testosterone, suggests research published online in the British Journal of Sports Medicine.

Twelve months of treatment to suppress testosterone is the period currently recommended by World Athletics (IAAF) and the International Olympics Committee to ensure a level playing field for all competing athletes.

But the study findings indicate that while hormone treatment was associated with changes in athletic performance, transgender women still retained a competitive advantage 2 years later.

The male hormone testosterone is known to boost muscle strength and endurance. But it’s not clear what impact treatment to suppress its production has on the athletic performance of transgender women during transition.

This makes it difficult to develop guidelines for their inclusion in competitive sports, say the researchers. And the guidelines that have been written are based on limited evidence.

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