The Effects of Testosterone Levels On Transgender Athletes (Essay Example)

Sports for generations have been divided into men’s and women's categories. As time has passed, intersex and transgender athletes have become a part of these categories. As the transgender community grows so does the number of athletes that compete with cisgender athletes. This increase in athletic involvement has raised many questions about the fairness and equity of sports with the involvement of transgender athletes, especially transgender women (women who were born male but transitioned into a female). This literature review examines the biological factors that have caused questions to arise on whether it is fair for transgender athletes to compete against cisgender athletes. Specifically looking at the testosterone levels, rules created about competing in sports with certain levels of testosterone, and testosterone-reducing treatments. Additionally, it illustrates how testosterone levels pertain to both transgender and cisgender athletes because there are athletes with naturally high levels of testosterone.  

Testosterone levels play a big role in the physical differences between transgender and cisgender athletes. A major cause of this difference is the testosterone levels that men and women have from their original sex, at birth. A male’s hormone levels after puberty can be close to 10 to 15 times the amount of a female’s. Normally females have a testosterone level of around 0.12–1.79 nmol/L and males have a level of around 7.7–29.4 nmol/L (Pam, 2020). The testosterone levels in a man’s body (after they hit puberty) cause more physical changes than in a female's body, including larger muscles, denser bones, and a higher amount of body mass. These advantages allow men on average to run faster, lift more weight, throw farther, etc. Due to these differences sports are separated into different categories men and women, to ensure that competition is fair. With the increasing involvement of transgender athletes, an unfair advantage has allowed many transgender females to maintain a high level of testosterone in their bodies. This high level of testosterone allows women to have male benefits and compete with cisgender females with normal levels of testosterone. But there are treatments that transgender athletes can go through to reduce the levels of testosterone in their body, these treatments are necessary for athletes to compete in competitive sports competitions. These treatments don’t remove all of the male advantages that transgender females may already have. Multiple longitudinal studies from different researchers have found that “the effects of testosterone suppression on muscle mass and strength in transgender women consistently show very modest changes, where the loss of lean body mass, muscle area, and strength typically amounts to approximately 5% after 12 months of treatment.” (Hilton, 2021).  This 5% loss isn’t much when comparing the advantages that people with high levels of testosterone may have. From this, we can tell that having 12 months of testosterone suppression, which is what transgender females have to do to compete in the Olympics and NCAA, is not enough to reduce the male advantages that they may already have. New studies have been done to show that there may be a need for testosterone suppression treatments to be close to 2 years instead of the original 12-month-long treatment. These testosterone suppression treatments aren’t just for transgender athletes, there are women with naturally high levels of testosterone that still have to go through testosterone suppression treatments. Overall it is very difficult to say whether transgender females should or shouldn’t be able to compete in competitive sports just because of the levels of testosterone in their bodies.

Due to the advantage that individuals with high testosterone levels have many rules and regulations have been created to limit the advantage. A majority of these rules have to do with the levels of testosterone in a woman’s body. Due to this the International Olympic Commission (IOC) and the NCCA have created certain rules including that when competing in a women’s category your testosterone level must be below 10 nmol/L (nanomoles per liter) for at least 12 months before and during the time of competition. Specifically, the NCAA has a specific set of steps that schools and athletes must complete to be eligible to compete. They first have to report any transgender athletes wanting to compete, next they must fill out a form confirming that the athlete has gone through a year's worth of hormone suppression. Lastly, the athlete has to take a test to show that their testosterone levels are within range (less than 10 nmol/L) 28 days before the first date of the championship the athlete wants to compete in. These rules and regulations have been made to try and make it fair for transgender and cisgender athletes to compete against each other. As new studies are done, new rules and regulations will come out limiting the accessibility of transgender athletes and cisgender athletes (with naturally high levels of testosterone) to compete against other athletes. The IAAF (International Association of Athletics Federations) also has regulations placed that prevent female athletes that have naturally high testosterone levels from competing. Many of the athletes that have high levels of testosterone have a condition called hyperandrogenism, which causes high levels of androgens (Chiu, 2021). One of the regulations the IAAF has is a women’s testosterone level must be below 5nmol/L, which is half of what the IOC and NCAA require. If females want to compete in the women’s category they either have to lower their testosterone levels through surgery or medications. All of these rules and regulations are limiting an athlete's ability to compete. As more rules come out it will start becoming unfair for transgender and cisgender athletes because of the number of treatments, testing, and stress-related activities they have to endure. 

There are many ways to reduce the testosterone in your body, but testosterone suppression surgeries and medications are not enough to make competing fair for cisgender athletes. When talking about the fairness between transgender and cisgender athletes, what many people point out is the levels of testosterone in their bodies. This amount of testosterone can be suppressed in transgender athletes, but some disadvantages may be concerning for transgender athletes and cisgender athletes. When testosterone suppression is done, the amount of testosterone in your body decreases and it can lead to physical changes. The physical changes may be minimal at the beginning of the treatment and after the first 12 months. An experiment done by Kvorning tested how suppression of testosterone influenced muscle hypertrophy and strength gains during a training program that took place during the last 8 weeks of the 3-month suppression period. During his experiment, he found that women in the control group had a 4% increase in leg lean mass,  a 2% increase in total lean body mass, and an increase in isometric knee extension strength (Hilton, 2021). We can tell from this, that training during a time of testosterone suppression counteracts muscle loss and can increase muscle mass and strength. While the athletes going through the treatment they are undergoing harsh medications and it can be hard on their mental health just to reduce the amount of testosterone in their body. Although they do get to the nmol/L that is required it doesn’t make the competition fair, which is the whole purpose of having athletes undergo testosterone suppression treatments. Multiple longitudinal studies have also come to find that after 12 months of testosterone suppression there is “a modest (approximately − 5%) loss of lean body mass or muscle size” (Hilton, 2021). From this data, the amount of muscle and body mass loss seems minimal, not enough to allow competitive fairness between the transgender and cisgender athletes. Having undergone certain treatment programs may seem beneficial, but after looking at the results of these studies we are seeing that the energy that has been put into lowering testosterone levels isn’t making competing fair for cisgender athletes.

 All of these sources come together to explain how difficult it is to keep athletes from competing. Just looking at the testosterone levels isn’t a valid point in determining whether it is fair, although there are justifications, we need to look at all the facts before we come for all transgender athletes. All of the research that has been done on transgender athletes and their testosterone levels offer a valid point in saying that it is not fair for transgender athletes to have a competitive advantage over cisgender athletes due to their testosterone levels. The increased focus on transgender athletes has caused the media and other individuals to think that having transgender athletes compete is unfair. But we need to think of solutions to try and make it fair for both transgender and cisgender athletes without the need for athletes to be excluded in a sport that they have a passion for.