1. Integrating Transwomen and Female Athletes with Differences of Sex Development (DSD) into Elite Competition: The FIMS 2021 Consensus Statement
- Author
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William O. Roberts, Jeroen Swart, Irina Zelenkova, Rogério Friedman, Alexander Kolliari-Turner, Victoriya Badtieva, Francisco Arroyo, Bulent O. Yildiz, Luigi Di Luigi, Blair R. Hamilton, Jane T. Seto, María José Martínez-Patiño, Andrew N. Bosch, Theodora Papadopoulou, Fergus M. Guppy, Paulette Y.O. Kumi, José A. Casajús, Guan Wang, Richard Twycross-Lewis, James L. J. Bilzon, Nick Webborn, Karin Vonbank, Evert Verhagen, Federica Fagnani, Jonathan Shurlock, Michael Miller, Kathryn N. North, Michele Verroken, Dimakatso A. Ramagole, Maurizio Casasco, Mats Börjesson, Christian Schneider, Borja Muniz-Pardos, Petra Zupet, Demitri Constantinou, Leighton Seal, Pedro Manonelles Marqueta, Patrick Singleton, Norbert Bachl, Nigel J. Jones, Kumpei Tanisawa, Yannis P. Pitsiladis, Sandra Rozenstoka, Fabio Pigozzi, Juergen M. Steinacker, Michael Geistlinger, Ali Erdogan, Dimitrios G. Goulis, Andre Debruyne, Antonia Karanikolou, André Pedrinelli, Herbert Löllgen, Shu-Hang Patrick Yung, Anca Ionescu, Ana V. Cintron, Joanna Harper, Konstantinos Natsis, Bernd Wolfarth, José Kawazoe Lazzoli, James Barrett, David Niederseer, Felix Drummond, Sigmund Loland, Siddhartha S. Angadi, Vasileios Skiadas, Dina Christina Janse van Rensburg, Chiara Fossati, Xavier Bigard, Giscard Lima, and Michiko Dohi
- Subjects
medicine.medical_specialty ,biology ,Sports medicine ,Inclusion (disability rights) ,Athletes ,Physical Therapy, Sports Therapy and Rehabilitation ,Testosterone (patch) ,Review Article ,030229 sport sciences ,Scientific literature ,biology.organism_classification ,Scientific evidence ,03 medical and health sciences ,0302 clinical medicine ,Categorization ,Transgender ,medicine ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Psychology ,Clinical psychology - Abstract
Sport is historically designated by the binary categorization of male and female that conflicts with modern society. Sport’s governing bodies should consider reviewing rules determining the eligibility of athletes in the female category as there may be lasting advantages of previously high testosterone concentrations for transwomen athletes and currently high testosterone concentrations in differences in sex development (DSD) athletes. The use of serum testosterone concentrations to regulate the inclusion of such athletes into the elite female category is currently the objective biomarker that is supported by most available scientific literature, but it has limitations due to the lack of sports performance data before, during or after testosterone suppression. Innovative research studies are needed to identify other biomarkers of testosterone sensitivity/responsiveness, including molecular tools to determine the functional status of androgen receptors. The scientific community also needs to conduct longitudinal studies with specific control groups to generate the biological and sports performance data for individual sports to inform the fair inclusion or exclusion of these athletes. Eligibility of each athlete to a sport-specific policy needs to be based on peer-reviewed scientific evidence made available to policymakers from all scientific communities. However, even the most evidence-based regulations are unlikely to eliminate all differences in performance between cisgender women with and without DSD and transwomen athletes. Any remaining advantage held by transwomen or DSD women could be considered as part of the athlete’s unique makeup.
- Published
- 2021