‘There’s no reason to ban us from playing’: Analysis debunks notion that transgender women have inherent physical advantages in sports
Transgender women who have undergone hormone treatment have comparable fitness levels to cisgender women, according to the most comprehensive analysis of its kind to date.
The review, published Tuesday February 3 in the British Journal of Sports Medicinereviewed 52 published studies assessing the body composition, muscle strength and aerobic capacity of nearly 6,500 people, including approximately 2,900 transgender women and 2,300 transgender men.
“Sport is multifactorial”, lead author of the study Bruno Gualanoassociate professor at the Center for Lifestyle Medicine at the University of São Paulo, told Live Science in an email. “Quality of training, access to facilities, psychological stress, and exposure to discrimination all influence performance, and these factors are rarely considered in physiological studies.”
Systematic analysis
The analysis was prompted by recent efforts around the world to ban transgender people from competing in sports.
“We have seen increasingly restrictive rules regarding transgender participation in sports, often justified by claims of significant and unavoidable physical benefits,” Gualano said.
While circulating testosterone levels appear to increase muscle mass, strength and aerobic capacity, these bans, which generally aim transgender Women and girls often argue that even prior exposure to testosterone during puberty gives individuals a permanent, inherent physical advantage over cisgender women.
To see if this was the case, the researchers pooled data from numerous studies using different approaches and measures to compare the fitness of transgender and cisgender people. Study participants ranged in age from 14 to 41 and most were adults.
In transgender women, hormonal therapies included different forms of estrogens and antiandrogens, which suppress the effects of testosterone, while transgender men used various forms of testosterone. Most studies followed participants for approximately one to three years of therapy.
When normalized for size, “transgender women, after gender-affirming hormone treatment, do not show more strength or aerobic capacity than cisgender women,” Gualano said. This included upper and lower body strength.
Transgender women also had body fat comparable to cisgender women.
They have slightly higher lean mass, he noted, but that doesn’t translate into greater strength or maximum oxygen consumption. Studies rarely look at specific sports performance metrics, so the team couldn’t assess that, Gualano added.
Most of the study participants included in the analysis were not competitive athletes, so “we should be cautious about extrapolating directly to elite sport,” Gualano noted. But that said, “if there were significant, intrinsic physical benefits, we would expect to see them even in non-athletic populations, and that is not the case.”
“What is new here is the consistency of these results across many datasets,” Ada Cheungan endocrinologist and head of the trans health research group at the University of Melbourne, who was not involved in the study, told Live Science in an email. The findings challenge the idea that trans women have intrinsic athletic advantages, she added.
Phoebe Toups Dugasassociate professor of human-centered computing at the Exertion Games Lab at Monash University in Australia, who was not involved in the study, agrees.
“Contrary to the narratives used to push transgender athletes out of sports, there is no evidence that transgender women have any advantage,” she told Live Science in an email. “There is no reason to ban us from playing.”
Olympic competition
Even though the American Olympic Committee has transgender women banned to participate in women’s events to align with a executive order from President Donald Trumpthe International Olympic Committee (IOC) has not yet done so. But recent the report suggests it could changeas the IOC announced, it will publish new rules this year. The IOC medical and scientific director was quoted as saying that, even after hormone treatment, transgender women who have reached male puberty retain physical advantages over cisgender women. She said the new rules could also apply to cisgender women with “masculine” characteristics, such as Y chromosomes or “male levels” of testosterone.
The results of the recent meta-analysis do not support these rules, Gualano said. Although the new analysis can’t tell us anything about the fitness of cisgender women with relatively high testosterone, other data sets suggest that “performance is not determined by testosterone alone,” he added.
“A major gap in the literature is our limited understanding of how hormonal effects interact with long-term training and social context, particularly in women and gender-diverse populations,” Gualano said. “Another shortcoming is the assumption that testosterone thresholds clearly separate ‘fair’ from ‘unfair’ competition, an idea that is much less scientifically sound than is often assumed.”
For now, the previous regulations are in force for the 2026 Winter Olympicswhich will begin on February 6 in Milan. Elis Lundholm of Sweden will compete in mogul skiing at the Winter Games first openly transgender athlete. As this discussion unfolds, it is important to note that few studies follow transgender athletes in high-stakes competitions, in part because so few of them compete.
Given the lack of data in elite sports, an analysis like Gualano’s can be very informative, Toups Dugas said.
“These findings are of considerable value to the IOC,” she said. “There is a big opportunity here for the IOC to make the Olympics more diverse and really support the athletes.”
Youth Sports
Of course, most athletes don’t compete in the Olympics. Instead, many are kids playing youth sports. At least 29 US states currently ban transgender youth from competing on teams aligned with their gender identity, and while some of these bans have been legally challenged, they are should be respected by the United States Supreme Court in 2026.
Although the new meta-analysis includes some data from adolescents, it is not sufficient to draw strong conclusions about children’s body composition, Toups Dugas said. “But I don’t think it’s necessary for us to make wise choices.”
Cheung agreed. “There is no evidence here to justify outright banning trans youth from sport.”
This article is for informational purposes only and is not intended to offer medical advice.
Sieczkowska, SM, Mazzolani, BC, Coimbra, DR, Longobardi, I., Casale, AR, Da Hora, JDFVMP, Roschel, H. and Gualano, B. (2026). Body composition and fitness in transgender and cisgender people: a systematic review with meta-analysis. British Journal of Sports Medicine. https://doi.org/10.1136/bjsports-2025-110239
