Longitudinal Performance Changes in Transgender Women Athletes Pre and Post Gender Affirming Hormone Therapy.

Average race times for transgender women runners increased by 14.6% after gender affirming hormone therapy.

• Sample consisted of 9 transgender women runners
• Average race time increased by 14.6 ± 5.6% post-GAHT
• GAHT duration averaged 31 ± 23 months with a range of 5–86 months
• Data were retrospectively verified and supplemented with 12 months of prospective data

Post-GAHT testosterone concentrations in transgender women were female typical.

• Post-GAHT testosterone concentrations were 1.10 ± 0.52 nmol·L-1
• This level is described as 'female typical' by the authors
• Testosterone, oestrogen, and haemoglobin concentrations were all measured pre- and post-GAHT

Pre-GAHT and post-GAHT age-grade scores for transgender women runners did not differ significantly, with or without adjustment for training differences.

• Comparison of pre- and post-GAHT average age-grade scores (AGs) yielded p = 0.304
• This non-significant result held both with and without adjustment for training differences
• Age-grade scores were used to account for age-related performance changes across the study period

Changes in training volume were positively associated with changes in age-grade scores in transgender women runners.

• The association between changes in training and changes in AGs was statistically significant (p = 0.008)
• Exercise training was identified as a factor that may help attenuate performance decrements following GAHT
• Training volume was one of the survey variables collected both pre- and post-GAHT

The transgender woman swimmer showed increased race times and improved FINA scores after GAHT.

• Average race times for the swimmer increased by 5.2 ± 2.3% post-GAHT
• FINA score increased by 65 points after 34 months of GAHT
• Only one transgender woman swimmer was included in the study sample

Longer distance events were associated with larger decrements in athletic performance following GAHT in transgender women.

• Event distance was identified as an important consideration in understanding the effects of GAHT on performance
• This pattern was observed across the runner sample competing in various distances
• The authors suggest event demands should be considered alongside training when evaluating GAHT effects on performance

The study used a combination of independently verified retrospective data and prospective data collection to assess performance changes.

• Survey methods were used with 9 transgender women runners and 1 transgender woman swimmer
• Retrospective data included race times, training volume, height, body mass, and hormone and haemoglobin concentrations
• Prospective data were collected for an additional 12 months following initial data collection
• Race time data were independently verified