Sports and Performance in the Transgender Population: A Systematic Review and Meta-Analysis

Abstract

Introduction: The debate surrounding the regulations on the participation of transgender individuals in sports is not recent, but it is still ongoing. Some sports organizations are more flexible in this regard, while others are more conservative. Objective: Through a systematic review and meta-analysis, this study summarizes the scientific evidence of the effects of cross-sex hormone therapy on muscle strength, hematocrit, and hemoglobin measurements, parameters that seem to be linked to sports performance. Methods: We conducted electronic searches for manuscripts published before November 20th, 2020. Studies published in three different databases (PubMed, SciELO, and Lilacs) were included, without any time or language restriction, and using keywords such as “transgender”, “gender dysphoria”, “strength”, “hematocrit”, and “hemoglobin”. The PRISMA systematization was used for the elaboration of this review, while a meta-analysis was conducted to mathematically evidence the results. The meta-analysis was performed using the random effect model, to find the pooled estimate effect of cross-sex hormone therapy on the parameters analyzed. Results: The electronic search retrieved 21 articles that were eligible for inclusion. Cross-sex hormone therapy influenced the three parameters analyzed in almost all the studies. Overall, there was a significant increase in muscle strength in female-to-males (FtMs), per muscle group analyzed: +17.7% (95% confidence interval [CI]14.9;20.6). In male-to-females (MtFs) the results of the muscle strength analysis were more controversial, but the pooled estimate effect showed a decrease: −3.6% (95% confidence interval [CI] −6.6; −0.6). Conclusion: Muscle strength, hematocrit, and hemoglobin were altered as a result of cross-sex hormone therapy in both FtMs and MtFs. However, there was a lack of studies comparing the transgender individuals to the population of the same desired gender. Such studies are needed, to better infer rules for the participation of transgender athletes in Olympic sports. Level of Evidence I; Systematic Review and Meta-analysis.

Há Relação No Comprimento Dos Dedos Com O Desempenho No Powerlifting Paralímpico?

“…A capacidade física é peça chave para o desenvolvimento esportivo do atleta. A sua capacidade bem desenvolvida dá vantagem ao seu desempenho e, consequentemente, êxito na modalidade que lhe é designada (25) .…”

“…Ligado ao fator supracitado, temos a TES com ação estimulante no aumento da síntese proteica muscular e no aumento da força do musculo. Este fator é fundamental para o melhor desempenho de atletas que competem em esporte de força (25) .…”

“…Em alguns esportes o aumento de TES circulante pós-puberdade pode levar um melhor desempenho do atleta, pois há um aumento da massa e, consequentemente, na FM (25) . 10nmol/l por pelo menos 12 meses, regra depois alterada para 5nmol/l em 2019 (25) . Desta maneira, é notório como a TES é fator fundamental para alteração de desempenho de atleta.…”