We are proud to have shared our voice in this important work! Since antiquity, athletic and Olympic competitions have been separated according to the traditional binary concept of male & females. We have gone past this binary definition in our contemporary society, yet sports are struggling to keep up with this debate. This consensus discussed some of those issues and provided a balanced consensus on how to deal with them.
Key points
The use of testosterone concentration limits of 5 nmol/L in transwomen and DSD women athletes is a justifiable threshold based on the best available scientific evidence.
There is a distinct lack of sports performance data to inform and update sports policy for DSD women and transwomen athletes.
Fair integration or exclusion of transwomen and DSD women athletes needs to be based on peer-reviewed experimental sporting performance evidence when such evidence becomes available.
Some further information
Sport’s governing bodies should consider reviewing rules determining the eligibility of athletes in the female category. 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 such athletes' inclusion into the elite female category is currently the objective biomarker supported by most available scientific literature. Still, 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 androgen receptors' functional status. 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. Each athlete's eligibility for a sport-specific policy needs to be based on peer-reviewed scientific evidence 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 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.
The full paper can be accessed here (open access)
Hamilton et al. Integrating Transwomen and Female Athletes with Differences of Sex Development (DSD) into Elite Competition: The FIMS 2021 Consensus Statement. Sports Medicine https://doi.org/10.1007/s40279-021-01451-8