References for trans inclusion in sports

###### The Inclusion of Transgender Athletes – pinkmantaray

Goes in detail about current regulations regarding inclusion of trans and intersex people in sports at elite levels,

> >  Many people miss the fact that the 70+ trans athlete bills in the US are about CHILDREN. They are NOT about any elite-level sport. They are children. And there are no significant biological differences that impact sports in children, except for the presence or absence of a penis. And no one plays sports with their penis. (So genital exam are further irrelevant.) Most people get hung up on testosterone, and besides the fact that testosterone is still only one factor that can contribute to athletic ability, there are also no differences in circulating testosterone between those assigned male at birth and those assigned female before Tanner stage II of puberty — around the age of 12 or 13.
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###### Sex in Sport: Men Don’t Always Have the Advantage

> > Anatomically, on average, men have larger hearts, larger lungs, less body fat, and more muscle mass than women. With the exception of body fat (which is linked to reproduction), many of these anatomical differences are due to the fact that men are typically larger than women. In muscular people, muscle mass tends to be more exaggerated in the upper body for men, whereas women often have greater lower body muscle mass. These differences do sometimes confer an athletic advantage to men, especially in sports that rely on power or being of a larger size, such as rugby. But size isn’t everything.
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> Importantly, there is no significant difference in strength between women and men with the same muscle mass. Furthermore, there appears to be no difference between women and men in terms of being able to activate muscle, known as neuromuscular recruitment. This matches up with more and more research that indicates there are no meaningful neurological differences between women and men.
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> Along with larger hearts and lungs, men also have a greater number of red blood cells (linked to the production of testosterone), which can give them an advantage in terms of oxygen delivery throughout the body—particularly for endurance sports such as running or cycling. Yet women appear to be metabolically better suited for endurance.
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###### "But I read a study that that showed trans women retained advantage over cis women even after hormone therapy" (refers to : [Effect of gender affirming hormones on athletic performance in transwomen and transmen: implications for sporting organisations and legislators)

> > In this study, we confirmed that use of gender affirming hormones are associated with changes in athletic performance and demonstrated that the pretreatment differences between transgender and cis gender women persist beyond the 12 month time requirement currently being proposed for athletic competition by the World Athletics and the IOC. This study suggests that more than 12 months of testosterone suppression may be needed to ensure that transgender women do not have an unfair competitive advantage when participating in elite level athletic competition.
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###### 4.NBC News article on the regarding the same study: Trans women retain athletic edge after a year of hormone therapy, study finds

> > “For the Olympic level, the elite level, I'd say probably two years is more realistic than one year,” said the study's lead author, Dr. Timothy Roberts, a pediatrician and the director of the adolescent medicine training program at Children's Mercy Hospital in Kansas City, Missouri. “At one year, the trans women on average still have an advantage over the cis women," he said, referring to cisgender, or nontransgender, women.
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> ...Harper said Roberts’ methodology is solid, but she sees some limitations in the study. In an assessment shared with NBC News, she questioned the lack of data on participants’ individual training habits. She also noted there was no coordination between when subjects started hormones and when they took their annual fitness test.
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> “The tests were placed into three bins,” Harper said. “One bin of tests that took place in the first year after the start of hormone therapy, one bin of tests that took place between one to two years of hormone therapy, and a third bin that took place between two and two and a half years after the initiation of hormone therapy.”
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> Lumping the data together could blur out changes that occurred within a 12-month period “and might distort the results notably,” she theorized.
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> The fact that the trans women were still faster after two years could be due to differences in training intensity, she speculated. But the pushup and situp tests involve muscular strength, technique, muscular endurance and cardiovascular endurance, and “are probably good proxies for success in many team sports.”
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