Body composition, exercise-related performance parameters and associated health factors of transgender women, cisgender women and cisgender men volleyball players.

Alvares, Leonardo Azevedo; Dos Santos Quaresma, Marcus Vl; Nakamoto, Fernanda Patti; Santos, Lívia Marcela; Navarro, Lucas Soglio; Navarro, Giovanna Soglio; Orozco, Bruno Marcos Mazoca; Sá, Beatriz Meconi Cardoso et al. · Br J Sports Med · 2025

cross_sectional · Level IV

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Abstract

The inclusion of transgender athletes in competitive sports has promoted significant dialogue and controversy among exercise-related professionals. The objective of this study was to investigate body composition, exercise-related performance parameters and associated health-related factors of transgender women (TW), cisgender women (CW) and cisgender men (CM) amateur volleyball players. This was a cross-sectional study comprising TW, CW and CM amateur volleyball players eligible with the following characteristics: 'gender incongruent' (for TW only); age between 18 and 35 years; body mass index (BMI) between 18.0 and 29.9 kg/m<sup>2</sup>; 'very active' according to the International Physical Activity Questionnaire, and engaged in regular volleyball training for at least 1 year. All participants were assessed for body composition, blood biomarkers, handgrip strength, countermovement jump height (CMJ), squat jump height (SQJ) and maximum oxygen consumption (V̇O<sub>2max</sub>). 69 amateur volleyball players were initially evaluated, but only 23 met the inclusion criteria and were included in the study (7 TW, 8 CW and 8 CM). Age (p=0.07) and BMI (p=0.26) were similar between groups. Estradiol (p=0.47), total testosterone (p=1.00) and haemoglobin (p=1.00) levels did not differ between TW and CW. However, analysis not adjusted by confounding variables showed that CM presented higher testosterone levels (p<0.001), haemoglobin levels (p=0.03), lean body mass (p=0.03), handgrip strength (p<0.001), CMJ (p<0.001), SQJ (p=0.012) and V̇O<sub>2max</sub> (mL/min) (p=0.001) compared with TW. When adjusted by confounding variables, all p values were <0.05, except for SQJ (p=0.062). TW athletes displayed similar exercise performance and biomarkers compared with CW but lower results compared with CM.

Medical subject headings

Anatomy