Physical Fitness and Exercise Performance of Transgender Women

ABSTRACT Introduction In spite of the evolving participation of transgender adults in exercise and sports, research investigating the physical fitness of transgender women remains scarce in the scientific literature. Methods In this cross-sectional study, a variety of reference standard measures of physical fitness of transgender women who had undergone gender-affirming orchiectomy (30 ± 4 yr; n = 15) and who had not (27 ± 4 yr: n = 15) were compared with reference males (28 ± 5 yr; n = 15) and reference females (29 ± 5 yr; n = 15) who were matched for age and estimated physical activity level. Transgender women had been undergoing feminizing gender-affirming therapy for 8 to 10 yr. Results Height and lean mass of arms, legs, and trunk (measured via dual-energy x-ray absorptiometry) of transgender women were greater than those of reference females but lower than those of reference males (all P < 0.05). No significant differences were found in isokinetic muscular torque between reference females and transgender women. Both absolute and relative measures of maximal oxygen consumption were greater in reference males than in reference females and transgender women (all P < 0.05) with no significant difference between the latter two groups. Reference males had greater peak Wingate anaerobic power (expressed in both absolute and relative to body weight), countermovement jump, and squat jump than reference females and transgender women (all P < 0.05). There were no significant differences in anaerobic power between reference females and transgender women. The results on the field tests, including agility T-test and sprint running acceleration, were consistent with the anaerobic power tests. There were no statistical differences in any of the physical fitness measures between transgender women with and without orchiectomy. Conclusions Transgender women demonstrated similar levels of reference standard measures of physical fitness to females that were significantly lower than males.