The Study
Cardiopulmonary capacity and muscle strength in transgender women on long-term gender-affirming hormone therapy: a cross-sectional study
This study is like taking a snapshot of how fit different groups of people are at one moment in time. It can tell us that transgender women have fitness levels in between cisgender men and women, but it can't prove why — just that there's a difference.
Analysis score
Maximum 44 for a cross-sectional study.
Where the score came from
This study checks how well trans women can breathe and use oxygen during exercise after many years of hormone therapy, and how strong their muscles are compared to cis men and women.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 544 / 100
Quality score
Snapshots of a population at a single point in time, or descriptions of small groups. Can identify correlations and prevalence, but cannot determine cause and effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Even though trans women were stronger and had better oxygen use in total numbers, their bodies work just as efficiently as cis women's when comparing similar muscle amounts.
- 2Trans women had higher oxygen use (2606 ml/min) than cis women (2167 ml/min) but lower than cis men (3358 ml/min).
- 3When body size was accounted for, the difference disappeared.
- 4Same with grip strength: 35.3 kg vs 29.7 kg (cis women), but no difference when adjusted for muscle mass.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
British Journal of Sports Medicine
Year
2022
Authors
L. Alvares, Marcelo Rodrigues Santos, F. Souza, L. M. Santos, B. Mendonca, E. Costa, M. J. N. Alves, S. Domenice
Related Content
Claims (6)
Trans women who aren't athletes and have been on hormone therapy for over a decade still have stronger hand grip than cis women, but not as strong as cis men — their strength falls somewhere in the middle.
For transgender women on long-term hormone therapy, how well their bodies use oxygen during exercise is closely linked to their muscle mass relative to height — but this doesn’t seem to be the case for cisgender men or women.
Trans women who've been on hormone therapy for years can take in more oxygen during intense exercise than cis women, but less than cis men — putting their heart and lung fitness somewhere in the middle.
When you account for muscle mass, trans women, cis women, and cis men have about the same heart and lung fitness level — even if their raw numbers look different.
When you account for how much muscle someone has, trans women and cis women are about equally strong — even if their total strength looks different at first.
Trans women on hormone therapy perform just as well—or just as poorly—as cis women in sports, with no real difference between them.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.