TY - JOUR T1 - How does hormone transition in transgender women change body composition, muscle strength and haemoglobin? Systematic review with a focus on the implications for sport participation JF - British Journal of Sports Medicine JO - Br J Sports Med DO - 10.1136/bjsports-2020-103106 SP - bjsports-2020-103106 AU - Joanna Harper AU - Emma O'Donnell AU - Behzad Sorouri Khorashad AU - Hilary McDermott AU - Gemma L Witcomb Y1 - 2021/02/28 UR - http://bjsm.bmj.com/content/early/2021/02/28/bjsports-2020-103106.abstract N2 - Objectives We systemically reviewed the literature to assess how long-term testosterone suppressing gender-affirming hormone therapy influenced lean body mass (LBM), muscular area, muscular strength and haemoglobin (Hgb)/haematocrit (HCT).Design Systematic review.Data sources Four databases (BioMed Central, PubMed, Scopus and Web of Science) were searched in April 2020 for papers from 1999 to 2020.Eligibility criteria for selecting studies Eligible studies were those that measured at least one of the variables of interest, included transwomen and were written in English.Results Twenty-four studies were identified and reviewed. Transwomen experienced significant decreases in all parameters measured, with different time courses noted. After 4 months of hormone therapy, transwomen have Hgb/HCT levels equivalent to those of cisgender women. After 12 months of hormone therapy, significant decreases in measures of strength, LBM and muscle area are observed. The effects of longer duration therapy (36 months) in eliciting further decrements in these measures are unclear due to paucity of data. Notwithstanding, values for strength, LBM and muscle area in transwomen remain above those of cisgender women, even after 36 months of hormone therapy.Conclusion In transwomen, hormone therapy rapidly reduces Hgb to levels seen in cisgender women. In contrast, hormone therapy decreases strength, LBM and muscle area, yet values remain above that observed in cisgender women, even after 36 months. These findings suggest that strength may be well preserved in transwomen during the first 3 years of hormone therapy. ER -