Medical Care of Transgender Athletes and Policy Implications: ACSM Contemporary Issue Statement

Although transgender and gender diverse people make up 0.6% of the population in the United States, they are underrepresented in sports. Transgender athletes are increasingly visible and subject to widely discrepant policies regarding their participation in sports. This Contemporary Issues statement reviews topics relevant to the care of transgender athletes, for the providers, trainers, coaches, and others caring for this population. We review: 1) barriers to sport participation, 2) gender-affirming medical and surgical care and the impacts on factors related to sport performance, 3) mental health considerations, and 4) a framework for understanding stressors and resilience. Most of the available data included here are from nonathlete transgender people, with limited data in transgender athletes. More robust data in transgender athletes are needed for future policies.

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Published: Apr 01, 2026
Vol/Issue: 11(2)
Pages: e000336
License: View

Authors

J

Janelle Marra

Medical Care of Transgender Athletes and Policy Implications: ACSM Contemporary Issue Statement Writing Group, American College of Sports Medicine, Indianapolis, IN

D

Dolores Christensen

Department of Athletics, University of Oklahoma, Norman, OK

J

Joanna M. Harper

Department of Pediatrics, Oregon Health & Sciences University, Portland, OR; School of Sport Exercise & Health Sciences, Loughborough University, Loughborough, UK; School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada

S

Sean J. Iwamoto

Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO

W

Whit Ryan

Cleveland Clinic Children’s Institute, Cleveland, OH; Margin to Center Therapy

J

Joshua D. Safer

Mount Sinai Center for Transgender Medicine and Surgery, New York City, NY

C

Carl G. Streed

Section of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA; GenderCare Center, Boston Medical Center, Boston, MA

N

NATALIE J. NOKOFF

Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO

K

Kerrie L. Moreau

Division of Geriatrics, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO

Cite This Article

Janelle Marra, Dolores Christensen, Joanna M. Harper, et al. (2026). Medical Care of Transgender Athletes and Policy Implications: ACSM Contemporary Issue Statement. Translational Journal of the American College of Sports Medicine, 11(2), e000336. https://doi.org/10.1249/tjx.0000000000000336

Medical Care of Transgender Athletes and Policy Implications: ACSM Contemporary Issue Statement

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