Body composition and physical fitness in transgender versus cisgender individuals: a systematic review with meta-analysis

A systematic review and meta-analysis of 50 studies involving 6099 participants compared body composition and physical fitness between transgender and cisgender individuals. Transgender women showed similar fat mass and lean mass to cisgender women, while transgender men had higher fat mass and lower lean mass. GAHT was linked to increased fat mass and reduced strength in transgender women, and decreased fat mass with increased strength in transgender men. The findings suggest no inherent athletic advantage for transgender women over cisgender individuals, though the evidence has low certainty and varied quality.