睪固酮是跨性別運動員參加國際競賽的關鍵角色

Testosterone plays a key role in transgender athletes’participation in international competitions

跨性別是指性別認同與出生時被指定的性別不一致的人。依國際奧林匹克委員會（International Olympic Committee, IOC）政策用詞，以「跨性別」做為概括性術語。2003年IOC就允許跨性別運動員參賽，但需進行過性別重置手術，2016年取消手術要求，2020年東京奧運是一新里程碑，有四位跨性別選手參與不同的競賽。之後於2021年11月IOC基於公平、包容及不歧視之理念，制訂出包容、預防傷害、不歧視、公平、無優勢推定、循證方法、健康與身體自主至上、以利害關係人為主、隱私權及定期審查共10條原則的指南，供各國際單項運動總會制定跨性別選手的參賽政策，其中睪固酮濃度扮演著重要的角色。本文將介紹跨性別的定義、跨性別運動員參加國際競賽之歷程、睪固酮的生理角色及比較男女生理影響運動表現上的差異、跨性別女性接受性別確認荷爾蒙治療對其運動表現之影響等。藉此回顧文章整理，讓讀者了解國際體壇上性別平權發展趨勢，並提出未來的展望。

Transgender refers to being a person whose gender identity differs from the sex the person had or was identified as having at birth. Following the terminology and definitions of the International Olympic Committee (IOC) and international sports federation policies, ''transgender'' is an umbrella term. In 2003, the IOC allowed transgender athletes to participate in competitions but they needed to undergo sex reassignment surgery. The surgery requirement was abolished in 2016. The 2020 Tokyo Olympics was a new milestone because four transgender athletes participated in different sports competitions. In November 2021, based on the concepts of fairness, tolerance, and nondiscrimination, the IOC developed a guideline containing ten principles—inclusion; prevention of harm; nondiscrimination; fairness; no presumption of advantage; evidence-based approach; the primacy of health and bodily autonomy; stakeholder-centered approach; right to privacy, and periodic reviews—for international sports federations to formulate their competition policies for transgender athletes. Testosterone concentration plays an important role in the entry system for transgender competition in these policies. In this review, we introduce the definition of transgender athletes, the history of transgender athletes’participation in international competitions, the multiple physiological roles of testosterone affecting body composition and the endocrine metabolic system, the comparison of physiological effects on sports performance of men and women, and the impact of transgender women receiving gender-affirming hormone therapy. We review articles to increase the understanding of the evolution of gender equality in the field of international sports and propose future developments.