If a transgender athlete wishes to compete in a sport that competes against others of their preferred gender, research has actually shown that hormone therapy reduces a trans woman's overall physical capacity to that of cisgender women. A researcher by the name of Jonna Harper has stated that after nine months of hormone replacement therapy, her running capability decreased by 12%, which coincided with that of other women in the field. A large part that contributes to aerobic capacity is the transfer of oxygen to tissues in the body, specifically muscles in this scenario. Testosterone has a direct association with levels of hemoglobin in the blood, which is responsible for oxygen transfer in the body, therefore, reducing one's testosterone levels results in a reduce in hemoglobin in the blood, which makes endurance practically equal to that of cisgender women.
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