ABC Medical Committee Addresses Safety of Transgender Combatant Licencing

Posted: December 30, 2013 in Uncategorized
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Few topics generate more debate when it comes to MMA regulation than licencing of transgender athletes.   Ultimately this is a debate that is best addressed through science as the most valid criticisms focus on the health and safety of participants.  To this end, the Association of Boxing Commissions Medical Committee (comprised of some 40 physicians) has released a suggested policy dealing with this.  Below are their recommendations which are noted to be “a starting point” with revision on an as needed basis as more medical evidence becomes available.

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ABC MEDICAL COMMITTEE SUGGESTED TRANSGENDER POLICY

The purpose of developing this policy was to allow combat sports
athletes the opportunity to participate in competition in accordance
with their gender identity while maintaining the relative balance of
competitive equity among competitors.

This document is based on review of current medical literature, review
of NCAA and IOC policy, and has been co-authored by one of the world’s
leading authorities on this topic, Dr. Eric Villain, M.D., PhD., chair of

Medical Genetics Clinic
Director, Center for Gender-Based Biology
Professor, Pediatrics
Urology
Human Genetics
at UCLA.

This document is a starting point. It will need to be revised as greater
bodies of evidence based medicine become available.

MALE TO FEMALE (MTF)

• Individuals undergoing sex reassignment PRIOR to puberty
should be regarded as females.
• Individuals undergoing sex reassignment AFTER puberty should
be eligible for participation in female competition under the
following conditions:
o Surgical anatomical changes have been completed
including gonadectomy and external genitalia
o Hormone therapy appropriate for the assigned sex
(female) administered by a board certified
endocrinologist or any specialist in good standing
with his/her licensing jurisdiction known to have
significant knowledge and experience with
transsexual and transgender individuals for a
MINIMUM of TWO years AFTER gonadectomy.
o A letter from a board certified physician responsible
for the care of the athlete should be submitted to the
athletic commission being petitioned for licensure
and to the ABC Medical Review Board.
o TUEs will not be granted for hormone replacement
therapy (HRT).
o The transsexual competitor (as with all competitors)
should be subject to random drug testing

FEMALE TO MALE (FTM)
• Individuals undergoing sex re-assigment from female to male
AFTER puberty should be eligible I male competitions under the
following conditions:
o Hormone therapy for the assigned sex (male) has
been administered by a board certified
endocrinologist or any specialist in good standing
with his/her licensing jurisdiction known to have
significant knowledge and experience with
transsexual and transgender individuals.
o A letter from a board certified physician responsible
for the care of the patient will need to be submitted to
the medical review panel of the athletic commission
being petitioned for licensure and to the ABC Medical
Review Board
o TUEs WILL be granted for FTM.
o The athlete maybe subject to drug testing before,
during and/or after competitions.

TRANS MALES (FTM)
• A trans male (FTM) athlete who is on testosterone replacement
therapy may compete ONLY AS A MALE.
• TUEs WILL be granted at the discretion of the licensing
commission provided appropriate documentation has been
submitted
• Athletes will be subject to random drug testing

TRANS FEMALES (MTF)
• TUEs need NOT be granted for HRT. A full disclosure of
prescribed medications is required for each applicant
• Athletes maybe subject to random drug testing

RECOMMENDED MINIMUM PAPERWORK FOR SUBMISSION TO THE
LICENSING JURISDICTION

• History, physical examination, baseline blood work (CBC, thyroid
function tests, blood chemistries, clotting times, lipid profile),
EKG, ophthalmologic examination CT or MRI/MRA of the head
(These guidelines can be found in the ABC Medical Handbook
edition 1)
• A declaration letter from the treating physician.

The physician must be board certified in his/her specialty
and in good standing with his/her jurisdiction. The
physician must have extensive experience with
transgender patients and the administration of related
medications, if required.

The physician should:
State the length of time the athlete has been in
his/her care
Submit a complete history and physical
examination
Include mandated blood work, as required by
the licensing jurisdiction
Include mandated tests, as required by the
licensing jurisdiction
Include the medications prescribed
Document therapeutic hormone levels, and the
intervals between testing of levels
Submit an appropriate request for TUE, if
applicable

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Comments
  1. […] 2013 the ABC’s Medical Committee released their position paper on suggested transgender policies for combative sports which can be found here […]

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