An Unpoplar Opinion on TRT Therapetic Use Exemptions

There is no doubt that the use of testosterone replacement therapy in MMA has been a farce in the past few years with lax and inconsistent standards being applied by various athletic commissions.  Today’s surprise development of the Nevada State Athletic Commission banning TRT TUE’s and urging other athletic commissions to follow suit is a great improvement from the past landscape.

As noted by official MMA record keeper Kirik Jenness, the response from the MMA community has been soundly one sided.

Kirik Tweet re TRT

Despite the overwhelmingly positive response from the MMA community there is work to be done.  As noted at MMAFighting, each jurisdiction is free to carve their own path and despite the NSAC’s influence, no other jurisdiction is bound by their decision.

So should other jurisdictions ban TRT TUE’s?  The unpopular reality is no.  This is not to suggest that a return to the former landscape is desirable.  Realistically, TRT TUE’s should be exceedingly rare as evidenced by the IOC and USADA track record, however, an outright ban is problematic as it can lead to legal claims of discrimination.

TUE’s gained notoriety with TRT, however, TUE’s exist for any number of medically needed medications.   Under the WADA standards adopted by many State and Provincial Athletic Commissions the TUE exists when a ”medication an athlete is required to take to treat an illness or condition happens to fall under the Prohibited List, a Therapeutic Use Exemption (TUE) may give that athlete the authorization to take the needed medicine.“.

If a medication is genuinely needed TUE’s must be considered by Athletic Commissions.  Failing to do so can result in violations of Human Rights / Anti Discrimination legislation.   In BC, to take one example, the Human Right’s Code prohibits discrimination in employment based on “physical disability“.  Such language is standard fare in Human Rights legislation across Canada.  If governments or sporting organization disallowed therapeutic use exemptions, they would likely run afoul of the protections offered by the Code.

The solution is not an outright ban but strict adherence to rigid standards about granting TUE’s.  The wheel does not even need to be reinvented.  WADA standards set out a sensible test for when TUE’s are to be granted, namely:

1. “The Athlete would experience a significant impairment to health if 
the Prohibited Substance or Prohibited Method were to be withheld in 
the course of treating an acute or chronic medical condition.” (Article 
4.1 a. of the International Standard for TUEs.)

2. “The Therapeutic Use of the Prohibited Substance or Prohibited 
Method would produce no additional enhancement of performance 
other than that which might be anticipated by a return to a state of 
normal health following the treatment of a legitimate medical 

3. “There is no reasonable Therapeutic alternative to the Use of the 
otherwise Prohibited Substance or Prohibited Method.” (Article 4.1 
c of the International Standard for TUEs.)

4. “The necessity for the Use of the otherwise Prohibited Substance or 
Prohibited Method cannot be a consequence, wholly or in part, of 
prior non-Therapeutic Use of any Substance from the Prohibited 
List.” (Article 4.1 d. of the International Standard for TUEs.)

This is a tough test to meet and if properly applied TRT TUE’s can largely be a thing of the past without resorting to an arguably unlawful outright ban.  Strict adherence to WADA TUE standards, coupled with random out of competition blood testing can go a long way to cleaning up PED abuse in combat sports.


5 thoughts on “An Unpoplar Opinion on TRT Therapetic Use Exemptions

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