(P16-003-24) Nutrition and Training Recommendations for Transgender and Gender Diverse Athletes Involved in Strength Sports and Resistance Training: A Case Series

Objectives: Transgender and gender diverse (TGGD) athletes have distinct nutrition and training considerations, yet guidelines for how nutrition professionals should address sex-specific data in a dietary analysis (energy, fiber, calcium, vitamin D, potassium, iron) are lacking.  The purpose of this case series was to depict nutrition assessment approaches for three TGGD athletes involved in strength sports and resistance training.

Methods: CZ is a CrossFit athlete in his early 30s. He was assigned female at birth, identifies as male, and uses he/him pronouns. He has been on masculinizing hormone therapy (HT) for over 11 years and completed top surgeries. CZ’s current training routine includes weekly CrossFit classes, resistance training, endurance training, and mobility exercises.

PL is an athlete in his early 30s who uses resistance training to support his endurance sports performance. He was assigned female at birth, identifies as transmasculine and nonbinary, and uses he/him and they/them pronouns. He completed masculinizing top surgery and is not on HT. PL competes in triathlons and Iron Man competitions; he trains six to seven days a week, including six days of endurance activities and resistance training up to four times a week.

TD is an athlete in his early 40s who participates in bodybuilding competitions and adaptive sports, including the USA Paralympic Team for spring kayaking. He was assigned female at birth, identifies as transmasculine, and uses he/him and they/them pronouns. TD has been on masculinizing HT for five years and completed top surgery. He became involved in strength sports following a spinal cord injury and now uses a wheelchair. His current training routine includes resistance training four days a week and aerobic activity five days a week.

Results: Nutrition professionals can apply clinical reasoning when managing sex-specific data by 1) using the values consistent with sex for athletes who are not on HT, 2) using the values consistent with the opposite sex for athletes who have been on HT for multiple years, or 3) using a range of values that reflect male and female data.

Conclusions: Nutrition professionals can individualize their care for TGGD athletes. Clinical reasoning can be applied based on the athlete's medical history, which may or may not include HT, and the nature of the data point.

Funding Sources: This project was supported by BarBend.