A study published by the journal Sports Medicine in 2020 found that "strength, lean body mass, muscle size and bone density are only trivially affected" by the testosterone suppression meds that biological males use to compete in female Olympic sports. This gives them a "major performance" advantage and has "safety implications" in sports where strength is critical, like wrestling, boxing, and weightlifting. Likewise, a 2021 study in the British Journal of Sports Medicine found that lean body mass and muscle area "in transwomen remain above those" of biological women "even after 36 months of hormone therapy." Based on dozens of studies, a 2024 paper in the Scandinavian Journal of Medicine & Science in Sports concludes that the Olympic Committee's framework for transgender competitors "does not protect fairness for female athletes."