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The safety and fairness of allowing male athletes who experience sex-discordant gender identity and undergo gender affirming medical interventions to compete in female sports continues to be debated. Understanding of the biological differences between males and females in physical attributes that affect athletic performance is essential for the establishment of sporting policies. Innate sex-specific genetic and hormonal influences and the specific effects of altering sex steroid levels will be discussed. This will include consideration of reversible and irreversible changes to body size, muscle mass and fiber type, cardiac output, and metabolic function.

List of Learning Objectives:

• Delineate male and female genetic and sex hormone influences on physical attributes that influence athletic performance.
• Counsel athletes on performance changes and injury risk following gender affirming medical interventions to alleviate gender dysphoria.
• Discuss objective data to governing institutions in setting appropriate standards for allowing sex segregated athletic competition.

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Accreditation: Christian Medical & Dental Associations is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Physician Credit
The Christian Medical & Dental Associations designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nurse Practitioner
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Individuals are responsible for checking with the AANPCP for further guidelines.
NPs may receive up to 1 credits for completing this activity.

Physician Assistant
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit(s)TM. by an organization accredited by the ACCME or a recognized state medical society. PAs may receive up to 1 credits for completing this activity.

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Disclosures
Disclosures for all those in control of the content of this activity. The names of the ineligible companies (within the last 24 months) and the nature of the financial relationship(s). There is no minimum financial threshold. Disclosure of all financial relationships with ineligible companies regardless of the potential relevance of each relationship to the education.