Biological sex is a primary determinant of athletic performance because of fundamental sex differences in anatomy and physiology dictated by sex chromosomes and sex hormones. Adult men are typically stronger, more powerful, and faster than women of similar age and training status. Thus, for athletic events and sports relying on endurance, muscle strength, speed, and power, males typically outperform females by 10%-30% depending on the requirements of the event. These sex differences in performance emerge with the onset of puberty and coincide with the increase in endogenous sex steroid hormones, in particular testosterone in males, which increases 30-fold by adulthood, but remains low in females. The primary goal of this consensus statement is to provide the latest scientific knowledge and mechanisms for the sex differences in athletic performance. This review highlights the differences in anatomy and physiology between males and females that are primary determinants of the sex differences in athletic performance and in response to exercise training, and the role of sex steroid hormones (particularly testosterone and estradiol). We also identify historical and nonphysiological factors that influence the sex differences in performance. Finally, we identify gaps in the knowledge of sex differences in athletic performance and the underlying mechanisms, providing substantial opportunities for high-impact studies. A major step toward closing the knowledge gap is to include more and equitable numbers of women to that of men in mechanistic studies that determine any of the sex differences in response to an acute bout of exercise, exercise training, and athletic performance.

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运动表现性别差异的生物学基础：美国运动医学学院的共识声明。

生物性别是运动表现的主要决定因素，因为由性染色体和性激素决定的解剖学和生理学上的基本性别差异。成年男性通常比同龄和训练状况相似的女性更强壮、更有力量、更快。因此，对于依赖耐力、肌肉力量、速度和力量的体育赛事和运动，根据赛事的要求，男性通常比女性高出 10%-30%。这些表现上的性别差异随着青春期的开始而出现，并且与内源性类固醇激素的增加相一致，尤其是男性的睾酮，到成年后增加了 30 倍，但女性的睾酮水平仍然较低。本共识声明的主要目标是为运动表现的性别差异提供最新的科学知识和机制。这篇综述强调了男性和女性之间解剖学和生理学的差异，这些差异是运动表现和运动训练反应中性别差异的主要决定因素，以及性类固醇激素（特别是睾酮和雌二醇）的作用。我们还确定了影响表现性别差异的历史和非生理因素。最后，我们确定了运动表现性别差异及其潜在机制方面的知识差距，为高影响力的研究提供了大量机会。缩小知识差距的一个重要步骤是让更多且公平数量的女性与男性参与机制研究，以确定对剧烈运动、运动训练和运动表现的反应中的性别差异。