Hunter · Medicine and science in sports and exercise 2023 · expert consensus statement · n=?

The Biological Basis of Sex Differences in Athletic Performance: Consensus Statement for the American College of Sports Medicine.

Cited 226 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

ACSM expert consensus statement and narrative mechanism review

PubMed 37772882 · doi:10.1249/MSS.0000000000003300 · record verified 2026-08-29

What was done

The American College of Sports Medicine (ACSM) developed a consensus statement reviewing the scientific literature on biological sex differences in athletic performance. The review synthesized anatomical, physiological, and endocrine mechanisms (primarily testosterone and estradiol) that drive performance differences and exercise adaptations between males and females, alongside historical and non-physiological factors and research gaps.

What was found

Adult males typically outperform females of similar age and training status by 10% to 30% in events reliant on endurance, muscle strength, speed, and power. These performance gaps emerge during puberty and coincide with divergence in endogenous sex steroids, notably an approximate 30-fold increase in testosterone in males by adulthood compared to low levels maintained in females.

Why it matters

The statement establishes an authoritative summary of the biological and endocrine drivers of male-female athletic performance disparities. It highlights how these physiological differences baseline athletic outcomes and calls for equitable female representation in mechanistic exercise research.

Limits

As an expert consensus statement and narrative review, this document presents synthesized conclusions rather than a systematic review with meta-analytic pooling or risk-of-bias grading. The abstract provides generalized performance ranges (10%-30%) without event-specific granularity, and underlying mechanistic evidence remains limited by historical underrepresentation of female cohorts in exercise physiology.

Cited by