Comparison of acute physiological responses between one long and two short sessions of moderate-intensity training in endurance athletes.

Purpose: To compare acute physiological responses and perceived training stress between one long and two short time- and intensity-matched sessions of moderate-intensity training in endurance athletes. Methods: Fourteen male endurance athletes (VO2max: 69.2 ± 4.2 mL·min-1·kg-1) performed one 6 × 10-min interval session (SINGLE) and two 3 × 10-min interval sessions interspersed with 6.5 h recovery (DOUBLE) of moderate-intensity training on two separate days, while running in the laboratory, using a counterbalanced cross-over trial. The two training days were separated into a first part/session (interval stage 1-3) and second part/session (interval stage 4-6). Respiratory variables, heart rate (HR), blood lactate concentrations (BLa), and rating of perceived exertion (RPE) were collected during sessions, whereas supine heart rate (HR) was assessed in a 60-min recovery period following sessions. Measures of perceived training stress (1-10) were assessed in the morning of the subsequent day. Results: HR, Bla, and RPE increased in the second compared to first part of SINGLE (168 ± 7 vs. 173 ± 7 bpm, 2.60 ± 0.75 vs. 3.01 ± 0.81 mmol·L-1, and 13.4 ± 1.0 vs. 14.8 ± 1.1-point, respectively, all p < 0.05). HR and Bla decreased in the second compared to first session of DOUBLE (171 ± 9 vs. 166 ± 9 bpm and 2.72 ± 0.96 vs. 2.14 ± 0.65 mmol·L-1, respectively, both p < 0.05). SINGLE revealed higher supine HR in the recovery period following sessions (65.4 ± 2.5 vs. 60.7 ± 2.5 bpm p < 0.05), session RPE (sRPE, 7.0 ± 1.0 vs. 6.0 ± 1.3-point, p = .001) and sRPE training load (929 ± 112 vs. 743 ± 98, p < 0.001) compared to DOUBLE. In the subsequent morning, increased levels of perceived fatigue and muscle soreness were observed following SINGLE compared to DOUBLE (7.0 ± 2.5 vs. 8.0 ± 1.0-point, p = .049 and 6.0 ± 2.5 vs. 7.0 ± 2.5-point, p = .002, respectively). Conclusion: One long moderate-intensity training session was associated with a duration-dependent "drift" in physiological responses compared to two short time- and intensity-matched sessions, thereby suggesting a higher overall training stimulus. Simultaneously, the lower cost of the two shorter sessions indicates that such organization could allow more accumulated time at this intensity. Overall, these findings serve as a starting point to better understand the pros and cons of organizing moderate-intensity training as one long versus shorter sessions performed more frequently (e.g., as "double threshold training") in endurance athletes.

Associations between levels of physical activity and satisfaction with life among Norwegian adolescents: a cross-sectional study.

Background: A robust association between physical activity (PA) and satisfaction with life (SWL) has been established, wherein self-efficacy has been identified as a mediator across different populations. However, there is a need to further examine the relationship between PA and SWL and whether self-efficacy act a as mediator within different levels of PA among Norwegian adolescents. Thus, the objective of this study was to explore the relationship between levels of PA and SWL by testing for self-efficacy as a possible mediator. Methods: Cross-sectional data from the 2022 Norwegian Ungdata Survey was utilized. Data included demographics and various health data that was collected anonymously. The electronic survey took place in classrooms and was administered by the respective teacher. Permission to access and use data was approved by the Norwegian Agency for Shared Services in Education and Research (SIKT). Statistical analyses were conducted using the PROCESS macro by Andrew Hayes for SPSS software. Results: Descriptive findings revealed that girls reported lower self-efficacy than boys (14.2 vs. 15.5, with a maximum of 20) and lower SWL (6.8 vs. 7.6, with a maximum of 10). About one out of five girls and one out of seven boys reported no days of weekly PA, whereas 4% of girls and 9.5% of boys adhered to the PA-recommendation of 60-min of daily exercise. Associations between PA levels and SWL was mediated by self-efficacy (all p < 0.05), with the highest indirect effect (56.3%) revealed in the association between those adhering to the PA-recommendations and SWL. Conclusions: Norwegian girls reported more sedentary behavior, less PA, lower self-efficacy, and lower SWL than boys across all grade levels. Mediation analysis revealed that up to 56.3% of the enhancement in SWL among those adhering to 60-min of PA recommendations was explained by increased self-efficacy. Norwegian government and policymakers should promote initiatives and regulations focusing on higher levels of PA to foster a resilient adolescent population with higher individual beliefs and higher subjective wellbeing.

The Training and Development Process for a Multiple-Grand-Slam Finalist in Tennis.

PURPOSE: To investigate the training and development process of a multiple-Grand-Slam finalist. METHODS: A mixed-methods case-study design was used to capture the quantitative and qualitative aspects related to the training and successful development process. We used a 3-step data-collection process and pragmatic analyses of (1) training history based on logs, plans, and questionnaires; (2) in-depth semistructured interviews with the player's head coach/father, physical coach, and team administrator/mother; and (3) systematic quality assurance through negotiation among researchers and all key informants, including the player. RESULTS: The player's exceptional performance level was achieved by a progressive, nonlinear increase in annual training load during childhood and early youth, stabilizing at 800 sessions and 1250 to 1300 hours per year at the age of 19. The annual tennis-specific training plateaued at ∼750 hours from the age of 15, and 60 to 80 matches were played in most of the analyzed years. Point-play accounted for approximately 50% of the total amount of specific tennis training, clearly ahead of ground strokes (∼30%), serve/return (∼15%), and smash/volley (∼5%). Physical-conditioning hours increased 5-fold from 12 to 19 years, before stabilizing at ∼500 hours at senior age. Key success factors included the athlete's multidimensional sports talent, discipline, and inner drive; a highly dedicated father and tennis-enthusiastic family; and strong support from a complementary and interdisciplinary performance team. CONCLUSION: This study provides novel information regarding the training and development process for a world-leading tennis player, providing a point of departure for the development of future talents.

Finding the optimal balance: father-athlete challenges facing elite Nordic skiers.

Background: In the last decade, a growing body of research has focused on the many aspects and challenges of combining parenthood with elite sport. Although the number of father-athletes is significantly higher than the number of mother-athletes, few studies to date have focused on male athletes' experiences in a parenting context. Aim: The aims of the present study were to explore how father-athlete challenges manifest among elite Nordic skiers in Norway, and to better understand how male athletes balance their priorities as they initiate, maintain, and/or discontinue their athletic career as a father-athlete. Methods: Qualitative data were collected through semi-structured interviews with 10 world-class male Nordic skiers in Norway (3 athletes without a child, 4 current father-athletes and 3 former father-athletes) and the content was analyzed using thematic analysis. Results: Four main stages were identified in the father-athlete transition: (a) Expecting incompatibility (b) Taking the step, (c), The first blow, and (d) Finding the optimal balance. Through these stages the informants expected/had experienced challenges such as performance decline, disturbed sleeping patterns, fear of sickness and role conflicts. To manage these challenges, the father-athletes had developed various strategies to balance their dual roles (e.g., adapting training and competition seasons). Among the benefits, the father-athletes mentioned that they had become more structured, time efficient and ruthless with their priorities, enhanced motivation to train and a better work-life balance. Conclusion: This study offers valuable insights into father-athlete challenges that can be used to support career longevity and work-life balance among male athletes.

The Evolvement of Session Design From Junior Age to Senior Peak Performance in World-Class Cross-Country Skiers.

PURPOSE: To compare designs of training sessions applied by world-class cross-country skiers during their most successful junior and senior season. METHODS: Retrospective analysis of self-reported training characteristics (ie, training form, intensity, and exercise mode) among 8 male and 7 female world-class cross-country skiers was conducted. RESULTS: Total number of sessions (441 [71] vs 519 [34], P < .001, large effect) and mean duration (1.5 [0.1] h vs 1.7 [0.1] h, P < .001, moderate effect) increased from junior to senior age. More double-session days were performed at senior age (124 [50] vs 197 [29] d, P < .001, large). The number (310 [64] vs 393 [64], P < .001, large effect) and duration (1.3 [0.1] h vs 1.5 [0.1] h, P < .001, moderate effect) of low-intensity training sessions increased from junior to senior age. Regarding intensive training, most emphasis was put on high-intensity training sessions lasting 20 to 39 minutes with <5-minute intervals at junior age, while 40 to 59 minutes of moderate-intensity training with 5- to 9-minute intervals was predominant at senior age. More MIXED (combined moderate- and high-intensity) sessions (9 [7] vs 14 [7], P = .023, moderate effect) and longer races (0.5 [0.1] h vs 0.6 [0.1] h, P = 0.29, moderate effect) compensated for fewer high-intensity training sessions at senior age (36 [17] vs 25 [10], P = .027, moderate effect). Duration of strength-training sessions increased significantly (0.6 [0.1] vs 0.8 [0.2] h, P = 0.30, moderate effect), while other training forms remained unchanged. CONCLUSIONS: World-class cross-country skiers increased their training volume from junior to senior age primarily by more and longer low-intensity training sessions and more often training twice per day. Concurrently, the most frequent intensive sessions were modified from high- to moderate-intensity training, lasted longer, and contained longer intervals.

Agreement Between the 2- and 3-Step Methods for Identifying Subtle Menstrual Disturbances.

Recent methodological recommendations suggest the use of the "3-step method," consisting of calendar-based counting, urinary ovulation testing, and serum blood sampling, for the identification of subtle menstrual disturbances (SMDs). However, the use of the 3-step method is not always feasible, so a less demanding combination of calendar-based counting and urinary ovulation testing, that is, the 2-step method, may be a viable alternative. PURPOSE: To investigate the agreement between the 2- and 3-step methods for the detection of SMDs. METHODS: Menstrual cycles (MCs, 98) of 59 athletes were assessed using the 2- and 3-step methods. Regular-length MCs (ie, ≥21 and ≤35 d) were classified as either having no SMD (luteal phase length ≥10 d, midluteal progesterone concentration ≥16 nmol·L-1, and being ovulatory) or having an SMD (eg, short luteal phase [<10 d], inadequate luteal phase [midluteal progesterone concentration <16 nmol·L-1], or being anovulatory). Method agreement was assessed using the McNemar test and Cohen kappa (κ). RESULTS: Substantial agreement was observed between methods (κ = .72; 95% CI, .53-.91), but the 2-step method did not detect all MCs with an SMD, resulting in evidence of systematic bias (χ2 = 5.14; P = .023). The 2-step method detected 61.1% of MCs that had an SMD ([51.4, 70.8]), as verified using the 3-step method, and correctly identified 100% of MCs without an SMD. CONCLUSIONS: MCs classified as being disturbed using the 2-step method could be considered valid evidence of SMDs. However, MCs classified without SMDs do not definitively confirm their absence, due to the proven underdetection via the 2-step method.

Optimization of Sprint Training Among European Coaches: Quality Over Quantity.

PURPOSE: To describe how high-level European sprint coaches (from 100 to 400 m) work to improve important factors associated with the quality of the holistic training process and the quality of the specific training session. METHODS: A descriptive analysis was conducted using questionnaires from 31 European elite sprint coaches (ie, training athletes defined as tiers 3, 4, and 5) who participated voluntarily. RESULTS: The coaches used traditional periodization (45%) with a 10- to 15-day tapering phase (48%) that includes a reduction in volume, maintenance of intensity, and focus on correct technical execution. In the 3 mesophases, coaches prioritized the basic development of strength and sprint work in the first phases of the season and emphasized more sprint-specific work in the competitive phase. Before sessions, adjustments were made based on factors such as psychological (77%), technical (48%), and physical (39%) parameters. In-session load management relies on a combination of objective and subjective measures (55%), in which the dialogue with athletes (65%) was regarded as the main resource. Feedback during and after sessions covers technical (54%), psychological (48%), and physical (35%) aspects. Recovery protocols after sessions mainly involve rest and professional guidance (42%). For performance assessment and testing, coaches utilize countermovement jump (52%), force-velocity profile (45%), and 30-m flying (61%) as main tools. CONCLUSIONS: European sprint coaches demonstrated a comprehensive approach to planning and management, shedding light on the multifaceted nature of their training methodologies and the diverse tools employed for athlete testing and monitoring.

Training Session Models in Endurance Sports: A Norwegian Perspective on Best Practice Recommendations.

BACKGROUND: Our scientific understanding of the mechanistic and practical connections between training session prescriptions, their execution by athletes, and adaptations over time in elite endurance sports remains limited. These connections are fundamental to the art and science of coaching. OBJECTIVE: By using successful Norwegian endurance coaches as key informants, the aim of this study is to describe and compare best practice session models across different exercise intensities in Olympic endurance sports. METHODS: Data collection was based on a four-step pragmatic qualitative study design, involving questionnaires, training logs from successful athletes, and in-depth and semi-structured interviews, followed by negotiation among researchers and coaches to assure our interpretations. Twelve successful and experienced male Norwegian coaches from biathlon, cross-country skiing, long-distance running, road cycling, rowing, speed skating, swimming, and triathlon were chosen as key informants. They had been responsible for the training of world-class endurance athletes who altogether have won > 370 medals in international championships. RESULTS: The duration of low-intensity training (LIT) sessions ranges from 30 min to 7 h across sports, mainly due to modality-specific constraints and load tolerance considerations. Cross-training accounts for a considerable part of LIT sessions in several sports. Moderate (MIT)- and high-intensity training (HIT) sessions are mainly conducted as intervals in specific modalities, but competitions also account for a large proportion of annual HIT in most sports. Interval sessions are characterized by a high accumulated volume, a progressive increase in intensity throughout the session, and a controlled, rather than exhaustive, execution approach. A clear trend towards shorter intervals and lower work: rest ratio with increasing intensity was observed. Overall, the analyzed sports implement considerably more MIT than HIT sessions across the annual cycle. CONCLUSIONS: This study provides novel insights on quantitative and qualitative aspects of training session models across intensities employed by successful athletes in Olympic endurance sports. The interval training sessions revealed in this study are generally more voluminous, more controlled, and less exhaustive than most previous recommendations outlined in research literature.

Sex Differences in Self-Reported Causes, Symptoms, and Recovery Strategies Associated With Underperformance in Endurance Athletes.

PURPOSE: This study investigated sex differences in self-reported causes, symptoms, and recovery strategies associated with underperformance in endurance athletes. METHODS: A total of 82 athletes (40 women) meeting the inclusion criteria (performance level ≥tier 3, used training diaries, and experienced 1 or more periods of underperformance during their career) completed an online questionnaire. The questionnaire encompassed inquiries regarding load monitoring and experiences with underperformance, focusing on causes, symptoms, and recovery strategies. RESULTS: The most frequently reported symptoms associated with underperformance included psychological (31%), physiological (23%), and health-related (12%) symptoms. Notably, female athletes were more likely to report psychological symptoms associated with underperformance (38% vs 25%, P = .01) compared with male athletes. The leading causes of underperformance comprised illness (21%), mental/emotional challenges (20%), training errors (12%), lack of recovery (10%), and nutritional challenges (5%). Female athletes reported nutritional challenges more frequently as the cause of underperformance compared with males (9% vs 1%, P = .01), whereas male athletes more often attributed underperformance to training errors (15% vs 9%, P = .03). Overall, 67% of athletes reported recovering from underperformance, with a tendency for more male than female athletes to recover (76% vs 58%, P = .07). Furthermore, a higher proportion of male than female athletes reported implementing changes in the training process as a recovery strategy (62% vs 35%, P = .02). CONCLUSIONS: This study offers valuable insights into sex differences in experiences with underperformance in endurance athletes. The findings could inform coaches and athletes in both the prevention and treatment of such incidents.

Adherence to physical activity recommendations and associations with self-efficacy among Norwegian adolescents: trends from 2017 to 2021.

Background: The crucial role of physical activity (PA) in promoting well-being and overall health of adolescents is widely acknowledged. Previous global studies have consistently revealed low adherence to PA recommendations among adolescents, emphasizing potential links between PA engagement and self-efficacy in school-based populations. However, there is a need for further exploration of this relationship, in particularly gender differences and taking into account the potential influences of the COVID-19 pandemic. The objective of this study is to provide a comprehensive description of adherence to PA recommendations and its associations with self-efficacy in Norwegian school-based adolescents over the period from 2017 to 2021. Methods: Cross-sectional data on physical activity (PA) levels and self-efficacy among 13-19-year-old Norwegian adolescents were collected from the Norwegian Ungdata Survey during the period 2017 to 2021. The survey, conducted in Norwegian lower- and upper-secondary schools, was administered electronically during school hours. All data collected is anonymous and has received approval from the Norwegian Agency for Shared Services in Education and Research (SIKT). Statistical analyses were performed using SPSS software. Results: Girls consistently exhibited lower adherence to PA recommendations (17.6-19.8%) compared to boys (27.7-31.1%) each year from 2017 to 2021 (all p < 0.01). Similarly, girls reported lower self-efficacy (14.1 to 14.8 out of 20) than boys (15.5 to 15.9) during the same period (all p < 0.01). Regression analyses highlighted robust positive associations between PA and self-efficacy in those adhering to PA recommendations (i.e., physically active at least 5 times a week) and strong inverse associations for those reporting inactivity (never active) in both girls and boys from 2017 to 2021. Conclusion: Adolescents in Norway report PA adherence ranging from 15 to 30%, with girls consistently exhibiting lower adherence to PA recommendations and reporting lower self-efficacy than boys. Notably, there are substantial associations between self-efficacy and both adherence to PA recommendations and inactivity over time. These findings underscore the significance of promoting adherence to PA recommendations during adolescence, especially among girls. Policymakers in Norway should focus on initiatives to increase PA levels among adolescents in both lower and upper secondary schools.

Performance and jump-to-jump development in the first female ski flying competition in history.

In 2023, for the first time in history, the international ski and snowboard federation (FIS) arranged an official ski flying competition where the 15 highest ranked women were allowed to participate. This study investigated jump-to-jump performance development in female ski flying, with men's results used as reference data. Official FIS data from all six jumps of women were evaluated together with the eight jumps by men. Performance was evaluated by a score, where the distance points compensated by wind were divided by take-off speed, enabling performance to be evaluated across jumps and sexes. Women improved performance by 96% from the first to the sixth jump, with two major leaps; from the first to the second jump and from the first to the second day. In contrast, men mainly improved from training to competition. The best women had performance scores equivalent to the 10-20 best ranked men and the sex-difference between the top 3 athletes was 26.2%. This difference was thereafter compared to similar results in the normal and large hill World championship in Planica 2023, in which sex-differences between the top 3 were 8.6% and 14.6% in normal and large hill. This historical competition showed the importance of gaining practical experience with ski flying on performance, exemplified by the large improvement of female athletes. This, together with the enlarge sex-differences in large compared to normal hills, indicates that female ski jumpers have a particularly large improvement-potential in ski flying and must gain specific experience on this through traning and competitions.

Menstrual Cycle Phase Has No Influence on Performance-Determining Variables in Endurance-Trained Athletes: The FENDURA Project.

PURPOSE: This study aimed to investigate the effect of the MC and endogenous sex hormone concentrations on performance-determining variables in three distinct MC phases in endurance-trained females. METHODS: Twenty-one eumenorrheic trained/highly trained endurance athletes completed a standardized test battery during the early follicular phase (EFP), ovulatory phase (OP), and midluteal phase (MLP) for either one ( n = 7) or two test cycles ( n = 14). MC phases were determined using calendar-based counting, urinary ovulation testing, and verified with serum hormone analysis. MCs were retrospectively classified as eumenorrheic or disturbed. Disturbed MCs were excluded from analysis. The test battery consisted of 4-6 × 5-min submaximal stages with stepwise speed increases, a 30-s all-out double-poling ski ergometer test, and a maximal incremental treadmill running test. RESULTS: At a group level, there was no effect of MC phase or the serum concentrations of estrogen and progesterone on peak oxygen uptake (V̇O 2peak ), oxygen uptake at 4 mmol·L -1 blood lactate concentration, time to exhaustion, running economy, or mean 30-s power output (MPO 30s ). Serum testosterone concentration was positively associated with MPO 30s ( P = 0.016). Changes in V̇O 2peak from EFP to MLP were inconsistent between individuals and across cycles. CONCLUSIONS: None of the measured performance-determining variables were influenced by MC phase or serum estrogen or progesterone concentrations. Although some individual patterns could be observed, there was no indication that any single MC phase is consistently associated with improved or impaired V̇O 2peak on a group level.

Training strategies of 10,074 athletes from 121 countries based on human development index in early COVID-19 lockdown.

The aim of this study was to investigate relationships between changes in training practices and human development index (HDI) levels, and identify strategies employed by athletes who consistently maintained their training quantity during the first 100 days of the COVID-19 pandemic. A total of 10,074 athletes (5290 amateur and 4787 professional athletes from 121 countries) completed an online survey between 17 May to 5 July 2020. We explored their training practices, including specific questions on training frequency, duration and quantity before and during lockdown (March-June 2020), stratified according to the human development index (HDI): low-medium, high, or very high HDI. During the COVID-19 lockdown, athletes in low-medium HDI countries focused on innovative training. Nevertheless, women and amateur athletes experienced a substantial reduction in training activity. Performance-driven athletes and athletes from higher HDI indexed countries, were likely to have more opportunities to diversify training activities during lockdowns, facilitated by the flexibility to perform training away from home. Factors such as lockdown rules, socioeconomic environment, and training education limited training diversification and approaches, particularly in low-medium and high HDI countries. Athletes (amateurs and professionals) who maintained the quantity of training during lockdown appeared to prioritize basic cardiovascular and strength training, irrespective of HDI level. Modifying training and fitness programs may help mitigate the decrease in training activities during lockdowns. Customized training prescriptions based on gender, performance, and HDI level will assist individuals to effectively perform and maintain training activities during lockdowns, or other challenging (lockdown-like) situations.

Using artificial intelligence for exercise prescription in personalised health promotion: A critical evaluation of OpenAI's GPT-4 model.

The rise of artificial intelligence (AI) applications in healthcare provides new possibilities for personalized health management. AI-based fitness applications are becoming more common, facilitating the opportunity for individualised exercise prescription. However, the use of AI carries the risk of inadequate expert supervision, and the efficacy and validity of such applications have not been thoroughly investigated, particularly in the context of diverse health conditions. The aim of the study was to critically assess the efficacy of exercise prescriptions generated by OpenAI's Generative Pre-Trained Transformer 4 (GPT-4) model for five example patient profiles with diverse health conditions and fitness goals. Our focus was to assess the model's ability to generate exercise prescriptions based on a singular, initial interaction, akin to a typical user experience. The evaluation was conducted by leading experts in the field of exercise prescription. Five distinct scenarios were formulated, each representing a hypothetical individual with a specific health condition and fitness objective. Upon receiving details of each individual, the GPT-4 model was tasked with generating a 30-day exercise program. These AI-derived exercise programs were subsequently subjected to a thorough evaluation by experts in exercise prescription. The evaluation encompassed adherence to established principles of frequency, intensity, time, and exercise type; integration of perceived exertion levels; consideration for medication intake and the respective medical condition; and the extent of program individualization tailored to each hypothetical profile. The AI model could create general safety-conscious exercise programs for various scenarios. However, the AI-generated exercise prescriptions lacked precision in addressing individual health conditions and goals, often prioritizing excessive safety over the effectiveness of training. The AI-based approach aimed to ensure patient improvement through gradual increases in training load and intensity, but the model's potential to fine-tune its recommendations through ongoing interaction was not fully satisfying. AI technologies, in their current state, can serve as supplemental tools in exercise prescription, particularly in enhancing accessibility for individuals unable to access, often costly, professional advice. However, AI technologies are not yet recommended as a substitute for personalized, progressive, and health condition-specific prescriptions provided by healthcare and fitness professionals. Further research is needed to explore more interactive use of AI models and integration of real-time physiological feedback.

The International Olympic Committee framework on fairness, inclusion and nondiscrimination on the basis of gender identity and sex variations does not protect fairness for female athletes.

The International Olympic Committee (IOC) recently published a framework on fairness, inclusion, and nondiscrimination on the basis of gender identity and sex variations. Although we appreciate the IOC's recognition of the role of sports science and medicine in policy development, we disagree with the assertion that the IOC framework is consistent with existing scientific and medical evidence and question its recommendations for implementation. Testosterone exposure during male development results in physical differences between male and female bodies; this process underpins male athletic advantage in muscle mass, strength and power, and endurance and aerobic capacity. The IOC's "no presumption of advantage" principle disregards this reality. Studies show that transgender women (male-born individuals who identify as women) with suppressed testosterone retain muscle mass, strength, and other physical advantages compared to females; male performance advantage cannot be eliminated with testosterone suppression. The IOC's concept of "meaningful competition" is flawed because fairness of category does not hinge on closely matched performances. The female category ensures fair competition for female athletes by excluding male advantages. Case-by-case testing for transgender women may lead to stigmatization and cannot be robustly managed in practice. We argue that eligibility criteria for female competition must consider male development rather than relying on current testosterone levels. Female athletes should be recognized as the key stakeholders in the consultation and decision-making processes. We urge the IOC to reevaluate the recommendations of their Framework to include a comprehensive understanding of the biological advantages of male development to ensure fairness and safety in female sports.