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29 de março de 2021Checklist for Therapeutic Use Exemption (TUE) Application:
Transgender Athletes
Prohibited Substances: Testosterone, spironolactone
This Checklist is to guide the athlete and their physician on the requirements for a TUE application that will allow the TUE Committee to assess whether the relevant ISTUE Criteria are met.
Please note that the completed TUE application form alone is not sufficient; supporting documents MUST be provided. A completed application and checklist DO NOT guarantee the granting of a TUE. Conversely, in some situations a legitimate application may not include every element on the checklist.
| • | TUE Application form must include: | |
| • | All sections completed in legible handwriting | |
| • | All information submitted in [language] | |
| • | A signature from the applying physician | |
| • | The Athlete’s signature | |
| • | Medical report should include details of: | |
| • | Medical history: age at onset of gender dysphoria, evidence of complete medical assessment prior to
start of any treatment, description of any previous partially or fully reversible treatment |
|
| • | Endocrinologist report on initiation of current therapy | |
| • | Interpretation of history, presentation and endocriniologist report by a physician regularly providing care to transgender people |
|
| • | Testosterone and spironolactone (both are prohibited at all times) prescribed including dosage,
frequency, administration route |
|
| • | Evidence of follow-up/monitoring of athlete by qualified physician including testosterone levels for renewals |
|
| • | Diagnostic test results should include copies of: | |
| • | Laboratory tests: regular testosterone levels since treatment started (incl. the method/
assay used) |
|
| • | Additional information included | |
| • | Surgery report where applicable | |
