Nonbinary Transmasculine Runner Receives TUE For Gender-Affirming Testosterone Use

Last Updated:

Cal Calamia is a 27-year-old nonbinary transmasculine runner and high school cross-country coach from San Francisco. Calamia has been an advocate and trailblazer in the nonbinary running community.

Calamia continues to play a significant role in creating opportunities and safe environments for trans and nonbinary runners. 

Last year, Calamia was an advocate for the first nonbinary division at the San Francisco Marathon, which they eventually won. Calamia also consulted with the Boston Marathon race organizers to help introduce a nonbinary division, which Calamia would also go on to compete in.

Calamia has been taking testosterone as part of their transition since 2019, something they have been open about on social media. However, in July, Calamia was informed by the U.S. Anti-Doping Agency (USADA) that they were at risk of being sanctioned as a result of taking testosterone.

Testosterone is a substance that is banned by the World Anti-Doping Agency (WADA) for its performance-enhancing effects. Many notable athletes, such as Lance Armstrong, have been caught and served bans for their use of testosterone.

However, this week, Calamia received an email from USADA granting them a therapeutic use exemption (TUE) for their testosterone use. This will allow Calamia to compete in male, nonbinary, and open categories at USATF-sanctioned events without fear of a potential sanction.

This is the first TUE for a nonbinary runner who is receiving gender-affirming hormone treatment. This has been celebrated throughout the nonbinary and trans athletic community as it is seen as a victory and a big step in the right direction.

Calamia spoke with the Washington Post of the victory: “This approval represents a turning point in conversations about trans athletes. To have this approval means I’m allowed to be a part of this conversation without being sidelined.”

A TUE is required for athletes taking prohibited substances for medical purposes. This allows the athlete to use the substance without facing the risk of violating WADA rules and receiving a sanction. Athletes who use prohibited substances for medical purposes but have not completed a TUE are violating anti-doping rules.

Calamia described the process of applying for a TUE as invasive. They first noticed that the application form only had two genders to select from, male and female. Calamia, therefore, left both boxes unchecked. 

USADA also requested a slew of documentation, including medical history, psychological records, medical notes, and a confirmed diagnosis of gender dysmorphia. The only other applicants required to provide psychological records are those seeking exemptions for banned substances to treat attention-deficit hyperactivity disorder.

Calamia saw these requirements as invasive and unnecessary and did not include any of the listed documents with their application.

Calamia’s application was accepted regardless of the missing documentation. Their exemption dates back to June 17, 2022, lasting ten years. Conditions for the exemption include changes in medication, dosage, or schedule, and they are required to have their testosterone levels monitored every six months.

Photo of author
Jessy has been active her whole life, competing in cross-country, track running, and soccer throughout her undergrad. She pivoted to road cycling after completing her Bachelor of Kinesiology with Nutrition from Acadia University. Jessy is currently a professional road cyclist living and training in Spain.

Leave a Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.