Sex Differences in Wheelchair Marathon Performance

OBJECTIVE: The aim of the study was to evaluate the historical trends of sex differences in athletic performance and participation among male and female wheelchair marathon athletes. DESIGN: This retrospective, observational study utilized secondary, publicly available data of the Boston, Chicago, and New York City marathons within the wheelchair division from 1984 to 2023. Athletic performance and participation were evaluated across all marathon events and over time using univariate analysis of variance and Pearson correlations. RESULTS: Sex differences in athletic performance were observed with males outperforming females in all marathon events over time ( P < 0.001). The sex difference among first place finishers was 20% and increased to 33% for tenth place finishers. Although sex differences decreased over time ( P < 0.001), large sex differences in performance remain. Female athlete participation in wheelchair marathon events significantly increased over time ( P < 0.001) and the ratio of male athletes to female athletes in these events significantly decreased over time ( P < 0.001). Overall participation and male athlete participation also generally increased over time. CONCLUSIONS: Significant sex differences were observed in wheelchair marathon performance and participation. These findings highlight the importance of sex as a key biological variable related to human health and performance, especially among wheelchair athletes.