USA Swimming, the governing body for competitive swimming in the U.S., updated its rules on transgender athletes Tuesday.

Under the new rules, biologically male athletes who say they are women and seek to compete in the women’s category will need to go through a “Self-Identity Verification” process, receive approval from a panel of medical experts and test below a determined threshold of testosterone levels at least three times in the preceding three years.

The requirements do not include physical examinations to determine sex, which are prohibited by the International Olympic Committee.

USA Swimming’s new rules deny that biological males retain any athletic advantage over females after hormone therapy.

“From a medical perspective, the prior physical development of the athlete as a Male, as mitigated by any medical intervention, does not give the athlete a competitive advantage over the athlete’s cisgender Female competitors,” the USA Swimming rules state.

A 2021 report from the Sports Councils’ Equality Group found that males retain an advantage over females in strength, stamina and physique even after undergoing testosterone suppression.

Biologically female transgender athletes who wish to compete in the men’s category only need to submit a “Self-Identity Verification” request, which in some cases may be reviewed by doctors or administrators.

The rules come amid renewed debate about males competing in women’s sports. Lia Thomas, formerly known as Will Thomas, competed for the University of Pennsylvania’s men’s swimming team for three years before proclaiming to be a woman. Thomas now competes on the women’s swim team and has dominated the sport at the national level.

It is unclear whether the new USA Swimming rules will affect Thomas.