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In a monumental move, the Nevada State Athletic Commission have banned testosterone-replacement therapy (TRT) from combat sports - including boxing and mixed martial arts.
The ruling, which passed by a unanimous vote, eliminates future applications for a therapeutic use exemption for TRT. It also denies the use of TRT to any fighter who had previously received permission for its use from the state.
NSAC chairman Francisco Aguilar noted the historic nature of the ruling and stated his hope that the Association of Boxing Commissions would take up the cause.
"I would encourage the ABC to look at this issue for all commissions in all states across the country," Aguilar said. "I think it's important that there be a standard and I think [the NSAC] is not afraid to set that standard."
The UFC, which regulates itself in the absence of an athletic commission in events held overseas, will apparently follow the NSAC's lead in banning TRT.
"We follow Nevada," UFC president Dana White told ESPN via text message. "It's a great day for the sport. I applaud the NSAC. TRT needed to go away."
At least 15 mixed martial artists have received exemptions for testosterone use since 2007, including six in Nevada. That number represents a high percentage of need compared to the general population, and especially other professional sports.
"We believe our athletes should compete based on their natural abilities and on an even playing field," White continued in a statement. "We also intend to honor this ruling in international markets."
The six athletes previously approved for TRT use in Nevada are Dan Henderson, Shane Roller, Todd Duffee, Chael Sonnen, Frank Mir and Forrest Griffin.
Dr. Timothy Trainor, medical consultant to the NSAC, led the meeting on Thursday. He acknowledged the commission's decision to ban TRT could prevent an athlete with a legitimate medical need of testosterone from competing, but argued that a rare case shouldn't outweigh the potential of other athletes abusing the treatment.
"If we assume it's someone who truly has that diagnosis, that would be just like someone with diabetes," Trainor said. "They didn't cause it themselves. That would be, in my mind, the athlete that would be penalized.
"Being granted a license to compete in combat sports, [however] is not a God-given right to anyone."
A major issue regarding the approval of TRT is a fighter's need for treatment. During his presentation, Trainor said he was uncomfortable granting the use of testosterone, as it's medically proven that previous steroid abuse can "shut down" an athlete's production of testosterone.
Trainor also argued against the idea that combat athletes require testosterone due to frequent head trauma. If that proves to be scientifically correct, Trainor said, their careers should likely end at that point. According to an Outside the Lines report this week, Nevada has never received an application from a professional boxer for a TRT exemption, meaning it has been a matter exclusive to MMA.
"A lot of these people who would apply for this would want to argue the reason they have low testosterone is because they've been fighters and have sustained head trauma," Trainor said. "OK. I can't prove that's the case or not; however, if that is the case, why should we grant them an exemption to take testosterone and get hit in the head more?"
Added NSAC board member Bill Brady: "Granting TUEs for TRT in the past has caused me great burden because there's always a person there fighting on the other side who isn't asking for anything - who is going to be tested and be clean. I think we have an obligation to the fighter who doesn't want an exemption to make sure they're getting an honest and fair fight."
The decision comes two months before UFC middleweight Vitor Belfort is scheduled to face Chris Weidman for the title at UFC 173 on May 24 in Las Vegas. Belfort, 36, was approved to use TRT in his past three fights, all of which took place in Brazil.
He was expected to file an application to the NSAC for a therapeutic use exemption.
This article originally appeared on ESPN.com