Barriers and facilitators of physical activity and sport participation among young transgender adults who are medically transitioning

Abstract

Background: Transgender people (those who feel incongruence between the gender they were assigned at birth and their gender identity) engage in lower levels of physical activity compared to cisgender people (non-transgender). Several factors have been shown to affect physical activity engagement in the cisgender population however; the physical activity experiences of young transgender adults have not been explored. It was therefore the aim of the current study to understand what factors are associated with physical activity and sport engagement in young transgender adults who are medically transitioning. Method: Semi-structured interviews were conducted with 14 young transgender adults (18-36 years) who had initiated their medical transition at a transgender health service in the United Kingdom. The data were analysed using thematic analysis. Results: Two main themes were identified: (1) barriers and (2) facilitators to physical activity and sport. Overall, the young transgender adults were insufficiently active due to inadequate changing facilities, body dissatisfaction, fears surrounding 'passing' and not being accepted by others. At the same time, participants were motivated to engage in physical activity to increase their body satisfaction and gender congruence. However, participants felt there were a lack of safe and comfortable spaces to engage in physical activity and sport. Conclusion: Young transgender adults who are medically transitioning experience several barriers to physical activity and sport, despite being motivated to be physically active. Initiatives to facilitate young transgender adults to be able to put their motivations into practice (i.e. to be more physically active) are needed.

The Levels and Predictors of Physical Activity Engagement Within the Treatment-Seeking Transgender Population: A Matched Control Study

“…1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 F o r P e e r R e v i e w given that 79% of survey respondents felt that transphobia was a barrier to participating in 397 sport. 56 This lack of association in our study may be explained by the fact that some 398 transgender people anticipate, as opposed to experience, transphobia 20,57 and the measure in 399 the current study only asked about the experience of transphobia. In addition, the percentage 400 of physical activity explained by the regression models was low.…”

“…Based on the amount of barriers that transgender people experience when engaging in 347 physical activity and sport 20,21 it is understandable that greater self-esteem was found to be 348 This study found that once cross-sex hormone treatment had commenced, self-esteem was no 361 longer the best statistical predictor of physical activity. In addition, transgender people who 362 were taking cross-sex hormones engaged in significantly more physical activity than 363 participants who were not.…”

“…This difference might be explained by 384 the findings from a recent qualitative study where transgender males who were taking cross-385 sex hormones discussed how wearing a chest binder a during physical activity was extremely 386 uncomfortable. 20 In addition, body satisfaction in transgender males has been found to 387 significantly increase following chest reconstructive surgery. 53 In light of the current study's 388 findings and previous research, chest reconstructive surgery should be offered in a timely 389 manner in accordance with the recommended Standards of Care, if this is what the person 390 wishes.…”

Quality of life of treatment-seeking transgender adults: A systematic review and meta-analysis

“…Many transgender people, particularly prior to their physical transition, face considerable challenges. These challenges can be physiological (development of some of the secondary sexual characteristics of the sex assigned at birth), social (lack of social support, rejection, discrimination, victimisation, transphobia) [ 3 – 12 ] and psychological (e.g. anxiety, depression, low self-esteem) [ 3 , 13 – 16 ].…”

The Gender Congruence and Life Satisfaction Scale (GCLS): Development and validation of a scale to measure outcomes from transgender health services

“…This was followed by a review of existing body dissatisfaction measures that are currently used to assess patient outcomes at transgender health services (Jones et al, 2016). Next, in-depth interviews with 14 transgender people attending a national transgender health service in the UK were undertaken as part of a larger study (Jones, Arcelus, Bouman, & Haycraft, 2017). These interviews highlighted how distress and dissatisfaction with gender, associated mental wellbeing, and life satisfaction improved over the treatment process.…”