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Physical activity in transgender people: a cross-sectional
matched control study
Bethany A. Jones 1,2, Emma Haycraft 2, Christina Richards1, Sally Robbins-Cherry1, Karen Baker1, Walter Bouman1 and Jon
Arcelus1 (Email: B.Jones@lboro.ac.uk)
1 Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom
2 School of Sport, Exercise, and Health Sciences, Loughborough University, United Kingdom
1. Background
•Transgender people who access gender services report higher levels of
mental health issues, such as depression, anxiety, and self-harm, than
comparative cisgender populations (e.g., Dhejne, Van Vlerken, Heylens &
Arcelus, 2016).
•People who engage in more physical activity report fewer mental health
problems (e.g., depression, anxiety), in comparison to people who do not
engage in frequent physical activity (e.g., De Moor et al., 2006; Maltby &
Day, 2001).
•However, transgender people are thought to have a negative experience
when engaging in physical activity due to specific barriers relating to gender
identity, transphobic experiences, lack of awareness about transgender
people, and discriminatory sport policies (Jones, Arcelus, Bouman &
Haycraft, submitted). This could indicate that engagement in physical
activity is low among the transgender population.
1. To explore the differences in the amount and type of physical activity
between treatment seeking transgender people and cisgender (non-trans)
people.
2. To explore differences in the amount and type of physical activity between
transgender people who had socially transitioned and taken Cross-sex
Hormone Treatment (CHT), and those who have not.
2. Aims
References:
•Dhejne, C., Van Vlerken, R., Heylens, G., & Arcelus, J. (2016). Mental health and gender dysphoria: A review of the literature. International Review of Psychiatry, 28(1), 44-57.
•De Moor, M. H. M., Beem, A. L., Stubbe, J. H., Boomsma, D. I., & De Geus, E. J. C. (2006). Regular exercise, anxiety, depression and personality: a population-based study. Preventive medicine, 42(4), 273-279.
•Jones, A. B., Arcelus, J., Bouman, P. W., Haycraft, E. (submitted). Sport and trans people: A systematic review of the literature relating to sport participation and sport policies. Manuscript submitted for publication.
•Maltby, J., & Day, L. (2001). The relationship between exercise motives and psychological well-being. The Journal of Psychology, 135(6), 651-660.
3. Method
Participants and recruitment:
•137 transgender participants and 137 cisgender participants matched by
age and experienced gender (42 participants identified as male, and 95
identified as female).
•Transgender participants were recruited from a national gender service in
the United Kingdom at the assessment stage.
•Cisgender participants were recruited via the community using snowball
sampling.
Measures and procedure:
•Participants (transgender and cisgender) who agreed to participate in the
study were invited to complete the Rapid Assessment of Physical
Activity questionnaire (Topolski et al., 2006) which assesses frequency,
type (aerobic or strength and flexibility) and intensity of physical activity
usually engaged in.
Analysis:
•Mann-Whitney U tests were conducted to explore differences between
transgender and cisgender people’s physical activity engagement.
•To explore the difference between people who had and had not socially
transitioned, a Mann-Whitney U test was conducted.
•Mann-Whitney U tests were conducted to explore the difference in physical
activity engagement between people who had and had not taken CHT.
6. Implications
5. Conclusion
The provision and accessibility of physical activity for transgender people
needs to be improved. To achieve this, non-transphobic and comfortable
environments need to be created. This could be done by:
•Increasing awareness of the diversity of gender expressions
•Increasing awareness of the issues transgender people may experience at
different stages of transition when engaging in physical activity
•Improving changing facilities (i.e., gender neutral, with cubicles).
Treatment seeking transgender people are less likely to engage in physical
activity in comparison to cisgender people when age and gender are controlled
for.
4. Results
• In comparison to
transgender people (males
and females), cisgender
people (males and females)
engaged in significantly
more aerobic (U=7108.00,
p<0.05) and more strength
and flexibility (U=7556.00,
p<0.05) physical activity.
Differences in physical activity between transgender and cisgender
participants:
0
1
2
3
4
5
6
Aerobic physical
activity Strength and
flexibility
physical activity
Total cisgender
mean score
Cisgender male
mean score
Cisgender female
mean score
Total transgender
mean score
Transgender male
mean score
Transgender
female mean score
The role of social transition and CHT on physical activity:
•There was no significant difference
in the activity levels of people who
had socially transitioned versus
those who had not socially
transitioned (UAerobic=1511.50,
p=0.141; UStrength and flexibility=1658.00,
p=0.375).
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
Aerobic
physical
activity
Strength
and
flexibility
physical
activity
Transgender
mean score:
full social
transition
Transgender
mean score: no
social transition
•There was no significant
difference between the activity
levels of people who had taken
CHT prior to assessment,
compared with those who had not
taken CHT (UAerobic=1901.50,
p=0.105; UStrength and
flexibility=2107.50, p=0.366).
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Aerobic
physical
activity
Strength and
flexibility
physical
activity
Transgender
mean score:
CHT
Transgender
mean score:
No CHT