Barriers and Facilitators for Participation in Physical Activity in the Transgender Population: A Systematic Review

Jay Holder; Jacqueline Morris; Mark Spreckley

doi:10.5334/paah.190

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Table 1

Search String Terms.

Transgender	transgender, transsexual, trans men, transmen, trans women, transwomen, nonbinary, non-binary, genderqueer, transmasculine, transfeminine
Physical activity	physical activity, sport, physical education, barriers to exercise, facilitators of exercise, exercise promotion
(‘transgender’ OR ‘transsexual’ OR ‘trans men’ OR ‘transmen’ OR ‘trans women’ OR ‘transwomen’ OR ‘nonbinary’ OR ‘non-binary’ OR ‘genderqueer’ OR ‘transmasculine’ OR ‘transfeminine’) AND (‘physical activity’ OR ‘sport’ OR ‘physical education’ OR ‘barriers to exercise’ OR ‘facilitators of exercise’ OR ‘exercise promotion’)

Table 2

Study details.

AUTHOR(S) AND YEAR	QUALITY SCORE	METHOD	GENDERS	AGES	BARRIERS	FACILITATORS
Elling-Machartzki, 2017	+	Qualitative; interviews	6 trans women, 6 trans men	Ages 27–51 years, Average age 40.5 years	Early stages of transition Alienation Changing rooms Single gender sports	“Boys” sports gender affirming for trans men Individual sports Recreational/informal sports LGBT sports Medical transition
Greenspan et al., 2019	++	Quantitative; surveys	2 trans female, 3 trans male, 2 genderqueer, 6 other	13–18 years	Specific sports Bullying and harassment Lack of support Locker rooms Feeling alienated/unwelcome Body image/dysphoria	Individual sport Sport outside school Positive peer relationships Staff support Practical solutions for changing rooms Choice of sportswear Mixed gender sports Staff training and awareness
Herrick and Duncan, 2018	++	Qualitative; focus groups	5 non-binary, 2 gender fluid, 2 trans men, 1 trans women, and 1 agender person	18+ years, Average age 28 years	Misgendering Sportswear Environments	Broader definitions of physical activity Gender neutral changing rooms Role models Safe spaces LGBT or queer friendly spaces
Herrick and Duncan, 2020	++	Qualitative; surveys	88 transgender men, 51 transgender women, 183 nonbinary	18+ years	Locker rooms Self-consciousness Feeling unwelcome Physical safety/violence	Passing/Medical transition/Body confidence Trans spaces Gender neutral changing rooms
Jones et al., 2017	++	Qualitative; interviews	9 trans men, 4 trans women	18–36 yearsAverage age 22.71	Changing facilities Misgendering/fears about passing Body dissatisfaction Sportswear Team sports/gender segregation	Physical activity at home Body satisfaction Medical transition Motivated to improve transition outcomes Trans only spaces
Jones et al., 2018	++	Quantitative; matched control study using surveys	Matched control sample: 42 transgender men, 42 cisgender men, 95 transgender women, 95 cisgender women Whole trans sample: Sex assigned at birth – 151 female, 209 maleGender identity – 166 female, 131 male, 14 partly male and female, 17 neither male nor female, 18 unsure, 8 other, 6 missing data	Mean age all participants 30.15 years	n/a	Medical transition – hormone therapy Self esteem Body satisfaction
Kulick et al., 2019	+	Quantitative; surveys	86 trans participants; genders not specified	High school age	Language/slurs	Feeling safe in toilets/changing rooms
López-Cañada et al., 2020	+	Quantitative; surveys	93 trans women, 108 trans men, 11 various other labels	10–62 yearsAverage age 30.63 years	Gender disclosure/early stages transition	Non organised physical activity Individual physical activity
Pistella et al., 2020	++	Quantitative; self report surveys	357 trans participants; genders not specified	12–17 years	n/a	Feeling safe
Stewart et al., 2020	++	Qualitative; interviews	20 trans women	16–65 years	Fears about passing Bullying/harassment/slurs Single gender spaces	Medical transition – speech therapy Relationships with coaches and peers Feeling accepted/welcome

Barriers and Facilitators for Participation in Physical Activity in the Transgender Population: A Systematic Review

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Table 1

Figure 1

Table 2

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