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

Abstract

Research question(s): What barriers and facilitators influence transgender people’s participation in physical activity? Background: Transgender equality has become a high-profile issue in recent years with transgender athletes making headlines in both the USA and the UK. Social and health inequalities experienced by transgender individuals are widely recognised. Physical activity promotion is a core area of public health due to its documented benefits. It is therefore important to understand reasons for participation rates in this community to support effective policies and practice. Methods: Data base searches were used to identify relevant studies. Studies were screened and data extracted systematically. Narrative synthesis was utilised to analyse results from heterogenous studies. Results: Ten relevant studies were identified, including six qualitative and four quantitative studies. Narrative synthesis determined five themes: changing rooms, medical transition, sports environments and activities, relationships and social support, physical and psychological safety. Participants described intense experiences of vulnerability, victimisation, and stigma. Conclusions: There are multiple intersecting barriers and facilitators for transgender people’s participation in physical activity. Practical barriers, such as lack of appropriate changing facilities or the gendered nature of sports teams and activities, may contribute. But more subtle, psychological issues, of feeling safe and fitting in may be equally important.

Keywords

• lgbtq+
• transgender
• exercise
• fitness
• public health