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DeChants JP, Green AE, Price MN, Davis CK. "I Get Treated Poorly in Regular School-Why Add To It?": Transgender Girls' Experiences Choosing to Play or Not Play Sports. Transgend Health 2024; 9:61-67. [PMID: 38312449 PMCID: PMC10835156 DOI: 10.1089/trgh.2022.0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Transgender girls' right to participate in high school sports has been attacked by legislation banning them from doing so. This study uses open-ended survey responses among transgender high school girls to examine reasons that they choose to participate or not participate in sports. Methods Data come from 294 transgender girls currently in high school who answered one of two open-ended questions about sports participation as part of a larger survey on lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) youth mental health. An inductive approach with exploratory and descriptive codes was used, resulting in a codebook with 14 codes about high school girls' choices to participate or not participate in sports. Results Among respondents' answers about why they participate in sports, six codes were identified: physical health benefits, mental health benefits, fun, social connections, family expectations, and gender affirmation. Among respondents' answers about why they do not participate in sports, eight codes were identified: not interested in sports, gendered teams or spaces, not athletic, physical or mental health limitations, social discomfort around peer athletes, worsened gender dysphoria, bullying or harassment, and lack of resources or access. These codes were not mutually exclusive and many responses were tagged with multiple codes. Conclusion This study highlights the need for inclusive sports environments for transgender athletes. Providing LGBTQ cultural competence training for coaches, administrators, and parents may decrease barriers and increase comfort for transgender athletes, allowing them to benefit from the skills and education that sports provide.
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Affiliation(s)
| | - Amy E. Green
- The Trevor Project, West Hollywood, California, USA
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Greey AD. 'It's Just Safer When I Don't Go There': Trans People's Locker Room Membership and Participation in Physical Activity. JOURNAL OF HOMOSEXUALITY 2023; 70:1609-1631. [PMID: 35179445 DOI: 10.1080/00918369.2022.2038968] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Building on findings demonstrating that transgender and gender non-binary (trans) people's participation in physical activity is impacted by their experiences in locker rooms, this study examines how trans people navigate transphobia and cissexism in locker rooms. I consider the concepts of membership and belonging to illuminate how locker room access impacts trans people's participation in the public sphere. Drawing on interviews with trans people, this study suggests that-because of iterative encounters of surveillance, scrutiny, harassment, and violence-trans people regularly adopt strategies for navigating locker rooms as nonmembers. To access locker rooms despite a denial of membership, trans people employ various strategies to minimize the visibility of their transness and/or gender non-conformity through managing the perceived threat their gender expression poses to a "cisgendered reality." Strategies such as hurrying, avoiding nudity and eye contact, and recruiting ally support function to facilitate locker room access by minimizing attention to trans nonmembership. The findings of this study suggest that whiteness broadens the availability of strategies for navigating locker rooms. This study offers insight into how people respond to stigma, evade surveillance and exclusion, and access public space despite a denial of membership.
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Voss RV, Kuhns LM, Phillips G, Wang X, Wolf SF, Garofalo R, Reisner S, Beach LB. Physical Inactivity and the Role of Bullying Among Gender Minority Youth Participating in the 2017 and 2019 Youth Risk Behavior Survey. J Adolesc Health 2023; 72:197-206. [PMID: 36369113 DOI: 10.1016/j.jadohealth.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/15/2022] [Accepted: 08/17/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Evidence from small-scale studies suggests that transgender youth are less physically active than nontransgender youth, putting them at risk for worse health outcomes. This study examined the relationship between gender modality and participation in physical activity, physical education (PE), and sports teams in a multistate sample of high school youth and assessed whether bullying impacted this relationship. METHODS Multiple regression was used to analyze data from the state and local Youth Risk Behavior Survey from 2017 to 2019 to examine the relationship between the gender modality and participation in physical activity, PE, and sports teams. The sample was stratified by sex and adjusted for demographics and in-school and online bullying victimization. RESULTS Transgender participants who reported a male or female sex, respectively, reported lower odds of physical activity (adjusted odds ratio [aOR] 0.46, p < .001; aOR 0.46, p < .001, respectively) but similar odds of PE participation. Female transgender students were less likely to participate in sports (aOR 0.55, p = .007); however, this relationship was not seen in adjusted models. Adjusting for demographics, male transgender students were significantly more likely to participate in sports (aOR 2.1, p = .002). Adjusting for bullying experiences did not significantly change these results. DISCUSSION Transgender youth are less likely to participate in physical activity but participate similarly or more than cisgender peers in PE and sports. Factors other than bullying may limit physical activity among transgender youth, and the Youth Risk Behavior Survey may not capture experiences of trans-specific victimization. Increased inclusion and safety may help increase physical activity and amplify its benefits for transgender students.
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Affiliation(s)
- Raina V Voss
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Lisa M Kuhns
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Gregory Phillips
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Xinzi Wang
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Sigrid F Wolf
- Department of Orthopedic Surgery and Sports Medicine, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Robert Garofalo
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Sari Reisner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Lauren B Beach
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois.
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Wilson OWA, Jones BA, Bopp M. College student aerobic and muscle-strengthening activity: Disparities between cis-gender and transgender students in the United States. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:507-512. [PMID: 33760722 DOI: 10.1080/07448481.2021.1895808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/04/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
Objective: To examine aerobic and muscle-strengthening activity disparities among college cis-gender and transgender students adjusting for other socio-demographic characteristics (age, race/ethnicity, sexual orientation). Methods: National Collegiate Health Assessment (NCHA) data collected between Fall 2015 and Fall 2018 were analyzed using chi-square tests for independence and odds ratios. Results: Cis-gender women were significantly less likely to meet aerobic and muscle-strengthening activity recommendations compared to cisgender men. Transgender men and transgender women were less likely to meet aerobic and muscle-strengthening activity recommendations compared to cisgender peers. Differences were also revealed among transgender individuals, with transgender women more and less likely to meet aerobic and muscle-strengthening recommendations respectively compared to transgender men. Conclusions: Considerable aerobic and muscle-strengthening activity participation disparities exist between cisgender and transgender emerging adults. The unique constraints that transgender college students experience in relation to both aerobic and muscle-strengthening activity participation require further examination to ensure the provision of equitable opportunities to be physically active.
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Affiliation(s)
- Oliver W A Wilson
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Bethany A Jones
- School of Social Sciences, Nottingham Trent University, Nottingham, England
| | - Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
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5
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Wilson OWA, Bopp M. College student aerobic and muscle-strengthening activity: the intersection of gender and race/ethnicity among United States students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:80-86. [PMID: 33650936 DOI: 10.1080/07448481.2021.1876709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/07/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Objective: To adopt an intersectional approach to examine differences in aerobic and muscle-strengthening participation based on the intersection of gender and race/ethnicity among college students. Methods: Data from the American College Health Association (ACHA) National College Health Assessment collected between 2015 and 2018 were analyzed. Differences in the prevalence of meeting activity recommendations based on the intersection of gender and race/ethnicity were computed and displayed graphically. Odds of meeting activity recommendations were determined by calculating odds ratios controlling for age, year of enrollment, sexual orientation, and health status. Results: Aerobic and muscle-strengthening activity differed significantly between races within genders, and between genders within races. With minor exceptions, men were more likely to meet aerobic and muscle-strengthening activity recommendations than women of the same race/ethnicity. Disparities based on race varied considerably between genders. Conclusions: The intersection of gender and race/ethnicity should be considered when examining and addressing physical activity disparities.
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Affiliation(s)
- Oliver W A Wilson
- Department of Kinesiology, Pennsylvania State University, University Park, PA, USA
| | - Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, University Park, PA, USA
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6
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Valentine A, Davis S, Furniss A, Dowshen N, Kazak AE, Lewis C, Loeb DF, Nahata L, Pyle L, Schilling LM, Sequeira GM, Nokoff N. Multicenter Analysis of Cardiometabolic-related Diagnoses in Transgender and Gender-Diverse Youth: A PEDSnet Study. J Clin Endocrinol Metab 2022; 107:e4004-e4014. [PMID: 35945152 PMCID: PMC9516032 DOI: 10.1210/clinem/dgac469] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Indexed: 12/30/2022]
Abstract
CONTEXT Studies on cardiometabolic health in transgender and gender-diverse youth (TGDY) are limited to small cohorts. OBJECTIVE This work aimed to determine the odds of cardiometabolic-related diagnoses in TGDY compared to matched controls in a cross-sectional analysis, using a large, multisite database (PEDSnet). METHODS Electronic health record data (2009-2019) were used to determine odds of cardiometabolic-related outcomes based on diagnosis, anthropometric, and laboratory data using logistic regression among TGDY youth vs controls. The association of gender-affirming hormone therapy (GAHT) with these outcomes was examined separately among TGDY. TGDY (n = 4172) were extracted from 6 PEDSnet sites and propensity-score matched on 8 variables to controls (n = 16 648). Main outcomes measures included odds of having cardiometabolic-related diagnoses among TGDY compared to matched controls, and among TGDY prescribed GAHT compared to those not prescribed GAHT. RESULTS In adjusted analyses, TGDY had higher odds of overweight/obesity (1.2; 95% CI, 1.1-1.3) than controls. TGDY with a testosterone prescription alone or in combination with a gonadotropin-releasing hormone agonist (GnRHa) had higher odds of dyslipidemia (1.7; 95% CI, 1.3-2.3 and 3.7; 95% CI, 2.1-6.7, respectively) and liver dysfunction (1.5; 95% CI, 1.1-1.9 and 2.5; 95% CI, 1.4-4.3) than TGDY not prescribed GAHT. TGDY with a testosterone prescription alone had higher odds of overweight/obesity (1.8; 95% CI, 1.5-2.1) and hypertension (1.6 95% CI, 1.2-2.2) than those not prescribed testosterone. Estradiol and GnRHa alone were not associated with greater odds of cardiometabolic-related diagnoses. CONCLUSION TGDY have increased odds of overweight/obesity compared to matched controls. Screening and tailored weight management, sensitive to the needs of TGDY, are needed.
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Affiliation(s)
- Anna Valentine
- University of Colorado Anschutz Medical Campus, Department of Pediatrics, Aurora, Colorado 80045, USA
- Children’s Hospital Colorado, Division of Endocrinology, Aurora, Colorado 80045USA
| | - Shanlee Davis
- University of Colorado Anschutz Medical Campus, Department of Pediatrics, Aurora, Colorado 80045, USA
- Children’s Hospital Colorado, Division of Endocrinology, Aurora, Colorado 80045USA
| | - Anna Furniss
- University of Colorado Adult & Child Consortium for Health Outcomes Research and Delivery Sciences (ACCORDS), Aurora, Colorado 80045, USA
| | - Nadia Dowshen
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania 19104, USA
| | - Anne E Kazak
- Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, Pennsylvania 19107, USA
| | - Christopher Lewis
- Washington University School of Medicine, St Louis, Missouri 63110, USA
| | - Danielle F Loeb
- University of Colorado Anschutz Medical Campus, Department of Medicine, Aurora, Colorado 80045, USA
| | - Leena Nahata
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Columbus, Ohio 43215, USA
- Division of Endocrinology, Nationwide Children’s Hospital, Columbus, Ohio 43205, USA
| | - Laura Pyle
- University of Colorado Anschutz Medical Campus, Department of Pediatrics, Aurora, Colorado 80045, USA
- University of Colorado School of Public Health, Department of Biostatistics and Informatics, Aurora, Colorado 80045, USA
| | - Lisa M Schilling
- University of Colorado Anschutz Medical Campus, Department of Medicine, Aurora, Colorado 80045, USA
- University of Colorado Data Science to Patient Value Initiative, Aurora, CO 80045, USA
| | - Gina M Sequeira
- Seattle Children’s Research Institute, Seattle, Washington 98121, USA
| | - Natalie Nokoff
- University of Colorado Anschutz Medical Campus, Department of Pediatrics, Aurora, Colorado 80045, USA
- Children’s Hospital Colorado, Division of Endocrinology, Aurora, Colorado 80045USA
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Fornander MJ, Roberts T, Egan AM, Moser CN. Weight Status, Medication Use, and Recreational Activities of Treatment-Naïve Transgender Youth. Child Obes 2022; 18:228-236. [PMID: 34762510 DOI: 10.1089/chi.2021.0155] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Studies of transgender/gender diverse (TGD) youth indicate a high prevalence of overweight/obesity and concern for unhealthy weight management behavior. This study describes the association of weight status with medication use and recreational activities among treatment-naïve, pediatric TGD patients. Methods: This study is a chart review of 277 patients [aged 9-18 years, 79.1% female sex assigned at birth (SAB), and 86.3% white] seen at a medical center from 2017 to 2020. BMI was calculated by age and SAB using CDC growth charts. BMI percentile (BMI%) and BMI z-score (BMIz) were used to define weight status. Results: By BMI% category, 3.6% patients were in the underweight range (BMI <5%); 50.5% had BMI >85%; and 30.3% had BMI >95%. Overweight and obesity rates were higher than national norms (χ2 = 15.152, p < 0.01). Female SAB participants had higher BMIz values than male SAB participants. Youth who reported watching/listening to media (t = 3.50, p < 0.01) and parent-reported creative arts involvement (t = 1.97, p = 0.05) were associated with higher BMIz values. Conversely, spending time with friends and family was associated with a lower BMIz. Over half of the patients were prescribed medications, and those patients taking medications had higher BMIz values than those not taking medications (t = -1.96, p < 0.05). Female SAB, involvement in sedentary recreational activities, and taking medications to treat gastrointestinal conditions were associated with elevated BMIz. Conclusions: Overweight/obesity is a common problem among TGD youth. TGD youth should be considered a high-risk group and targeted in obesity prevention and treatment efforts. Interventions to decrease sedentary activities and improve connections with friends and family are promising strategies to address overweight and obesity among TGD youth.
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Affiliation(s)
- Mirae J Fornander
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Timothy Roberts
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Anna M Egan
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Christine N Moser
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
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8
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Barriers and Motives for Physical Activity and Sports Practice among Trans People: A Systematic Review. SUSTAINABILITY 2022. [DOI: 10.3390/su14095295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This study aimed to analyze the research conducted between 2016 and 2021, regarding barriers and motives for the practice of physical activity (PA), physical exercise (PE), and sports among trans individuals. The searches were carried out in the PubMed, Scopus, and Web of Science databases between January 2022 and April 2022, and included papers published between October 2016 and December 2021. After reading the full text of the studies, and according to the eligibility criteria previously defined, only six studies met the inclusion criteria. Internal barriers were related to body dissatisfaction and discomfort, discrimination, and fear of other people’s reactions. Regarding external barriers, sports environment, PE environment, and sports participation policies and regulations are the main factors expressed by trans individuals that hinder the practice of sports and PE. The desire to achieve a specific physical form and the role that PE plays in the preparation and/or replacement of gender-confirming surgery are the most important motives for the practice. This study highlights the importance of continuing to fight the barriers encountered in the practice of PE and sports, suggesting the main motives that could help create better interventions, plans, and inclusive policies that may help promote its practice.
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9
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Hydock DS. Sex Hormone Suppression and Physical Activity: Possible Implications for Transgender Individuals. Transgend Health 2022; 7:43-51. [PMID: 36644022 PMCID: PMC9829143 DOI: 10.1089/trgh.2020.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose Transgender individuals tend to be less physically active than cisgender individuals, and the primary focus of these physical activity barriers have been psychosocial in nature. Very little attention has been given to the role that changes in the sex hormone milieu (such as that occurring during gender-affirming hormone therapy) play on physical activity. The purpose of this study was to explore the effects of sex hormone suppression using a gonadotropin-releasing hormone agonist (GnRHa) on physical activity levels and patterns. Methods Female and male rats received 4 weeks of sex hormone suppression using the GnRHa goserelin acetate (GA) or received a placebo as a control (CON). Animals were then allowed free access to voluntary running wheels, and activity was recorded throughout the treatment period. Results Female rats receiving GA (F GA) had a significantly lower total wheel running distance than female CON (F CON, 53±11 km vs. 113±28 km, respectively, p=0.042), and male rats receiving GA (M GA) had a significantly lower total wheel running distance when compared with male CON (M CON, 31±7 km vs. 69±18 km, respectively, p=0.037). Differences in daily wheel running distances were first observed at day 18 between F GA and F CON (p=0.037) and at day 2 between M GA and M CON (p=0.021). Conclusion Reduced sex hormone availability reduced wheel running activity in female and male rats. Understanding the role that sex hormone manipulation has on physical activity may be an important consideration in promoting physical activity in transgender individuals receiving treatments that reduce sex hormone availability.
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Affiliation(s)
- David S. Hydock
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, Colorado, USA.,Address correspondence to: David S. Hydock, PhD, School of Sport and Exercise Science, University of Northern Colorado, Gunter 2590, Box 39, 501 20th Street, Greeley, CO 80639, USA,
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10
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Barkley JE, Farnell G, Boyko B, Turner B, Wiet R. Impact of Activity Monitoring on Physical Activity, Sedentary Behavior, and Body Weight during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7518. [PMID: 34299973 PMCID: PMC8304600 DOI: 10.3390/ijerph18147518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/25/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022]
Abstract
Decreases in individuals' physical activity and increases in sedentary behavior and bodyweight have been reported during the COVID-19 pandemic. The present study assessed the ability of physical activity monitoring, which may promote physical activity and discourage sedentary behavior, to mitigate these negative outcomes. An evaluation of university samples (N = 404, 40.5 ± 15.4 years) of self-reported physical activity, sedentary behavior, and bodyweight prior to the closure of campus due to the pandemic in March of 2020 and again at the time of the survey administration (May-June 2020) during pandemic-related restrictions was performed. Participants also reported whether they did (n = 172) or did not (n = 232) regularly use physical activity monitoring technology. While physical activity was unchanged during the pandemic (p ≥ 0.15), participants significantly increased sitting by 67.8 ± 156.6 min/day and gained 0.64 ± 3.5 kg from pre-campus to post-campus closure (p < 0.001). However, the use of activity monitoring did not moderate these changes. In conclusion, while physical activity was not affected, participants reported significant increases in sedentary behavior and bodyweight during the COVID-19 pandemic. These changes occurred regardless of whether participants regularly used physical activity monitoring or not.
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Affiliation(s)
- Jacob E. Barkley
- School of Health Sciences, Kent State University, Kent, OH 44242, USA;
| | - Gregory Farnell
- Department of Exercise Science and Sports Studies, John Carroll University, University Heights, OH 44118, USA; (G.F.); (B.B.); (B.T.)
| | - Brianna Boyko
- Department of Exercise Science and Sports Studies, John Carroll University, University Heights, OH 44118, USA; (G.F.); (B.B.); (B.T.)
| | - Brooke Turner
- Department of Exercise Science and Sports Studies, John Carroll University, University Heights, OH 44118, USA; (G.F.); (B.B.); (B.T.)
| | - Ryan Wiet
- School of Health Sciences, Kent State University, Kent, OH 44242, USA;
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11
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Herrick SSC, Rocchi MA, Sweet SN, Duncan LR. Exploring Proximal LGBTQ+ Minority Stressors Within Physical Activity Contexts from a Self-determination Theory Perspective. Ann Behav Med 2021; 56:551-561. [PMID: 34185051 DOI: 10.1093/abm/kaab052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND LGBTQ+ (lesbian, gay, bisexual, transgender, queer, etc.) individuals experience challenges such as discrimination and marginalization (referred to as minority stressors) that are detrimental to their mental and physical health. Specifically, proximal or internalized LGBTQ+ minority stressors may influence motivation for and willingness to participate in physical activity. PURPOSE To explore whether proximal LGBTQ+ minority stressors relate to the basic psychological needs-motivation-physical activity pathway, as per self-determination theory. METHODS An online cross-sectional survey was completed by 778 self-identified LGBTQ+ adults. Structural equation modelling analyses were used to examine how proximal LGBTQ+ minority stressors relate to the motivational sequence. RESULTS Findings support that proximal LGBTQ+ minority stressors are negatively associated with psychological need satisfaction within physical activity (β = -.36), which in turn is positively associated with autonomous motivation (β = .53) and reported physical activity participation (β = .32). Overall, the final model accounted for 13% of variance in need satisfaction (small effect size), 53% of variance in autonomous motivation (moderate-large effect size), and 10% of variance in moderate-to-vigorous physical activity levels (small effect size). CONCLUSIONS Future research focused on increasing LGBTQ+ participation in physical activity should investigate the effects of (a) reducing proximal LGBTQ+ minority stressors and (b) better supporting LGBTQ+ adults' autonomy, competence, and relatedness within physical activity contexts.
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Affiliation(s)
- Shannon S C Herrick
- Department of Kinesiology and Physical Education, McGill Research Center for Physical Activity and Health, McGill University, Montreal, Canada
| | | | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill Research Center for Physical Activity and Health, McGill University, Montreal, Canada
| | - Lindsay R Duncan
- Department of Kinesiology and Physical Education, McGill Research Center for Physical Activity and Health, McGill University, Montreal, Canada
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12
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Wilson OWA, Brittain DR, Bopp M. College Student Aerobic and Muscle-Strengthening Activity: The Intersection of Gender and Sexual Orientation Among United States Students. ACTA ACUST UNITED AC 2021. [DOI: 10.1891/lgbtq-2020-0015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of the study was to examine differences in aerobic and muscle-strengthening activity participation based on the intersection of gender and sexual orientation among cisgender college students. Data from the American College Health Association National College Health Assessment collected between Fall 2015 and Fall 2018 were analyzed. Differences from the population average for meeting aerobic and muscle-strengthening activity (separately) recommendations were computed for each gender and sexual orientation intersection. The likelihood of meeting aerobic and muscle-strengthening activity (separately) recommendations were calculated using a series of logistic regression analyses to determine odds ratios controlling for age, year of enrollment, race/ethnicity, and health status. Overall, more men and those identifying as straight met activity (aerobic and muscle-strengthening) recommendations. Asexual and straight women were less likely to meet activity recommendations compared to men, and bisexual and questioning women were less likely to meet muscle-strengthening recommendations compared to men. Bisexual, pansexual, and questioning individuals were less likely to meet activity recommendations compared to straight individuals among both genders, as were queer and gay men and women who identified as pansexual or another identity. Men who identified as pansexual or another identity, as well as lesbian and queer women were less likely to meet muscle-strengthening recommendations compared to straight individuals. In summary, findings demonstrate that aerobic and muscle-strengthening activity participation disparities are evident based on the intersection of gender and sexual orientation. The intersection of socio-demographic characteristics should be considered by researchers and physical activity promoters in order to better understand and address disparities.
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13
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Hilton EN, Lundberg TR. Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage. Sports Med 2021; 51:199-214. [PMID: 33289906 PMCID: PMC7846503 DOI: 10.1007/s40279-020-01389-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Males enjoy physical performance advantages over females within competitive sport. The sex-based segregation into male and female sporting categories does not account for transgender persons who experience incongruence between their biological sex and their experienced gender identity. Accordingly, the International Olympic Committee (IOC) determined criteria by which a transgender woman may be eligible to compete in the female category, requiring total serum testosterone levels to be suppressed below 10 nmol/L for at least 12 months prior to and during competition. Whether this regulation removes the male performance advantage has not been scrutinized. Here, we review how differences in biological characteristics between biological males and females affect sporting performance and assess whether evidence exists to support the assumption that testosterone suppression in transgender women removes the male performance advantage and thus delivers fair and safe competition. We report that the performance gap between males and females becomes significant at puberty and often amounts to 10-50% depending on sport. The performance gap is more pronounced in sporting activities relying on muscle mass and explosive strength, particularly in the upper body. Longitudinal studies examining the effects of testosterone suppression on muscle mass and strength in transgender women consistently show very modest changes, where the loss of lean body mass, muscle area and strength typically amounts to approximately 5% after 12 months of treatment. Thus, the muscular advantage enjoyed by transgender women is only minimally reduced when testosterone is suppressed. Sports organizations should consider this evidence when reassessing current policies regarding participation of transgender women in the female category of sport.
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Affiliation(s)
- Emma N Hilton
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Tommy R Lundberg
- Department of Laboratory Medicine/ANA Futura, Division of Clinical Physiology, Karolinska Institutet, Alfred Nobles Allé 8B, Huddinge, 141 52, Stockholm, Sweden.
- Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
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Braumüller B, Menzel T, Hartmann-Tews I. Gender Identities in Organized Sports-Athletes' Experiences and Organizational Strategies of Inclusion. FRONTIERS IN SOCIOLOGY 2020; 5:578213. [PMID: 33869505 PMCID: PMC8022765 DOI: 10.3389/fsoc.2020.578213] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/22/2020] [Indexed: 06/12/2023]
Abstract
In relation to conceptualizing sports, beliefs about sex binary and male hegemony are dominant. To match these assumptions and provide level playing fields, sport systems are based on sex-segregation. Thus, people who do not fit into or reject fitting into sex categories are hindered from participating in sports, particularly organized sports. Studies on social exclusion of gender-identity minorities in sports mainly adopt a qualitative approach and focus on Anglophone countries. This research is the first to provide a comprehensive picture of the experiences of LGBT+ athletes in organized sports settings in Europe and is based on a quantitative online survey (n = 2,282). The current paper draws special attention to differences between cisgender and non-cisgender athletes (including transgender men, transgender women, non-binary, and non-identifying individuals). Besides athletes' experiences, organizational strategies of inclusion, derived from qualitative interviews with stakeholders from sport systems in five European countries (Germany, Scotland, Austria, Italy, and Hungary) are examined. Theoretically anchored in Cunningham's (2012) multilevel model for understanding the experiences of LGBT+ individuals and Meyer's (2003) minority stress model, the paper aims to (1) analyze the assessment of transnegativity and (2) examine negative experiences (prevalence, forms, perpetrators) of LGBT+ athletes from organized sport contexts in Europe; and (3) discuss inclusive strategies in sports organizations in Europe. Data reveal that transnegativity is perceived as a major problem in European sports, and non-cisgender athletes are the most vulnerable group, suffering particularly from structural discrimination. The implementation of inclusive strategies for non-cisgender athletes is perceived as a complex and essential task, but the sports organizations in the five countries differ substantially in terms of the status of implementation.
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Affiliation(s)
- Birgit Braumüller
- Institute of Sociology and Gender Studies, German Sport University Cologne, Cologne, Germany
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15
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Marinkovic M. Novel Findings From a Multicenter Trial: Monitoring Lipids in Transgender/Gender-Diverse Youth Is Advised. J Adolesc Health 2020; 67:309-310. [PMID: 32829752 DOI: 10.1016/j.jadohealth.2020.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Maja Marinkovic
- Division of Pediatric Endocrinology, Rady Children's Hospital, University of California in San Diego, San Diego, California
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Millington K, Schulmeister C, Finlayson C, Grabert R, Olson-Kennedy J, Garofalo R, Rosenthal SM, Chan YM. Physiological and Metabolic Characteristics of a Cohort of Transgender and Gender-Diverse Youth in the United States. J Adolesc Health 2020; 67:376-383. [PMID: 32417098 PMCID: PMC7483238 DOI: 10.1016/j.jadohealth.2020.03.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/24/2020] [Accepted: 03/07/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to describe baseline physical and laboratory characteristics of participants in the largest prospective study of transgender and gender-diverse (TGD) youth in the United States. METHODS Participants were recruited from four clinics which specialize in the care of TGD youth before starting either GnRH analogs for pubertal suppression or gender-affirming hormone treatment. Anthropometric and laboratory measurements were abstracted from the medical chart. Baseline characteristics including height, weight, body mass index, blood pressure, and laboratory measurements were compared with those of age-matched National Health and Nutritional Examination Survey comparison group. RESULTS Seventy-eight TGD youth with a median age of 11 years (range 8-14 years) were recruited before pubertal suppression, of whom 41 (53%) were designated male at birth, and 296 participants with a median age of 16 years (range 12-20 years) were recruited before beginning gender-affirming hormones, of whom 99 (33%) were designated male at birth. The mean high-density lipoprotein cholesterol was lower in the study participants when compared with that of National Health and Nutritional Examination Survey participants (50.6 ± 12.3 mg/dL vs. 53.3 ± 13.3 mg/dL, p = .001). Otherwise, the study cohorts were similar in terms of body mass index, proportion of overweight and obesity, blood pressure, and baseline laboratory variables. CONCLUSIONS Before starting gender-affirming treatment, TGD youth are physiologically similar to the general population of children and adolescents in the United States, with the exception of slightly lower high-density lipoprotein cholesterol. Evaluation of this cohort over time will define the physiological effects of pubertal blockade and gender-affirming hormone treatment.
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Affiliation(s)
- Kate Millington
- Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts.
| | - Caroline Schulmeister
- Division of Pediatric Endocrinology, Benioff Children's Hospital, University of California at San Francisco, San Francisco, California
| | - Courtney Finlayson
- Division of Endocrinology, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois
| | - Ren Grabert
- Division of Adolescent Medicine, Lurie Children's Hospital, Chicago, Illinois
| | | | - Robert Garofalo
- Division of Adolescent Medicine, Lurie Children's Hospital, Chicago, Illinois
| | - Stephen M Rosenthal
- Division of Pediatric Endocrinology, Benioff Children's Hospital, University of California at San Francisco, San Francisco, California
| | - Yee-Ming Chan
- Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts
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Physical Activity and Sport in Trans Persons Before and After Gender Disclosure: Prevalence, Frequency, and Type of Activities. J Phys Act Health 2020; 17:650-656. [PMID: 32404533 DOI: 10.1123/jpah.2019-0192] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 02/04/2020] [Accepted: 04/21/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study describes the prevalence, frequency, and type of physical activity and sport (PAS) practiced by trans persons before and after their gender disclosure (GD). METHODS A face-to-face survey was administered to 212 Spanish trans persons, aged from 10 to 62 years old. McNemar and chi-square tests were used to determine significant differences. RESULTS About 75.5% of the trans persons in this study engaged in PAS and more than 50% did so ≥3 times/week, which is similar as in the general Spanish population. Participation was higher in trans men (78.7%) than trans women (72%). However, GD emerges as a key issue in characterizing trans persons' PAS participation. A group of 14.5% of them stopped activity after GD. Participation in nonorganized PAS was higher than in organized PAS, and this difference is greater after GD because most participants gave up organized PAS in favor of nonorganized PAS. Trans persons preferred individual sports and activities than team sports before and after GD, and the top 3 activities were jogging, walking, and bodybuilding. Trans men participation was higher than trans women in team PAS, whereas individual PAS were equally practiced before and after GD. Participation in football, swimming, basketball, dancing, and volleyball declined after GD, whereas bodybuilding increased in trans men. CONCLUSIONS The results show that the high involvement of trans persons coincides with strategies used to hide or conceal their gender identities when participating in PAS. A decrease in PAS participation is observed after GD probably because it is an acute potential period of anxiety, discrimination, and victimization caused by trans persons' body exposure.
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Bishop A, Overcash F, McGuire J, Reicks M. Diet and Physical Activity Behaviors Among Adolescent Transgender Students: School Survey Results. J Adolesc Health 2020; 66:484-490. [PMID: 31959401 DOI: 10.1016/j.jadohealth.2019.10.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/10/2019] [Accepted: 10/13/2019] [Indexed: 01/28/2023]
Abstract
PURPOSE Diet and physical activity behaviors are determinants of health for adolescents; however, few studies have assessed these behaviors among transgender youth. This study examined dietary behaviors, physical activity, weight-based bullying, and weight status among four groups based on transgender and gender nonconforming (TGNC) status and birth-assigned sex. METHODS Data were from a large cross-sectional, population-based, statewide survey of high school students (n = 80,794, Minnesota Student Survey, 2016). Comparisons were made for dietary and physical activity behaviors among TGNC and cisgender youth and among TGNC birth-assigned males and females and cisgender males and females. RESULTS About 2.7% of the total survey respondents identified as TGNC. TGNC students were more likely to be ethnically diverse, not living with a biological parent, participating in free or reduced-price school meals, and skipping meals compared with cisgender students. TGNC youth reported less frequent intake of fruit and milk and more frequent intake of fast food and soft drinks than cisgender students. TGNC students were also more likely to be overweight or obese, bullied for weight or size, and less likely to be physically active compared with cisgender youth. TGNC birth-assigned males reported more frequent intake of fast food and soft drinks and less physical activity compared with TGNC birth-assigned females and cisgender boys and girls. CONCLUSIONS TGNC students reported more negative health behaviors than cisgender students. Programs to address disparities in diet and physical activity behaviors may need to be tailored by gender identity and gender identity subgroups.
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Affiliation(s)
- Anna Bishop
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, Minnesota
| | - Francine Overcash
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, Minnesota
| | - Jenifer McGuire
- Department of Family Social Sciences, University of Minnesota, St. Paul, Minnesota
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, Minnesota.
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Pistella J, Ioverno S, Rodgers MA, Russell ST. The contribution of school safety to weight-related health behaviors for transgender youth. J Adolesc 2020; 78:33-42. [DOI: 10.1016/j.adolescence.2019.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 11/26/2019] [Accepted: 12/01/2019] [Indexed: 10/25/2022]
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Abstract
The purpose of this article is to articulate the need for a strong commitment to transgender inclusion in sport and physical activity, including in locker rooms and team spaces. The authors begin by defining key constructs and offering a theoretical overview of stigma toward transgender individuals. The focus then shifts to the changing opportunities for transgender athletes at all participation levels, case law and rulings germane to the topic, and the psychological, physical, and social outcomes associated with inclusion and exclusion. Next, the authors present frequently voiced concerns about transgender inclusion, with an emphasis on safety and privacy. Given the review, the authors present the case for inclusive locker rooms, which permit access by transgender athletes to facilities that correspond to their gender identity. The authors conclude with the official AKA position statement—“The American Kinesiology Association endorses inclusive locker rooms, by which we mean sex-segregated facilities that are open to transgender athletes on the basis of their gender identity”—and implications for sport and physical activity.
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Jones BA, Arcelus J, Bouman WP, Haycraft E. Sport and Transgender People: A Systematic Review of the Literature Relating to Sport Participation and Competitive Sport Policies. Sports Med 2018; 47:701-716. [PMID: 27699698 PMCID: PMC5357259 DOI: 10.1007/s40279-016-0621-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Whether transgender people should be able to compete in sport in accordance with their gender identity is a widely contested question within the literature and among sport organisations, fellow competitors and spectators. Owing to concerns surrounding transgender people (especially transgender female individuals) having an athletic advantage, several sport organisations place restrictions on transgender competitors (e.g. must have undergone gender-confirming surgery). In addition, some transgender people who engage in sport, both competitively and for leisure, report discrimination and victimisation. Objective To the authors’ knowledge, there has been no systematic review of the literature pertaining to sport participation or competitive sport policies in transgender people. Therefore, this review aimed to address this gap in the literature. Method Eight research articles and 31 sport policies were reviewed. Results In relation to sport-related physical activity, this review found the lack of inclusive and comfortable environments to be the primary barrier to participation for transgender people. This review also found transgender people had a mostly negative experience in competitive sports because of the restrictions the sport’s policy placed on them. The majority of transgender competitive sport policies that were reviewed were not evidence based. Conclusion Currently, there is no direct or consistent research suggesting transgender female individuals (or male individuals) have an athletic advantage at any stage of their transition (e.g. cross-sex hormones, gender-confirming surgery) and, therefore, competitive sport policies that place restrictions on transgender people need to be considered and potentially revised.
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Affiliation(s)
- Bethany Alice Jones
- Nottingham Centre for Gender Dysphoria, 3 Oxford Street, Nottingham, NG1 5BH, UK.,School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Jon Arcelus
- Nottingham Centre for Gender Dysphoria, 3 Oxford Street, Nottingham, NG1 5BH, UK. .,Division of Psychiatry and Applied Psychology, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
| | - Walter Pierre Bouman
- Nottingham Centre for Gender Dysphoria, 3 Oxford Street, Nottingham, NG1 5BH, UK
| | - Emma Haycraft
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
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The Levels and Predictors of Physical Activity Engagement Within the Treatment-Seeking Transgender Population: A Matched Control Study. J Phys Act Health 2018; 15:99-107. [DOI: 10.1123/jpah.2017-0298] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Jones BA, Arcelus J, Bouman WP, Haycraft E. Barriers and facilitators of physical activity and sport participation among young transgender adults who are medically transitioning. Int J Transgend 2017. [DOI: 10.1080/15532739.2017.1293581] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Bethany Alice Jones
- Nottingham National Centre for Transgender Health, Nottingham, UK
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Jon Arcelus
- Nottingham National Centre for Transgender Health, Nottingham, UK
- Division of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Emma Haycraft
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
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