Where's the Joy in That? Sexual Minority College Students Report Lower Physical Activity Engagement and Enjoyment Compared to Heterosexual Students

Sexual minority (e.g. non-heterosexual) individuals are at greater risk for negative health outcomes, often linked to inadequate physical activity (PA). The purpose of this study was to assess PA levels and PA enjoyment among college students, by sexual orientation. Data were collected from a volunteer sample of college students enrolled in general health and wellness courses offered at a large, Northeastern U.S. university via an online survey. Participants self-reported demographic information, PA levels using the Global Physical Activity Questionnaire (GPAQ), and PA enjoyment using a 7-item Physical Activity Enjoyment scale (PACES). Among participants (n = 1471), independent sample t-tests showed that sexual minority (SM) students reported significantly lower mean MET-mins/week of MPA (MHeterosexual = 568.09 ± 488.12 vs. MSexual minority = 469.95 ± 471.51; p = .006) and VPA (MHeterosexual = 1089.54 ± 1110.64 vs. MSexual Minority = 628.93 ± 942.78; p < .001), ST days/week (MHeterosexual = 1.93 ± 1.90 vs. MSexual Minority = 1.00 ± 1.60; p < .001), and reported lower total PACES score (MHeterosexual = 7.80 ± 1.92 vs. MSexual Minority = 6.87 ± 2.14; p < .001) compared to heterosexual students. Bootstrap mediation analyses with 5000 samples revealed that PACES has direct and indirect mediation effects on the association between sexual orientation status and MET-mins/week of MPA and VPA, and ST days/week. The current findings provide evidence of the underlying mechanisms linked to the physical activity disparities experienced by SM college students compared to heterosexual students. Additionally, PACES can serve as a facilitator to promote PA engagement among SM students. These findings can inform future intervention work to target PA enjoyment for meaningful behavior change.

The Unique Lived Experiences of LGBQ Athletes: A Collegiate Women's Rugby Club Team as an Inclusive & Empowering Community

There is ongoing debate regarding the culture of competitive women's sports. On one hand, women who participate in sports are viewed as adhering to and reinforcing heteronormative stereotypes and hegemonic masculinity. Conversely, women's sports are viewed as an inherently supportive environment for those involved. The current study explored the latter phenomena, specifically related to factors that promote an inclusive and empowering community for LGBTQ+ women. Eleven individual semi-structured interviews and one follow-up focus group with six participants were conducted with women from a collegiate women's rugby club team. All participants described their sexual identities as Lesbian, Gay, Bisexual, and/or Queer (LGBQ). A reflexive thematic analysis was used to analyze the data collectively. Participants described their collegiate rugby team as being one of their first encounters with a safe and inclusive LGBTQ+ environment. Membership on the team also was viewed as an important experience that helped participants come to terms with their sexual identity. Specifically, findings indicate the supportive actions of teammates, an inclusive team culture, and unique factors related to the sport of rugby helped promote an inclusive and empowering community for LGBTQ+ women. Indeed, from a critical positive youth development perspective, social justice life skills (e.g., allyship) provided actionable behaviors that promote an inclusive and empowering community for LGBTQ+ women. However, future research must seek to understand the lived experiences of all women's rugby participants, particularly transgender and athletes of color.

Disparities in physical activity between sexual minority and heterosexual women: A systematic review and meta-analysis

Research examining potential differences in physical activity (PA) between sexual minority women (SMW) and heterosexual women have yielded inconsistent results.

OBJECTIVE

Therefore, the purpose of this systematic review and meta-analysis is to examine potential differences in PA between SMW and heterosexual women and to identify potential moderators that may partially explain observed differences in PA.

METHODS

All studies were peer reviewed, published in English, and included a continuous measure of PA for SMW and heterosexual women. A standardized mean difference effect size (ES) was used to compare groups, with random effects models used to estimate a mean ES and 95% CI using a 3-level meta-analysis model to adjust for the correlation between effects nested within studies.

RESULTS

The cumulative results of 24 effects gathered from 7 studies indicated there was no difference in PA between SMW (n = 1619) and heterosexual women (n = 103,295) (ES = -0.038, 95%CI -0.179 to 0.102, p = 0.576). Despite no mean differences, moderate-high heterogeneity was observed, indicating that the results were not consistent across effects (I2 = 64.8%, Q23 = 36.7, p = 0.035). The difference in PA was associated with age (β = -0.018, 95%CI -0.034 to -0.003, p = 0.022) and BMI (β = -0.145, 95%CI -0.228 to -0.061, p = 0.002), with a quadratic relationship observed for both variables.

CONCLUSIONS

Although the results of the current analysis did not indicate significant differences in PA behaviors between SMW and heterosexual women, age and BMI modify the association and are curvilinear in nature; such that smaller differences in PA were observed between SMW and heterosexual women when samples were middle-aged and overweight.

The relationship between physical activity, stress, and resilience in sexual and gender minority college students

OBJECTIVE

To assess the role of sexual orientation and gender identity in the relationship between physical activity (PA), stress and resilience.

PARTICIPANTS

A nationally-representative sample of students (n = 91,718) from United States postsecondary institutions.

METHODS

Students reported aerobic and strength training (ST) behaviors, stress, resilience, gender identity and sexual orientation. Moderated regressions examined the influence of gender identity and sexual orientation on the relationship between PA and stress or resilience.

RESULTS

Men and heterosexual students reported higher PA and resilience and lower stress than did women, gender minorities, and sexual minorities. Significant moderation was found for women, queer students, bisexual students, trans women and lesbians in the various models.

CONCLUSIONS

Gender minority and sexual minority students display poorer levels of PA and mental health than cisgender and heterosexual counterparts, but this relationship varies by identity group.

Differences in Ideal Cardiovascular Health Between Sexual Minority and Heterosexual Adults

Importance

Research on the cardiovascular health (CVH) of sexual minority adults has primarily examined differences in the prevalence of individual CVH metrics rather than comprehensive measures, which has limited development of behavioral interventions.

Objective

To investigate sexual identity differences in CVH, measured using the American Heart Association's revised measure of ideal CVH, among adults in the US.

Design, Setting, and Participants

This cross-sectional study analyzed population-based data from the National Health and Nutrition Examination Survey (NHANES; 2007-2016) in June 2022. Participants included noninstitutional adults aged 18 to 59 years. We excluded individuals who were pregnant at the time of their interview and those with a history of atherosclerotic cardiovascular disease or heart failure.

Exposures

Self-identified sexual identity categorized as heterosexual, gay/lesbian, bisexual, or something else.

Main Outcomes and Measures

The main outcome was ideal CVH (assessed using questionnaire, dietary, and physical examination data). Participants received a score from 0 to 100 for each CVH metric, with higher scores indicating a more favorable CVH profile. An unweighted average was calculated to determine cumulative CVH (range, 0-100), which was recoded as low, moderate, or high. Sex-stratified regression models were performed to examine sexual identity differences in CVH metrics, disease awareness, and medication use.

Results

The sample included 12 180 participants (mean [SD] age, 39.6 [11.7] years; 6147 male individuals [50.5%]). Lesbian (B = -17.21; 95% CI, -31.98 to -2.44) and bisexual (B = -13.76; 95% CI, -20.54 to -6.99) female individuals had less favorable nicotine scores than heterosexual female individuals. Bisexual female individuals had less favorable body mass index scores (B = -7.47; 95% CI, -12.89 to -1.97) and lower cumulative ideal CVH scores (B = -2.59; 95% CI, -4.84 to -0.33) than heterosexual female individuals. Compared with heterosexual male individuals, gay male individuals had less favorable nicotine scores (B = -11.43; 95% CI, -21.87 to -0.99) but more favorable diet (B = 9.65; 95% CI, 2.38-16.92), body mass index (B = 9.75; 95% CI, 1.25-18.25), and glycemic status scores (B = 5.28; 95% CI, 0.59-9.97). Bisexual male individuals were twice as likely as heterosexual male individuals to report a diagnosis of hypertension (adjusted odds ratio [aOR], 1.98; 95% CI, 1.10-3.56) and use of antihypertensive medication (aOR, 2.20; 95% CI, 1.12-4.32). No differences in CVH were found between participants who reported their sexual identity as something else and heterosexual participants.

Conclusion and Relevance

Results of this cross-sectional study suggest that bisexual female individuals had worse cumulative CVH scores than heterosexual female individuals, whereas gay male individuals generally had better CVH than heterosexual male individuals. There is a need for tailored interventions to improve the CVH of sexual minority adults, particularly bisexual female individuals. Future longitudinal research is needed to examine factors that might contribute to CVH disparities among bisexual female individuals.

Examination of eating disorder psychopathology across sexual and gender identities among a Canadian sample

OBJECTIVE

Eating disorders (EDs) disproportionately affect sexual and gender minorities, with majority of research conducted among samples in the United States. The purpose of this study was to examine ED psychopathology among adolescents and young adults in Canada with diverse gender and sexual identities.

METHOD

Data were collected from 2,714 Canadians, aged 16-30 years old, via an online survey at the end of 2021 during the COVID-19 pandemic. Participants responded to sociodemographic questions (including history of EDs) and reported on eating attitudes and behaviors. Descriptive statistics and multiple modified Poisson and linear regressions were conducted.

RESULTS

Over half the sample was heterosexual, 35% were sexual minority cisgender men and women, and 6.5% were transgender and gender non-conforming (TGNC) people. The sample overall reported elevated ED psychopathology based on their eating attitudes and behaviors. TGNC participants reported the most severe ED psychopathology. Generally, sexual minority cisgender women and cisgender men had elevated ED psychopathology compared to their heterosexual counterparts. Regression analyses revealed all gender and sexual minorities reported greater ED psychopathology compared to heterosexual cisgender men.

DISCUSSION

The Canadian sample reported elevated ED psychopathology compared to previous studies among various populations. Additional investigations are now needed to observe how ED psychopathology continues to change after the onset of the pandemic. Further research is needed among cisgender men, TGNC people, and sexual minorities to understand the unique stressors they face that lead to high ED psychopathology, and develop appropriate prevention and treatment tools.

PUBLIC SIGNIFICANCE

EDs affect people of all gender and sexual identities. People who identify as a gender and/or sexual minority often experience problematic eating attitudes and behaviors, particularly transgender and gender non-conforming people of all sexual identities. More research attention is needed among these populations, especially due to a paucity of research among Canadians, to develop effective diagnostic tools, prevention efforts, and treatment programs specific to gender and sexual identities.

The Practice of Physical Exercise and Sports in Portuguese Trans Youth: A Case Study

The following case study aims to analyze the experience of a Portuguese trans individual regarding their practice of physical exercise (PE) and sports in Portuguese gyms and sports clubs. A 30-min interview was conducted through the Zoom platform. Before the interview, four questionnaires-Satisfaction with Life Scale (SWLS), Positive and Negative Affect Schedule (PANAS), Hospital Anxiety and Depression Scale (HADS), and EUROHIS-QOL 8-item index-were also applied, all in their Portuguese version. The interview was digitally video recorded after consent was obtained, transcribed verbatim, and subject to thematic analysis. Findings suggest positive values for satisfaction with life and quality of life. The values of positive affect were higher than those of negative affect, and there was an absence of depressive and anxious symptomatology. In the qualitative analysis, mental health was the main motive for the practice, while locker rooms separated by gender and university life were the main barriers mentioned. Mixed changing rooms were identified as facilitators of PE practice. This study highlights the importance of developing strategies for the creation of mixed changing rooms and sports teams in order to promote a comfortable and safe practice for all individuals.

Perceived Body Image towards Disordered Eating Behaviors and Supplement Use: A Study of Mauritian Gym-Goers

Purpose: Individuals with body image distortions tend to develop an obsession with calorie intake and weight, leading to compounded coping strategies such as modified eating behaviors, supplement use, and excessive exercise. In the local context, little is known about the equation connecting body image to improper eating behaviors and other potential coping mechanisms. This study primarily aims at critically identifying the nexus between features of disordered eating behavior including supplement use, and body image. Methodology: A probabilistic randomized sample of 305 gym members was assessed based on their level of body satisfaction and its influence on their eating habits and supplement use through a structured survey. Findings: Only 37% of the participants were satisfied with their body image. The results concurred with the notion of a poor body image influencing body esteem (χ2 (10) = 137.21, p < 0.05; Cramer V = 0.474). While exercise motivated the use of supplements, a significant relationship was also observed between disordered eating habits and supplement use (χ2 (4) = 48.63, p < 0.05; Cramer V = 0.399). A predictive model was successfully drawn inclusive of the disordered eating behaviors dimensions as a potent predictor of body image (χ2 (56) = 397.12, p < 0.001. Implications: This study presents an in-depth analysis of the magnitude of disordered eating behaviors with respect to individuals in the local fitness industry, and the need for professional support programs toward the re-alignment of body image in an effort to curtail the development of eating disorders in Mauritian gym-goers.

Physical Activity as a Mediator for Health Outcomes Among Sexual Minority Adults

Purpose: This study aimed to examine physical activity (PA) as a protective measure of health outcomes among sexual minority (SM) and heterosexual adults. Methods: Using data from the 2018 National Health Interview Survey, differences in key health outcomes between three groups (heterosexual, SM, and "other") and the mediating effects of PA were explored. Chi-square tests were used to examine group differences. Multinomial logistic regression models were fit to examine associations between PA and health outcomes (body mass index [BMI], psychological distress, health status, and use of alcohol, cigarettes, and e-cigarettes). Results: Compared with heterosexual respondents, "other" adults had higher levels of BMI above 24.9 and were less active; SM respondents had elevated levels of alcohol use, smoking, binge drinking, and psychological distress, and reported worse overall health status. Unadjusted models showed that PA served as a protective factor for BMI above 30 and health status for all groups. PA was also protective for BMI below or above 18.5-24.9, smoking, psychological distress, and health status for both heterosexual and SM groups. Alternatively, PA behaved as a risk factor for alcohol use and binge drinking for all groups. Adjusted modeling removed PA as a risk factor for light alcohol use and binge drinking for SM respondents and added a protective factor for e-cigarette use for heterosexual respondents. Conclusion: This study adds to current literature on health disparities affecting SM populations and the health benefits associated with PA. Further research is needed to explore tailored PA intervention for SM populations and those who mark "other," "something else," "don't know," or refuse to answer questions on sexual orientation.

College student aerobic and muscle-strengthening activity: Disparities between cis-gender and transgender students in the United States

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.

"There may not be a rainbow sticker at the door, but there are my rainbow shoes": A qualitative exploration of resilience among LGBTQ+ adults in physical activity contexts

Researchers have identified LGBTQ + -specific stressors that hinder physical activity participation; however, LGBTQ + resilience against these stressors has yet to be explored. The purpose of this study was to gain an understanding of how LGBTQ + resilience is experienced within physical activity. Ten focus groups with LGBTQ + adults (N = 36) were conducted online and subject to abductive thematic analysis. Experiences of individual resilience were conceptualized through the interplay of: (a) persistence-adaptability (ranging from being regimented with physical activity to being flexible and amenable to changes), (b) toughness-tenderness (possessing mental grit to self-kindness), and (c) complaisance-resistance (internalizing to resisting norms that govern physical activity). Participants also described three sites for community resilience: (a) LGBTQ + communities that provided pivotal social support, but rarely for physical activity, (b) digital communities that could support or thwart LGBTQ + resilience, but often prioritized aesthetics, and (c) physical activity communities that supported participation, but often perpetuated LGBTQ + exclusion.

Prevalence and correlates of dry scooping: Results from the Canadian Study of Adolescent Health Behaviors

Dry scooping is a novel dietary practice characterized by consuming pre-workout powders without mixing with a liquid as directed. Despite purported benefits of this practice, such as increased energy due to the high concentration of caffeine, there are potential harms of engagement. To date, no known empirical research has investigated dry scooping in epidemiological research. Therefore, the aim of this study was to characterize the prevalence and correlates of dry scooping among a sample of Canadian adolescents and young adults. Data from the Canadian Study of Adolescent Health Behaviors (N = 2731) were analyzed. Prevalence of any dry scooping in the past 12 months among the overall sample, and by gender, was estimated. Modified Poisson regression analysis was used to determine the adjusted associations between sociodemographic and descriptive characteristics and dry scooping. Overall, 16.9 % of the sample reported dry scooping in the past 12 months, which was significantly more common among men (21.8 %) compared to women (14.2 %) and transgender/gender non-confirming participants (8.0 %). Participants who reported weight training, greater time spent on social media, and clinically significant symptoms of muscle dysmorphia were more likely to report dry scooping, while sexual minorities, relative to heterosexual participants, and those with higher education were less likely to report dry scooping. This study is the first known epidemiological study of dry scooping, underscoring the common nature of this contemporary dietary behavior. Findings emphasize the need for future research and prevention and intervention efforts to protect the health and well-being of young people.

Protective Factors, Risk of Violence and Discrimination and Mental Health Indicators of Young LGB People

Lesbian, gay and bisexual (LGB) people have more risk of suffering from violence and situations of discrimination than heterosexual people. The current study compares LGB people with heterosexual people in protective factors, violence, health and well-being factors. The sample comprises 609 Spanish people between 14 and 25 years old. We established a cross-sectional design. A survey including questions about sociodemographic information and protective, violence and health and well-being factors was designed ad hoc for this study. The results show that the LGB group (n = 342) is more at risk of verbal and physical violence and feels more isolated than the heterosexual participants (n = 267). In contrast, heterosexual participants report having more employment discrimination. No significant differences were found in social support or psychological health. These results are important to understand the state of social normalization and non-discrimination for LGB people in certain contexts in Spain, and its impact on psychological health.

Differences in physical activity and perceived benefits and barriers to physical activity between LGBTQ + and non-LGBTQ + college students

ObjectiveTo compare physical activity (PA) behaviors and perceived benefits and barriers among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) and non-LGBTQ + college students. Participants: Participants were 406 college students. Methods: Surveys assessed PA behaviors and perceptions of PA among college students. Multivariate ANOVA assessed differences in PA behaviors and perceptions of PA. Results: LGBTQ + students (n = 71) engaged in 17% less aerobic PA and 42% less resistance training than their counterparts (n = 335; both p < .05). LGBTQ + students reported 6.5% lower total Exercise Benefits and Barriers Scale scores and 13.3% higher Barriers Scale scores (both p < .05). Conclusions: LGBTQ + college students are at higher risk of not meeting PA guidelines than non-LGBTQ + students. More perceived barriers and fewer perceived benefits to PA may contribute to this disparity. Identification of LGBTQ+-specific barriers to PA among college students is needed to inform programming to increase PA among this at-risk community.

Examining Pride Cups as a health promotion resource to address homophobia in Australian men's sport

Effective interventions are needed to stop homophobic behaviours in sport settings as these behaviours are associated with negative health and social outcomes for individuals who identify as Lesbian, Gay, Bisexual, Transgender, Queer or other diverse genders and sexualities. This paper reports the results of a quasi-experimental study commissioned by a public health agency to explore the benefits of a novel intervention that has been widely adopted by Australian community sport clubs. The 'Pride Cup' intervention includes education for club leaders, sport participants and the hosting of a rainbow-themed 'pride game'. Survey responses of male participants from six randomly selected sport clubs which had received the intervention (n = 148) were compared to responses (n = 137) from six randomly selected comparison clubs (Australian Football, cricket, field hockey, roller derby). Employing a post-test-only design, the study explored differences in homophobic attitudes, behaviours and individual efficacy to react negatively to homophobic behaviours. The study found significant differences (p < 0.001) in self-reported use of homophobic slurs (e.g. fag) in the last 2 weeks by participants in the treatment (11%) versus comparison (31.8%) clubs, and significant differences in the perceived use of these slurs by teammates (25.9% vs. 56.6%) or coaches (7.8% vs. 23.3%). There were also significant differences in efficacy scores, but no differences in homophobic attitudes. These results, combined with evidence of community-driven adoption, support the allocation of public health resources to conduct larger scale trials using pre/post designs to confirm these findings.

Fostering Engagement, Reflexivity, and 21st-Century Skills in Middle School: A Pilot Collaborative Action Research on Identity Formation with Adolescent Co-Researchers

Identity construction during adolescence constitutes a primary psychosocial developmental task. A growing body of research has addressed the importance of school education in fostering adolescents' identity formation and the skills they need to thrive. Although several studies aimed at defining the factors contributing to a coherent, stable, and integrated identity formation, none sought to investigate this question from the adolescents' perspective. This contribution aimed to explore new ways of fostering 21st-century skills among adolescents through action research. Five adolescents aged 13 to 15 participated in the research process, creating a survey to answer a research problem mainly focused on identity construction in adolescence. A reflexive analysis of the co-research process highlighted the interest in involving adolescents as co-researchers to foster their social and emotional skills. The deployment of the resulting survey in a sample of 1210 adolescents from the general population highlighted the importance of gender diversity for constructing various dimensions of identity.

Gender differences in college student physical activity, and campus recreational facility use, and comfort

Objective: To examine disparities in physical activity, campus recreation facility (CRF) use, and CRF comfort of college students. Methods: Students (n = 319) responded to an online survey that assessed their demographics, physical activity behaviors, CRF use, comfort using CRFs, as well as reasons for discomfort, and strategies used to feel comfortable. Results: Women reported less muscle-strengthening activity, lower frequency of weight use and informal sport participation, and higher frequency of cardio and group exercise participation. Women also reported lower comfort using CRFs, particularly weights areas. The presence of men, a perceived lack of skill (competence), and self-consciousness/judgement emerged as dominant themes explaining women's discomfort. Disassociation using music, going with friends for social support, knowledge acquisition regarding equipment, and clothing selection emerged as strategies used to increase comfort. Conclusions: Meaningful differences in physical activity behaviors, facility use, and comfort using facilities emerged. Administrators should consider changing environments and/or policies to provide equitable physical activity opportunities.

Recommendations from LGBTQ+ adults for increased inclusion within physical activity: a qualitative content analysis

For decades, physical activity contexts have been inherently exclusionary toward LGBTQ+ participation through their perpetuation of practices and systems that support sexuality- and gender-based discrimination. Progress toward LGBTQ+ inclusivity within physical activity has been severely limited by a lack of actionable and practical suggestions. The purpose of this study was to garner an extensive account of suggestions for inclusivity from LGBTQ+ adults. Using an online cross-sectional survey, LGBTQ+ adults (N = 766) were asked the following open-ended question, "in what ways do you think physical activity could be altered to be more inclusive of LGBTQ+ participation?" The resulting texts were coded using inductive qualitative content analysis. All coding was subject to critical peer review. Participants' suggestions have been organized and presented under two overarching points of improvement: (a) creation of safe(r) spaces and (b) challenging the gender binary. Participants (n = 558; 72.8%) outlined several components integral to the creation and maintenance of safe(r) spaces such as: (i) LGBTQ+ memberships, (ii) inclusivity training for fitness facility staff, (iii) informative advertisement of LGBTQ+ inclusion, (iv) antidiscrimination policies, and (v) diverse representation. Suggestions for challenging the gender binary (n = 483; 63.1%) called for the creation of single stalls or gender-neutral locker rooms, as well as for the questioning of gender-based stereotypes and binary divisions of gender within physical activity (e.g., using skill level and experience to divide sports teams as opposed to gender). The findings of this study represent a multitude of practical suggestions for LGBTQ+ inclusivity that can be applied to a myriad of physical activity contexts.

Older gay men's engagement with physical activity: A scoping review

Older gay men experience an elevated prevalence of adverse health conditions that may be compounded by age-related deterioration. Some of these conditions may be ameliorated by regular adherence to physical activity (PA). However, many gay men participate in less PA than their age-matched heterosexual counterparts. With a focus on gay men aged 60 and over, the aims of this review were to examine the evidence for older gay men's engagement with PA and the research approaches used to describe this group. A systematic search of six academic databases (Academic Search Premier, Cinahl, PubMed, Sport Discus, APA PsychInfo and APA PsychArticles) generated 23 papers from 1970 to 2020 that focused on older gay men's engagement with PA. Although surveys were well represented in the literature, further studies utilising qualitative methodological frameworks have the potential to inform targeted interventional programs aimed at reducing less health disparities. The value of PA in older adults lies principally in improved performance of activities of daily living, independent living, increased longevity, decreased cognitive decline and improved mental well-being.

Exploring Proximal LGBTQ+ Minority Stressors Within Physical Activity Contexts from a Self-determination Theory Perspective

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.

Exercise as a Mitigator of Poor Mental Health Among Lesbian, Gay, and Bisexual Adults

INTRODUCTION

There is a positive association between exercise and improved mental health in the general population. Although there is a greater burden of psychological distress among lesbian, gay, and bisexual (LGB) people, little is known about the association between exercise and mental health in this population. The authors explored the association between exercise and poor mental health reported by LGB adults in the United States.

METHODS

Our analyses used data from the 2017 Behavioral Risk Factor Surveillance System survey. Multiple regression analyses were used to determine the association between exercising and mental health days adjusting for sociodemographic characteristics.

RESULTS

Data were available for 6371 LGB participants. LGB adults who participated in any exercise reported almost 1.0 day less of poor mental health in the past 30 days compared with LGB adults who did not exercise (P ≤ .01). LGB adults who met one or both of the physical activity guidelines had between 1.2 and 1.7 days less of poor mental health compared with those who did not meet the guidelines (P ≤ .01).

CONCLUSION

Fewer days of poor mental health were reported by LGB adults who exercised. Determining whether physical activity interventions, including aerobic and strengthening exercises, could improve mental health outcomes in LGB adults should be studied.

College Student Aerobic and Muscle-Strengthening Activity: The Intersection of Gender and Sexual Orientation Among United States Students

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.

Assessing and Addressing Cardiovascular Health in LGBTQ Adults: A Scientific Statement From the American Heart Association

There is mounting evidence that lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) adults experience disparities across several cardiovascular risk factors compared with their cisgender heterosexual peers. These disparities are posited to be driven primarily by exposure to psychosocial stressors across the life span. This American Heart Association scientific statement reviews the extant literature on the cardiovascular health of LGBTQ adults. Informed by the minority stress and social ecological models, the objectives of this statement were (1) to present a conceptual model to elucidate potential mechanisms underlying cardiovascular health disparities in LGBTQ adults, (2) to identify research gaps, and (3) to provide suggestions for improving cardiovascular research and care of LGBTQ people. Despite the identified methodological limitations, there is evidence that LGBTQ adults (particularly lesbian, bisexual, and transgender women) experience disparities across several cardiovascular health metrics. These disparities vary by race, sex, sexual orientation, and gender identity. Future research in this area should incorporate longitudinal designs, elucidate physiological mechanisms, assess social and clinical determinants of cardiovascular health, and identify potential targets for behavioral interventions. There is a need to develop and test interventions that address multilevel stressors that affect the cardiovascular health of LGBTQ adults. Content on LGBTQ health should be integrated into health professions curricula and continuing education for practicing clinicians. Advancing the cardiovascular health of LGBTQ adults requires a multifaceted approach that includes stakeholders from multiple sectors to integrate best practices into health promotion and cardiovascular care of this population.

Locker-Room Experiences Among LGBTQ+ Adults

Locker rooms operate as pivotal access points to physical activity across sports, physical education, and fitness facilities. However, locker rooms are predicated on cis-heterosexual assumptions that can be isolating to LGBTQ+ individuals. Using an online cross-sectional survey, LGBTQ+ adults (N = 1,067) were asked open-response questions about their past and present locker-room experiences. The resulting texts were independently coded by two researchers using thematic analysis and compared. All discrepancies were discussed with and rectified by a third researcher who acted as a critical peer. The results present distinct experiences across three intersecting aspects of embodiment: self-conscious-"I hate(d) being seen," sexual transgression, and gender transgression. The findings provide insight into how harmful LGBTQ+ stereotypes influence locker-room experiences and support the redesign of locker rooms to challenge the binary organization of these spaces.

A Qualitative Exploration of LGBTQ+ and Intersecting Identities Within Physical Activity Contexts

LGBTQ+ (lesbian, gay, bisexual, transgender, queer, etc.) individuals face an array of challenges to physical activity participation, such as discrimination and exclusion. The purpose of this study was to gain an understanding of LGBTQ+ experiences in physical activity. Eight focus groups of LGBTQ+ individuals (N = 42) were conducted using a semistructured interview guide, and broad discussions about personal physical activity experiences were encouraged. All focus groups were audio-recorded, transcribed verbatim, and subject to thematic analysis. Three main themes emerged with the following considerations: (a) intersectionality-an intersectional approach is required to explore the complexity of LGBTQ+ experiences within physical activity; (b) the contested concept of "athlete"-LGBTQ+ communities have unique conceptions associated with "athlete" that can render sport, and by extension physical activity contexts, elitist and inaccessible; and (c) "a safe space for us"-LGBTQ+-friendly physical activity practices should be explored to provide practical suggestions for inclusive practices.

Sexual Orientation Differences in Modifiable Risk Factors for Cardiovascular Disease and Cardiovascular Disease Diagnoses in Men

PURPOSE

Despite higher rates of modifiable risk factors for cardiovascular disease (CVD) in gay and bisexual men, few studies have examined sexual orientation differences in CVD among men. The purpose of this study was to examine sexual orientation differences in modifiable risk factors for CVD and CVD diagnoses in men.

METHODS

A secondary analysis of the National Health and Nutrition Examination Survey (2001-2012) was conducted. Multiple imputation was performed for missing values. Differences across four distinct groups were analyzed: gay-identified men, bisexual-identified men, heterosexual-identified men who have sex with men (MSM), and heterosexual-identified men who denied same-sex behavior (categorized as exclusively heterosexual). Multiple logistic regression models were run with exclusively heterosexual men as the reference group.

RESULTS

The analytic sample consisted of 7731 men. No differences between heterosexual-identified MSM and exclusively heterosexual men were observed. Few differences in health behaviors were noted, except that, compared to exclusively heterosexual men, gay-identified men reported lower binge drinking (adjusted odds ratio [AOR] 0.58, 95% confidence interval [CI] = 0.37-0.85). Bisexual-identified men had higher rates of mental distress (AOR 2.39, 95% CI = 1.46-3.90), obesity (AOR 1.69, 95% CI = 1.02-2.72), elevated blood pressure (AOR 2.30, 95% CI = 1.43-3.70), and glycosylated hemoglobin (AOR 3.01, 95% CI = 1.38-6.59) relative to exclusively heterosexual men.

CONCLUSIONS

Gay-identified and heterosexual-identified MSM demonstrated similar CVD risk to exclusively heterosexual men, whereas bisexual-identified men had elevations in several risk factors. Future directions for sexual minority health research in this area and the need for CVD and mental health screenings, particularly in bisexual-identified men, are highlighted.

Cardiovascular Disease Risk in Sexual Minority Women (18-59 Years Old): Findings from the National Health and Nutrition Examination Survey (2001-2012)

OBJECTIVE

Sexual minority women (lesbian and bisexual) experience significant stigma, which may increase their cardiovascular disease (CVD) risk. The purpose of this study was to examine the prevalence of modifiable risk factors for CVD (including mental distress, health behaviors, blood pressure, glycosylated hemoglobin, and total cholesterol) and CVD in sexual minority women compared with their heterosexual peers.

MATERIALS AND METHODS

A secondary analysis of the National Health and Nutrition Examination Survey (2001-2012) was conducted. Multiple imputation with chained equations was performed. Logistic regression models adjusted for relevant covariates were run. Self-report (medical history and medication use) and biomarkers for hypertension, diabetes, and high total cholesterol were examined.

RESULTS

The final analytic sample consisted of 7,503 that included 346 sexual minority women (4.6%). Sexual minority women were more likely to be younger, single, have a lower income, and lack health insurance. After covariate adjustment, sexual minority women exhibited excess CVD risk related to higher rates of frequent mental distress (adjusted odds ratio [AOR], 2.05; 95% confidence interval [CI], 1.45-2.88), current tobacco use (AOR, 2.11; 95% CI, 1.53-2.91), and binge drinking (AOR, 1.66; 95% CI, 1.17-2.34). Sexual minority women were more likely to be obese (AOR, 1.61; 95% CI, 1.23-2.33) and have glycosylated hemoglobin consistent with prediabetes (AOR, 1.56; 95% CI, 1.04-2.34). No differences were observed for other outcomes.

CONCLUSIONS

Sexual minority women demonstrated increased modifiable risk factors for CVD, but no difference in CVD diagnoses. Several emerging areas of research are highlighted, in particular, the need for CVD prevention efforts that target modifiable CVD risk in sexual minority women.