The Levels and Predictors of Physical Activity Engagement Within the Treatment-Seeking Transgender Population: A Matched Control Study

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Background: Physical activity has been found to alleviate mental health problems and could be beneficial for at-risk populations, such as transgender people. This study had 3 aims. First, to explore the amount of physical activity that treatment-seeking transgender people engage in and to compare this to matched cisgender people. Second, to determine whether there was a difference in physical activity depending on cross-sex hormone use. Third, to determine factors that predict physical activity among treatment-seeking transgender people. Methods: Transgender (n = 360) and cisgender people (n = 314) were recruited from the United Kingdom. Participants were asked to complete questionnaires about physical activity, symptoms of anxiety and depression, self-esteem, body satisfaction, and transphobia. Results: Transgender people engaged in less physical activity than cisgender people. Transgender people who were on cross-sex hormone treatment engaged in more physical activity than transgender people who were not. In transgender people on cross-sex hormones, high body satisfaction was the best statistical predictor of physical activity, whereas high self-esteem was the best statistical predictor in people who were not. Conclusion: Transgender people are less active than cisgender people. Cross-sex hormone treatment appears to be able to indirectly increase physical activity within this population, which may be beneficial for mental well-being.

Jones, Bouman, and Arcelus are with the Nottingham Centre for Transgender Health, Nottingham, United Kingdom. Jones and Haycraft are with the School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom. Arcelus is also with the Division of Psychiatry and Applied Psychology, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom.

Haycraft (E.Haycraft@lboro.ac.uk) is corresponding author.
Journal of Physical Activity and Health
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References
  • 1.

    World Health Organization. Physical Activity: Fact Sheet. 2016. http://www.who.int/mediacentre/factsheets/fs385/en/. Accessed September 15 2016.

    • Search Google Scholar
    • Export Citation
  • 2.

    Lee IMShiroma EJLobelo Fet al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219229. PubMed doi:10.1016/S0140-6736(12)61031-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Carter TMorres IDMeade OCallaghan P. The effect of exercise on depressive symptoms in adolescents: a systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2016;55(7):580590. PubMed doi:10.1016/j.jaac.2016.04.016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Herring MPJacob MLSuveg CO’Connor PJ. Effects of short-term exercise training on signs and symptoms of generalized anxiety disorder. Ment Health Phys Act. 2011;4(2):7177. doi:10.1016/j.mhpa.2011.07.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    McMahon EMCorcoran PO’Regan Get al. Physical activity in European adolescents and associations with anxiety, depression and well-being. Eur Child Adolesc Psychiatry. 2017;26(1):111122. PubMed doi:10.1007/s00787-016-0875-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Rebar ALBoles CBurton NWet al. Healthy mind, healthy body: a randomized trial testing the efficacy of a computer-tailored vs. interactive web-based intervention for increasing physical activity and reducing depressive symptoms. Ment Health Phys Act. 2016;11:2937. doi:10.1016/j.mhpa.2016.08.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    National Institute for Health and Care Excellence. Depression in adults: recognition and management. Treatments for mild to moderate depression. 2016. https://www.nice.org.uk/guidance/cg90/ifp/chapter/treatments-for-mild-to-moderate-depression. Accessed June 10 2016.

    • Search Google Scholar
    • Export Citation
  • 8.

    Arcelus JBouman WP. Language and terminology.Chapter 1. In: Bouman WPArcelus J eds. The Transgender Handbook—A Guide for Transgender People Their Families and Professionals. New York, NY: Nova Publishers; 2017:112.

    • Search Google Scholar
    • Export Citation
  • 9.

    Beek TFKreukels BPCCohen-Kettenis PTSteensma TD. Partial treatment requests and underlying motives of applicants for gender affirming interventions. J Sex Med. 2015;12(11):22012205. PubMed doi:10.1111/jsm.13033

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Arcelus JClaes LWitcomb GLMarshall EBouman WP. Risk factors for non-suicidal self-injury among trans youth. J Sex Med. 2016;13(3):402412. PubMed doi:10.1016/j.jsxm.2016.01.003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Bouman WPClaes LMarshall Eet al. Socio-demographic variables, clinical features and the role of pre-assessment cross-sex hormones in older trans people. J Sex Med. 2016;13(4):711719. PubMed doi:10.1016/j.jsxm.2016.01.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Bouman WPDavey AMeyer CWitcomb GLArcelus J. Predictors of psychological well-being among trans individuals. Sex Relation Ther. 2016;31(3):359375.

    • Search Google Scholar
    • Export Citation
  • 13.

    Bouman WPClaes LBrewin Net al. Transgender and anxiety: a comparative study between transgender people and the general population. Int J Transgenderism. 2017;18(1):1626. doi:10.1080/15532739.2016.1258352

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Claes LBouman WPWitcomb GLThurston MFernandez-Aranda FArcelus J. Non-suicidal self-injury in trans people: associations with psychological symptoms, victimization, interpersonal functioning and perceived social support. J Sex Med. 2015;12(1):168179. PubMed doi:10.1111/jsm.12711

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Dhejne CVan Vlerken RHeylens GArcelus J. Mental health and gender dysphoria: a review of the literature. Int Rev Psychiatry. 2016;28(1):4457. PubMed doi:10.3109/09540261.2015.1115753

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Marshall EClaes LBouman WPWitcomb GLArcelus J. Non-suicidal self-injury and suicidality in trans people: a systematic review of the literature. Int Rev Psychiatry. 2016;28(1):5869. PubMed doi:10.3109/09540261.2015.1073143

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Millet NLongworth JArcelus J. Prevalence of anxiety symptoms and disorders in the transgender population: a systematic review of the literature. Int J Transgenderism. 2017;18(1):2738. doi:10.1080/15532739.2016.1258353

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Warren JCBryant Smalley KNikki Barefoot K. Psychological well-being among transgender and genderqueer individuals. Int J Transgenderism. 2016;17(3–4):114123. doi:10.1080/15532739.2016.1216344

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Unger CA. Hormone therapy for transgender patients. Transl Androl Urol. 2016;5(6):877884. PubMed doi:10.21037/tau.2016.09.04

  • 20.

    Jones BAArcelus JBouman WPHaycraft E. Barriers and facilitators for physical activity and sport participation among young transgender people. Int J Transgenderism. 2017;18(2):227238. doi:10.1080/15532739.2017.1293581

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Jones BAArcelus JBouman WPHaycraft E. Sport and trans people: a systematic review of the literature relating to sport participation and sport policies. Sports Med. 2016;47(4):701716. doi:10.1007/s40279-016-0621-y

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Muchicko MMLepp ABarkley JE. Peer victimization, social support and leisure-time physical activity in transgender and cisgender individuals. Leisure. 2014;38(3–4):295308. doi:10.1080/14927713.2015.1048088

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    British Heart Foundation. Physical Activity Statistics. 2015. https://www.bhf.org.uk/~/media/files/publications/research/bhf_physical-activity-statistics-2015feb.pdf. Accessed June 12 2016.

    • Export Citation
  • 24.

    Costa RColizzi M. The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review. Neuropsychiatr Dis Treat. 2016;12:19531966. PubMed doi:10.2147/NDT.S95310

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Heylens GVerroken CDe Cock ST'Sjoen GDe Cuypere G. Effects of different steps in gender reassignment therapy on psychopathology: a prospective study of persons with a gender identity disorder. J Sex Med. 2014;11:119126. PubMed doi:10.1111/jsm.12363

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Fisher ADCastellini GBandin Eet al. Cross-sex hormonal treatment and body uneasiness in individuals with gender dysphoria. J Sex Med. 2014;11:709719. PubMed doi:10.1111/jsm.12413

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Gorin-Lazard ABaumstarck KBoyer Let al. Hormonal therapy is associated with better self-esteem, mood, and quality of life in transsexuals. J Nerv Ment Dis. 2013;201(11):9961000. PubMed doi:10.1097/NMD.0000000000000046

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Kruger JLee CDAinsworth BEMacera CA. Body size satisfaction and physical activity levels among men and women. Obesity. 2008;16(8):19761979. PubMed doi:10.1038/oby.2008.311

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Noordstar JJvan der Net JJak Set al. Global self-esteem, perceived athletic competence, and physical activity in children: a longitudinal cohort study. Psychol Sport Exerc. 2016;22:8390. doi:10.1016/j.psychsport.2015.06.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Lantz CDHardy CJAinsworth BE. Social physique anxiety and perceived exercise behavior. Sport Behav. 1997;20(1):8393.

  • 31.

    Joseph RPRoyse KEBenitez TJPekmezi DW. Physical activity and quality of life among university students: exploring self-efficacy, self-esteem, and affect as potential mediators. Qual Life Res. 2014;23(2):659667. PubMed doi:10.1007/s11136-013-0492-8

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Sonstroem RJMorgan WP. Exercise and self-esteem: rationale and model. Med Sci Sports Exerc. 1989;21(3):329337. PubMed doi:10.1249/00005768-198906000-00018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Hendricks MLTesta RJ. A conceptual framework for clinical work with transgender and gender nonconforming clients: an adaptation of the Minority Stress Model. Prof Psychol Res Pract. 2012;43(5):460467. doi:10.1037/a0029597

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674697. PubMed doi:10.1037/0033-2909.129.5.674

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Topolski DTLoGerfo JPatrick LDWilliams BWalwick JPatrick MB. The rapid assessment of physical activity (RAPA) among older adults. Prev Chronic Dis. 2006;3(4):118.

    • Search Google Scholar
    • Export Citation
  • 36.

    Zigmond ASSnaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361370. PubMed doi:10.1111/j.1600-0447.1983.tb09716.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Bjelland IDahl AAHaug TTNeckelmann D. The validity of the hospital anxiety and depression scale: an updated literature review. J Psychosom Res. 2002;52(2):6977. PubMed doi:10.1016/S0022-3999(01)00296-3

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Becker INieder TOCerwenka Set al. Body image in young gender dysphoric adults: a European multi-center study. Arch Sex Behav. 2016;45(3):559574. PubMed doi:10.1007/s10508-015-0527-z

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Appelt HStrauß B. PsychoendokrinologischeGynäkologie: Ergebnisse und Perspektiven [Psycho-EndocrinologicalGynaecology: Results and Prospects]. Stuttgart, Germany: Enke; 1988.

    • Search Google Scholar
    • Export Citation
  • 40.

    Rosenberg M. Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press; 1965.

  • 41.

    Robins RWHendin HMTrzesniewski KH. Measuring global self-esteem: construct validation of a single-item measure and the Rosenberg Self-Esteem Scale. Person Soc Psychol Bull. 2001;27(2):151161. doi:10.1177/0146167201272002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42.

    Clements-Nolle KMarx RKatz M. Attempted suicide among transgender persons: the influence of gender-based discrimination and victimization. J Homosex. 2006;51(3):5369. PubMed doi:10.1300/J082v51n03_04

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Nuttbrock LHwahng SBockting Wet al. Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. J Sex Res. 2010;47(1):1223. doi:10.1080/00224490903062258

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Field A. Discovering Statistics Using IBM SPSS Statistics. London, UK: Sage Publications; 2013.

  • 45.

    Auer MKHohne NBazarra-Castro MAet al. Psychopathological profiles in transsexuals and the challenge of their special status among the sexes. PLoS ONE. 2013;8(10):e78469. PubMed doi:10.1371/journal.pone.0078469

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Bouman WPRichards C. Diagnostic and treatment issues for people with gender dysphoria in the United Kingdom. Sex Relation Ther. 2013;28(3):165171. doi:10.1080/14681994.2013.819222

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 47.

    Kanamori YCornelius-White JHD. Big changes, but are they big enough? Healthcare professionals’ attitudes toward transgender persons. Int J Transgenderism. 2016;17(3–4):165175. doi:10.1080/15532739.2016.1232628

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 48.

    Kattari SKWalls NEWhitfield DLLangenderfer-Magruder L. Racial and ethnic differences in experiences of discrimination in accessing health services among transgender people in the United States. Int J Transgenderism. 2015;16:6879. doi:10.1080/15532739.2015.1064336

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 49.

    Fennell MJV. Cognitive therapy in the treatment of low self-esteem. Adv Psychiatr Treat. 1996;4:296304. doi:10.1192/apt.4.5.296

  • 50.

    Staring ABPvan den Berg DPGCath DCSchoorl MEngelhard IMKorrelboom CW. Self-esteem treatment in anxiety: a randomized controlled crossover trial of eye movement desensitization and reprocessing (EMDR) versus competitive memory training (COMET) in patients with anxiety disorders. Behav Res Ther. 2016;82:1120. PubMed doi:10.1016/j.brat.2016.04.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51.

    Murad MHElamin MBGarcia MZet al. Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes. Clin Endocrinol. 2010;72(2):214231. doi:10.1111/j.1365-2265.2009.03625.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 52.

    Van de Grift TCElaut ECerwenka SCet al. Effects of medical interventions on gender dysphoria and body image: a follow-up study. Psychosom Med. 2017;79:815823. PubMed doi:10.1097/PSY.0000000000000465

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 53.

    Van de Grift TCKreukels BPCElfering Let al. Body image in transmen: multidimensional measurement and the effects of mastectomy. J Sex Med. 2016;13(11):17781786. PubMed doi:10.1016/j.jsxm.2016.09.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 54.

    Coleman EBockting WBotzer Met al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgenderism. 2012;13(4):165232. doi:10.1080/15532739.2011.700873

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 55.

    Wylie KBarrett JBesser Met al. Good practice guidelines for the assessment and treatment of adults with gender dysphoria. Sex Relation Ther. 2015;29(2):154214. doi:10.1080/14681994.2014.883353

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 56.

    Smith MCuthbertson SGale N. Out for sport. Tackling homophobia and transphobia in sport. Equality Network. 2012. http://www.equality-network.org/wp-content/uploads/2013/03/Out-for-Sport-Report.pdf. Accessed June 29 2016.

    • Search Google Scholar
    • Export Citation
  • 57.

    Hargie ODMitchell DHSomerville IJ. People have a knack of making you feel excluded if they catch on to your difference: transgender experiences of exclusion in sport. Int Rev Sociol Sport. 2017;52(2):223239. doi:10.1177/1012690215583283

    • Crossref
    • Search Google Scholar
    • Export Citation
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