Transgender, gender-diverse youth take significantly fewer steps each day

Key takeaways:

• Greater gender diversity across several measures associated with fewer daily step counts.
• A researcher suggested that physical activity among LGBTQ youth may be replaced by time spent online.

Adolescents who identified as transgender or gender diverse appeared to be less physically active compared with those who identified as cisgender, a cross-sectional analysis in the Annals of Epidemiology showed.

As a result, primary care providers “should ask questions about gender identity and physical activity in adolescents,” Jason Nagata, MD, an associate professor of pediatrics at the University of California, San Francisco, told Healio. “Most adolescents don't reach the recommended levels of physical activity, and this is especially the case for transgender and gender-diverse adolescents.”

According to Nagata, transgender youth may experience discrimination and stigma that ultimately discourages them from partaking in physical activity or sports.

“Physical activity may instead be replaced by more time spent online, where they might find more accepting and supportive environments,” he said in a press release.

Individuals in the LGBTQ+ community already face a greater risk for a number of physical and mental health conditions, including loneliness and alcohol use disorder.

Nagata and colleagues assessed correlations between daily physical activity and gender identity using data from a cohort of 6,038 adolescents aged 11 to 12 years who had participated in the Adolescent Brain Cognitive Development study.

The participants had worn Fitbits on their wrists to record their daily steps.

Researchers assessed gender identity using several measures. For transgender identification, participants answered “no,” “yes” or “maybe” when asked if they identified as such.

Youth were also asked about the degree of satisfaction they felt with their assigned sex, their expression of gender norms and how much they felt their gender identity aligned with their assigned sex.

The researchers found that greater gender diversity across multiple measures corresponded with fewer daily step counts after adjusting for covariates. Specifically, adolescents who said “yes” to identifying as transgender took 1,394 (95% CI, 284-2,504) less steps a day vs. those who identified as cisgender.

Nagata and colleagues pointed out that this difference equates to 12% of the daily 60 minutes of moderate to vigorous physical activity recommended for the cohort’s age group.

Youth who answered “maybe” to identifying as transgender took 1,304 (95% CI, 365-2,242) fewer steps a day compared with those who identified as cisgender.

The researchers acknowledged that some participants may not have answered truthfully, whereas the study’s design did not allow them to establish temporality between physical activity and gender identity.

Nagata and colleagues also highlighted some ways to improve the inclusivity of youth sports, which include “allowing transgender students to use the locker rooms, showers, and restrooms where they feel the safest, offering more private changing areas, promptly updating students’ names on team rosters and making sure that all individuals involved in that sport are informed of changes in students’ names or pronouns.”

Further research “could investigate gender differences in physical activity among older adolescents and young adults,” Nagata told Healio.

References:

• Nagata J, et al. Ann Epidemiol. 2024;doi:10.1016/j.annepidem.2024.11.004.
• Transgender, gender-diverse preteens less physically active than peers. Available at: https://www.eurekalert.org/news-releases/1066582. Published Dec. 4, 2024. Accessed Dec. 4, 2024.