A scoping review of trans and gender diverse children and adolescents' experiences of physical activity, sport, and exercise participation

Increasing young people's physical activity, along with their motivation and confidence to be active, is widely advocated for supporting desirable health outcomes. Trans and gender diverse (henceforth; trans) young people experience significant physical activity-related barriers compared to cisgender (i.e., an individual for whom gender identity and sex presumed at birth are in alignment) peers. This scoping review aimed to synthesise information relating to physical activity, sport, and exercise, as well as participation experiences among trans young people aged 10-25 years. Database searches of CINAHL, Embase, Medline, PsychINFO, and SportDiscus were conducted for publication until August 2023. Broad search terms included exercise, physical activity, sport, transgender, gender diverse, youth, child, and adolescents, with 24 studies identified for full text review. Following title, abstract, and full text review, 12 studies were retained for data extraction. Methodological quality was assessed with scores ranging from 0.14 to 0.95. Eleven studies reported trans young people participated in less physical activity compared to cisgender peers. All 12 studies reported on barriers to exercise participation-resulting from gender-based isolation, exclusion, and rejection in sports or school physical education-that were associated with mental health-related concerns. Findings demonstrate trans young people typically have lower physical activity participation levels, feel less safe while playing sport, and face more barriers to participation than their cisgender peers, resulting in isolation and exclusion. Findings suggest a need to create more inclusive opportunities and harness motivating factors (e.g., gender affirmation, social capital) to assist the adoption of healthy exercise behaviours.