Physical activity behaviors in trans and gender diverse adults: a scoping review

Figures & data

Figure 1. Article selection flow chart.

Table 1. Study characteristics.

Author	Year	Study Design	Participant Details (n)	Age	Quality Assessment	Quantitative Measure of Physical Activity Levels	Gender-Affirming Medical Care Accessed
Ålgars et al.	2012	Cross-sectional Grounded theory Mixed methods	9 trans women,11 trans men	Mean: 35.2 ± 12.10 Range: 21-62	0.75	N/A	81.81% of trans men and 63.64% of trans women on hormones 54.55% of trans men and 0% of trans women had chest surgery. 0% of trans men and 66.66% of trans women genital surgery.
Alzahrani et al.	2019	Cross-sectional Quantitative	1788 trans women, 1267 trans men, 410828 cisgender women, 306046 cisgender men	Mean for trans men: 51.4 ± 18.9) Mean for trans women: 53.1 ± 17.6 Ranges: not provided	0.95	Non-validated measure: Classified as either meeting CDC Exercise recommendations (≥ 150 min per week) or not meeting recommendations.	No hormone or surgical values provided.
Ceolin et al.	2023	Case-control Quantitative	47 trans people assigned male at birth, 78 trans people assigned female at birth, 57 cisgender women, 89 cisgender men	Assigned female at birth trans mean: 26.09 ± 7.42 Assigned male at birth trans mean: 26.89 ± 8.72 Ranges: not provided	0.95	Validated measure: International Physical Activity Questionnaire	All participants not on hormones. Surgical status not specified.
Cunningham et al.	2018	Cross-sectional Quantitative	234 trans women, 344 trans men, 167 trans non-conforming, 2183 don’t know/refused, 197966 cisgender people	Mean: Not provided Range: 21 to “65+”	0.73	Non-validated measure: Yes/no response to the following question “During the past month, other than your regular job, did you participate in any physical activities or exercises, such as running, calisthenics, golf, gardening, or walking for exercise?”	No hormone or surgical values provided.
Downing & Przedworski	2018	Cross-sectional Quantitative	1073 trans women, 699 trans men, 449 gender non-conforming, 297810 cisgender women, 218021 cisgender men	Mean: Not provided Range: 18 to “65+”	0.91	Non-validated measure: Yes/no response: “No physical activity/ exercise during the past 30 days other than regular job”	No hormone or surgical values provided.
Elling-Machartzki	2017	Narrative approach Qualitative	6 trans women, 6 trans men	Mean: 40.5 ± 6.75 Range: 27-51	0.85	N/A	All participants “fully transitioned”. No hormone or surgical values provided.
Hargie et al.	2017	Thematic analysis Qualitative	10 trans people	Mean: Not provided Range: 25-62	0.65	N/A	No hormone or surgical values provided.
Jones et al.	2017	Thematic analysis Qualitative	9 trans men, 5 trans women	Mean: 22.71 Range: 18-36	0.75	N/A	Some participants had “undergone physical transition”. No hormone or surgical values provided.
Jones et al.	2018	Case-control Quantitative	95 trans women, 42 trans men, 95 cisgender women, 42 cisgender men	Mean: 30.15 ± 11.87 Range: not provided	0.91	Validated Measure: Rapid Assessment of Physical Activity	38.7% of trans participants on hormones. Surgical values provided.
Krueger et al.	2021	Cohort study Quantitative	52 trans participants, 313 cisgender sexual minority women, 120 cisgender sexual minority men, 1021 cisgender heterosexual women, 792 cisgender heterosexual men	Mean: 21.2 (SD not provided) Range: not provided	0.80	Non-validated measure: Yes/no to a question asking participants if they utilized ‘over exercise’ as a coping strategy during the COVID-19 pandemic.	No hormone or surgical values provided.
Lapauw et al.	2008	Cross-sectional Quantitative	23 trans women, 46 cisgender men	Mean: 41 ± 7 Range: not provided	0.91	Validated measure: Baecke Physical Activity Questionnaire	All trans participants on hormones and had genital surgery.
Muchicko et al.	2014	Cross-sectional Quantitative	33 transgender, 47 cisgender	Mean: 32 ± 15 Range: not provided	0.82	Validated measure: The Godin Leisure Time Exercise Questionnaire	No hormone or surgical values provided.
Nagata et al.	2020a	Cohort study Quantitative	172 trans women, 312 trans men	Mean for trans men: 30.5 ± 9.7). Range for trans men: 18-67 Mean for trans women: 41.2 ± 14.9) Range for trans women: 20-74	0.91	N/A	No hormone or surgical values provided.
Nagata et al.	2020b	Cohort study Quantitative	988 gender-expansive people	Mean: 29.5 ± 9.2 Range: 18–71	0.95	N/A	No hormone or surgical values provided.
Sedlak et al.	2017	Cohort study Content analysis Mixed methods	14 trans women, 13 trans men, 4 ‘other’ gender identity	Mean: 43.0 ± 12.1 Range: 30-71	0.73	Non-validated measure: Calculated by how many times in the past month participants had engaged in vigorous physical activity, lasting at least 10 min, in the past month. This was presented as a mean daily physical activity level.	90% on hormones 48.4% had “transgender-related surgery”
Smalley et al.	2016	Cross-sectional Quantitative	82 trans women, 126 trans men, 117 genderqueer, non-binary or other, 2038 cisgender women, 916 cisgender men,	Mean: 29.8 ± 11.4 Range: Not provided	0.82	Non-validated measure: “How often do you exercise at least 20 min per day, 3 days per week?”	No hormone or surgical values provided.
Stewart et al.	2020	Cohort study Interpretive phenomenology analysis Mixed methods	20 trans women	Mean: Not provided Range: 16-65	0.65	N/A	40% “transitioning” 60% “fully transitioned” No hormone or surgical values provided.
Teti et al.	2020	Thematic analysis Qualitative	16 trans masculine people	Mean: Not provided Range: 19-25	0.85	N/A	All participants had not had surgery. No hormone values provided.
Uniacke et al.	2021	Cohort study Quantitative	77 trans women, 74 trans men, 41 non-binary, 34 genderqueer, 3 another gender identity, 39 cisgender women, 19 cisgender men	Mean: 35.6 ± 13.3 Range: 17–81	0.95	N/A	78.7% on hormones in past year 3.8% on puberty blocking medication in past year 63.1% had ever had surgery
Van Caenegem et al.	2013a	Cross-sectional Quantitative	25 trans women, 25 cisgender men	Mean: Not provided Range: 28-42	1.0	Validated measure: Baecke Physical Activity Questionnaire	All participants not on hormones and not had surgery.
Van Caenegem et al.	2013b	Cross-sectional Quantitative	44 trans men, 44 cisgender women	Mean: 37 ± 7 Range: 24-46	0.91	Validated measure: Baecke Physical Activity Questionnaire	All participants on hormones. All participants had hysterectomy, bilateral oophorectomy, mastectomy, and phalloplasty. 13.63% haspelld metoidioplasty prior to phalloplasty.
Velez et al.	2016	Cross-sectional Quantitative	304 trans men	Mean: 24.51 ± 6.84 Range: 18-53	0.95	N/A	No hormone or surgical values provided.
Vilas et al.	2014	Cohort study Quantitative	91 trans women, 66 trans men	Mean: 32.9 ± 9 Range: Not provided	0.45	Non-validated measure: Physical activity-recall questionnaire, reporting level of effort (light, moderate, or vigorous) and hours spent on each activity.	All participants on hormones. Surgical values not provided.
Wilson et al.	2021	Cross-sectional Quantitative	117 trans women, 397 trans men, 152452 cisgender women, 64363 cisgender men	Mean: 20.0 ± 1.5 Range: Not provided	0.86	Non-validated measure: Participants responded to three questions about their physical activity in the past seven days: 1)“Do moderate-intensity cardio or aerobic exercise (caused a noticeable increase in heart rate, such as a brisk walk) for at least 30 min?”; 2) “Do vigorous-intensity cardio or aerobic exercise (caused large increases in breathing or heart rate, such as jogging) for at least 20 min?”; 3) “Do 8–10 strength training exercises (such as resistance weight machines) for 8-12 repetitions each?”	No hormone or surgical values provided.