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

: There is currently limited data regarding the physical activity behaviors of trans and gender diverse people (including binary and non-binary identities; henceforth trans). The aim of this review was to synthesize the existing literature in this area, with a focus on physical activity behaviors as they relate to health (e.g. health benefits, risks of adverse health outcomes). : A scoping review protocol was used to search Medline, Scopus, ProQuest, and CINAHL in order to identify qualitative and quantitative articles, published as of September 2023, that reported physical activity behaviors in trans adults. Quality assessments were conducted based on standard criteria. : Twenty-four articles were included in the final analysis, with methodological quality ranging from 0.45 to 0.95 on a scale ranging from 0.0 (low quality) to 1.0 (high quality). Five articles reported low levels of physical activity compared to global health recommendations and one article reported physical activity exceeding the minimum recommendation. Nine articles reported lower levels of physical activity in trans people compared to cisgender people, whereas two reported similar levels of physical activity and one reported higher levels in trans people. A total of 12 different measures were used to assess physical activity levels, of which only seven were validated measures. Seven articles reported compulsive exercise in trans people and five articles reported physical health risks in a sample of trans people with low physical activity levels. Five articles reported physical activity levels influenced by gender congruence or body satisfaction. Six articles reported physical activity influenced by minority stress, experienced discrimination, or anticipated discrimination. : This review highlights the need for further research regarding the physical activity behaviors of trans individuals, especially with regard to the impact on health (e.g. excessive, or insufficient levels of activity) and consideration of consistency of physical activity measures and reporting. The findings suggest a need to consider the unique influences on physical activity participation in this population when providing services and/or promoting physical activity in support of health.