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Let Them Play: Physical Activities and Sports Are Associated With Better Psychosocial Functioning for Transgender and
Coleen R Williams1, Amalia Feld2, Kerry McGregor1
1Center for Gender Health, Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts; Department of Psychology, Harvard Medical School, Boston, Massachusetts.
Purpose:
Evidence suggests that transgender and gender-diverse (TGD) youth participation in physical activity and sports (PA/S) remains low, despite the ample benefits associated with PA/S engagement.
Methods:
This retrospective cohort study utilized data that were collected at the Gender Multispecialty Service (GeMS) at Boston Children's Hospital as part of a readiness assessment for gender-affirming hormones (GAHs). The analytic sample included 1,087 individuals between the ages of 13 and 18 years who underwent a gender-affirming hormone assessment between January 2018 and January 2025. Participants and their caregivers/legal guardians provided consent at the time of the assessment, which included completion of psychosocial measures to assess youth mental health, functioning, and well-being via the Youth Self-Report (YSR).
Results:
Linear regression was used to determine the association between PA/S participation and clinically relevant mental health scales. PA/S participation was associated with significantly lower T-scores for total problems (β = -2.20, p < .001), internalizing problems (β = -2.63, p < .001), anxious/depressed (β = -2.18, p = .001), withdrawn depressed (β = -2.73, p < .001), depressive problems (β = -2.27, p < .001), anxiety problems (β = -2.15, p < .001), stress problems (β = -1.98, p -.01), and a significantly higher T-score for positive qualities (β = +2.74, p < .001). PA/S participation was associated with a 0.72 odds (p = .02) of thinking about suicide compared to those who did not engage in PA/S. There was no association between playing sports and a recent history of self-harm.
Discussion:
PA/S participation in TGD youth is associated with significant psychosocial benefits, including reductions in depression, stress, and other internalizing problems, and an increased perception of personal positive qualities.
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