Objectives This study aimed to assess participation rates of transgender and gender diverse (trans) people in sport/fitness activities, compare mental health outcomes for trans people participating in sport/fitness with those who do not and explore internal/external barriers and bullying experiences faced by trans people in sport/fitness contexts. Methods A cross-sectional online survey open to trans people aged ≥16 years living in Australia was conducted between February and April 2023 and it assessed rates of sport/fitness participation, barriers to participation and bullying experiences through multiple-choice questions. Mental health measures comprised the Kessler Psychological Distress Scale (K10) and self-reported history of self-harm and suicidality. Covariate-adjusted binary logistic regression models tested associations between interpersonal factors, sport/fitness variables and mental health outcomes. Results Of 664 respondents (median age 32 years), around one-third (32.8%) regularly participated in sport/fitness. Common internal barriers to participation included anxiety about others’ reactions (63.9%), body dissatisfaction/dysphoria (56.5%) and fears about feeling accepted/affirmed by others (54.7%). Respondents commonly reported experiencing inadequate bathroom/changing facilities (44.4%), exclusionary rules and regulations surrounding gender (36.7%), and invasive or uncomfortable policies or procedures (23.3%). Over one-third (34.4%) of trans people had experienced gender-based bullying or exclusion. Regular sport/fitness participation was associated with significantly lower K10 scores (mean difference=−4.4, 95% CI−5.8, –2.9, p<0.001) and a 40% reduction in odds of recent thoughts of self-harm and suicide (aOR 0.6, 95% CI 0.5, 0.9, p=0.01; aOR 0.6, 95%CI 0.4, 0.9, p=0.02). Conclusion Trans people face significant barriers to sport/fitness despite experiencing significant mental health and personal benefits from participation. Affirming and including trans people in sport and fitness should be a key priority for sport and fitness federations, organisations and policy-makers.

中文翻译：

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跨性别者在运动与健身中的参与、障碍、促进因素与霸凌经历：澳大利亚跨性别者全国性社区调查结果


目的 本研究旨在评估跨性别者和性别多元（trans）者参与体育/健身活动的比率，比较跨性别者与未参加体育/健身的跨性别者的心理健康结局，探讨跨性别者在体育/健身环境中面临的内/外障碍和欺凌经历。方法 2023 年 2 月至 4 月期间，对生活在澳大利亚的 ≥16 岁跨性别者进行了一项横断面在线调查，通过多项选择题评估了运动/健身参与率、参与障碍和霸凌经历。心理健康措施包括 Kessler 心理困扰量表 （K10） 和自我报告的自残和自杀史。协变量调整的二元 logistic 回归模型测试了人际因素、运动/健身变量和心理健康结果之间的关联。结果在 664 名受访者 （中位年龄 32 岁） 中，约三分之一 （32.8%） 定期参加运动/健身。参与的常见内部障碍包括对他人反应的焦虑 （63.9%）、身体不满/烦躁不安 （56.5%） 和害怕被他人接受/肯定 （54.7%）。受访者通常报告说，他们遇到过浴室/更衣设施不足 （44.4%）、围绕性别的排他性规则和规定 （36.7%） 以及侵入性或不舒服的政策或程序 （23.3%）。超过三分之一 （34.4%） 的跨性别者经历过基于性别的欺凌或排斥。定期参加运动/健身与 K10 分数显著降低相关（平均差 =-4.4,95% CI-5.8，-2.9，p<0.001）和最近自残和自杀念头的几率降低 40%（aOR 0.6,95% CI 0.5,0.9，p=0.01;aOR 0.6,95% CI 0.4,0.9，p=0.02）。结论 跨性别者尽管在运动/健身方面经历了显著的心理健康和个人益处，但在运动/健身方面仍面临重大障碍。肯定跨性别者并让他们参与体育运动和健身应该是体育和健身联合会、组织和政策制定者的首要任务。