A new pilot trial found a group-based, gender-affirming and inclusive exercise program designed for trans and gender diverse youth could improve mental health through movement and social connection.
Dr Felicity Austin and Associate Professor Bonnie Furzer, from The University of Western Australia and Thriving in Motion, and Associate Professor Kemi Wright from the University of New South Wales, collaborated with colleagues at Perth Children’s Hospital Gender Diversity Service and Telethon Kids Institute Australia to evaluate the 12-week study for trans young people aged 12 to 24 in Western Australia.
“Trans and gender diverse young people are among the least active in the community and not necessarily by choice,” lead author Dr Austin said.
“Reviews consistently show that trans young people take part in far less physical activity than cisgender peers, shaped by exclusion, the binary structure of most sport and a lack of psychological safety in gyms and physical education at school – at the same time, this group carries a heavier load of mental and physical health challenges.”
A new pilot trial, published in Health Education and Behavior, assessed whether a program could be built where trans young people could feel safe enough to walk into and keep coming back to.
Twenty young people were recruited through the Perth Children’s Hospital Gender Diversity Service and community-based health and youth services and of these 18 completed the program.
The sessions, delivered by accredited exercise physiologists alongside peer facilitators all trained in trauma-informed, gender-affirming practice, ran weekly for an hour and combined cardiovascular, strength and team-based activity.
Inclusivity was built into the detail rather than assumed: pronoun use and opt-in introductions, non-gendered programming, participant-led activity choices, flexible participation, and environmental changes such as all-gender facilities and covered mirrors.
Both engagement and retention in the program was at 95 per cent with 93 per cent of participants rating session enjoyment highly, every parent and carer reported high satisfaction, and everyone said they would recommend it.
“For a voluntary youth exercise program, and for a group often excluded from mainstream sport, those numbers are unusually high, which is good thing,” Associate Professor Wright said.
Physical fitness improved across strength, endurance, power and aerobic recovery, though the effects were small and spread across individuals rather than concentrated in any one measure.
The strongest improvement was in the mental health component of quality of life where participants had started below the general population norm.
“This was probably driven by the combination of movement, social connection and identity affirmation, rather than a blanket lift in wellbeing,” Associate Professor Furzer said.
The study demonstrated that gender-affirming exercise programs were feasible and acceptable across clinical and community settings, supporting a broader integration of exercise into gender-affirming health care,.
A larger, multi-site ARCTYC Youth Moves trial is now under way across Australia.