Societal Discrimination and Mental Health Among Transgender Athletes: a Systematic Review and Meta-analysis

Overview

Journal BMC Psychol

Publisher Biomed Central

Specialty Psychology

Date 2024 Jan 16

PMID 38229114

Authors

Alex Siu Wing Chan

Alston Choong

Kean Chang Phang

Lok Man Leung

Patrick Ming Kuen Tang

Elsie Yan

Affiliations

Soon will be listed here.

Abstract

Background: Discrimination and inequality have been identified as significant problems faced by transgender individuals in sports participation. However, uncertainties remain regarding the effectiveness of interventions aimed at promoting equality.

Objectives: This systematic review and meta-analysis aimed to examine the experiences of transgender athletes in sports, focusing on mental health issues and factors contributing to inequality among transgender and other sexual minorities.

Methods: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched 10 electronic databases, including PubMed, Google Scholar, and Web of Science, to identify eligible studies published between 2005 and 2022. The search yielded 1430 articles, of which only 12 studies met the inclusion criteria for this review.

Results: The meta-analysis of the 12 studies included in this review revealed that transgender athletes faced social discrimination and inequality in sports participation, resulting in mental health problems and higher rates of suicide. From a cohort of 21,565 participants in the studies, 7152 (33%) were subjected to discrimination in sports participation and healthcare, with a rate of 0.61 (95% confidence interval [CI]: 0.35, 0.81). However, transgender athletes who felt welcomed and embraced by their respective teams accounted for 0.39 (95% CI: 0.19, 0.65). These results indicated significant differences between how transgender athletes are treated in healthcare settings and when participating in sports.

Conclusion: The study findings underscore the need for policies, cultural research, and interventions to address discrimination and inequality faced by transgender athletes in sports participation. Promoting equality and safeguarding the rights of transgender athletes can mitigate the risk of mental health problems and increase physical activity among sexual minorities.

Citing Articles

Discrimination, Heterosexism and Perceived Stress Among Young LGBT Tunisians: Unveiling the Moderation Effects of Self-Esteem.

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PMID: 39552631 PMC: 11562904. DOI: 10.1080/19317611.2024.2399119.

Factors influencing sports performance: A multi-dimensional analysis of coaching quality, athlete well-being, training intensity, and nutrition with self-efficacy mediation and cultural values moderation.

Yang P, Xu R, Le Y Heliyon. 2024; 10(17):e36646.

PMID: 39263094 PMC: 11386267. DOI: 10.1016/j.heliyon.2024.e36646.

References

Cooper M, Chacko M, Christner J . Incorporating LGBT Health in an Undergraduate Medical Education Curriculum Through the Construct of Social Determinants of Health. MedEdPORTAL. 2019; 14:10781. PMC: 6342423. DOI: 10.15766/mep_2374-8265.10781. View

Meyer I . Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003; 129(5):674-697. PMC: 2072932. DOI: 10.1037/0033-2909.129.5.674. View

Nelson M, Gordon-Larsen P, Adair L, Popkin B . Adolescent physical activity and sedentary behavior: patterning and long-term maintenance. Am J Prev Med. 2005; 28(3):259-66. DOI: 10.1016/j.amepre.2004.12.006. View

Toomey R, Syvertsen A, Shramko M . Transgender Adolescent Suicide Behavior. Pediatrics. 2018; 142(4). PMC: 6317573. DOI: 10.1542/peds.2017-4218. View

Greenberg N . Transgender Health. Am J Nurs. 2022; 122(10):10. DOI: 10.1097/01.NAJ.0000890136.11007.88. View

Reisner S, Poteat T, Keatley J, Cabral M, Mothopeng T, Dunham E . Global health burden and needs of transgender populations: a review. Lancet. 2016; 388(10042):412-436. PMC: 7035595. DOI: 10.1016/S0140-6736(16)00684-X. View

Keuroghlian A, Ard K, Makadon H . Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments. Sex Health. 2017; 14(1):119-122. DOI: 10.1071/SH16145. View

Walen D, Nye E, Rogers S, Crossway A, Winkelmann Z, Walker S . Athletic Trainers' Competence, Education, and Perceptions Regarding Transgender Student-Athlete Patient Care. J Athl Train. 2020; 55(11):1142-1152. PMC: 7709206. DOI: 10.4085/1062-6050-147-19. View

Nye E, Crossway A, Rogers S, Games K, Eberman L . Lesbian, Gay, Bisexual, Transgender, and Queer Patients: Collegiate Athletic Trainers' Perceptions. J Athl Train. 2019; 54(3):334-344. PMC: 6485848. DOI: 10.4085/1062-6050-260-17. View

10.

Chan A . RuPaul's Drag Race: A Cultural Phenomenon That Challenges Gender Norms and Sparks Conversations Across Borders. J Homosex. 2023; 71(8):1863-1866. DOI: 10.1080/00918369.2023.2216336. View

11.

Ceatha N, Mayock P, Campbell J, Noone C, Browne K . The Power of Recognition: A Qualitative Study of Social Connectedness and Wellbeing through LGBT Sporting, Creative and Social Groups in Ireland. Int J Environ Res Public Health. 2019; 16(19). PMC: 6801602. DOI: 10.3390/ijerph16193636. View

12.

Utamsingh P, Richman L, Martin J, Lattanner M, Chaikind J . Heteronormativity and practitioner-patient interaction. Health Commun. 2015; 31(5):566-74. DOI: 10.1080/10410236.2014.979975. View

13.

Jones B, Arcelus J, Bouman W, Haycraft E . Sport and Transgender People: A Systematic Review of the Literature Relating to Sport Participation and Competitive Sport Policies. Sports Med. 2016; 47(4):701-716. PMC: 5357259. DOI: 10.1007/s40279-016-0621-y. View

14.

Tudela J . Sex, sport and doping: conflicts for bioethical analysis. Cuad Bioet. 2022; 33(108):213-217. DOI: 10.30444/CB.125. View

15.

Munson E, Ensign K . Transgender Athletes' Experiences With Health Care in the Athletic Training Setting. J Athl Train. 2020; 56(1):101-111. PMC: 7863600. DOI: 10.4085/1062-6050-0562.19. View

16.

Castro V, King W, Augustaitis L, Saylor K, Gamarel K . A Scoping Review of Health Outcomes Among Transgender Migrants. Transgend Health. 2023; 7(5):385-396. PMC: 9829141. DOI: 10.1089/trgh.2021.0011. View

17.

Yoshida E, Matsushima M, Okazaki F . Cross-sectional survey of education on LGBT content in medical schools in Japan. BMJ Open. 2022; 12(5):e057573. PMC: 9119159. DOI: 10.1136/bmjopen-2021-057573. View

18.

Kuyper L, Wijsen C . Gender identities and gender dysphoria in the Netherlands. Arch Sex Behav. 2013; 43(2):377-85. DOI: 10.1007/s10508-013-0140-y. View

19.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

20.

White W, Brenman S, Paradis E, Goldsmith E, Lunn M, Obedin-Maliver J . Lesbian, Gay, Bisexual, and Transgender Patient Care: Medical Students' Preparedness and Comfort. Teach Learn Med. 2015; 27(3):254-63. DOI: 10.1080/10401334.2015.1044656. View