Exercise experiences of adolescents engaged with gender diversity services: A qualitative approach

BACKGROUND: Trans young people report lower levels of physical activity than their cisgender peers, with one in four limiting exercise participation due to their gender. Exercise provision within gender-affirming services represents an underexplored strategy to support health and wellbeing. To inform the development of collaborative and responsive programs, this study engaged stakeholders-including trans young people, parents, and healthcare providers-to explore exercise experiences, beliefs, barriers, and support needs. METHODS: Participants were recruited through networks of trans youth, families, and professionals working in trans healthcare across Australia. Twenty individuals participated (six trans and gender diverse young people, two parents, and 12 healthcare providers). Semi-structured interviews were conducted and analysed using reflexive thematic analysis to identify patterns of shared meaning across accounts. RESULTS: Four themes were developed; navigating intersectionality in adolescence; binary nature of community sport and physical activity spaces; external pressures and societal marginalisation shaping participation; and inclusive exercise as a reimagined social practice. CONCLUSION: Findings highlight the need for structural and cultural change within sport and exercise environments to better support trans young people's physical activity participation. Embedding inclusive, gender-affirming exercise models within multidisciplinary services may enhance access, sustained engagement, and wellbeing, while providing a foundation for future research evaluating exercise-based health interventions.